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9/4/19

CAP's rebrand of "universal health care" is vacuous and dangerous



Yet again, Neera Tanden is repeating the Center for American Progress's talking point that "universal health care" applies to a full range of proposals that are not single payer. The marketing reasons for making this point are obvious: UHC is an extremely popular brand on the liberal-left, and opposing it is extremely unpopular, which means that anyone who wants the liberal-left's support for their agenda needs to make some claim to the brand.

One problem with this, of course, is that people in the United States have historically used UHC to mean single-payer. This isn't some wonky or technical definition, but just a matter of linguistic fact: if you look at media coverage prior to 2009, for example, people routinely use the two terms interchangeably.

But a second, underappreciated problem is that CAP's redefinition makes the UHC brand so meaningless that even the hard right can lay claim to it. In order to defend a role for the free market in their proposals, revisionists insist that it is the aspiration to complete coverage, rather than the system which gets us there, that qualifies as proposal as UHC. This then allows them to say that people who insist on single payer are abandoning what the liberal-left has fought for, which is an outcome rather than a system.

The danger of course is that anyone can promise complete coverage. Worse still, the right has developed a whole rhetoric around insisting that it is government intervention that stands in the way of complete coverage:
The misconception that the American health care system is a free market system and the European systems are socialized because they provide universal coverage are complete fallacies....A free-market system is shown to be the only reasonable method of reform that addresses the true underlying problems of the U.S. health care system and effectively lowers health care costs, allowing for universal insurance coverage for most everyone so any reasonable person — doctor, patient, Republican or Democrat — could support. 
What can the Center for American Progress say to an argument like this? It makes every one of their moves - the author appeals to the mixed insurance systems of Europe and insists that we all share the same goal of "universal insurance coverage" - but then, at the last moment, it insists that the "free-market system" is what can do this. 

Obviously, the liberal-left response to this argument is to insist that the free-market system cannot actually provide coverage for everyone, and that only government intervention can guarantee UHC. But now we are back to what the left has been arguing all along, which is that "universal health care" implies something about the system, and doesn't simply refer to an aspirational outcome.

(Photo credit: Steve Rhodes)