Obama at Portsmouth: 'Civil Rights' for the Sick

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.