The Health Care Bait-and-Switch
Medicare for All advocates march in New York City during the 2011 Occupy
movement. (Michael Fleshman / CC BY-SA 2.0)
On the campaign trail in January of 2016, Hillary Clinton told Iowa voters
that Bernie Sanders' single payer health care proposal was an idea whose
time would never come. "People who have health emergencies can't wait for us
to have a theoretical debate about some better idea that will never, ever
come to pass," said the presumed shoo-in for president. Two years later,
one-third of Democrats in the Senate have endorsed Sanders' Medicare for All
Act and half the Democrats in the U.S. House have signed on to Rep. John
Conyers' Expanded and Improved Medicare for All Act, HR 676. Polls show 75
percent of Democrats favor "expanding Medicare to provide health insurance
to every American," and 31 percent of the public at-large wants health care
to be the first problem the Democrats tackled if they win the White House in
2020.
Predictably, however, Hillary Clinton's favorite think tank is still trying
to make sure single payer health care never happens. The lavishly funded
Center for American Progress (CAP) last week unveiled their counterfeit,
sound-alike health care plan, dubbed Medicare Extra for All, whose sole
purpose is to distract and confuse a public that is demonstrably "ready" for
single payer. The CAP scheme, like Obamacare, keeps the private insurance
corporations at the center of the money-stream, doesn't cover everyone,
charges fees, co-pays and premiums, doesn't save much money, and would fail
to provide millions with adequate coverage. "CAP's plan maintains the
current tiered system in which some people have private health insurance,
those with the greatest needs have public health insurance, some people will
have inadequate coverage and others will have no coverage at all," writes
Dr. Margaret Flowers, of Health Over Profit. "By offering a solution that
sounds good to the uninformed-'Medicare Extra for All'-but continues to
benefit their Wall Street donors," said Flowers, "Democrats hope to fool
people or buy enough support to undermine efforts for NIMA," or National
Improved Medicare for All, the comprehensive single payer plan supported by
the activists like Flowers.
National Improved Medicare for All would save half a trillion dollars a year
on administrative costs and another $100 billion on reduced drug costs,
according to Flowers. "The CAP plan maintains the complicated multi-payer
system that we have today," she said. "At best, it will only achieve 16% of
the administrative savings of a single payer system and it will have less
power to reign in the high costs of care."
The CAP scheme would leave the link between employment and health coverage
intact, keeping workers ultimately dependent on the whims of their bosses
for healthcare coverage. "When people who have private health insurance lose
their job or move, they risk losing their health insurance," said Flowers.
"NIMA creates a health system that covers everyone no matter where they are
in the United States and its territories."
The Obama-Scam, Repackaged
The Center for American Progress is running the same bait-and-switch con
that Barack Obama played in the set-up to his Affordable Care Act. Bruce
Dixon and I were introduced to Obama's healthcare scam in June of 2003 when
we engaged the then candidate for the U.S. Senate in a month-long telephone
and email conversation, at The Black Commentator. At the time, Obama was
trailing the field of candidates and in need of every Black vote in
Illinois. Dixon and I had just learned that Obama had joined the Democratic
Leadership Council (DLC), the corporate money-bag operation for the right
wing of the party founded by white southern Democrats including Bill Clinton
and Al Gore. On top of that, he'd recently removed his 2002 (mildly)
anti-war speech from his campaign website, apparently to get in line with
George Bush's triumphal "Mission Accomplished" speech, the previous month.
Obama denied that he'd become a member of the DLC, and claimed his website
was undergoing "routine" updating. (Years later, when the war was clearly
lost, Obama's team would resurrect "The Speech" as proof of his early
anti-war credentials.)
Dixon and I decided that the best way to determine if Obama should be in the
DLC or not, would be to put him to a three-question "bright line" test on
the issues of war, health care and U.S. membership in the NAFTA, the North
American Free Trade Agreement. If the candidate answered all three questions
correctly, then he should not be a member of the DLC. If he failed, then the
DLC was where he belonged, and voters should make their decisions,
accordingly.
We presented our bright line questions to Obama in the June 19, 2003, Cover
Story of the publication:
1. Do you favor the withdrawal of the United States from NAFTA? Will you in
the Senate introduce or sponsor legislation toward that end?
2. Do you favor the adoption of a single payer system of universal health
care to extend the availability of quality health care to all persons in
this country? Will you in the Senate introduce or sponsor legislation toward
that end?
3. Would you have voted against the October 10 congressional resolution
allowing the president to use unilateral force against Iraq?
Note that we specified "a single payer system of universal health care."
Obama used weasel-language to fudge his answers to the Iraq War and NAFTA
questions. On health care, he wrote:
"I favor universal health care for all Americans, and intend to introduce or
sponsor legislation toward that end in the U.S. Senate, just as I have at
the state level. My campaign is also developing a series of interim
proposals-such as an expansion of the successful SCHIP program-so that we
can immediately provide more coverage to uninsured children and their
families."
Obama left out the words "single payer." Only after he became president, six
years later, would it become clear that his definition of "universal" health
care meant only that all Americans would be required to enroll in an
insurance program-just as states require that all drivers be insured.
Despite his use of weasel-wording in all three answers, we at The Black
Commentator gave Obama a passing grade. "BC is not seeking to martyr Barack
Obama on a left-leaning cross," we wrote.
(Our actual motive in 2003 was fear of being labeled "crabs in a barrel" for
undermining the prospects of such an attractive, progressive-sounding, young
Black up-and-coming politician-a failure of political nerve for which I will
forever be ashamed.)
A year and a half later, in the week before Obama was sworn into the Senate,
he told me that the country was not "ready" for single payer. But, if he
really believed that, he would not have spent the next four years misleading
the people through his calculated misuse of the term "universal."
"Universal" was Obama's bait-and-switch to confuse the public, much of which
continued to wishfully assume that he favored some kind of single payer
plan. Once he got in office-and after announcing that "all entitlements,
including Social Security, Medicaid and Medicare, would be "on the table"
for cutting under his administration-Obama banished single payer advocates
like Rep. Conyers from the White House and quite publicly allowed the
for-profit healthcare corporations to write his Affordable Care Act, with
its "universal" mandate that added many of millions of new "customers" for
the industry.
The Democratic Leadership Council disbanded near the end of Obama's first
term in office. Faux-progressives claimed a victory. "One of the things
that's happening right now in Democratic politics is that progressives are
winning the battle for the party," said Progressive Congress president Darcy
Burner. "The corporate-focused DLC type of politics isn't working inside the
Democratic party."
That was nonsense. The DLC went out of business because it had won its
battle for corporate hegemony in the party. By 2011, Obama had revealed
himself as a full-blooded austerity (and war) president, and was still
seeking his "Grand Bargain" with the Republicans. The "progressives" were
defenestrated (thrown out of the White House windows) and humiliated in his
first year, and were not to rise again until Bernie Sanders, the nominally
non-Democrat, made his bid for the White House in 2016-with single payer
healthcare at the tip of his spear.
Sanders' version of single payer is "highly flawed," said Health Over
Profit's Margaret Flowers, who is also co-director of Popular Resistance,
but, "the fact that the Democrats are proposing something that sounds like
NIMA means we are gaining power." The legislation "calls for a four-year
transition period, during which the newly improved Medicare would first
insure all children and adults 55 or older, then expand gradually to cover
all adults," writes the Huffington Post.
The Sanders bill's endorsers in the Senate include a number of obvious
Trojan Horses, such as Cory Booker, a deeply reactionary politician who
could have been the "first Obama" had he won prominent office just a few
years sooner (see The Black Commentator, April 4, 2002, "Fruit of the
Poisoned Tree.") He was among 13 Democrats that voted against creating a
reserve fund to allow Americans to import cheaper drugs from Canada, lamely
claiming that it didn't address consumer protection issues. Booker and
others are joining the pro-single payer bandwagon to weaken it from the
inside, while his allies in the Clinton camp and their Center for American
Progress scheme to extend the life of for-profit healthcare under the
Medicare brand.
Meanwhile, Donald Trump is the greatest negative motivator for single payer.
He last month proposed new rules that would allow sale of short-term
insurance policies that omit "essential health benefits"-what Sen. Ron Wyden
calls "junk insurance"-to allow the market to work its miracles. But the
people are learning that the market will kill you.
Glen Ford is the executive editor of Black Agenda Report. He can be reached
at Glen.Ford@xxxxxxxxxxxxxxxxxxxxx.
