Theories of Change

In case the point gets lost in the discussion of the many, many problems with Dore’s idea and with his denunciations of AOC for not signing onto it, it’s worth emphasizing that a point of agreement between all sides in this intra-left debate is that it makes perfect sense to center Medicare for All right now. Out of all of the social-democratic demands popularized by Bernie and the Squad, Medicare for All has the broadest public support. And the movement definitely has an opportunity during the COVID-19 crisis to solidify some of that support and use it to politically differentiate ourselves from liberals. The pandemic has been in effect a giant PSA about the evils of the existing system of private and mostly employer-linked health insurance.

As such, the core of the Dore proposal that makes sense is that picking a fight — any fight — with the Democratic leadership that gets people talking about Medicare for All makes sense if only because it would raise public awareness about how the social-democratic faction in the Democratic caucus wants everyone to have health care and the leadership doesn’t. That’s useful in itself.

A single day of news coverage that a floor vote would net isn’t much of a payoff for such a fight, especially since most of that coverage would be about how badly it lost. And while Gray points out that the members of the Squad “are famously adept at making viral moments out of congressional hearing testimony,” it’s likely that the Democratic leadership would allow about fifteen minutes of floor debate and no such viral moments would be forthcoming.

Gray argues that the floor vote tactic couldn’t be ignored by the corporate media if the Squad “were to coordinate with the activists and protesters who helped to organize the historically large mass protests from this summer,” or if their play was backed up by “organized labor” through “the threat of a general strike,” and this is all true enough as far as it goes, but it’s a bit like saying that three people waving around signs in front of a city council meeting couldn’t be ignored if they coordinated with space aliens so that an intergalactic spaceship simultaneously landed on the roof of City Hall.

Even putting aside the fancifulness of thinking that a credible threat of a general strike is in the cards anytime soon in a country with 6.2 percent private-sector unionization and where those unions that do exist are mostly in a deep defensive crouch, the problem is that a political landscape in which there was any chance furious mass protests over the failure of Democratic politicians to support Medicare for All would be one in which a lot of the most important obstacles to Medicare for All becoming law had already been overcome.

But there are more grounded ways that the basic message about which side of the ideological divide within the Democratic Party wants everyone to get health care and which side is standing in the way of that could be sent. A sit-in on the floor of Congress like the one staged by mainstream Democrats over gun control, for example, would be a dramatic piece of political theater that could actually add to the movement’s momentum rather than sending the counterproductive message that Medicare for All doesn’t have a realistic chance of happening anytime soon.

A series of such gestures could both avoid the political costs of sending that message and keep the issue in the public eye far longer than a floor vote that would be over shortly after the new session starts. Unlike hoping for a general strike to materialize in time to back up a floor vote, this kind of thing is well within the realm of short-term political possibility.

Even so, we shouldn’t exaggerate the potential payoff of any of this. Political theater can be a useful educational tool, but it can’t be a substitute for the long, slow, and often dismally unsexy work of organizing and mobilizing citizens at the grass roots and actually winning elections. And a widespread failure to appreciate these distinctions is the biggest problem not only with the fixation of much of the online left on insisting on engaging in a purely symbolic parliamentary maneuver that might well do more harm than good but with Jimmy Dore’s belief that AOC is a “sellout” who is “standing between” her constituents and health care.

This controversy perfectly encapsulates both the powerlessness of a Left arguing about ways to somehow pressure or trick or cajole our thoroughly dominant centrist enemies into helping us accomplish our goals and the dangers of political voluntarism.

During the presidential election, most intra-left debate on electoral strategy seemed to be dominated by the argument between figures like Noam Chomsky who thought it was a good idea to vote for Biden “and then pressure him” and figures like Briahna Joy Gray and her Bad Faith podcast cohost Virgil Texas who thought it made more sense to strategically withhold the Left’s votes in exchange for concessions. On paper, these are polar opposite strategies, but in reality they’re variations on the same idea — that the Left can accomplish its goals not by defeating centrists and achieving power for ourselves but by somehow maneuvering to get centrists to accomplish those goals for us.

The same bad idea underlies the Dore plan — but the difference is that in this case we’re not being asked to try to extract policy concessions but just a procedural concession whose value, if any, would be as symbolic political theater. I have my doubts that a pure reminder of how far Medicare for All is from becoming a legislative reality would be the kind of theater the movement should want, but whatever you make of that issue the larger question is what to make of the disconnect between the extremely limited value that even the supporters of the plan think it would have and the idea that not signing onto this specific plan reveals AOC and other social-democratic politicians as “sellouts” unwilling to fight for Medicare for All.

This is an extreme manifestation of a voluntarist worldview according to which anything is possible regardless of the objective political terrain — so if some good political outcome doesn’t come to pass, we should suspect that leaders who said they wanted it are too institutionally compromised to really want it, or at least aren’t sufficiently committed to fighting for it. This is the ideology of those who thought that Evo Morales was a sellout because Bolivia didn’t expropriate its capitalist class and transform itself into a socialist republic. I also want to end capitalism but a lot more is blocking that goal than insufficient political will by left politicians. The same is true even of goals as modest as Medicare for All.

It’s true enough that there are moments when individual personalities do have an outsize role in shaping the course of history. If Lenin hadn’t returned to Petrograd in 1917, it’s plausible that the Soviet Union never would have come into existence. If a staunchly antiwar president had come into office instead of Barack Obama in 2008, much more of the Bush-era “war on terror” might have been reversed. But the reasonable case that can be made about these examples isn’t an instance of voluntarism because there are deeper structural and institutional factors at play. “Dual power” between the Provisional Government and Soviets of Workers’ Deputies already existed in Russia before Lenin got on his sealed train. Presidents have tremendous, almost emperor-like powers over foreign policy in the American system. A single freshman congresswoman in a caucus dominated by neoliberal centrists has very few chips with which to bargain for anything.

The reason that there is no chance whatsoever of Medicare for All becoming a reality in the coming congressional session isn’t that the few social democrats in that Congress are insufficiently committed. It’s that the insurance industry and the rest of the capitalist class thoroughly dominates the levers of power. There aren’t nearly enough Medicare for All supporters in office for the legislation to have a chance of passing, and despite the widespread popularity of the reform the grassroots movement for it isn’t nearly powerful enough to effectively pressure fence-sitters and overcome inevitable ruling-class resistance.

The good news is that both halves of that situation were much worse just a few years ago. Bernie Sanders’s two campaigns for president played a tremendous role in forcing Medicare for All into the center of debate about health care and grassroots organizing by Democratic Socialists of America, National Nurses United, Physicians for a National Health Program, and others has slowly but effectively built on that. As soft as some of these votes may be, the fact that there are 118 cosponsors in the House is a remarkable victory for a movement that’s been working tirelessly to end the abomination that is the American health care system.

“If barely half of House Democrats are willing to cosponsor Medicare for All even while it has the support of 88 percent of Democratic voters during a global pandemic,” Briahna Joy Gray asks in Current Affairs, “what are the odds the holdouts will be more amenable once the vaccine is distributed and life begins to normalize?” The answer is that they won’t come around in the future with or without any particular symbolic tactic being employed right now. They have to be defeated and replaced. That’s a matter of on-the-ground organizing, candidate recruitment, and so on — none of which will gain any sort of meaningful boost from bringing holdouts “on record” about something which the Democratic establishment could hardly be more “on record” about already.

Gray concludes by arguing that “[a]t the end of the day, the moral case for action requires no strategic justification,” but this is exactly wrong. It’s precisely because achieving Medicare for All is so morally urgent that it’s so important to think carefully about what strategies might actually get us there and which ones are unhelpful diversions.

The Left’s goals can’t be won with procedural tricks or exhorting individual leaders to fight harder. They have to be won by organizing the working class at the base of society and, hand in hand with that, building an electoral left that can, instead of using some dubious “leverage” against centrists for the sake of symbolism, defeat those centrists and take power for itself.

The problem is a political landscape in which a ghoul-like Pelosi could become speaker in the first place, and in which if she was replaced, it would likely be with something worse, not with one of our tiny handful of actual allies in Congress not doing a good enough job of “playing hardball” with Pelosi.

Voluntarism is dangerous for the same reason that it’s dangerous to go swimming in a riptide and tell yourself that you won’t drown if you only paddle hard enough. We need to understand why we’re losing if we ever want to win.