In his Portsmouth town hall meeting President Obama continued his recent theme of flogging insurance companies as the villains of our current health care system. He noted, for example, that a “recent report actually shows that in the past three years over 12 million Americans were discriminated against by insurance companies because of a preexisting condition.” He repeated that point with emphasis:
And insurance companies will continue to profit by discriminating against people for the simple crime of being sick.
President Obama’s belief that insurance companies are guilty of discrimination when they refuse coverage to applicants with preexisting conditions tells us a great deal about his view of what ails the American economy, and it is a much more radical view than he has admitted, at least recently.
This charge of insurance company discrimination is intended, no doubt, to make health care reform — now presented as merely health insurance reform — seem like simply another anti-discrimination law, a civil rights law for the sick. “No one holds these companies accountable for these practices,” the president said, but his reform will hold them accountable because allowing that “discrimination” to continue is “not a future I want for my children. It’s not a future that I want for the United States of America.”
To say, as the president did, that “no one in America should go broke because they get sick” is to say that having health insurance is a civil right. Not only does the president think of his health care health insurance reform as at least in part a civil rights measure, but it is important to realize that what he means by civil rights is both far broader and deeper than what most of us think of when we think of civil rights enforcement — removing artificial barriers based on race, sex, or ethnicity that block equal opportunity.
In a piece on Pajamas Media last week I argued that President Obama views civil rights not as protections for individuals against racially discriminatory treatment, but as a lever to produce fundamental economic redistribution. He believes, I argued, that the United States continues to be plagued by pervasive “structural inequality,” and that getting rid of it “requires the eradication of all manifestations of ‘inequality,’ whether or not the inequality was caused by discriminatory barriers.” Moreover, he stated in his speech to the NAACP convention on July 16, the most imposing “barrier” to equality today is not discrimination in the traditional sense but the very nature and structure of the American economy.
“Our task of reducing these structural inequalities,” he said, “has been made more difficult by the state, and structure, of the broader economy; an economy fueled by a cycle of boom and bust; an economy built not on a rock, but sand.”
The president has said many times that reforming health “insurance” is the linchpin of his effort to transform the economy, and he repeated that argument in Portsmouth:
Because even before this recession hit, we had an economy that was working pretty well for the wealthiest Americans. It was working pretty well for Wall Street bankers. It was working pretty well for big corporations, but it wasn’t working so well for everybody else. It was an economy of bubbles and busts. And we can’t go back to that kind of economy. If we want this country to succeed in the 21st century and if we want our children to succeed in the 21st century, then we’re going to have to take the steps necessary to lay a new foundation for economic growth. We need to build an economy that works for everybody and not just some people.
Now, health insurance reform is one of those pillars that we need to build up that new foundation.
So employer-provided private insurance is just one more bit of “structural inequality” to eradicate. And, despite the president’s assertion in Portsmouth that “I have not said that I was a single-payer supporter,” he has in fact said so, and more than once. “If I were designing a system from scratch, I would probably go ahead with a single-payer system,” he told a town hall meeting in New Mexico as recently as last August. And he was even more explicit in 2003, complete with road map:
I happen to be a proponent of a single payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its gross national product on health care cannot provide basic health insurance to everybody. … A single payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.
A Wall Street Journal editorial has just pointed out that insurance rates in the five states that prohibit what President Obama calls “discrimination” against people with preexisting conditions is considerably higher than in all the states that don’t, and that “ObamaCare would impose New York-type rates nationwide.” Forcing higher rates on private insurers while simultaneously offering a subsidized “public option” that could offer lower rates would eventually fulfill Obama’s dream of doing away with private health insurance and having a single-payer system.
In short, President Obama’s health care vision — prohibiting private insurer “discrimination” — is of a piece with his civil rights vision of eradicating all “structural inequalities.” And both are manifestations of his overarching goal of replacing “boom and bust” capitalism, “built on sand,” with a system that would promote a massive redistribution of wealth.
Indeed, in a candid interview on WBEZ, a public radio station in Chicago, on January 18, 2001, then state senator and Chicago law professor Obama was critical of the civil rights movement for relying too heavily on the courts because the Constitution, “at least as it’s been interpreted” by the Supreme Court, “never entered into the issues of redistribution of wealth, and sort of more basic issues of political and economic justice in this society.” The audio of that interview can be found here and here (the video has been removed from YouTube), and the following relevant passage was quoted here:
You know, if you look at the victories and failures of the civil-rights movement, and its litigation strategy in the court, I think where it succeeded was to vest formal rights in previously dispossessed peoples. So that I would now have the right to vote, I would now be able to sit at a lunch counter and order and as long as I could pay for it, I’d be okay, but the Supreme Court never entered into the issues of redistribution of wealth, and sort of more basic issues of political and economic justice in this society.
And uh, to that extent, as radical as I think people tried to characterize the Warren Court, it wasn’t that radical. It didn’t break free from the essential constraints that were placed by the Founding Fathers in the Constitution — at least as it’s been interpreted, and Warren Court interpreted it in the same way, that generally the Constitution is a charter of negative liberties: [It] says what the states can’t do to you, says what the federal government can’t do to you, but it doesn’t say what the federal government or the state government must do on your behalf.
And that hasn’t shifted, and one of the, I think, the tragedies of the civil-rights movement was because the civil-rights movement became so court-focused, uh, I think that there was a tendency to lose track of the political and community organizing and activities on the ground that are able to put together the actual coalitions of power through which you bring about redistributive change. And in some ways we still suffer from that.
Now President Obama is attempting to correct “the tragedies of the civil rights movement,” to expand dramatically “what the federal government or the state government must do” for their citizen subjects through “political and community organizing and activities on the ground that are able to put together the actual coalitions of power through which you bring about redistributive change.”
And who knows. Another Supreme Court appointment or two and the Court itself may lose its hang-up on “formal rights” and join the Obama revolution by forthrightly entering “into the issues of redistribution of wealth.”