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Roberta Crawford, 87, wears a sticker on her head showing her support for a single payer health care system during a forum at the South County Civic Center August 20, 2009 in Delray Beach, Florida. (Photo: Joe Raedle/Getty Images)

5 Reasons We Need a National Organization to Energize the Fight for Single Payer

Health care is a national crisis that requires a national solution.

Now is the time.

1. There is a need for a national group of grassroots activists advocating, mobilizing, and organizing exclusively for national single payer.

In the early days of 2021, when it became clear no member of Congress would champion the cause of Medicare for All, a group of long-time health care activists, unionists, grassroots organizers, and progressives met to discuss the need for a national organization to unite activists across the country and rally the movement for national single payer health care free from corporate profits. The activists were frustrated. After all, the Democrats held power in the House, in the Senate, and in the Executive Branch, and yet, there was no enthusiasm for improved and expanded Medicare for All. 

There is no incremental reform that can ease the nation step by step into a removal of the corporate insurance industry from health care.

2. There is no bill in Congress that promotes national single payer free from corporate profits.

Any bill for a national health program must start with non-negotiable principles grounded on the belief that health care is a human right and that the system must be public, universal, comprehensive, sustainable, accessible and free at the point-of-care, high quality and evidence-based with equal outcomes, gender-affirming, anti-racist, respectful of dignity, equitable, and free from corporate profit. The Medicare for All bills in the House and in the Senate fulfill many of these principles, but both allow corporate facilities to operate and generate profits, diverting funds from health care to corporations. Commercial insurance companies run clinics and own physician practices. Private equity firms own and staff specialty and primary care clinics and emergency departments. There is no mechanism in either bill to convert these profit-driven facilities to non-profit status through buyouts, which would be economically feasible according to a recent analysis.

3. National single payer must be "national" not "state" not "incremental."

In the last 15 years, a plethora of groups has sprung up across the country, organizing for state-based "single payer." No state can obtain enough funds to establish a single payer plan without federal funds, and unlike the federal government, states must balance their budgets, forcing them to sacrifice health during lean years. States’ rights, as a concept, have never moved the U.S. forward, and, in many instances, have promoted racial injustice. Health care is a national crisis that requires a national solution.

The public option, improving Medicare but maintaining the stranglehold of commercial insurers in Medicare Advantage or encouraging investor-owned Direct Contracting Entities or ACO-REACH in Traditional Medicare are all incompatible with single payer. There is no incremental reform that can ease the nation step by step into a removal of the corporate insurance industry from health care.  Private insurance and corporate profits must be removed from the system through national legislation.  

Our system of no-system is irreparably broken and must be replaced with a national, single payer, public program that claims health care is a human right and is free from all corporate profits.

4. No national organization is opening the discussion of a National Health Service

As the most prominent health policy proponents of single payer wrote recently, while we urgently need single payer reform, "the accelerating corporate transformation of U.S. health care delivery complicates this vision." The idea of public payments flowing from a single payer to independent practitioners and non-profit hospitals, so popular in the 1960s and 70s, when many high-income countries developed their own universal health care systems, is outdated and must be reconsidered. Wall Street is busy buying up doctors, hospitals, and other health care facilities, where profit, not health care, becomes the principal aim. Do we want our single payer payments to flow to these players? Who should own our health care assets? People or corporations? These questions demand an honest discussion.

5. This is our crisis moment

The Covid-19 pandemic has laid bare the inequities, inefficiencies, and indifference of our health care system. This is our crisis momen—when individuals from all social justice organizations must unite under a broad people's movement that demands a national health system. We cannot leave health care, or any human right, to the whim of states, just like Medicaid expansion, which leaves millions of poor people out, just like abortion rights, which jeopardizes the lives of women, and voting rights, which threatens our democracy. 

Our system of no-system is irreparably broken and must be replaced with a national, single payer, public program that claims health care is a human right and is free from all corporate profits. National Single Payer (@NSPhealthcare) is the organization fighting for health care justice for all.

National Single Payer Health Care Declaration

We believe health care is a human right.
We demand the elimination of corporate profit-making from the health care system.
We reject a health care system based on racism.
We recognize the struggle for health care justice champions all social justice movements.
We oppose incremental reforms.We maintain national single payer is non-partisan.

For more information please see National Single Payer Webinars, Publications, and Interviews.

Our work is licensed under Creative Commons (CC BY-NC-ND 3.0). Feel free to republish and share widely.
Dr. Judy Albert

Judy Albert

Dr. Judy Albert is a retired reproductive endocrinologist and medical director of the Reproductive Health Specialists. Her experience includes practicing and teaching at the Hospital of the University of Pennsylvania and at the University of Pittsburgh Medical Center’s Magee-Womens Hospital, where she served as medical director of the in-vitro fertilization program and as a medical executive committee member. She is a founding member of the Physicians for a National Health Program Pittsburgh chapter and sits on the Board of Physicians for a National Health Program.


Claire M. Cohen

Claire M. Cohen is a child psychiatrist in Pittsburgh, PA who is a member of National Single Payer, PNHP and the Western PA Coalition for Single Payer Healthcare. You can contact her at

Sandra Fox

Sandra Fox

Sandra Fox is a psychiatric social worker who has worked in Pittsburgh and rural West Virginia during her 40 year career in health care.  She was a co-founder of the Western PA Coalition for Single Payer Healthcare and is currently on the steering committee of National Single Payer.

Edwarfd Grystar

Ed Grystar

Ed Grystar has decades of experience organizing and negotiating contracts for healthcare employees. He is co-founder and current chair of the Western Pennsylvania Coalition for Single Payer Healthcare. Served as the President of the Butler County (PA) United Labor Council for 15 years. 

Ana Malinow

Dr. Ana Malinow has  spent her career taking care of undocumented, refugee, and poor children in Cleveland, Houston and Pittsburgh before moving to San Francisco, where she is currently practicing as a general pediatrician. She is past President of Physicians for a National Health Program (PNHP), an organization of 20,000 health care providers that support single payer national health care.

Kay Tillow

Kay Tillow is the coordinator of the All Unions Committee for Single Payer Health Care, which builds union support for national single payer health care. She lives in Louisville, Kentucky.

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