Tuesday, August 19, 2008


Many progressives are cheering the health care plank of the DP platform because it commits to a goal of health care for all. Laudable language about a "guarantee" for individuals loses some lustre in the details, however. The system of health care provision described by the platform is a hodgepodge of individually-purchased and/or work-based private insurance, with an optional alternative "public plan" for those left out. That kind of patchwork does not get us out of the for-profit, hierarchical system of provision that is largely tied to employment. Progressives used to be for a tax-based (not employment- & premium- based) system much like medicare. Now many are settling for the promise of "affordability" -- which is a promised based on the assumption that individuals pay for insurance...and get what they can pay for. To back up its choice to tinker with the existing system -- expanding the public system to pick up some slack and otherwise making private coverage "affordable" -- the platform states that as health coverage becomes more affordable, "individuals should purchase insurance and take steps to live healthy lives." (platform p.10-11). Under the Democratic "guarantee" not only are individuals expected to bear the burden of health care provision but they bear blame for becoming unhealthy, too.

The 2004 DP platform declared health care "a right not a privilege." That platform contained different emphases, but not a different impulse. In 2004, the party was concerned with costs and affordability, the expansion of SCHIP, prescription price negotiation for seniors, and pushing scientific boundaries to fight disease -- concerns espoused this year, as well. Two commitments articulated in 2004 are not repeated this year: 1) to provide all Americans with access to the same coverage that members of Congress give themselves, and 2) a Patient's Bill of Rights.

Despite some differences of degree and formulation between 2004 and 2008, the two planks belong to the same tradition of health care reform. So much for "change".

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