From left: Jason, Gumbun and sweaty old me mugging like a doofus

PREFACE
I'm indebted to many sincere and capable people here who put their money where their mouth is when Congress began stumbling over health care reform. Scores of TPM bloggers paid to send Gumbun and me to Washington last week on a mission to rally with other supporters of Single-Payer health care and to lobby lawmakers on Capitol Hill.

Sadly, I must note the passing Monday of Marilyn Clement, founder and National Coordinator of Healthcare Now! -- the group that organized the July 30 rally -- who died after a painful year-long battle with multiple myeloma. My thought are with her family and co-workers.

I won't repeat the substantial rationale for a Single-Payer health care system. Other posts at TPM already argue its case. Instead, my purpose is to pull together the threads of my experience on this trip and to weave a coherent analysis of health care reform's future in the United States. That includes a look at Single Payer, the various Public Options and more. Finally, I will offer my list of imperatives that advocates of progressive reform must implement if they are to gain traction in the health care debate.

The conclusions I have reached are my own, and if my reasoning is found lacking in any way, please do not fault those who sent me on such a noble errand as this trip. I am honored to have gone in their place and on their hard-earned dollars.

PRE-FLIGHT
The rally was billed as a celebration of Medicare's 44th birthday, a chance to impress Congress and the nation with the benefits of adopting "Medicare for All" as the model for a uniquely American system of Single-Payer health care. The rally was set for 1 p.m. Thursday, July 30th in the Upper Senate Park. Lobbying visits to lawmakers were encouraged before and after the rally.

I was looking to share a ride there by car or bus, but got drafted alongside Gumbun with expenses paid courtesy of fellow bloggers. As donations from TPM contributors came in, I began working the phones, the web and my email to build momentum in whatever way I could.

When I learned that the event's principal organizer, an umbrella group called Healthcare Now!, had confirmed a list of important speakers without a single household name among them, I contacted the Screen Actors Guild for help with a "big name" to headline the event. Separately, I spoke with a fellow Missourian, Doug Pitt, who (not unexpectedly) politely declined to act as a go-between for his brother, Brad.

To coordinate my lobbying with other people from my state, I emailed all the other Missourians listed as contacts on the Healthcare Now! web site. I received only one reply, and that from a person who wasn't going to the rally.

On advice from a Missouri labor organizer and four-decade veteran of Single Payer reform, I called a representative of Missourians for Single Payer. When I expressed my shock that her organization -- with "hundreds" of dues-paying members -- was sending a lone individual to the July 30th rally, she got extraordinarily defensive and began attacking me personally. She said her group had planned several local "actions" in Missouri the week of the rally.

I stayed in the loop as much as I could with Katie Robbins of Healthcare Now! and with a rally co-organizer, Mark Dudzic of the Labor Campaign for Single Payer.

In the last days before I boarded my red-eye flight to D.C., I learned several bits of unwelcome news. Actor, activist and SAG board member Elliot Gould called me (me?!) to say he was interested in helping but could not attend the rally due to the start of filming on a movie the day after the rally. Although getting a call from Gould was surprising, I was stunned when both Robbins and Dudzic said they expected attendance at the rally to be only about a thousand people -- an order or two of magnitude less than I'd anticipated. I worried our trip might become a mere boondoggle.

MR. MCCORD GOES TO WASHINGTON
Like Jimmy Stewart in "Mr. Smith Goes to Washington," I made several blunders along the way, but with the help of others invested in my mission, managed to rectify them. I arrived late Tuesday morning at Dulles and checked in that afternoon to my room at the Hotel Harrington, close to Capitol Hill. I spent most of the day on my cell phone, completing my scheduling for lobbying visits and letting the ad hoc "committee" of TPMers in charge of my trip know I had arrived safe and sound, although I had left some of my own spending money at home. Synch, Bwakfat, Jason and others quickly agreed to make up my shortfall.

Wednesday morning, I met the ridiculously helpful Jason Everett Miller in person. He gave me a lift to the D.C. headquarters of the California Nurses Association to pick up a few of the lobbying kits that staffers were still busy assembling. Then he dropped me on Capitol Hill, where I met with a legislative aide for Sen. Kit Bond and later with an aide for Rep. William Lacy Clay.

Late Wednesday afternoon, I purchased a ticket and got a quickie tour of Washington landmarks, stopping at the Washington Monument, Franklin Roosevelt Memorial, Lincoln Memorial and the Wall. That evening, Gumbun arrived very late at the Harrington and went to sleep almost immediately after a frustrating, 16-hour ordeal of flight delays and rerouting, all stemming from hydraulic failure on a jet eventually grounded before she could finally board in California.

THE PITCHING MOUND
To borrow a George Will metaphor, I threw my pitches for Single Payer on Wednesday and Thursday mornings. I had decided to engage my lawmakers' representatives in actual give-and-take conversations rather than simply spouting my position. Here are the legislative aides I met with and my sense of how those meetings went:

• I had arranged a late morning meeting with Julie Jolly, the point-woman on health care policy in Sen. Kit Bond's office. In a perfect Zen moment of irony, predictability or both, she called half an hour before our meeting to say she was sick. Filling in would be Robert C. Skinner, a legislative aide for Bond. He and I had met during my lobbying visit with the HCAN people in late June, when I related in detail my history of suffering under the current health care system. He remembered me, so I kept the focus this time on the moral and economic benefits of Single Payer.

Skinner toed the conservative line of the GOP and rejected any hope for Bond's support of Single Payer. Now understand, Skinner is a pleasant young man with 90210 looks who never blinked at all while I spoke, but who blinked often when it was his turn to answer a question. In fact, he was noticeably uncomfortable because he couldn't articulate very much at all about where Bond stood on health care reform or how the senator would prefer to fix the health care system. At one point, he offered to see if there might be a position paper on file. I left expressing cordial gratitude for the meeting, knowing that Bond has not the slightest interest in nor curiosity about health care reform whatsoever, except when it serves to protect his corporate masters.

• I was lucky to meet with Marvin J. Steel, Jr., the savvy, focused office manager and legislative assistant for Democratic Congressman William Lacy Clay, Jr.

Steel reminded me Clay is a co-sponsor of HR 676 (the House version of Single Payer), and he bluntly assured me Clay would vote "Yes" for Single-Payer when it is brought to the House floor for a vote this year. Speaking honestly, Steele said he could not promise that Clay would vote "No" against a strong Public Option if it were the only way left to achieve reform this year.

(Embarrassing admission: Rep. Clay is not my congressman. Oops. In hastily setting up my lobbying schedule, I was thinking of my previous trip to attend the Health Care for America Now rally in June, which had included a lobbying visit with Clay. My error occurred to me after meeting with Clay's aide Wednesday, and I quickly arranged a visit for Thursday with an aide to my actual congressman, Rep. Russ Carnahan.)

• Thursday morning, I was to meet with Melissa Garza, the legislative aide on healthcare for Democratic Sen. Claire McCaskill. As was the case with Bond's office, I was bumped, this time to Garza's assistant, a legislative aide named Jacqueline K. Stewart. Nonetheless, Stewart seemed attentive, sincere and allowed me an unusual 45 minutes to converse. And unlike Bond's aide, she was knowledgeable about health care and McCaskill's position.

McCaskill favors a strong Public Option over Single Payer. But in conveying my personal story and talking with Stewart, I sensed that she had great sympathy for my point of view and that it would be taken into consideration. She took copious notes. She didn't pull punches. And she was stunned when I said the people I was representing (TPM bloggers and Healthcare Now!) would prefer McCaskill to vote "No" if the final legislation did not include at least a strong government-run Public Option (as opposed to the Finance Committee's co-op plan).

• Jeremy Haldeman, legislative director for Democratic Congressman Russ Carnahan, brought another aide out with him to speak with me. They listened carefully as I explained my health history and responded by saying that Carnahan favors Single Payer but expects the Public Option to be the best achievable plan this year. Again, I got the feeling that what I was saying was being heard and had made some impression that would be taken into consideration.


Tomorrow:
Pics, vids and Part 2: The rally and the future of health care reform advocacy