Single-payer is a “non-reformist reform”

Talk given at Howard Zinn Book Festival, San Francisco, November 19, 2017

Members of Democratic Socialists of America meet up before a single-payer canvass in Berkeley, California

There is a misconception on the radical left that reforms are always a deferral of revolution. Some people think that a change to the current order like single-payer healthcare — which will help millions of people survive and thrive, but won’t actually end capitalism — is fundamentally opposed to the idea of a revolution, which is rightly conceived as a radical rupture.

But this misconception relies on the mistaken idea that revolutions are instantaneous affairs. As socialist of yore Peter Camejo put it, “First of all, you have to have clear in your mind the meaning of the word ‘revolution’. Many people have a stereotyped picture of what a revolution is like. They say a revolution is when people come with guns, when they surround a fortress or take over a city. What they do is they confuse revolution with insurrection. Insurrection is just one stage of revolution. Revolution is a lot more. It’s a long process.”

To make a socialist revolution you need two things: first, you need the working-class majority to understand what’s wrong with capitalism and see the need for its replacement. Second, you need the working-class majority to be strong enough to really go toe-to-toe with capital, and stand a chance at winning. When the left thinks about how to choose the campaigns it should focus its energy on, we should always be asking whether the campaign serves these purposes — building revolutionary consciousness and confidence, and building material working-class power.

This is why it’s not a contradiction in terms to speak of revolutionary reforms. There are some reforms that position us better to square off with capitalism. The Austrian socialist Andre Gorz came up with a term for this kind of reform: he called it a non-reformist reform. That’s kind of a mouthful, but it makes sense. Reformism is when your mission is to tinker with the system to make people’s lives better, but not really alter the basic structure at the end of the day. And reformists prefer changes that give people a much-needed helping hand, but don’t really undermine capitalism. But there are other kinds of reforms that actually shift the balance of power in a dramatic way, even if they don’t by themselves demolish all of capitalism. They do the things we talked about a moment ago: broadening the popular political imagination, and giving shape and solidity to working-class institutions and political formations.

The American left had the wind knocked out of it in the middle of the 20th century, and we haven’t recovered. In the mass popularity of the Bernie Sanders campaign and the growing favorability rating of the word ‘socialism’ we detect stirrings of life, but we have to be strategic or else we’ll waste the opportunity. That means we have to pick our battles very intelligently. We need to focus on these non-reformist reforms that Andre Gorz talked about, which are both ambitious in theory and achievable in practice. For a nearly-drowned political movement, a really good one of these could be a life-raft.

Well, great news: staring us right in the face is the most popular decommodification-oriented demand in decades. Decommodification is a really important concept here: the word means to take something out of the market, to shield it from the predations of private enterprise, to ban the involvement of corporations and to give it wholly to the people. It’s what socialists want to do with everything, from housing to transportation and beyond. And guess what? Millions of people are demanding that that we do that right now, in 2017, with health insurance. In record numbers, we see that ordinary working-class people want health insurance to be provided by the state, to the detriment of insurance CEOs and benefit of everyone else. For those of us who see the importance of non-reformist reforms to moving the revolutionary needle, single-payer is a godsend.

Single-payer health care will help millions of people. But then all progressive reforms do that, from a raise in the federal minimum wage to increasing funding for food stamps. Single-payer isn’t smart for leftists just because it helps, it’s smart because it attacks the core logic of capitalism in a serious way. It forcefully affirms the principle that there exist zones that are off-limits to capitalism. In a society which is being increasingly subjected to the whims of the market and its victors, single-payer actually gives a bunch of wealthy people and corporations the boot. In an age when curbing the appetites of private enterprise is considered anathema, single-payer forcibly dismantles an entire industry.

And it doesn’t just offer relief to working people, it increases their ability to intentionally act in conflict with the ruling class. If unions don’t have to negotiate for better health care contracts, what else can they fight for? If an employee doesn’t have to worry about losing health insurance when they lose their job, how much bolder can they be in standing up to their boss? The liberatory potentials of mass decommodification reforms are not just cumulative — they’re exponential. Some reforms are an extra chunk of change here, an extra subsidy there. But a reform like this upsets the balance of forces between the working class and the ruling class. Far from circumventing revolution, it builds the crisis between labor and capital.

Single-payer doesn’t end capitalism, not even in health care. But it puts us on the right road to a decisive conflict with capitalism. It takes control of a major system away from the private sector and places it in the hands of the public, and in doing so it emboldens the working class to imagine new dimensions of political possibility, new claims on the future. At this critical juncture the left must fight to win, and that means learning to spot a winning campaign when we see one.