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Did progressives suffer a “set-back” or even a “defeat” in the health care campaign? A progressive “movement” activist from the 1960’s, waking up today, would find this view not simply wrong, but literally incomprehensible. Here’s why

This item by James Vega was first published on March 23, 2010.
In the last days before the HCR bill passed the house last Sunday several influential progressive bloggers put forth a rather startling thesis — that although the health care bill was still worth passing, the compromises that were required to enact it actually made the bill a setback or defeat for progressives rather than a victory. For example:

• Jeff Greenwald in Salon – “…this process highlighted – and worsened – the virtually complete powerlessness of the left and progressives generally in Washington.…no one will ever take progressive threats seriously again in the future”
• Jane Hamsher in Firedoglake- “nobody will take progressives in Congress seriously, nor should they…Whatever Barack Obama wants to do will be the farthest left any piece of legislation gets.”
• McJoan in DailyKos – “Trying to argue that the provisions in this bill signify a progressive victory is from my perspective a negotiating mistake…I’d argue that it’s bad politically and for future policy for progressives to lose sight of the fact that we had some pretty big losses in this one. Who lost? Labor…Women…Latinos.”

To be very clear, unlike some other, more extreme critics, all three of these commentators did indeed agree that the bill needed to be passed and none advocated its rejection. But, as the quotes show, they were also united in the view that the compromises embodied in the final bill made it represent a major defeat for progressives.
A progressive Rip Van Winkle from the social movements of the 60’s, suddenly waking up today, would be profoundly bewildered by this perspective. He or she would not be at all surprised to hear that a progressive reform had been “diluted”, “sold-out” “watered down” or “compromised” in the process of passing a bill in Congress. But what he or she would find utterly baffling were the implicit assumptions that underlay the argument.
1. That it was possible to directly identify the broad progressive campaign for universal and affordable health care with the quality of any one specific piece of legislation.
2. That the major measure of progressive “influence” on the struggle for a social reform like universal and affordable health care could properly be defined as how far an initial bill proposed in Congress could be pushed in a progressive direction, a view that essentially identifies all progressive “influence” with bargaining power inside the halls of Congress.
3. That progressives could reasonably expect to achieve a genuinely significant social reform without having first built a vibrant and genuine grass-roots social movement deeply committed to that reform.
In fact, it would actually take the newly awakened 60’s progressive several re-readings of the various commentaries to fully convince himself that these actually were the implicit assumptions underlying the debate. On all three topics, the 60’s movement progressive would start off with almost directly opposite assumptions.


First, a progressive activist from the 60’s would automatically assume that winning a major social reform like universal and affordable health care would require an active, mobilized mass movement to pressure government from outside. By the mid 60’s, in fact, there was a reasonably well agreed upon multi-step strategy for how to build a mass movement to achieve any significant social reform. In the first phase, dramatic non-violent protests, generally involving civil disobedience or visually compelling symbolic actions would be required to create awareness of the issue. In the second phase, continuing direct actions would be supplemented with efforts at educating the public about the issue — “teach-in’s”, petitions, ads in newspapers, leafleting, door to door canvassing and similar tactics. In the third phase support committees would be established in cities around the country, and then mass rallies would be organized, culminating in one or more marches to Washington. It would only be after a sufficient base of support had been built and momentum for reform generated that the organizers of the movement would actually consider the time ripe for seeking national legislation.
Second, the 60’s progressive activist would assume that once a bill was introduced, there would continue to be an emphatically clear separation between the legislative maneuvering to achieve its passage and the strategy and tactics of the mass movement seeking the long range goal. In the view of almost all the major progressive leaders in the 60’s, the introduction of a bill in Congress was visualized as a response to the pressure of the mass movement and not as the embodiment or goal of the movement itself. The successful passage of a bill in congress was seen as, in effect, a retrospective event – it was a step that codified whatever level of progress had already been achieved by the struggles of the mass movement, not as a force that created the mass movement or the level of progress itself.
Finally, a 60’s progressive activist would not accept that the proper yardstick to measure progressive “influence” should be the extent to which specific progressive demands are incorporated into any specific piece of legislation or executive decision. During the early 1960’s, for example, when the broad goal of a “war on poverty” was originally put forward by leading progressives like John Kenneth Galbraith and Michael Harrington, employment was seen as the central challenge. The 1963 march on Washington had the demands of “jobs and justice” as its twin objectives and the core problems of automation and structural unemployment led American progressives in the labor movement and elsewhere to frequently cite the comprehensive manpower programs of the Swedish labor market board and the German “social market economy” as ways that America could seek to achieve genuine full employment and job and economic security.
The economists in Kennedy’s council of economic advisors, however, argued that comprehensive manpower programs were too disruptive of the “free market” and that an across-the-board tax cut was a much more conservative approach. Their view prevailed, and the only major initiative directly related to employment in Lyndon Johnson’s War on Poverty was the very limited Job Corps program.
This dilution of the original progressive vision in the war on poverty represented an even more substantial “watering down” of an initial progressive initiative than even the removal of the public option from health care reform. But no significant group of progressives in the 60’s argued that the economic stimulus of the 1964 tax cut or programs like the Job Corps represented “set-backs” or “defeats” for progressives because they were less than adequate. When Martin Luther King wrote his third book, Where Do We Go from Here in 1966, he treated these measures not as evidence of the movements’ weakness or failure, but as limited victories and hesitant first steps in a progressive direction.
As a result of these basic assumptions about how movements for social reform succeed, the reawakened 60’s progressive would find the current arguments bewildering. As he studied the evolution of the health care reform campaign more closely, however, he would quickly come to recognize the major source of the differences between his understanding of social change and that of the commentators who interpret the health care bill as a setback or defeat for progressives. He would recognize that the major difference was that the health care reform bill was not driven by the pressure from an independent grass-roots mass social movement over a period of years, but was rather crafted by policy experts in the newly installed Obama administration and supported by quickly mobilized internet-based organizations.
The differences between this kind of campaign for social reform and those of the 60’s is generally obscured because the same terminology is used in both cases – the language of “popular support” and “grass roots organizing”. But there are profound differences between the practical meaning of these terms in the two different cases. The 60’s progressive would note the following:

1. The “grass-roots” character of virtual, internet-based organizations is not same as that of traditional mass movements. MoveOn, Netroots Nation and even Organizing for America, while they most certainly communicate with and coordinate the actions of large groups of people, are not the sociological equivalent of organic mass movements like the trade union or civil rights movements. Rather, they are the modern equivalent of liberal lobbying organizations of the 1960’s like the Americans for Democratic Action whose activism was narrowly focused on congress. Liberal organizations of this kind focus on specific short-term goals and do not create the kind of ongoing long-term commitment and self-sustaining “movement culture” that mass social movements do.
2. There is a vast difference between the kind of “popular support” that is indicated by the replies people offer on public opinion polls and the kind of “popular support” that dynamic mass social movements generate and organize. The fact that 55 or 60% of the respondents on a survey assert their support for a public option in health care does not represent the same kind of support that is signaled by mass attendance at rallies, the signing of petitions, knocking on doors or, as was the case in the civil rights movement, the commitment of hundreds of black ministers and pastors across the south to preach in support of the movement in their sermons every Sunday, week after week, year after year.

The most dramatic illustration of the difference between the two categories of progressive movements can be seen in the fact that the conservative Tea Party movement — although it was clearly undergirded by industry-funded Astroturf organizations like FreedomWatch — actually followed the strategy of 60’s movement organizing much more closely than did the supporters of health care reform. One reason the Tea Party movement so rapidly achieved the level of recognition that it has attained was because there was no comparable Democratic countermobilization at the grass-roots level.
These considerations suggest a very different perspective than the view that the health care bill actually represents a “set-back” or “defeat” for progressives.
First, from this perspective the health care bill is not in any meaningful strategic sense a setback or defeat. It represents the maximum that could be achieved without the active support of an aroused and mobilized mass movement standing behind it. Tactics like threats to vote against legislation and bluffing have only a very limited effect on legislative outcomes. Congressional progressives’ only real and enduring source of “power” in legislative negotiations comes from the size and energy of the organized mass movement that they represent.
Second, from this perspective the loss of the public option cannot reasonably be treated as a congressional “betrayal” of a demand carried to Washington by an active progressive mass movement. Instead, the loss was result of the fact that progressives simply did not have enough time to wage a major, multi-year, nationwide educational campaign to explain to America what the public option was and why it was desirable. It was absolutely no fault of progressives that the sudden opportunity to move a health care reform bill through congress in less than a year did not provide them with time to undertake such a educational campaign, but neither is it reasonable for them to expect that they should have been able to exert the same degree of influence on Congress as if the time had actually been available and a successful educational campaign had actually been carried out.
The essential fact is that electing a Democratic president – one supported by a political campaign with significant elements of a mass social movement — created the hope that there might be a short cut to social progress — one that avoided the slow, difficult battle to build solid and passionate public support for progressive policies and goals. Obama’s election has indeed jump-started a progressive surge, moving progressives much closer to their long-term goals then if they had to start from scratch, but in the process many indispensible intermediate steps have been omitted and ignored.
Further progress now requires going back and doing the hard grass-roots organizing and education that are the foundation of every successful campaign for major social reform. Every single successful and enduring progressive social movement at some point completes these basic tasks of grass-roots organizing and education. Every unsuccessful social movement, on the other hand, grinds to a halt somewhere along the way.

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