Here’s a smart piece by Jeff Cohen that says the netroots and liberal campaigners for health care this summer have made a huge mistake by pushing for a public option instead of going all out for Medicare for All. If everyone who wants universal health care pushed for Medicare for All, maybe we would come out of it at least with a decent public option. If we all just push for a decent public option, maybe we’ll come out of it with a toothless public option or no public option at all.

Had liberal groups sent out millions of emails building a movement that posed an existential threat to the health insurance industry, Senator Baucus and Blue Dog Democrats and their corporate health care patrons might well be on their knees begging for a comprehensive public option – to avert the threat of full-blown Medicare for All.

The article was written two weeks ago but is still totally on the money and is worth highlighting today, the first day of the Netroots Nation conference in Pittsburgh. (My colleague and co-creator of Tikkun Daily, Alana Price, is representing us there) .

So what might Cohen be missing from Tikkun/NSP’s point of view? Only the framing of the whole push. Medicare for All is already much smarter as a name than Single Payer: most people on Medicare, or with relatives and friends who are, appreciate it, and it has ‘care’ in the title. Single Payer is about the financing of healthcare, but what we actually care about is people’s health. It should always be framed that way, every time we talk about it. But a lot more work is needed to bring out the emotions of care behind universal health care if it is ever to get enthusiastice mass support.

The goal here is not to increase the size of government, it’s to cure the sick and enable everyone to have equal care. If private charity actually worked to do that, we wouldn’t need to bring in government. And considering most of our experiences with government bureaucracies (know anyone on unemployment or welfare right now? Are they tearing their hair out like the folks I know?) we’d rather we didn’t have to.

But government services are necessary, since voluntarism hasn’t done it. So along with bringing in government to do the caring, we have to rework government bureaucracies so that people actually feel cared for when they get services. After a huge run-around and totally conflicting advice, not to mention similar horror stories from friends, my wife finally found someone at EDD this year who took care of her unemployment benefits problems: what an incredible find! How thankful we are to that woman in an EDD office who really cares! Give her a promotion, let her run the whole thing! She explained what was wrong at a policy level but was herself unable to change it.

How many netroots or other healthcare campaigners are emphasizing what Michael Lerner calls (e.g. in this excellent editorial in Tikkun) the Subjective Caring side of government services? People on Medicare often do feel cared for: what a relief it is to turn 65 for so many people. That’s why people like it and why it works to talk about Medicare for All. Others have not had such great experiences. But if all government services were known for the quality of the care that the government workers displayed, there would not be half this resistance to expanding them.

This is not primarily a criticism of government workers. Many of them have become cynical in their jobs because there seems to be nothing they can do to make their services more customer-friendly. It’s more a criticism of policy makers and of us, the liberal public. We care so much about all the people who are being driven to the wall and not cared for by the community that we see that government has to do the job. But we have not gone the extra mile to make sure government care feels like care. Is this because we middle class people just want to get shot of the poor and the problem and think we’ve done that once we have set up Objective Caring institutions? Probably so.

So, let’s push for “Putting the Care Back Into Healthcare.” Let’s push for Medicare for All. Let’s prioritize Subjective as well as Objective Caring by government (or by any other service provider, come to that).

To frame healthcare as a right, as many on the secular and spiritual Left do (e.g., a fine piece here on TD by Valerie Elverton-Dixon) is fine in one way: it should be a right. But every single civil right is gained only when others who already have it empathize with those who don’t. Empathy is the other side of struggle and is the deepest force in it. That’s another whole argument, and I made it here on this blog, in my own attempt to explain what the difference is between a spiritual progressive and a secular one. Hint: that difference is NOT about belief in the “supernatural.” Another whole way of explaining it, to get away from the “spiritual/secular” frame which only captures it if you go into long explanations about how “spirituality” and “religious belief” are two different things and often oppposites, is to look at the role of emotion in politics.

The Republicans and the Right use emotion much more effectively than the Democrats and the Left, in general. The Left is full of policy wonks. What could be more wonkish than to sell Care For All in terms of Single Payer? It’s rational. It’s not emotive.

The underlying argument that I have understood from Peter Dunlap and others (and that I would like to understand better) goes something like this. At the time of the Enlightenment liberals went into a hugely rational mode both for its own sake (rational is good) and because the people’s emotions at that time could so easily be swayed by conservative calls to God, Country, Race, Traditional Motherhood, Father Knows Best and so on. As if they can’t today. But then that was everyone’s upbringing. There were two options: to promote an alternative set of emotions that could win out, or to disparage emotion altogether.

The Left of course has often promoted an alternative set of emotions. Often these were empathic (buttons with a chained slave and the words “Am I Not a Man and a Brother?” were everywhere in the early anti-slavery movement). Often they were angry. Sometimes they rather successfully evoked the religious DNA in the culture (“The Broterhood of Man Under the Fatherhood of God” was a 19th century trade union slogan). In fact most of the progressive reforms of the 19th century in the U.S. and Britain were framed in progressive religious language by large sections of the reform movement.

But the anti-religious prejudice of the Left and of rational Enlightenment thinkers gradually took over in the 20th century. So that even while we liberals were getting savvier about our personal emotions through therapy and so on, our policy initiatives were getting more and more rationalistic and less emotive. So rather than framing this as spiritual vs. secular, we can see it as psychologically adept (able to integrate emotion with reason) vs. psychologically dry (afraid of emotion in public advocacy).

Dunlap wrote a fine article explaining this kind of approach in Tikkun. He argues that Obama is psychologically adept, but the liberal/left culture has not caught up with him.

Emotion is not the opposite or the enemy of rationality. Understanding our emotions explains much about our lives to us. Using our emotions appropriately enables us to act and persuade and empathize and generally be social.

Get some emotion going down there in Pittsburgh! Let’s put the care back into health care!!! Have a happy netroots conference, y’all.

P.S. Thanks to Steve Phelps on the NSP-NYC listserve for pointing this piece out. He wrote:

I recommend our NSP-NYC group read Jeff Cohen’s article on errors of strategy and philosophy in progressives’ approach to health care reform. This dovetails powerfully with Rabbi Lerner’s arguments that *spiritual* progressives must continually aim as high as possible, in moral terms — and make necessary compromises later, when necessary.

P.P.S. Guess I should have said something about the other religious progressives today.  Jim Wallis, PICO, Rabbi David Saperstein of Reform Judaism, Faith in Public Life and others are making a big push for universal health care right now, and all power to their elbows. But they aren’t even pushing for a public option, let alone Medicare for All! They want to stay in communion with the great religious middle and edge it slowly to the left. They are very good on talking about their congregants and others who are dying or going bankrupt through lack of health insurance. They are trying to be prophetic, but it’s milk and water prophesy from where we stand. And they are making a big deal about the health legislation needing to be abortion-neutral. My description here, and lament about Saperstein here, and Rabbi Lerner’s take here on why he signed a weak statement with other religious leaders.