At the end of this weekend’s Single Payer Strategy Conference in Chicago, the activists gathered together for a group photo and sang “solidarity forever.”

But if solidarity meant getting behind the Democratic Party, many were not sold.

Some skeptics saw the conference as a rally for Vermont Senator and Democratic Presidential candidate Bernie Sanders, who raises single payer at almost every campaign stop.

After the opening plenary on Saturday morning, three of the first four questions from the audience addressed the wisdom of wedding the single payer movement to the Democratic Party.

One of questioners was a Chicago nurse — Dennis Kosuth.

“The Democratic Party has a long history of betraying people,” Kosuth said. “And the Democratic Party is not like a buffet, where you can say — I’m going to leave the Salisbury steak and go for the health salad. It’s a whole smorgasbord. You can’t pick and choose what you want based on what you feel like taking that day. The Democratic Party has deep ties to the one percent, it takes money from the one percent. And their policies reflect that over the last forty or fifty years — there is no question about that. It’s fine that Bernie Sanders is running on Medicare for All — which I personally agree with. But the problem is that he is running with a party that wants nothing to do with that. There is no way that the Democratic Party establishment is going to let that person win. I feel as if all that work that people here are putting in to support him will go toward Hillary Clinton — who is not a friend of workers.”

Kosuth’s preference is that single payer activists run outside the two party system as independents.

A single payer activist from Vermont, who asked not to be identified, said that when Sanders loses to Clinton, he will travel the country and urge everyone to vote for Clinton saying that “this is the most important election of our lifetime.”

“Bernie says that about every election — it’s the most important election of our lifetime,” the Vermont single payer activist said.

Dissidents also questioned the conference’s focus on state single payer initiatives.

During the Sunday small group sessions, some of the activists said that the focus should be on federal legislation — HR 676 — not on efforts to pass fake single payer initiatives — like one that will be on the ballot in Colorado.

At the 2013 Physicians for a National Health Program annual meeting in Boston, then Vermont Governor Peter Shumlin was challenged by PNHP co-founder David Himmelstein.

Himmelstein made clear that he had real misgivings about the state by state approach.

Himmelstein said at the time that while that one can make “substantial and important progress” at the state level, and politically the state efforts can be extremely important to the movement, “actually implementing single payer and achieving the full benefits of what can be achieved requires Washington’s work.”