http://www.truthout.org/072309RThursday 23 July 2009
by: Norman Solomon, t r u t h o u t | Perspective
"I want to cover everybody," President Obama said at his news conference Wednesday night. "Now, the truth is that unless you have a - what's called a single-payer system, in which everybody's automatically covered, then you're probably not going to reach every single individual ..."
The same conventional wisdom keeping single payer off Washington's table has been spinning for various "reform" plans with such accelerated RPMs that at this point the nation's "health care debate" is suffering from a severe case of vertigo.
"The overwhelming majority of Americans want health care, but millions of them can't afford it," Obama told the assembled journalists. "So the plan that has been - that I've put forward and that - what we're seeing in Congress would cover, the estimates are, at least 97 to 98 percent of Americans. There might still be people left out there who, even though there's an individual mandate, even though they are required to purchase health insurance, might still not get it, or despite a lot of subsidies, are still in such dire straits that it's still hard for them to afford it. And we may end up giving them some sort of hardship exemption."
That may sound good. But it's in the service of an agenda for "health care reform" that's seriously flawed.
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Days ago, buried in a chart under the headline, "How the Health Care Bills Compare," The New York Times provided some cogent yet cryptic information in the category of "Public Plan."
A key Senate committee had just approved a bill with a public plan that would "compete with private insurers," the Times chart explained on July 18. The public plan "would provide 'only the essential health benefits,' as defined by the bill, 'except in states that offer additional benefits.'"
Meanwhile, the newspaper noted, "Democrats from three House committees are working on a single plan." Under that plan, "Different levels of coverage - 'basic, enhanced and premium' - can be offered through the public option."
Those few grainy sentences, quickly swept beneath the waves from oceans of media, referred to a disturbing aspect of "public plan" scenarios. If the ostensible goal is health care for all, then - at best - some of the "all" would end up being much more equal than others.
The Republican Party is coming from such a right-wing place that any government action to improve health care access is ideologically unacceptable. In contrast, the broad outlines of a Democratic "public plan" at least embrace the precept that the not-so-tender-mercies of the market are insufficient to fully provide for the population's medical needs.
But as a practical matter, a "public plan" coexisting with the private health insurance system - generally touted by US media as the pole of real options farthest from the Republican "free market" fixation - is inherently reconciled to major inequality in access to health care.
Even while straining to put forward a "public option" as some sort of stunning government intervention to level the health care playing field, media coverage rarely comes to terms with the situation that would actually remain under such a scenario.
How does "health care apartheid" strike you?
For the government to offer the public a multi-tier set of options for health insurance - in the words of The New York Times, "different levels of coverage" such as "basic, enhanced and premium" - is to imitate the approach of the corporate health care establishment.
After all, isn't it implicit that the government plan's "different levels of coverage," offered to the public, would be based on ability to pay?
Missing from the dominant health care debate - not only along Pennsylvania Avenue but also along media row - is a principle that could be debated and should be debated.
In a few words: health care is a human right.