American Patients for Universal Health Care has announced it will form a “patients’ union” to organize patients across the country to “demand the quality of care for which they are paying and to demand meaningful health care reform.” Frustrated by what it sees as a perverse incentive structure that rewards health care providers for keeping patients just sick enough to need constant care, the organization is launching this union to empower patients to demand higher quality care and to encourage them to patronize only those doctors who support universal health care.

While this "unionization" could prove a powerful building block in the growing grassroots movement for universal health care, the very nature of healthcare presents huge challenges to those who would use market forces for change.

Even if this union gains widespread support, its members decisions on what doctors to visit won’t set in motion the market forces necessary to force doctors to provide better, more personal, more affordable care. Health care isn’t dry cleaning or car repair – patients can’t forego health care altogether, and demand will probably always exceed supply. Thus, consumers have little power to force suppliers to offer better service or risk falling profits. Further, the health care market offers limited choices: a patient considering doctors who take the right insurance, who are located a reasonable distance from work or home, who can provide the appropriate care, and who have an opening any time in the near future may well face fewer options than they face when selecting peanut butter at the grocery store.

This relative powerless of consumers underscores the need for government action. But right now we’re far from seeing the kind of government action needed to solve our health care crisis – particularly with even the frontrunners in the Democratic presidential primary likely to reserve a significant role for backers of the status quo in any healthcare reform. Insurance companies, doctors, and the pharmaceutical industry have powerful lobbies, while patients – who of course comprise a much larger percentage of the population – are largely un- or under-represented.

This may be changing. APUHC’s Patients’ Union reflects Americans’ mounting outrage with our health care system. With more and more Americans finding themselves without health insurance, the outrage will only grow – and outrage can motivate action. A Patients’ Union is a start. It can empower individual patients, further raise awareness about our system’s failings, and can induce doctors to announce their support for universal health care to gain the business of these union members, which will lend a trusted voice that could help legitimize and motivate the movement. With any luck, widespread demand for universal health care will help make change possible next November.