Dollars & Sense Article: “The Vermont Workers’ Center Leads Breakthrough on Healthcare”

This was published in Dollars and Sense‘s 2011 Labor Day issue (print only).  I’m only now getting around to posting it here.  The Vermont Migrant Farmworker Solidarity Project has sinced changed their name to Migrant Justice/Justicia Migrante.

On Sunday, May 1st, thousands of Vermonters gathered in the state capital of Montpelier under the banner of the Healthcare Is a Human Right (HCHR) Campaign. This was the third year in a row the Vermont Workers’ Center (VWC), which coordinates the HCHR campaign, had organized a mass rally for healthcare on this traditional workers’ holiday, but this year was especially significant in two ways. The first was that after years of grassroots organizing by the HCHR campaign and others, the state legislature was on the verge of passing a bill, supported by the governor, that would commit the state to a universal, single-payer healthcare system by 2017. The second, however, was more troubling. The week before this May Day rally, the state senate had added an amendment to the healthcare bill that would have specifically excluded undocumented people from coverage – an amendment that, according to the governor’s office, had “zero percent” chance of being removed from the final bill.

This challenge gave this year’s May Day rally more of the flavor of the other major May Day rallies the country has seen in recent years, with signs supporting immigrants’ rights seen throughout the crowd. Working together with the Vermont Migrant Farmworker Solidarity Project, the VWC mobilized Vermonters to demand that universal means everyone, that Healthcare Is a Human Right means that we all have a right to healthcare by virture of being human, regardless of immigration status or any other category.

One of the featured speakers, a farmworker, spoke of the struggles both he and the farmer who employs him have had with the healthcare system. He explained that three years ago, after the barn roof caved in, “We worked in the damp cold all winter and that’s when I got this cough.” He finally went to the hospital and has since paid over $1000 in monthly installments out of his meager wages. But he does not blame his employer. “The farmer pays us what he can. I know he can’t pay more. His wife is paralyzed. His son is incapacitated. His bills keep piling up. I couldn’t do what he does.”

While some healthcare advocacy organizations had been reluctant to fight the amendment, urging a “pragmatic” approach in order to make sure the overall healthcare bill passed, the VWC and VTMFSP held firm and continued to mobilize grassroots pressure. By the time the bill passed out of conference committee on May 2nd, the amendment had been removed.

The Workers’ Center Movement

The Vermont Workers’ Center and the Vermont Migrant Farmworker Solidarity Project are both part of a wave of new worker-based grassroots organizations which have emerged around the country in the past two decades, often referred to as the “workers’ center” movement. Mostly, though not entirely, based in working-class communities of color and/or sectors of the economy with little or no union representation, these organizations have emerged in part because the traditional “workers’ movement” – the trade unions – has been either unable or unwilling to organize these workers, or to be a vehicle for their political aspirations.

The political and organizational vacuum that workers’ centers have emerged to fill has its roots in the economic changes of the last several decades, in the legal framework of collective bargaining in the United States, and in the political and organizational conservatism of the US trade union movement.

The economic agenda of the corporate elite since the 1970s, commonly referred to as “neoliberalism,” has fundamentally restructured the workplace. Production has been shifted from the vertically-integrated national corporations of the mid-twentieth century to flexible, global supply chains, while services have been increasingly privatized. The large factories and government workplaces that were bastions of union strength have been replaced with myriads of sub-contractors and private service agencies, and this period has also seen a tremendous growth in casual or precarious work, part-time jobs, low-wage “independent contractors,” day labor and other forms of temporary work.

These changes have posed organizing challenges for all of the world’s labor movements, but the legal framework for collective bargaining in the United States, which requires unions to win representation elections on a shop-by-shop basis, exacerbates those challenges even further. Furthermore, certain categories of workers – domestic workers, taxi drivers or port drivers classified as “independent contrators,” public-sector workers in many Southern states, and others – are excluded from any collective bargaining rights at all.

Finally, the organizational and political conservatism of US trade unions has made it difficult for the labor movement to rise to these challenges. Decades of reliance on the government labor boards rather than direct worker action has left many unions unable to even conceive of workers in these new and growing areas of the economy as “organizable.” Unions that have brought in workers as dues-paying members have often then buried them in bureaucratic local unions which do little to engage their new members as leaders. And the hostility towards radicalism that has been endemic in the labor movement since the anti-communist purges of the 1950s has left few unions with a political vision which could appeal to this new and growing sector of the working class, whose issues are not merely the bread and butter of wages and benefits on the job, but also racial and gender justice; social rights to healthcare, education, and transportation; and immigrants’ rights to live and work in dignity and without fear.

Locked out of or uninterested in joining the formal “labor movement,” workers have created their own organizations, and in recent years these organizations have formed or joined a variety of networks, including the National Day Labor Organizing Network, Jobs with Justice, Right to the City, the Pushback Network, Grassroots Global Justice, the National Domestic Workers Alliance and the Excluded Workers Congress. These networks have begun to have a serious organizational impact on progressive movements in the United States, and have won significant victories. GGJ was crucial in organizing the first and second US Social Forums. The NDWA recently helped secure passage of a convention on domestic work at the International Labor Organization. The Excluded Workers Congress, who slogan is “Building a Labor Movement for the 21st Century,” has begun to redefine what the “labor movement” is.

The Vermont Workers’ Center

The Vermont Workers’ Center was founded in 1998 by a group of young, low-wage workers, who envisioned an organization that would fight for “an economically just and democratic Vermont in which all residents have living wages, decent health care, childcare, housing and transportation.” Early campaigns for livable wages and against privatization brought the group into contact with rank and file trade unionists, and in 2000 the group affiliated with the national labor-community coalition Jobs with Justice.

The core work of the VWC in its early years centered around building community support for workers who were engaged in organizing and contract struggles. The VWC articulated the issues that workers were fighting for, such as wages, preserving healthcare benefits, and fighting plant shutdowns, as part of a broader political agenda for livable wages, universal healthcare, or global justice. In doing this, the VWC was able to move other members of the broad working class into taking action in solidarity with particular workers’ struggles. However, even with many union organizing victories in the early part of the new century – many of them into progressive, democratic unions and some of them in large workplaces – leaders of the VWC realized that union organizing alone was not going to build the kind of working-class power needed to realize an “economically just and democratic Vermont.”

The VWC began experimenting with other approaches to organizing. In 2003, the VWC formed a partnership with the United Electrical Workers union (UE) in a campaign to organize all of the retail workers in the state capital of Montpelier. In the fall of 2005, the VWC helped organize a campaign with a group of parents in Burlington, the largest city in the state, when the school district tried to shut down the elementary school in their working-class neighborhood. And the VWC built relationships with other workers’ centers and independent working-class organizations around the country, joining Grassroots Global Justice in 2005 and bringing a delegation to the first US Social Forum in 2007.

In 2008 the VWC launched the Healthcare Is a Human Right Campaign. This campaign was chosen for several reasons:

  • The broken healthcare system was an issue in all of the VWC’s work. It was difficult if not impossible for workers to achieve livable wages when the cost of healthcare kept rising. Unionized workers were increasingly being forced to go on strike to defend their benefits, and non-unionized workers were afraid to organize for fear of being fired and losing their health coverage. Healthcare costs were squeezing public sector budgets, prompting public employers to cut services for the public and demand givebacks from workers.
  • It would be a campaign that could truly engage all Vermonters. Most of the VWC’s activity had been concentrated in the parts of the state with greatest union density: Burlington and Central Vermont. A statewide healthcare campaign would require becoming a truly statewide organization. Furthermore, the immediacy of healthcare as an issue would make the campaign much more accessible than union solidarity campaigns, which often require would-be supporters to master unfamiliar acronyms and jargon.
  • Most importantly, it would allow the VWC, and the state’s labor and progressive movements in general, to go on the offensive, after nearly a decade of fighting mostly defensive battles. It would be a campaign in which the VWC could put forward its vision of an economically just and democratic Vermont, not just as a mission statement, but as a goal that could be won, at least in part.

Health Care as a Working-Class Issue

The VWC sees healthcare as a crucial arena for working-class organizing. Much as workers around the country have felt and acted on the need to build worker organizations independent of the AFL-CIO, the VWC leadership believes that the working class needs organizations independent of political parties. “We need to build a powerful people’s movement around the basic moral values our communities share: values about taking care for one another and having everyone be able to lead a dignified life,” says VWC Director James Haslam.

The economic well-being of almost all parts of the broad working class – from the unemployed and disabled through to “middle-class” workers such as teachers and nurses – is deeply tied to the healthcare system. Healthcare costs eat up wages at the bargaining table. Rising healthcare costs are also drive up expenses in public sector budgets; this is then used to justify austerity measures which hit low-income communities the hardest. The employer-based system of healthcare ties workers who do have coverage to their jobs, giving employers more control and helping them to squeeze workers for higher productivity. The entire working class has an economic stake in universal healthcare.

The current healthcare system also divides the working class into separate groups, who perceive themselves as having different interests: “middle class” workers who still have coverage, those who have little or no coverage, and those who rely on Medicare and Medicaid. Striking teachers in Vermont, fighting to preserve their health coverage, face resentment, instead of class solidarity, from other sectors of the working class who do not have coverage. Conversely, the struggle for universal healthcare has great potential for uniting people across boundaries not only of coverage, but of race, gender, sexual orientation, and immigration status. As VWC leader Mary Gerish puts it, “The thing that’s so great about the human rights context is that it unifies everyone.”

Finally, healthcare is an ideal terrain to take on the ruling class ideologies that permeate our society. Healthcare is an issue that is deeply felt. It is, after all, an issue about our very bodies, and those of the ones we love and care about. Most people have an intense commitment to taking care of their families, and of their communities. In healthcare especially, that commitment is in contradiction with the ideologies of individualism, consumerism and market fundamentalism which are widely accepted, on a surface level, throughout US society. When a healthcare campaign stays grounded in human experience rather than being drawn into the dry realm of cost-benefit analyses, there is an opportunity to transform the way people think about the world.

A New Healthcare Law

On May 26th, Vermont’s governor signed the new universal healthcare bill into law. It had taken years of struggle, during which the Vermont Workers’ Center engaged tens of thousands of Vermonters through surveys, petitions, postcard campaigns, public hearings and mass rallies. Through human rights hearings, “people’s forums” and innovative video projects, the VWC had kept the experiences of regular people with the healthcare system at the front and center of the debate for three years. The VWC had grown from a small organization with a single staff person to a true statewide network, with organizing committees in every county, active volunteer committees for media, education and policy, and most importantly dozens of grassroots leaders with a sophisticated understanding of how political power works.

There are still many challenges ahead. The bill passed this year leaves much to future legislators to decide, including both the scope of coverage and the funding mechanism for the new healthcare system. But the Vermont Workers’ Center and its allies will face those challenges with the crucial understanding that politics is not about policy, it is about power, and that the economics of healthcare, like all economics, is fundmentally not about dollars and cents, but about people and their experiences.

The Vermont Breakthrough: Grassroots Organizing Moves a State towards Health Care for All

This article was originally written for and published in the Summer 2011 issue of Social Policy

On May 26, Vermont’s new governor signed a universal healthcare bill that promises to be truly universal, in contrast to the federal Affordable Care Act. While the passage of the bill itself has received attention from the national media, few have told the story of the grassroots organizing that made this breakthrough possible, changing what is “politically possible” through a massive campaign that has engaged tens of thousands of working-class and low-income Vermonters as political actors.

More than anything else, this bill owes its passage to the Healthcare Is a Human Right campaign, spearheaded by the Vermont Workers’ Center (VWC). Founded in 1998 by a group of young, low-wage workers in Central Vermont, the Workers’ Center’s mission is building a democratic, diverse movement of working and low-income Vermonters to achieve an economically just and democratic Vermont. We seek a Vermont in which all residents have living wages, decent health care, childcare, housing, and transportation. For over a decade, the VWC has worked to build working-class power through livable wage campaigns, union solidarity, innovating organizing, coalition-building, community campaigns, and direct action.

The VWC launched the Healthcare Is a Human Right campaign in 2008 as a natural outgrowth of our mission to build working-class power. Healthcare had emerged as an issue across all our work — as one of the main issues in strikes, as one of the biggest costs driving public-sector employers to want to cut and/or privatize services, and as one of the biggest issues for unorganized workers in sectors like retail which make up a huge proportion of jobs in Vermont. It is an issue with great potential for uniting the working class, as nearly everyone has had experiences with the dysfunctional U.S. healthcare system, or has had family or friends who have. As a statewide political issue, it offers all Vermonters a chance to participate. Finally, and perhaps most importantly, it was a campaign that allowed us to go on the offensive, and demonstrate that grassroots organizing can actually achieve victories which improve the material conditions of the working class as a whole — instead of the pattern which we had been stuck in, of defending past victories.

Inspired by the International Worker Justice Campaign led by UE Local 150 in North Carolina — a campaign to repeal the state’s ban on collective bargaining in the public sector which uses international human rights standards as its framework — we adopted the human rights framework for our healthcare campaign. By keeping human rights at the center of our campaign, we developed a campaign language that connected with working people at the level of values, rather than through the abstract and often confusing language of policy. The human rights framework also encourages movement-building discussions of how healthcare intersects with other issues such as domestic violence, racism, immigration, war, privatization, and attacks on the public sector.

The first phase of the campaign had three main components. We developed a “human rights survey” as a grassroots organizing tool, which allowed us to engage over a thousand Vermonters in a conversation about healthcare which began with their experiences and their values. We also worked to frame the healthcare crisis as a human rights crisis, and to build relationships with other movements and sectors, through human rights hearings held around the state which allowed people to tell their stories, a human rights report released on International Human Rights Day, December 10, and a human rights conference held the following weekend which drew over 500 people. The third component of the first phase was building for a mass rally at the statehouse on May 1st, 2009, which fell on a Friday. Choosing to focus on a direct action, rather than legislation, meant that we had to have conversations with our growing base about the nature of political power, to expand our collective understanding of “politics” beyond elections, online petitions, and polite lobbying of legislators — the “low intensity” democracy that is taught in high school civics classes.

Well over a thousand people showed up at the statehouse — the largest weekday rally in Vermont in recent memory. The HCHR campaign had succeeded in establishing a statewide network of organizing committees, including committees in the traditionally more conservative rural areas of the state.

On the opening day of the 2010 legislative session, dozens of Vermonters in red “Healthcare Is a Human Right” t-shirts delivered thousands of postcards to legislative leaders demanding that they hold hearings on H.100, a bill that outlined a single-payer healthcare system for the state. In addition to collecting postcards, the campaign had been busy in the fall holding “People’s Forums” around the state, to showcase working-class people’s often moving stories of struggling to get the care they need for themselves and their loved ones, and to ask legislators to commit to supporting five Human Rights Principles for healthcare reform.

The Human Rights Principles — Universality, Equity, Transparency, Accountability, and Participation — were developed together with the National Economic and Social Rights Initiative (NESRI), which have been a key national partner in this campaign. As we entered the legislative fray, the principles have been an invaluable tool in helping to evaluate actual legislation, while keeping our “eyes on the prize” of a values-based campaign. Numerous healthcare reform bills were floating around the legislature; despite the fact that we were told that H.100 was outside the realm of the “politically possible,” it was the only bill that began to meet the five human rights principles.

Legislative hearings were flooded, generating grassroots pressure in every legislative district around the state, and after another huge rally on May 1st, H.100 became law as Act 128 in May of 2010, when the Republican governor chose not to veto it. The bill set out a road map for Vermont to develop a healthcare system that treats healthcare as a public good, and explicitly included the five principles of universality, equity, accountability, transparency, and participation. It provided for the state to select an architect to develop three options for how to get there, and Dr. William Hsiao of Harvard, who designed Taiwan’s single-payer system, was chosen.

After Dr. Hsiao delivered his plans in January, the house and senate held joint hearings on what would become H.202, “An Act Relating to a Universal and Unified Health System.” The hearings were done through Vermont’s Interactive Television system, which allows people at over a dozen sites throughout the state to participate via video conferencing. Each site was packed with VWC members and HCHR campaign supporters. Follow-up hearings held by the Senate – even one dedicated solely to hearing testimony from business – showed overwhelming support in the state for moving forward for universal healthcare. When IBM – the largest private employer in the state and frequently referred to as the “big dog” of state politics – expressed reservations about the bill, the VWC and allies from the Alliance@IBM, a “non-majority” union of IBM workers, held a press conference exposing IBM’s claim that they already provide quality healthcare for their employees and denouncing the company’s lobbyists for claiming to speak on behalf of IBM’s workers, who support universal healthcare. H.202 eventually passed both houses by wide margins. The “politically possible” had changed.

The Workers’ Center believes that the successes of the HCHR campaign stem from three key components:

1. Mass Organizing. At every stage of the campaign, we have had a mass organizing component – a survey, postcards, a petition, a call-your-legislators campaign – in which we asked large numbers of people to participate in the campaign in a small but tangible way. In addition to generating pressure on legislators, these mass campaigns keep us constantly talking to the “unorganized,” they provide a simple way for people not only to support the campaign but to feel like they have contributed to it, and they provide opportunities for emerging leaders to develop organizing skills, for instance by asking a few friends or family members to sign a petition or make calls.

2. A Struggle over Values. Using the human rights framework and keeping the actual experiences of working-class people with the healthcare system central to our campaign has kept us connected to our base at the level of values about what they hold most dear: their children, parents, spouses and partners, and their own bodies. Framing the healthcare struggle as part of a broader movement for social justice has kept us connected to allies in other movements, working on other fronts of the struggle.

3. Real Leadership Development. One of the biggest barriers to building movements for fundamental social change is the belief that change comes only through elections, or comes only through “practical” single-issue campaigns, or – most commonly – is not possible at all. Developing leaders who understand and consciously work to undo these ideas, and address the underlying systems of patriarchy, white supremacy and capitalism that produce them – is one of the most pressing tasks for our movement. The HCHR campaign has addressed this need both through popular education workshops and “solidarity schools” for our members, but also through being flexible enough in our strategies and tactics to be open to the creativity and initiative of our members, helping them to see themselves as protagonists of the struggle, not just obedient foot soldiers.

The importance of all of these was made abundantly clear at the very end of the legislative session, when the State Senate – by a large majority – added an amendment to the healthcare bill explicitly excluding undocumented workers from coverage. We had a choice: we could risk derailing the whole bill by raising opposition to the anti-immigrant amendment, or we could abandon the principle of universality in the name of “pragmatism.”

Fortunately, we had built the kind of movement that allowed us to make the first choice, and to win. From years of leadership development work – including explicit anti-racist education – our grassroots leaders in this overwhelmingly white state understood why this amendment had to be opposed. We could point to the Human Rights Principles we had campaigned on, to make the case that this amendment violated principles of universality and equity. We had the ability to turn out masses of people for a May Day rally that truly addressed both healthcare and immigrants’ rights. In the conference committee, the amendment was struck from the final bill.

The bill signed this May is not a single-payer system – though it does commit the state to moving towards one by 2017. Key questions about funding mechanisms and the scope of benefits will be fought out in future legislative sessions, and corporate interests will no doubt pour hundreds of thousands, if not millions, of dollars into the state to defeat real healthcare reform.

The Workers’ Center is under no illusion that this will be an easy struggle, but we believe that we are on the right path, and we look forward to working with allies in other states and fighting on other fronts of struggle, so that more of our movement can go on the offensive towards winning the world we wish to see.

The struggle for healthcare at the state and national levels: Vermont as a catalyst for national change

For more than two years, the Vermont Workers’ Center, a community-based workers’ rights organization, has been leading a statewide campaign to implement a universal and equitable healthcare system in the state of Vermont, the Healthcare Is a Human Right Campaign. This campaign won legislation in the 2010 legislative session which commits the state to implementing a new healthcare system which meets the human rights principles of universality, equity, accountability, transparency and participation. Dr. William Hsiao, who designed Taiwan’s single-payer system, is designing three options for the state, one of which will be a single-payer system and all of which must meet the human rights principles. While there are many struggles ahead to make sure that the state chooses and implements a new plan that actually meets human rights principles, Vermont is certainly headed in the right direction.

The contrast with the national situation is stark, especially in light of last week’s election results. The 2008 election of Barack Obama as President and majorities for the Democratic Party in both houses of Congress opened up the possibility for national healthcare reform for the first time since Bill Clinton’s disastrous attempts in the early 90s. However, Obama followed much the same script as Clinton, refusing to stand up to the insurance companies, putting forward proposals that would protect the insurance companies’ profits, and yet still being ruthlessly attacked by these same companies and their allies in both parties. While Obama did finally succeed in passing a bill, it is based on retaining and consolidating a market-based system and will not solve our healthcare crisis. Obama’s and the Democrats’ poor performance in the political battle over healthcare contributed mightily to resurrecting the Republican Party, which regained control of the House of Representatives in part on a promise to repeal or de-fund the legislation. In contrast, Vermont elected a new, Democratic governor who campaigned on a platform of support for single payer — a political stance made possible and popular in large part because of the Healthcare Is a Human Right campaign.

In this situation, how do we best struggle for the right to healthcare, and the right to health more generally? At the US Social Forum in Detroit in June, Vermont Workers’ Center members got a chance to participate in several workshops, exchanges and People’s Movement Assemblies around these questions, and it has prompted us to think more about how our efforts within Vermont can best contribute to building a national movement.

In Vermont, there are several strong networks of single-payer and healthcare reform advocates, as well as a high-profile and popular politician — former U.S. Congressman and current U.S. Senator Bernie Sanders — who regularly talks about the importance of single-payer. Their work over the past decade or more laid important ground-work for this current victory. However, what the Vermont Workers’ Center has brought to the struggle, and what we believe has contributed to moving the struggle forward dramatically in the past two years, is an organizing practice based on the understanding that the struggle for universal healthcare cannot be separate from building a social movement — i.e., it must engage the people most affected by the problem on a mass level, and be animated by a vision of a better, more equal society.

This practice can be viewed through two of our slogans — the title of the campaign itself, “Healthcare Is a Human Right,” and our frequent reference to “changing what is politically possible.” The first reflects our practice of engaging in ideological struggle — waging the “battle of ideas” (or, more accurately, “values”), and the second reflects our explicitness about power, and changing power relationships by doing mass organizing among the people affected by our healthcare system. We believe that both of these are key components of a successful healthcare struggle.

Ideological Struggle: Using the Human Rights Framework

When we began organizing in 2008, we opened each organizing conversation with a new person with the question: “Do you believe healthcare is a human right?” Over 95% of the thousands of Vermonters we have spoken with agreed, and this is the basic point of unity on which our campaign is built. With the assistance of the National Economic and Social Rights Initiative (NESRI), we have further developed this basic claim into five human rights principles for healthcare: universality, equity, accountability, transparency and participation.

Using the human rights framework allows us to start by connecting with people around a basic shared value, one which is deeply intertwined with what they hold most dear: their children, parents, spouses and partners, and their own bodies. It connects the very personal to a broader set of values — values such as caring, community, and social solidarity — that are often in contradiction with existing institutions and social relationships. The human rights framework allows people to develop a political understanding of their personal experiences with the healthcare system. This political understanding then allows them to make judgements, and take action, based on a vision of a better society rather than the artificial constraints of what politicians and pundits consider “politically possible.”

The human rights framework also encourages movement-building discussions of how healthcare intersects with other issues such as domestic violence, racism, immigration, war, privatization and attacks on the public sector. Building a shared commitment to human rights around healthcare gives us a chance to move people on other issues when the hegemonic ideologies they have absorbed from the dominant culture (racism, sexism, individualism and consumerism, etc.) come into conflict with the human rights framework.

Building Power: Mass Organizing Campaigns

The Healthcare Is a Human Right campaign has used a wide variety of tactics, beginning with those drawn from human rights strategies such as documenting people’s experiences of human rights violations and holding human rights hearings, and, as the campaign got to the point of moving legislation, including traditional lobbying and accountability sessions with legislators.

These activities have always been backed by our ability to engage and mobilize hundreds and eventually thousands of people. Our mass organizing campaigns — collecting surveys, postcards, and petition signatures — have directly engaged over seven thousand Vermonters (more than 1% of the state’s population), and indirectly engaged a far wider part of the population through a variety of successful, grassroots-driven media strategies.

A mass organizing campaign is more than just using a “mass” tactic such as a petition or survey. Especially in the internet age, it is easy to collect a large number of signatures without really having one-on-one organizing conversations — the kind of conversations that build relationships, engage people in a discussion about values, and move them to become more active and engaged. Our mass campaigns are always built around the premise that the survey, postcard or petition is a tool that allows us to have those conversations, to engage each person who takes the survey or signs the petition in the “ideological struggle” for healthcare as a human right.

Mass organizing campaigns are useful not only for building numbers, they are also important tools for building leadership. The strength of our regional organizing committees around the state is that they are composed of people who have emerged from and carry out mass organizing campaigns — they are regularly talking to other people in their communities and workplaces, and moving those people to action.

Engaging in mass organizing campaigns means that we are, on a fairly regular basis, asking thousands of people to make a decision, based on their values, to participate in a political struggle. We are expanding people’s experience of “politics” beyond elections, online petitions and polite lobbying of legislators — the “low-intensity” democracy that is taught in high school civics classes. To overcome this traditional understanding, we are having lots of patient conversations with new members about not only the healthcare system, but also the nature of power, how social change really happens, and what it means to build a social movement.

The Role of Single-Payer Reforms in the Broader Struggle for Social Justice

The goal of our campaign is to enact a single-payer system in the state of Vermont, and we are not shy about stating that. However, we rarely emphasize it in organizing conversations, because our vision is much broader — social and economic justice for all. A single payer system is a reform that is necessary, but not sufficient, for realizing that vision.

We also understand healthcare reform to be a strategic opportunity in the struggle for social and economic justice, an opportunity to win a significant reform that can further the broader struggle. The healthcare system has become so dysfunctional that some sectors of the elite will accept the relatively radical reform of socializing the financing of healthcare in ways that it is hard to imagine happening with, say, housing. This division among elites, combined with the fact that single-payer will actually save money, makes it far more winnable in the current political context than any other struggle to establish human needs as public goods rather than commodities.

We are, however, clear that it matters how we win this struggle. Unlike some other single-payer advocates in Vermont, we are not promoting single-payer as “the most fiscally conservative solution” to the healthcare crisis. This is precisely the kind of slogan that, while seemingly pragmatic, actually reinforces the overall ideology of our opponents (small government, low taxes, etc.), and thereby undermines other struggles, such as struggles against cutbacks in the public sector and the looming struggle to prevent Social Security and Medicare from being gutted and/or privatized in the name of “fiscal responsibility.”

Single-payer in One State and the National Struggle

Proponents of struggling for single-payer on the state level, including us, frequently point to the Canadian example, where Medicare (the Canadian single-payer system) was first enacted in the province of Saskatchewan and later spread nationwide. However, what is frequently forgotten (or not known) about that history is that, immediately following the passage of single-payer in Saskatchewan, the province’s doctors refused to treat patients under the new system. The “Saskatchewan Doctor’s Strike” (though in reality more of a lockout of patients) lasted for 23 days; the healthcare reform was only saved because progressive physicians from across Canada, as well as from the U.S. and Great Britain, came to the province to help break the “strike.”

Changes in the healthcare system in the past half-century have vastly reduced doctors’ opposition to single-payer; however, new, more formidable opponents have appeared — a highly consolidated for-profit insurance industry and the vast pharmaceutical industry. Therefore, we believe that we cannot succeed in one state without the support of a national movement, one that is strong enough to take a victory in Vermont and spread it throughout the country.

In the 2011 legislative session, the Vermont state legislature will have the opportunity to enact a fully-designed single-payer healthcare system. Getting them to do it, however, will be a massive and intense struggle. We fully expect that there will be national insurance and pharmaceutical industry resources deployed against the effort, especially now that the federal healthcare debate is over. The insurance companies and other corporate interests are not going to see this as a local struggle, and leave their Vermont counterparts to fend for themselves. Therefore, we desperately need the national movement for healthcare for all to also view this struggle in Vermont as a national struggle.

Specifically, for our struggle to succeed, we need:

  1. Taking the offensive in other states. If the national insurance companies can concentrate all of their resources on Vermont, we face a much more unequal battle than if they are also dealing with serious offensives in other states. It is crucial that we not let the defeat on the federal level immobilize us, especially in those states that have a real chance to move single-payer legislation. Vermont is committed to providing whatever assistance we can to efforts in other states.
  2. Given that state governments will be mandated to create “exchanges” by the new federal legislation, there is also both an opportunity and a need to press state governments to make a realistic assessment of their state’s healthcare needs. In places where the movement is not yet strong enough to make a serious attempt to pass single payer legislation, study bills similar to the one passed in Vermont in 2010 could be an achievable goal.
  3. A national strategy of ideological struggle and mass organizing. While we recognize that passing state-level legislation is not immediately possible in every state, we believe that a unified effort across the country to engage in ideological struggle, combined with a unified mass campaign, would go a long way to aid state-level efforts, provide a context for the important work of critically evaluating the actual effects of the federal legislation, and rebuild our capacity as a national movement in the wake of the division and confusion that have resulted from the struggle over the federal healthcare bill.
  4. Resources. Finally, we of course need money to be able to pay our organizers. Much of the campaign is volunteer-driven, and we have run this campaign so far on a shoe-string budget, but as more and more Vermonters get excited and get involved, we need to have staff to be able to support these volunteer organizing committees.

Ideological Struggle: We need, as a national movement, to have an ideological framework, a set of concisely stated shared values. No matter how much we agitate for “single-payer” or “Medicare for All” or “HR 676,” our opponent’s values-based appeals to “liberty” and “freedom” are going to be more compelling for far too many people. The Right has spent the last half-century carefully constructing a narrative about government encroaching upon people’s freedoms — a narrative that appeals to many people’s values of individual liberty and their experiences of frustration with government bureaucracy. We must construct a counter-narrative which speaks to people’s values of caring and community, as well as their experiences with the healthcare system, and corporate power more generally. We believe that the human rights framework offers the best and most strategic option for countering the Right’s current ideological offensive, as well as their longer-term ideological dominance.

Mass Organizing Campaign: Our movement also needs to be getting out and talking to more people. It is not enough to be right, to have a good narrative and ideological framework, or even to have polling data that show that the majority of people support our position. We need to be engaging more people in one-on-one organizing conversations — that is the only way we will build to the scale necessary. Doing something together, as a national movement, would be a way for smaller local groups or chapters of national networks to do work within their current capacity, but still contributing to a real “mass” organizing campaign.

We believe that the national movement for healthcare needs to have a frank discussion about these issues, one that can lead to unity around a strategic plan of action incorporating both of these elements. An option that we have been exploring with our partner organization NESRI would be to submit a large number of individual complaints about the U.S. healthcare system, developed from a mass survey campaign, to the UN Special Rapporteur on the Right to Health. An effort like this, locally organized but nationally coordinated, could offer an opportunity to engage in ideological struggle, to amplify the voices of those most affected by the healthcare crisis, and to build relationships with the leaders of various communities and constituencies that are currently under-represented in our movement. This strategy has the advantage of being scalable (i.e., smaller local organizations could simply collect some surveys, while larger ones could organize human rights hearings, etc.), and it could also be combined with the work of assessing the actual effects of the new federal legislation.

We submit these requests for support and proposals for action to the national movement, knowing full well that we lack the resources necessary to coordinate any national action, as we are a small organization and will shortly be engaged in such sharp struggle on the ground in Vermont. Nonetheless, we want to share our thoughts and experiences with the national movement, because we fully believe that when we win in Vermont, it can serve as a catalyst for pushing forward the national movement, not only for single-payer, but for health and justice for all people.

The Vermont Workers’ Center: Movement Building Through Healthcare Organizing

It’s a dark night in January and the chambers of the Vermont state legislature are filled with a sea of red. Hundreds of Vermonters, many of them wearing the red t-shirts of the Vermont Workers’ Center’s Healthcare Is a Human Right campaign, have driven in from all corners of the state to attend a joint hearing held by the Senate Health & Welfare Committee and House Committee on Healthcare. The hearing, at the opening of the 2010 legislative session, is to consider two bills that would establish a universal, single-payer healthcare system in the state — bills that, as recently as a year ago, few felt had any chance of passage. With a clear strategic vision, a movement-building approach and a ton of grassroots organizing, the Healthcare is a Human Right (HCisHR) campaign has mobilized thousands of Vermonters around a vision of healthcare for people, not for profit, and has therefore succeeded in changing what was considered “politically possible.”

Campaign Origins

The Vermont Workers’ Center/Jobs with Justice was founded in 1998 by a group of low-wage workers, to fight for “an economically just and democratic Vermont in which all residents have living wages, decent health care, childcare, housing and transportation.” Over the first decade we engaged primarily in struggles around livable wages, workers’ rights and the right to organize. The number one issue we kept hearing about — from callers to our workers’ rights hotline, from low-wage workers struggling for a livable wage, from nurses and other healthcare workers organizing unions to have a voice to speak out for patient care — was the dysfunctional healthcare system.

At the same time as it was becoming increasingly clear that we needed to take on the healthcare system, we began to understand the need to connect to national and international movements and develop deeper political analysis among our leadership. In 2001, the Workers’ Center affiliated with the national workers’-rights network Jobs With Justice, and in 2005, we joined Grassroots Global Justice, an alliance of grassroots organizations based in working-class communities, communities of color and Indigenous peoples.

Members of the VWC attended the World Social Forum in 2002 and 2006, and we sent a dozen folks to the first US Social Forum in Atlanta in 2007. Learning from the other organizations we got to know through these networks and forums, we developed and launched a popular education program in the winter of 2007, a three-day “Solidarity School” that has since become an annual event. Solidarity School covers hands-on organizing skills, strategic thinking, people’s history and in-depth analysis of capitalism, patriarchy and white supremacy.

At our 10th anniversary celebration dinner in April 2008, we announced the Healthcare Is a Human Right campaign. Rather than a legislative campaign to win a single-payer bill, we were clear that this was a campaign about building people’s power. We consciously framed the campaign as a human rights campaign, rather than a campaign for single-payer legislation, to encourage movement-building discussions of how healthcare intersects with other issues such as domestic violence, racism, immigration, privatization and attacks on the public sector.

Our campaign plan for the first year avoided anything related to the legislature. Instead it focused on base-building in local communities, elevating the voices of those most affected by the healthcare system through surveys and public hearings, leadership development, and the direct action of calling in sick on May 1st of last year, for a massive rally at the statehouse while it was in session.

Eyes on the Prize

One of the tools used by corporate power to manage dissent is indoctrinating people with the belief that social change comes through elections and polite lobbying of legislators — the “low-intensity” democracy that is taught in high school civics classes. As we began to talk to people about fixing the healthcare system, the immediate reaction of a lot of people was shaped by this assumption, that we simply needed to talk to our legislators.

Maintaining a clear focus on our campaign goals — building a movement that is strong enough to compel the legislature to adopt legislation that meets human-rights standards — as we built organizing committees in communities around the state required lots of patient conversations new members about the nature of power, how social change really happens, and what it means to build a social movement. Few people — especially working-class people in rural Vermont — have been exposed to this way of thinking about politics. In addition to building this kind of education into our organizing conversations, we brought HCisHR leaders to Solidarity School and developed a one-day popular education workshop specifically for the campaign, which we held around the state.

We also connected the HCisHR campaign to broader campaigns and movement-building opportunities. Recognizing that a failure to address racism and white privilege has been a key weakness of many progressive movements in the US, we brought the Catalyst Project to facilitate a series of anti-racism workshops around the state in the fall of 2008.

In December of 2008, we organized the Ella Baker Human Rights Conference at the University of Vermont. Working with allies from the labor, student, anti-war, women’s, LGBTQ, anti-racism, anti-domestic violence, immigrants’ rights, indigenous, disability rights and other movements, we brought 500 people together on an icy winter’s day for workshops on a wide variety of topics. We heard keynote speeches from VWC allies Senator Bernie Sanders, Ai-jen Poo of Domestic Workers United and Ashaki Binta of Black Workers for Justice and the United Electrical Workers (UE).

From May Day to the 2010 US Social Forum

Our patient work paid off. On May 1st, over a thousand people descended on the state capitol in the largest weekday rally in Vermont in recent memory. In the fall, seasoned local organizing committees held ten “people’s forums” around the state which, unlike what many legislators were used to, were not platforms for the legislators to explain themselves but forums for the people to explain their experiences with the system and their demands for change. At the opening of the legislative session we delivered over 4,000 postcards demanding that the legislature take action in 2010 by passing the single-payer bills, and within the first week joint hearings were held on those bills.  We have launched an ambitious 16-week plan to increase pressuem which will culminate in a mass rally on May 1st of this year. The action is scheduled for May Day in order to connect the struggle for healthcare with the history of working-class struggles — from the struggle for the 8-hour work day in the 1880s to the worker-led struggle for immigrant rights that reclaimed May Day in 2006.

We also see the second US Social Forum in Detroit this June, as a key part of our campaign. It is the most important space for national movement-building, cross-sector exchange and connecting with international movements, and our campaign would not have been possible without the social forum process and the lessons we have learned and relationships we have built with Jobs with Justice and Grassroots Global Justice. We hope to bring a bus full of our members and allies from Vermont and are looking forward to sharing our experiences and continuing to learn from the experiences of others.

The Vermont Workers’ Center chose healthcare as our major campaign not only because it is an issue that affects all sectors of the working class, but because it offers an opportunity to engage people in a discussion about social values and a vision for a different society. Too often, we let our policy work be restricted to what is “politically possible,” our mass grassroots organizing be restricted by our policy work, and our visionary work — movement-building and political education — be restricted to abstract discussions, and not brought to policy work or mass organizing.  Since all these areas of work are necessary, we offer our experiences — with its mistakes and weaknesses as well as its victories and strengths — as our contribution to building a movement for a more just society.

This was originally written for Left Turn magazine, and was published in their March/April 2010 issue.  A version of this was also published in Labor Notes.

Taking on the Right over Healthcare Reform: Lessons from Vermont

On Saturday, August 15, hundreds of people converged on a U.S. Senator’s Town Hall meeting in Rutland, Vermont, with healthcare reform on their minds.  Despite the fact that Rutland had seen a 200-person-strong “Tea Party” rally less than two months before, and that various right-wing radio stations has been ceaselessly promoting the event for weeks, this event turned out very differently from town hall meetings held elsewhere in the country in recent weeks, where Democratic representatives and senators were largely cowed by large, well-organized and disruptive crowds.  Instead, the audience, physical space, and media coverage of this town meeting, and a similar one held later in the day in the town of Arlington, were dominated by the red placards and t-shirts of the “Healthcare Is a Human Right” campaign of the Vermont Workers’ Center/Jobs with Justice.

Anti-reform speakers got their share of time at the microphone but were unable to be disruptive because of the large Workers’ Center mobilization, and Independent Senator Bernie Sanders — a long-time supporter of a single-payer, national healthcare plan — remained in control of the room, challenging the lies, disinformation, and contradictions that came from some of the right-wing speakers.

Media reports attributed the lack of disruption to Vermont’s tradition of civility during debates at annual town meetings.  While this, along with the relative weakness of Vermont’s right wing, no doubt was a contributing factor, the real reason was good old-fashioned grassroots organizing: dozens of volunteers making hundreds of calls to a base built over more than a year of the Healthcare Is a Human Right campaign.

The Vermont Workers’ Center/JwJ believes that there are important lessons to be learned from our success in turning back the right wing.

Putting Policy Reforms in the Context of a Values-based Campaign

Since the Workers’ Center launched the Healthcare Is a Human Right Campaign in April of 2008, we have begun our organizing with each new person with the question: “Do you believe healthcare is a human right?”  Over 95% of the thousands of Vermonters we have spoken with agreed, and this is the basic point of unity on which our campaign is built.  While we have promoted single-payer bills in the state legislature as the best option to achieve recognition of this right, basing the campaign on a commitment to this basic value has allowed us to build a larger and more engaged base than a policy-based campaign could have.  Furthermore, it provided a certain amount of inoculation against the disinformation and scare-mongering of the right.  While many, if not most, of the people we turned out to the town hall meetings may not have understood the ins and outs of “public options” and other policy issues, they were committed to the notion that healthcare is a human right and understood the talk of “death panels” and such as a right-wing campaign against that right.

Understanding That This Is a Struggle over Power, Not a Debate over Policy

Throughout our campaign, we have been clear with our base that winning real healthcare reform will require serious struggle from the grassroots, regardless of how many Democrats get elected.  While our campaign is focused on state legislation, we mobilized our base for these town hall meetings with the message that this was a critical battle with an opposition that has access to friendly media and unlimited resources from the insurance companies.

Placing the Voices of People Most Affected Front and Center

A central part of the Healthcare Is a Human Right Campaign has been raising the voices of those most affected by the healthcare crisis.  At Human Rights Hearings held around the state in the fall and winter, a wide spectrum of Vermonters — from union members with “good” health insurance who had been denied care, to uninsured loggers who live with daily fear of accidents, to women who stayed with abusive husbands out of fear of losing health insurance — shared their stories about the broken healthcare system.  We collected this testimony, as well as results from our survey of over 1,400 Vermonters, in a report and video “Voices of the Vermont Healthcare Crisis.”  In the town hall meetings, this kind of powerful personal testimony stood in sharp contrast to the shrill rhetoric of the right wing.

Leadership Development

Too often, campaigns are so focused on winning policy goals that we neglect to develop the skills and leadership potential of the people who we are organizing.  During the course of the Healthcare Is a Human Right Campaign, the VWC held daylong organizer trainings around the state, and also brought campaign leaders to our 3-day intensive leadership development program, “Solidarity School,” held every winter.  Both the workshops and the Solidarity School are based on the participatory principles of popular education that build from people’s own experience.  As a result, at the town hall meetings campaign leaders were prepared to speak up, explain the goals of our campaign and why they got involved, especially the powerful voices from people who have suffered under the current system and nurses who see needless suffering everyday.

Taking on Right-wing Beliefs about Government

Finally, it was important that the senator who had called this town meeting — Bernie Sanders, a self-described “democratic socialist” — was willing to defend not only Obama’s proposed reforms, but also the role of government itself.  Instead of defensively trying to clarify that the Obama reforms are neither the single-payer system nor government-run healthcare that the right wing calls them, Sanders challenged the audience on these points, asking how many people would want to get rid of Medicare, “a single-payer system” or the Veterans’ Administration, a system of “government-run healthcare” (only a few people raised their hands).

The Vermont Workers’ Center/JwJ chose healthcare as our major campaign not only because it is an issue that affects all sectors of the working class, but also because it offered an opportunity to engage people in a discussion about social values and a vision for a different society.  We don’t believe that progressive forces can win policy debates if we accept the values framework of neoliberal capitalism that markets are inherently more efficient than government and that individuals are on their own to provide for their own welfare.  By challenging these values with a vision of a caring society, in which communities take collective responsibility for the general welfare, we hope to contribute to building a movement than can win universal healthcare and a just society.

Originally published at MRzine and the Jobs with Justice blog.  A shorter version also appeared on Organizing Upgrade.