by Gregory Lebens-Higgins

If you spend any time in left circles, you will hear the call to “organize!” We are encouraged to organize our workplaces, get involved in organizations, and to become organizers. By these means, the working class will escape its condition of oppression under capital. But what does it mean to “organize”? How do we make organizing a practice, rather than merely a rallying cry?

Perhaps it’s best to begin by differentiating organization from spontaneity. When the lower orders can no longer withstand the pressure placed upon them by their class condition—whether from starvation, exploitation, or exhaustion—they may periodically rise up against their oppressor. These wildcat strikes, looting, riots, and isolated acts of violence are, per Lenin, “outbursts of desperation and vengeance.” Such blows against the status quo may relieve psychological anxiety and even improve immediate conditions; but they have neither the vision nor the formation for a truly revolutionary undertaking.

Examples abound. Occupy Wall Street took the form of a mixed ideological coalition—libertarians, anarchists, socialists, and liberals—with disparate demands and a lack of coordination. The George Floyd uprising was an explosion against the state violence exposed by the callous murder of George Floyd and underscored by failure to manage the pandemic. After each wave, the tide rolled back; with no accountability for the extravagances of Wall Street, and few lasting cuts to police budgets.

The task of socialists, describes Lenin, is to combat spontaneity and bring it under the wing of a revolutionary socialist movement. We must prepare for the inevitable crises of capitalism, giving shape to the response. Through organization, spontaneous street movements can be perpetuated into lasting formations of working class power, with an informed strategy and a collective will toward revolutionary objectives.

“Political power … is merely the organized power of one class for oppressing another,” instructs Marx. It is clear that the capitalists—business owners, landlords, and the governing class—are organized to ensure their continued access to a compliant workforce and the accumulation of profit. Wages are fixed, prices are raised, and workers are disempowered by monopolies and secret agreements to set aside the normal conditions of competition. Even that high priest of capitalism, Adam Smith, recognized “People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices.” 

To organize the working class is to organize in opposition to this coordinated oppression. To use the advantage in numbers and role in the process of production to threaten the capitalists’ access to profit, and thereby strip them of their unearned power. An organized working class is uniquely positioned to overturn the rule of the capitalist class, and to rule for itself and the common provision of all. “From each according to their ability, to each according to their needs.”

While this describes the goals and purpose of organizing, we must break down its concrete tasks. First among these, is the raising of political consciousness among the working class. To be organized as a class, the working class must be aware of itself; as existing in opposition to the forces controlling capital. This is achieved through political education, exposing the reasons and mechanisms behind our misery—exploitation and alienation under capitalism.

We must then democratically engage the working class in its own liberation. By taking an active role in the further development of the movement, participants become invested in the process. Their demands must be articulated in a coherent program, focusing energy and providing a measure of accountability. Always, the working class must remain self-critical, analyzing how its objectives further the fundamental alteration of class relations. 

Organizing also occurs on a practical level. Meetings must be scheduled for planning and discussion; minutes and records maintained; roles defined; and tasks assigned. All participants must be taught in the methods of revolution. “Revolutionary experience and organizational skill are things that can be acquired, provided the desire is there to acquire them,” writes Lenin. Teaching these skills to members develops the capabilities of the movement and maintains its democratic character. Rather than entrust an elevated vanguard, we must have faith that “every cook can govern,” and empower them to do so.

The concentrated resistance against the genocide in Palestine demonstrates improved coordination among a broad coalition on the left, that has become the nucleus for planning and information transmission. It is our responsibility to bring these forces together under a unified socialist movement.

Ultimately, the socialist movement must prepare itself for the task of proletarian governance. Its current organizing—in the forms of participative democracy, mutual aid, and interpersonal relationships—must model the structures we wish to see in society. From these, we shall lay the foundations for a future where relations are no longer defined by the market.

The post What Does it Mean to “Organize”? first appeared on Rochester Red Star.

By Chris Brady

Three North Shore Massachusetts communities recently agreed to tentative bargaining agreements won through heroic teacher strikes. The towns of Beverly, Marblehead, and Gloucester voted to strike in early November, each lasting 12, 11, and 10 school days, respectively.  Beverly’s strike was the longest industrial action by educators in modern Commonwealth history.

The strikes won concessions on wages for teachers and paraprofessionals, and increased paid parental leave, among additional gains. The local unions persevered despite incurring an unprecedented sum of state fines for the illegal public sector strikes. The North Shore teachers built upon the recent wave of Massachusetts educators leveraging their collective power through striking in Woburn, Andover, Newton, and more localities in 2023. Although these concessions are not enough — teachers and paraprofessionals remain underpaid for the invaluable labor they provide — the message is clear – when workers organize, they win.  

Communities around the Commonwealth remain largely consistent in their popular support of these actions. The notable exception is Governor Maura Healey and the corporate Massachusetts Democrat machine. Healey bucked the pro-teacher stance of the more progressive senators Elizabeth Warren and Ed Markey, and decried the strikes as “unacceptable” in a recent statement, pressuring the teachers to yield “to ensure that students can return to the classroom.” 

This is unfortunately in character for anti-labor Maura Healey. In 2023, she told the striking Newton teachers to “Get back to class”, and even argued for increasing the daily state fines levied against the Newton union. Indeed, Healey was quoted in an interview with WBZ News tas opposed to one of the Massachusetts Teachers Association’s (MTA) biggest priorities, legalizing strikes by public-sector workers in the Commonwealth, saying she is “not a fan” of any such legislation

It is clear that the corporate Democrats who run Massachusetts, namely Healey, State House Speaker Mariano, and State Senate President Spilka, do not represent the working people of the Commonwealth. So why do our labor unions consistently endorse Democrats who could not respect them less?

The dispute between the MTA and Healey on the North Shore comes just after Healey and the MTA butted heads during the educators’ successful referendum campaign removing MCAS as a graduation requirement. The MTA out-spent and out-organized the Massachusetts business apparatus to get Question 2 passed, despite Healey and other top state Dems viscerally opposing the measure. Notably, many of the ‘No-on-2’ campaign corporate backers are also Healey donors.

MTA President Max Page and Vice President Deb McCarthy released a statement following Healey’s announcement, saying, “It’s disappointing that Governor Healey has chosen to side with the few corporate donors opposing Question 2 and against Massachusetts educators, parents and students.” The statement also noted that the opposition campaign was largely backed by wealthy CEOs and reactionary conservative organizations. 

The MTA recommended Maura Healey for Governor in 2022. In their endorsement statement, then MTA President Merrie Najimy stated that “As governor, [Healey] will make public education — from prekindergarten through college — a top priority.” 

Clearly that has not been the case. The labor movement in Massachusetts will be tokenized and ignored by Massachusetts Democrats for as long as we allow ourselves to be abused by them instead of standing firmly for labor values. The Democrat machine, which for too long has held our labor organizations hostage with sustenance-level concessions and lip service, can not be the sole representative of workers any longer. Our endorsements must be earned.

Massachusetts is uniquely positioned for educators to create change. High rates of teacher union membership and decades of struggle have contributed to the consistent ranking of Massachusetts being #1 in public education out of all fifty states – a fact that leaders are quick to note. The inflated value of housing here, at least in part, is due to the excellent school districts Massachusetts educators create and the access that residents have. This positioning reveals leverage – Massachusetts doesn’t work without teachers – and consequently, teachers are positioned to force elites to make Massachusetts work for us.

The MTA should seriously reevaluate the automatic endorsement the Massachusetts DNC seems to earn every cycle. The MTA represents 117,000 members, and AFT-MA represents 25,000. There is a vast network of people, financial resources, and willpower waiting to be activated, and it offers a credible framework for contesting the corporate hegemony on Beacon Street. Every moment that these resources remain committed to candidates like Healey is time wasted; the labor movement cannot win working-class concessions when the organizations which represent workers aren’t forcing concessions from the establishment machine. 

Tami Gouveia was a recent example of a candidate for a major state political office that presented a potential deviation from the corporate class. MTA was correct to give her their recommendation in the primary and going forward, it would be right to endorse other progressive challengers committed to labor issues. Even better still, the MTA has the infrastructure to source and run their own candidates for these offices. The best representation for teachers will always be other teachers, and more importantly, the union provides a mechanism for accountability for candidates – insulating them from some of the corruptive elements of navigating the legislative apparatus.

The MTA has already proven its commitment to “bargaining for the common good,” using its leverage not only to secure improvements to wages and working conditions, but also to win broader social programs. But this logic must also be applied to the field of electoral politics. Our unions must have one foot in the negotiating room and one foot on the streets, drawing inspiration from heroic struggles from the North Shore to Chicago. This is the source of our real power. But it also takes trusted and allied elected officials to transform our power from below into legislation reforms and favorable political conditions. Building real power only to rely on corporate politicians to turn that power into results is a recipe for betrayal.

The path forward necessitates a bold, new political project, a party that combines the class interest of the specific group of workers they represent, the broader class struggle, and popular social movements into a cohesive, organized unit. 

Governor Healey doesn’t respect teachers unions, and she won’t, until workers make her.

Chris Brady is a member of Boston DSA.

Featured image: Photo of Empty Classroom by Diana

What should Maine leftists aim to accomplish in the coming few years? After many decades in the doldrums, the U.S. Left grew by leaps and bounds in 2016 and 2017, spurred social protests like Red State teachers strikes, #MeToo, Standing Rock, Black Lives Matter, and climate justice. Bernie Sanders’s 2016 and 2020 campaigns introduced the language of working class solidarity and socialism to millions of people; and Trump’s elections, COVID, and Gaza have hardened radical convictions.

Nationally, much (but not all) of this new socialist and anticapitalist energy has coalesced in the Democratic Socialists of America (DSA), catapulting the group from 6,000 to almost 90,000 members in a few short years. Proportionally, Maine DSA has grown even more, starting from less than a dozen long-term members in 2016, there are now over 600 dues-paying members state-wide. Over the last eight years, those members have won seats in the state Legislature and Portland City Council, marched for Black Lives, organized mutual aid during COVID, walked picket lines, organized renters unions, spoken out for abortion rights, and played a central role in Gaza solidarity, to name just a few. We’ve learned how to win. Just look at the staying power of the People First Portland referendums that raised the minimum wage, strengthened renters’ rights, and instituted Green building codes. And we’ve learned how to fight for a good cause even if the capitalists can overwhelm us with campaign cash, like when they outspent us 50 to 1 to defeat Public Power. Along the way, we’ve organized innumerable study groups, socials, art builds, and canvasses. Maybe most important of all, we’ve built a collaborative, active, and principled group of organizers while demonstrating our usefulness to a wide range of political allies. 

Trump 2.0 will put Maine DSA and all progressive forces in Maine to the test. But we’re much stronger than we were in 2017 and hundreds of people are interested in joining, not to mention lots of members who are considering reconnecting or upping their level of commitment. In sum, if 2017 and our work since then put Maine DSA on the map, we have the opportunity to get to the next level in the coming years in terms of size, influence, experience, and state-wide presence. Exactly how we do that is up to us. 

Right around when Trump takes office in January Maine DSA will hold its convention, and in its lead up Pine & Roses is encouraging readers to submit articles so as many folks as possible can think through what we should do in the coming year and beyond. If you have ideas for how the Left in Maine could better organize, or if you’re part of a group that has fought for social justice and have a story to tell, we want to hear what you’ve been up to in the past year and what you are thinking for the next. If you want to analyze Maine’s economy, then take a crack at it. If you are a union member and want to talk about your workplace or assess Maine unions’ strengths, we want to hear from you. Likewise if you have ideas for art, music, education, or culture. 

Trump plans to go to war. We’ll be on the defensive on the national level and we shouldn’t underestimate the damage he can do here in Maine. But we don’t have to sit by and wait. How can we defend our immigrant and trans communities? How can we prepare for attacks on education, environmental protection, and union rights? Whatever we do, we will have to figure out how to marshall our considerable, but limited, resources and consult with friends and allies. But before we can act, we need to share ideas, debate, and then come together to democratically decide. That’s how it should be done in any democratic space worth its weight. Please join in by sending us your thoughts. Preferably in 1,000 word bites. Don’t worry if you need help with editing. We’re happy to help get your ideas in easily readable form. 

Send articles and ideas to pineandrosesme@gmail.com

The post Going Into 2025: A Call for Voices appeared first on Pine & Roses.

Upcoming Events

Tuesday, December 3 (6:00 p.m. – 7:30 p.m.): What is DSA? (In person at 1916 McAllister)

Tuesday, December 3 (7:00 p.m. – 8:00 p.m.): Ecosocialist Monthly Meeting (Zoom)

Wednesday, December 4 (7:00 p.m. – 8:00 p.m.): New Member Happy Hour (In person at Zeitgeist, 199 Valencia)

Wednesday, December 4 (6:45 p.m. – 8:00 p.m.): Tenant Organizing Working Group Meeting (In person at 1916 McAllister)

Thursday, December 5 (6:00 p.m. – 7:00 p.m.): Palestine Solidarity and Anti-Imperialist Working Group (Zoom and in person at 1916 McAllister)

Friday, December 6 (2:00 p.m. – 6:00 p.m.): Office Hours (In person at 1916 McAllister)

Friday, December 6 (7:00 p.m. – 8:00 p.m.): Tenant Organizing Social (In person at Karl’s Beacon, 1355 Taraval)

Friday, December 6 (7:00 p.m. – 9:30 p.m.): Film Screening: Nihon Sekigun x PFLP Declaration of War (In person at 1916 McAllister)

Sunday, December 8 (1:00 p.m. – 4:00 p.m.): Homelessness Working Group Training & Outreach (Meet at 1916 McAllister)

Sunday, December 8 (7:00 p.m. – 9:15 p.m.): Labor Movie Night: Four Winters: A Story of Resistance and Bravery in WWII (In person at 1916 McAllister)

Monday, December 9 (6:30 p.m. – 8:15 p.m.): Homelessness Working Group (On Zoom)

Monday, December 9 (7:00 p.m. – 8:00 p.m.): Labor Board Reading Group: San Francisco Reds (On Zoom)

Wednesday, December 11 (6:45 p.m. – 9:00 p.m.): December General Meeting (Zoom; in person location TBD)

Saturday, December 14 (5:00 p.m. – 8:00 p.m.): DSA SF Community Dinner (In person at 1916 McAllister)

Check out https://dsasf.org/events for more events and updates.

Events & Actions

Support the Appeal of the SFMTA RV Ban!

The Homelessness Working Group is helping fight SFMTA’s ban on RVs parking overnight around the city, and we need your assistance! RVs are critical homes for those who would otherwise be on the street — but the city keeps punishing vulnerable people.

Speak out by filling out this form to email the Board of Supervisors, asking them to overturn the RV ban. And save the date to give live public comment on December 10!

DSA SF Holiday Dinner

Join DSA SF for a holiday dinner on Saturday, December 14, 5:00 p.m.-8:00 p.m. at 1916 McAllister. Come wind down with your favorite socialists before we recharge for the struggle to come in the new year. Bring friends, family and something small to share.

No Appetite for Apartheid in SF!

Inspired by long-standing Palestinian boycott tactics and the BDS call, the Palestine Solidarity Anti-Imperialist Working Group are canvassing local stores and asking them to pledge to become Apartheid-Free by dropping products from companies complicit in the genocide of Palestinians and colonization of Palestine. It’s time to turn up the heat on this apartheid regime and take apartheid off our plates!

Want to show your support? Sign our Apartheid-Free Pledge so business owners know how popular this movement is with their local customers. After signing the pledge, we would love to see you at any of our upcoming canvassing. Check dsasf.org/events for updates.

Behind the Scenes

The Chapter Coordination Committee (CCC) regularly rotates duties among chapter members. This allows us to train new members in key duties that help keep the chapter running like organizing chapter meetings, keeping records updated, office cleanup, updating the DSA SF website and newsletter, etc. Members can view current CCC rotations.

To help with the day-to-day tasks that keep the chapter running, fill out the CCC help form.

Recently, residents of Linnhaven Mobile Home Park in Brunswick formed the Blueberry Fields Cooperative, and collectively purchased the park from its owner. Peach, a member of Maine DSA, interviews three leading members of the Cooperative to discuss why residents felt it was necessary, the organizing work that made it possible, and how it has helped bond residents to collectively own their own home park. Please listen, enjoy, and share!

The post Maine Mural – Blueberry Fields Cooperative, Pt. 1 appeared first on Pine & Roses.

By Jacob Schles

FENWAY — Following several charges of unfair labor practices filed November 7, Fenway Health Center is under investigation by the National Labor Relations Board (NLRB) for suppressing union action and bypassing the union, according to documents obtained from the NLRB. The center, which has been a leading force in LGBTQ healthcare and research for over 50 years, has faced several unfair labor practice charges since workers voted to form a union as a part of Service Employees International Union 1199 in October of last year.

Under Investigation

The latest charges explicitly mention six violations of the National Labor Relations Act, including a refusal to bargain, making coercive statements, and retaliation. Management’s use and alleged mishandling of disciplinary meetings, coaching sessions, and investigatory interviews marked a pattern of targeting employees engaged in union activity.

Management threatened disciplinary action towards those engaged in union activities, often requiring months-long coaching sessions. One worker’s allegations claimed that simply raising concerns with meal break policy and describing corrective action led her to be “subject to discipline,” according to the charges.

The charges also describe a consistent pattern of failure to give notice and opportunities to bargain regarding disciplinary action. This led to workers being denied Weingarten rights, the right to have a union representative present at investigatory interviews.

Fenway Health Center declined a request for comment.

Not the First Time

Shortly after the union’s formation in October 2023, two employees filed separate charges of unfair labor practices regarding discipline. One instance mirrored the current alleged failure to give the union an opportunity to bargain. 

“They take me into a room, tell me I’m making threats, and fire me,” said Sabel Flynn, a former nurse at Fenway Health in the Trans Youth Health program and active organizer during the union’s formation. 

Shortly after the vote to organize, Flynn said he made “emboldened” pro-union posts that management saw, prompting him to post again on Halloween asking who shared the posts with higher ups. Flynn said that by ending the post with “I will find you,” donned in Halloween makeup, management saw grounds for termination. 

According to Flynn, higher ups like Chief People Officer Shari Stier were in the room where Flynn was unexpectedly fired, and did not allow him to say goodbye to his patients. The union was able to assist Flynn in getting onto unemployment benefits post firing.

Raine Hellmann, a former per diem nurse who also worked in the Trans Youth Health program and part of the union organization committee, also alleged termination on the basis of union activity. “They cut my hours completely,” he said. Hellmann left Fenway Health after being passed up for a full time position. Despite previously working nearly full time as a per diem nurse for two years, he was denied hours amid an understaffing issue.

Understaffed, Overworked

Hellmann and Flynn both described a pattern of understaffing and overworking at Fenway Health. To combat complaints, the center sent an email to staff saying there was no hiring freeze in August of 2023. However, during a period of several months with no new hires, Fenway Health told individual staff members that there was in fact a hiring freeze, according to Fenway Rebel Nurse, a now out of use outlet for Fenway Health’s union news.

“Management is not on the floor, not actually helping,” said Hellmann. Flynn also said blame was placed on the workers during periods of understaffing. “They turned it around on the workers saying ‘you’re not working hard enough,’ or ‘you’re not being a team player enough,” he said. “Why aren’t we getting the staffing we need?”

Flynn also said that management was overly punitive, in line with the disciplinary violations alleged by recent unfair labor practice charges, saying that reporting small errors was threatened with termination. “When the response to errors is punishment and disciplinary hearings, that de-incentivizes nurses to report medication errors,” he said. “And then they happen, and nobody says anything.”

The current charges are being investigated by an NLRB field attorney. Past charges, like Flynn and Hellmann’s, are stuck in “NLRB limbo” according to Flynn. All cases are being represented by Ian Russell, who has previously represented many unions and union members.

Jacob Schles is a student at Emerson College and writer for Working Mass.

Featured image by Kaboompics.

Workers in the pet aftercare industry help veterinarians and pet owners navigate the hardest part of their journey with their pets.

The post Pet Death Care Industry Workers Are Organizing. This Is Why. appeared first on EWOC.

Opening Scene

On the quiet morning of Saturday, November 16th, 2024, I met a retired neurosurgeon from the Carolinas ready for a healthcare revolution. 

He wasn’t alone; over 300 doctors, medical students, and allied health professionals arrived at Venue Six10 in Chicago to take part in Physicians for a National Health Program (PNHP)’s annual conference. They arrived from across the country, hailing from sprawling health networks and neighborhood clinics, Ivy League academic centers and county hospitals. They were doctors at the end of storied careers and medical students who had not yet spent a full year on the wards – a dynamic group of committed professionals who deeply understood why American healthcare wasn’t working but did not entirely agree on the best next step.

Although most of the American left is familiar with Senator Bernie Sanders’ signature platform, Medicare4All, the attendees at PNHP prefer the more generic concept of “single-payer” to describe a shared idea for a national health insurance covering everyone. This is not to say attendees are not ardent supporters of current insurance plans like Medicare and Medicaid, which respectively enroll 67.7 million and 79.6 million Americans. Indeed, protecting and fortifying these two institutions represents the organization’s legislative roadmap for success. Outgoing PNHP president Dr. Paul Verhoef, a critical care physician currently working in Hawaii, summarized the organization’s vision: a “Triple Aim” that seeks to convert inertia and apathy for change into widespread confidence in a unified, government-managed program. 

A single-payer system cannot be achieved without proving to voters that doctors have the political power to end healthcare profiteering and strengthen “traditional Medicare,” which includes the current benefits afforded to retirees, disabled individuals, and dialysis patients. Alongside these legislative goals, PNHP features a critical research branch to change the medical narrative on for-profit healthcare, as well as a fledgling coalition model of organizing which brings together unions, medical students, retirees, and healthcare justice activists to carry their message into the general populace. 

Opposing Medicare Advantage

In the U.S., the two major political parties are equally guilty of loosening healthcare’s regulatory apparatus and allowing legalized graft to gum up the current system. Both Presidents Trump and Biden encouraged a mass transfer of patients from government-managed Medicare to Medicare Advantage, a network of privately administered insurance providers that bills the government for any retirees it accepts into its risk pool. Medicare “Disadvantage”, as conference lecturers dubbed it, represents a prime example of corporate greed impeding the group’s vision.

First, private insurance companies run aggressive advertiseing campaigns at senior citizens who are promised vision, hearing, and dental plans (which traditional Medicare does not offer) as well as free home nursing assessments if they switch from Medicare to Medicare Advantage. The government agrees to pay insurers a “per-capita” cost for every person covered. On paper, different companies are bidding to provide this insurance to large groups of patients at the lowest possible rates; in practice, insurers seek niche, carve-out populations in specific neighborhoods or with union retirement plans to avoid competition.

Once these patients have been aggregated, the company’s actuaries start calculating the risk of catastrophic health problems they might experience. For retirees, these risks represent the burdens of economic and social disparities experienced throughout life, and future costs of care can be modeled and anticipated using clinical risk factors. 

For example, a college-educated grandmother who just ran a marathon is going to cost significantly less than an elderly nursing home resident struggling with multiple chronic medical conditions and a new cancer diagnosis. To balance out these varying levels of “healthiness,” the government offers higher per-capita payment plans for high-risk patients. The insurance companies have realized they can game risk pools by recategorizing the marathoning grandmother to look sicker on paper. 

Cue the visiting home nurse, who documents that the grandmother actually lives on the second floor of a townhouse with enough stairs to qualify as a fall risk. Then, according to some lab work drawn during the visit, it turns out she meets the criteria for pre-diabetes and has chronically low potassium, which has never been an issue but which now appears in her medical documentation. Suddenly, she bumps over into the higher-tiered risk pool and earns the company a higher per-capita rate. From her perspective, she gets optical and dental insurance that she doesn’t have to purchase on a fixed income, but behind the scenes, she will be limited to the same narrow selection of in-network doctors’s offices and subject to many of the same insurance claim denials and prior authorizations that the average person with private insurance through their job experiences.

Finally, insurance companies can score additional rebates if they meet benchmark health criteria set by the government. These criteria, while conceptually valid, often become a system of automatic flags that prompt doctors to order repeat tests. In combination, all these perverse incentives, as well as the baseline advertising costs, shareholder dividends, and CEO payouts, add up to a significantly inflated cost of care compared to traditional Medicare. 

There were numerous slides describing and predicting the rates of overpayment and abuse this kind of system permits, but during the first two hours of the conference I was so overwhelmed by the stream of high density statistics that I didn’t jot down any of the half-dozen charts meant to clinch your conviction that Medicare Advantage is a threat to all healthcare socialists. Instead, I’ll quote one slide by Dr. Adam Gaffney, a powerhouse researcher working out of Cambridge Health Justice Lab: “Medicare Advantage does not only waste money, its business model is based on care denial, and it is undermining the idea of equitable single-tier for the elderly.” 

PNHP Victories

Given all the clear evidence of overpayments, PNHP National has staked out intense opposition to these corporate handouts. Since Medicare Advantage is a federal program, it represents a yearly budget fight between insurance companies and executive-branch employees at the Centers for Medicare and Medicaid Services (CMS). In 2024, PNHP won a rare budget victory by opposing the above-inflation rate increases that Medicare Advantage lobbyists demanded of the Biden administration. In a coordinated campaign across multiple chapters, activists drew the eyes of enough federal legislators to make CMS wary of continuing business as usual. 

The audience applauded in catharsis when the presenter showed images of insurance company stocks dropping $95 billion after the federal government’s announcement it would limit the rate increase of Medicare Advantage payments. Presenters also told of labor organizers and PNHP allies fighting against the New York City Council, which dropped 250,000 city employees onto an inferior Medicare Advantage plan. These retirees have now won a string of lawsuits to regain their original healthcare benefits and demonstrate another spark of hope against the decades-long onslaught of privatization. 

These individual stories pale in comparison to the immense task of electoral victory required to expand the welfare state. This could be most clearly seen in President Biden’s failure to pass Build Back Better, which would have included provisions that strengthened traditional Medicare in the form of adding vision, dental, and hearing insurance to every beneficiary. PNHP was a staunch supporter of Build Back Better in order to meet its Triple Aim, but obviously represented just a fraction of the progressive pressure that failed to win Senator Manchin’s vote of support. From one perspective, the structure of the U.S. Senate represents public enemy number one to members of the group seeking to achieve a single-payer system; from another, it is the only formidable barrier that has protected the Affordable Care Act (ACA) and Medicaid expansion from hostile Republicans. This could not have been clearer than when a medical student leaned over during Dr. Verhoef’s presentation to tell me “This guy has no concept of theory of change.” Among PNHP leadership, faith in electoral incrementalism remains the path for welfare expansion. 

Students for a National Health Program

The relationship between Students for a National Health Program (SNaHP) and PNHP is not unlike that of YDSA to DSA. The goal is to capture vibrant student idealism for health equity and pull it into a larger political formation with progression and skill-building. PNHP believes so much in this mission that SNaHP members could attend a bonus half-day of the conference dedicated to organizing during medical training. The 151 who attended on Friday represent the far left of healthcare— future doctors who already have multiple years of experience organizing for Palestinian liberation or abolishing ICE and demand change now. Their very existence demonstrates a keen ability to jump through the hoops of high-stakes meritocratic testing while maintaining a robust bullshit detector against all the pageantry of co-opted social movements professed by medical school deans.

The Friday afternoon SNaHP Summit at nearby Roosevelt University included breakout groups teaching students how to write testimony, build campaigns, and organize medical school events to teach fellow classmates about single-payer policies. I appreciated how these organizers had deeply analyzed the structure of medical school curricula to maximize impact. “Spreading propaganda is super-important to us,” said one presenter while discussing essential rules to prevent the message from falling flat; for example, never host an event on the week of an exam, host events after mandatory lectures when classmates are already on campus, always offer food for students, and give every member who commits to organizing an event a named position in that SNaHP chapter for their résumé. “Your medical school, as a rule, wants you to do their work for free,” noted another presenter while pulling up a slide with the national curricular requirements for what medical schools must teach students about health policy. It’s an open secret that if you design a lecture that meets a teaching requirement, your professor will probably use it to cut costs even if it contains a pro single-payer message. 

The most well-attended SNaHP breakout session was a packed room of over 40 students who wanted a chance to hear from labor organizers. For doctors, clinical training includes a mandatory 3-7 years after medical school in a hospital-based program called residency. These programs are notoriously exploitative, often expecting trainees to work 24- to 28-hour call shifts and up to 80 hours a week without overtime pay. Since 1957, several waves of resident unionization have occurred in response to these conditions, first at public hospitals in New York City, Los Angeles, and Chicago, and followed by other cities predominantly across the West Coast, Midwest, Mid-Atlantic, and New England. 

Currently, the SEIU (Service Employees International Union)-affiliated Committee of Interns and Residents (CIR) represents the nation’s largest physician union with over 33,000 residents, and it’s estimated up to 25% of the resident trainee sector are now unionized. In recent years, CIR members passed resolutions in support of a national single-payer program and a ceasefire in Gaza. Recently unionized members spoke highly of their relationship to the Emergency Workplace Organizing Committee (EWOC), a joint venture between the United Electrical, Radio and Machine Workers of America and DSA as a way to build up organizing capacity before CIR took on their case. I met several doctors familiar with or members of DSA which speaks to the growing networks between health justice projects and labor organizing. 

The union organizing session had been held at previous SNaHP summits, and this year’s version was attended by current CIR president Dr. Taylor Walker. Dr. Walker made a clear pitch that medical students should join the labor movement to propel health justice projects like abortion care, medical debt relief, and Palestinian liberation into a democratic debate at the workplace. This vision would serve both medical workers and their patients, and the rising leadership who will pilot PNHP in the coming years agreed. Talking to both current CIR members and doctors who have completed residency, a SNaHP-to-CIR-to-PNHP pipeline represents a promising model for maintaining an organized formation of progressive physicians. Each organization would contribute to a doctor’s organizing skills parallel to the steps of their medical education. 

Dr. Arya Zandvakili, an infectious disease physician in Iowa who is now approaching the final hurdle of his sub-specialist training, is one such representative of this new batch of mid-career doctors who remains motivated to show up for PNHP. “People are going into financial ruin and debt,” he told me when I asked him what draws him to the organization. “Single-payer is a way to get universal healthcare that’s economically efficient.” However, even if we count on a burgeoning labor movement and a rising generation of radical doctor organizers, it’s still unclear how to translate power into politics. 

State or Federal

Though all PNHP members have made the same conclusions as Dr. Zandvakili given the data at hand, the conference did not clarify a best path forward. One flyer being passed around called for organizing state-managed single-payer insurance plans. This would allow progressive states to bypass federal roadblocks and roll out a one-size-fits-all plan for their populations. This is far from perfect. Some fear a small state like Vermont or Rhode Island would go bankrupt under such legislation and set a bad example for the national project (full disclosure: I have previously testified at the Rhode Island Statehouse in favor of a Medicare4All-style bill). For the New York Metro chapter of PNHP, which has its own staff organizer supporting their campaign for the New York Health Act, it would mean leading the country with an exemplary model of universal coverage. Even this project requires federal backing, however, as the CMS would have to be granted permission to deliver its federal insurance money as a lump sum payout to New York, which would then dispense care.

Debate within PNHP chapters about state-based programs remains contentious. Dr. Cheryl Kunis, a nephrologist from New York, told me she’s skeptical of state-based single-payer legislation. “It’s unethical for New York to have it, but the rest of the country does not have it.” No one knows if a single state could bear the burden of a democratic experiment, or how citizens in neighboring states would respond to the free care next door. Nothing from the lecture about PNHP’s triple aim— stop profiteering, improve traditional Medicare, and win single-payer— supports or disavows an alternative state-managed path to victory. By side-stepping the all-important question of implementation, it feels like PNHP has held off from the big unknown at the center of the project: who is actually going to wield the democratic power that commands private insurance companies to get lost? 

At the end of the day, it seems doctors who’ve stuck it out the longest have seen enough suffering that they’ll take any win they can find. Former PNHP president Dr. Johnathon Ross recalled being snubbed by then-Governor Bill Clinton alongside several thousand activists in Little Rock, Arkansas while trying to pressure him to support single-payer. Back then, he told me, PNHP was much smaller, without formal elections, an active national board, or a SNaHP wing. The organization’s growth over one professional lifetime has been tremendous, but it still doesn’t seem like we’re any closer to a national project succeeding before a state project passes. As we were filing out of a conference room breakout session and back to the main auditorium, Dr. Ross confided in me: “When you look at the history of doing hard things in America, a state always does it first.”

Joey DiZoglio, MD, is a practicing OB/GYN in Wisconsin. He was a former leader of his medical school’s SNaHP chapter and a current dues-paying member of PNHP and DSA.  

The post A REPORT FROM THE ANNUAL CONFERENCE OF THE PHYSICIANS FOR A NATIONAL HEALTH PROGRAM appeared first on Midwest Socialist.

Monthly Newsletter of the Rochester Chapter of Democratic Socialists of America

As 2024 comes to a close, it is important to reflect on the lessons from this past year, and to outline our tasks for the next.

Editor’s Note: There is a typo on Page 5 – The correct date for Socialist Sunday School #68: Strike! is December 15 (a Sunday). The Movie Night is being rescheduled. Use bit.ly/ssslabordec to register for all sessions. As always, reach out to rochesterdsa@gmail.com if you have questions or issues!

The post Rochester Red Star | December 2024 (Issue 08) first appeared on Rochester Red Star.