The Health Care Bait-and-Switch
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@BlackAgendaReport.com.