New book by sociologist examines single-payer healthcare reform

In the new book, sociologist Lindy Hern examines the recent rise of “Medicare for All” in America and in American political discourse.

By Susan Enright

Lindy Hern holds her book entitled, Single Payer Healthcare Reform: Grassroots Mobilization and the Turn Against Establishment Politics in the Medicare for All Movement
Sociologist Lindy Hern holds her new book entitled, Single Payer Healthcare Reform: Grassroots Mobilization and the Turn Against Establishment Politics in the Medicare for All Movement. Courtesy photo.

An associate professor of sociology at the University of Hawai‘i at Hilo has written a book about the “Medicare for All” movement. One of Lindy Hern’s main goals in her new book, Single Payer Healthcare Reform: Grassroots Mobilization and the Turn Against Establishment Politics in the Medicare for All Movement, is to inform readers who are analyzing the current presidential primary season, especially within the context of anti-establishment politics.

In the book, Hern, who describes herself a scholar-activist primarily through her work for progressive health care reform, approaches her topic in three main ways. She provides a comprehensive history of the grassroots movement for health care reform in the United States from within the single-payer movement. She discusses the role that narrative or “constructions of opportunity” plays in grassroots mobilization, which builds on existing social movement theory. And she examines the turn against “politics as usual” and establishment politicians that began in progressive social movements long before the election of Donald Trump.

“While the book was already timely, given the emphasis on healthcare policy in the current election cycle and the increasing support of Medicare for All, the COVID-19 pandemic, which has resulted in millions of Americans losing their health insurance during a global health crisis, makes the analysis presented even more relevant,” explains Hern in an email. “This loss of health insurance isn’t happening in other similar countries that have some form of universal health care that is not tied to specific employment.”

A press release on the publication states that in the book, Hern analyzes the past decade when the single payer movement grew and garnered more public and political support than ever before. The author argues this relative success cannot be attributed to any one political figure or political era. Hern tells the story of how the support grew over time, and how it is tied to a turn against establishment politics on both the left and right—as well as the rise of outsider politicians such as Senator Bernie Sanders—during the Clinton, G.W. Bush, Obama, and Trump administrations. During each of these eras, activists experienced shifting opportunities that they interpreted through the telling of stories.

Hern says these “narratives of opportunity” encouraged participation in particular forms of grassroots mobilization, which then affected the outcome of each era. The sociologist argues this has had lasting effects on the development of healthcare policy in the United States.

In the book, Hern presents her argument through a political ethnographic analysis in which she uses historical records, interviews, and participant observation to tell the story of the single-payer movement. She also discusses lessons that can be learned from this history, and develops a framework—the Environment of Opportunity Model—that involves a holistic understanding of social movement activity through the analysis of narrative practice.

In addition to studying the single-payer movement, Hern has conducted projects on student retention, community responses to natural disaster, and roller derby.

“I hope that the new book can be a resource for people who desire to learn more about other healthcare system options as well as the process of healthcare policy creation, whether they are academics, policy makers, or just engaged citizens,” she says.


Story by Susan Enright, a public information specialist for the Office of the Chancellor and editor of UH Hilo Stories. She received her bachelor of arts in English and certificate in women’s studies from UH Hilo.