This post is part of a three-part series of arguments surrounding the Healthcare For All resolution: one from the authors of the original resolution, and one from the authors of each of the two proposed amendments.
- Healthcare For All Resolution Response to Amendments
- Rationale Behind the Amendment: Building Organizing Power to Win Universal Healthcare (this post)
- Rationale Behind the Amendment: For a Fighting & Organization Building Campaign (To Be Posted on Thursday, October 29)
We are also interested in posting blog pieces by any interested DSA member on how they are orienting around the resolution and amendments: what they agree and disagree with, and what they are supporting. We are looking to post more opinions on this topic up until the convention on November 14th. Please reach out to the Working Group if you'd like to contribute.
This document lays out why we propose to amend the original “Healthcare for All” proposal, where we agree and disagree with the authors of the proposal, and how we believe we should move forward strategically as a chapter to create a socialist healthcare system for all. We present our amendment as part of a respectful, strategic debate within the chapter about how to pursue the healthcare system transformation we all want.
As coauthors of the amendment, we agree with the authors of the original proposal on several key issues. First, our chapter must prioritize healthcare work in 2027. Second, our goal should be a universal, single-payer healthcare system. Third, we can and should push to achieve such a system at the state level, through the New York Health Act (NYHA).
These points of consensus have guided NYC-DSA’s work on healthcare since 2017. NYHA has been the primary, and often the exclusive goal of our healthcare work for nearly a decade; it was made a chapter priority campaign in 2021. Some of us have spent years rallying, canvassing, and organizing for NYHA in coordination with the statewide umbrella coalition which has worked to advance the legislation for many years.
Unfortunately, NYHA is no closer to passage now than it was in 2019. Its passage seems more remote than it did in 2019, when Democratic control of the state senate raised widespread hopes that the legislation might finally pass. Since that time, it has become clear that, despite widespread paper support in the legislature, Democrats in Albany — influenced by insurance companies, the pharmaceutical industry, major hospital systems, and the rich — have no intention of bringing the legislation to a vote, much less enacting it. In fact, NYHA has fewer co-sponsors now than it did in 2021. In addition, some groups who should be allies in the fight for universal healthcare, including the leaders of many major unions, remain opposed.
This lack of progress is not surprising. NYHA is an extraordinarily ambitious piece of legislation. It would not only eliminate the entire health insurance industry in New York State, but impose comprehensive public control of the state’s entire healthcare sector — nearly one fifth of its economy. The legislation will be opposed not only by the health insurance lobby but by the enormously powerful hospital and pharmaceutical industries. After all, big pharma and the state’s largest, most powerful hospital systems would stand to lose billions of dollars under a system that distributed healthcare funding more equitably. NYHA would also require replacing private insurance premiums with roughly $130 billion in taxes—roughly doubling the state’s tax revenue. While most New Yorkers would pay less for healthcare under the new system, the ultra-wealthy, who wield enormous power in Albany, would likely pay dramatically more.
None of this should weaken our support for NYHA. On the contrary, the bill’s radicalism is exactly what makes it worth fighting for. As socialists, we should demand comprehensive democratic control of the healthcare sector, and we should welcome the opposition of powerful industry groups as evidence that we’re on the right track. But we should also understand that the fight to assert this control will not be easy nor quick.
The original proposal rightly insists that we prioritize NYHA, but it does not offer a realistic strategy or timeline for achieving its passage. The campaign plan merely proposes that we repeat what we and other members of the NYHA coalition have already been doing for many years: rally, canvass, lobby, and hope something changes. It orients field and messaging around the imminence of NYHA's passage, which does not build organizing capacity. If we, despite believing that NYHA is not immediately passable, tell organizers and volunteers the opposite, we will burn capacity and trust in the working group and across NYC-DSA. In fact, we already have; since 2021, the Healthcare Working Group has churned through volunteers, burned out organizers, and alienated itself from complementary initiatives in DSA (e.g., the Tax the Rich campaign). Pursuing NYHA-or-nothing as our chapter’s exclusive orientation towards healthcare organizing (our “singular demand,” in the original proposal’s words) will actually thwart our ability to organize on healthcare.
Simply put: we need a new strategy — one that can mobilize people angry about our existing healthcare system and build the power required to transform that system.
Our proposal offers such a strategy. It emerges from years of conversation among healthcare activists and longtime Healthcare Working Group members about how to shift the balance of power in Albany and meaningfully advance single-payer in New York. We believe that enacting NYHA will require a strong electoral mandate for transforming the healthcare industry, a shift in orientation by major unions, and legislative action to weaken the grip of privatization on our healthcare system.
To start, an electoral mandate is necessary to demonstrate popular demand - and statewide elections in 2030 including the gubernatorial race present an opportunity to win that mandate.
Second, changing the orientation of unions requires the long, slow work of organizing among union members. Continuing this rank-and-file work is a point of consensus between us and the authors of the original proposal.
In the meantime, NYC-DSA cannot ignore the intersecting crises in our healthcare system — massive loss of Medicaid coverage, skyrocketing costs of private health insurance, and ongoing conflicts within the healthcare sector. In our view, we should take an active role in these conflicts by fighting specifically for legislation that expands the role of public authority and reduces the power of private interests over that system. Specifically, we should fight to empower public hospital systems like NYC Health + Hospitals and weaken the role of massive private hospital conglomerates in the state’s healthcare system. We should also fight to expand the role of public programs like the Essential Plan and reduce the role of private, employer-sponsored insurance in covering New Yorkers. A campaign to strengthen H+H, in particular, would take advantage of the strategic opportunity offered by Zohran Mamdani’s election by expanding public healthcare at the city level. Importantly, NYHA will still remain at the forefront of all our organizing as our North Star, in both our communications and field work. Simultaneously, we will deploy additional campaigns to rhetorically tie the immediate failures of our healthcare system to their resolution in NYHA.
Our purpose in engaging in these fights is not simply to mitigate the worst effects of our existing healthcare system on everyday New Yorkers. Rather, it is to weaken privatized power over the healthcare system, to debilitate NYHA’s opponents, thus paving the way to implement single-payer. Expanded public insurance and public provision of care brings us closer to the moment when we can eliminate the role of privatized healthcare entirely. We believe this strategy that cuts at NYHA opponents will deliver universal healthcare on a shorter timeline than the original proposal’s campaign.
Just as importantly, these intermediate campaigns can build momentum for NYHA by organizing around pressing issues and achieving meaningful wins. These campaigns have the potential to do for our healthcare work what state legislative races did for our electoral work — build the organization, skills, and excitement required for more ambitious wins at higher levels. Such wins have the potential to break the cycle of burnout and disillusionment generated by our previous strategic orientation and achieve the momentum we need to enact single-payer.
Our amendment refocuses our NYHA organizing, offering a feasible timeline, meaningful short-term goals, and a long-term strategy. It maintains the original proposal’s orientation towards NYHA, without "deprioritizing" NYHA as the authors of the original proposal have claimed. Our amendment also eliminates the confusing and duplicative structure proposed in the original proposal, housing the campaign within the broader Healthcare Working Group where it belongs. This proposal offers, not an alternative to NYHA, but a new strategy capable of actually passing the New York Health Act and winning healthcare for all.
Two final notes:
- Procedurally, we view our amendment as part of a strategic debate within the Healthcare Working Group and the chapter as a whole about how to pursue a campaign for the New York Health Act. While there is broad consensus among HCWG members that NYHA should be our ultimate goal, the working group as a whole has not come to a consensus on what strategy we should use to pursue this goal, nor were working group members offered a meaningful chance to debate or vote on the text of the Healthcare for All resolution. Given this context, we believe that putting the debate before convention delegates offers the best opportunity to democratically determine the best way forward for NYHA.
- Another amendment has been offered to the original proposal, “For a Fighting & Organization Building Campaign.” While we naturally prefer our own amendment, we believe that this amendment would also make the campaign stronger by eliminating duplicative campaign structures and by permitting the chapter to engage in a broader range of activity in support of socialized healthcare.