medicare for all

Elizabeth Warren’s Health-Care Rhetoric Is Irking Some Black Politicos for the Wrong Reasons

Senator Elizabeth Warren.
Senator Elizabeth Warren. Photo: Zach Gibson/Getty Images

As she’s surged in the polls and flourished at the debates, Elizabeth Warren has drawn heat from fellow Democrats about how she’ll pay for her health-care proposal, one of several that bear the catchall title “Medicare for All,” which has become shorthand for a federally funded, single-payer system. One target in particular has been her refusal to discuss the plan in terms of the tax hikes it will require, choosing instead to focus on how it’ll affect costs. “Costs are going to go up for the wealthy, and they’re going to go up for big corporations. They will not go up for middle-class families,” she said at the October 15 primary debate in Ohio.

Opponents to Warren’s ideological right, namely Pete Buttigieg, have tried casting her as evasive around this question. She responded on Friday by releasing a detailed explainer for how she’ll afford the multitrillion-dollar policy behemoth. As my colleague Eric Levitz wrote, it will combine payment rate cuts to hospitals, doctors, and drug companies, with a diversion to federal coffers of 98 percent of the money employers spend currently on private insurance for their workers. She’ll likely fund the rest with taxes on the rich and cuts to military spending, among other similarly popular means. In the face of criticism and doubts about the plan’s feasibility, Warren defends it as a moral imperative and remedy to America’s ghoulish status quo, which provides substandard care while pushing many families into financial ruin.

The senator’s conception of universal health care as more human right than political calculation is evident in the movements to which she compares it. Here’s the parallel she drew for New Hampshire voter Martin Murray last week, according to Politico’s Ryan Lizza:

You don’t get what you don’t fight for. In fact, can I just make a pitch on that? People said to the abolitionists: ‘You’ll never get it done.’ They said it to the suffragettes: ‘You’ll never get that passed.’ Right? They said it to the foot soldiers in the civil rights movement. They said it to the union organizers. They said it to the LGBT community. We’re on the right side of history on this one.

Warren’s meaning was fairly straightforward: Every paradigm-shifting human-rights victory in American history has had its naysayers, but that didn’t stop their advocates from asking for what may have sounded, at the time, like the moon. Some critics bristled at the comparison anyway. Speaking to Politico, former South Carolina state legislator and CNN analyst Bakari Sellers, a Kamala Harris supporter, said, “Medicare for All does not equate in any shape, form or fashion to the Civil Rights Act, or Voting Rights Act, or the 13th Amendment, or 14th Amendment. It doesn’t.” Former senator Carol Moseley Braun took matters a step further. “I have the highest respect for Sen. Warren but she’s wrong about this. Abolition and suffrage did not occasion a tax increase. People weren’t giving something up — except maybe some of their privilege.”

Both criticisms take umbrage at Warren’s invocation of vaunted movements for equal rights for black people. Both were leveled by black politicos, one of whom supports a candidate who wants to preserve private insurance. And both are factually incorrect. Sellers’s proclamation that no parallels exist between the battles for universal health care and passage of the Voting or Civil Rights Acts is an overstatement. All three were legislative attempts to answer systemic problems. All have sought to upend systems of fictional scarcity imposed from on high by the rich — in the case of health care, the notion that only those with means can have the resources to physically and financially survive being sick; and in the case of civil rights, the idea that black people should be denied full citizenship and safety in favor of white people’s. (By design, both stances have been extremely lucrative for their wealthy proponents.)

They are not exactly the same, and there’s a debate to be had over their relative import, but Warren’s comparison clearly included examples of varying intent, reach, and impact. My personal belief is that several of the purportedly “color-blind” victories she noted — women’s suffrage, labor rights — have been tainted by the degree to which black people have been denied their benefits. It’s also true that many civil-rights advances helped middle-class black people more than poor black people. But neither precludes that both were progressive social equalizers and stemmed from broad-based efforts among the citizenry to push lawmakers not to let the government and private enterprise conspire to kill them.

While there’s room to quibble over semantics here, and reasonable people can disagree, the same cannot be said of Braun’s claim. The notion that people weren’t “giving something up” when abolition was implemented is patently false, and easily refutable by looking at a few historical realities. Slavery enabled the survival of the early colonies, and though its centrality to America’s economy diminished with time, it remained a primary source of wealth for the South’s monied classes until its death. It was so important to the region’s social and financial self-conception that its proponents started an entire war to preserve it, and erected monuments and flags and established holidays in its wake to enshrine its memory and terrorize its black survivors.

The financial fallout was so obvious at the time that President Lincoln signed a bill guaranteeing reparations to slave owners in Washington, D.C., who remained loyal to the Union. But it’s also clear that people who owned slaves, those whose livelihoods relied on them and the material goods their slaves produced, and those who fought to keep their way of life intact didn’t just lose money upon emancipation — roughly a quarter-million lost their lives. To Braun’s other point, the power shift that women’s suffrage produced cannot be chalked up to a mere loss of “privilege.” Any time legislators are required to answer to a new constituency, older constituencies relinquish their grip on total power. This loss deepens when it accounts for the results of the actual votes: Women’s suffrage is understood as a precipitating factor in Prohibition, which women voters supported disproportionately and which, for a time, choked an entire industry.

Absent further clarification, we can only hope that Braun is aware that abolition and suffrage indeed forced some people to relinquish something, and is rejecting Warren’s comparisons for other reasons altogether. What these might be is a separate question. Perhaps she thinks the sanctity of past human-rights struggles shouldn’t be sullied by modern analogies. Perhaps she truly believes that paying extra taxes is a sacrifice akin to the “privileges” that slave owners were stripped of. What shouldn’t be ignored either way is that even if some people had to give up power to enable these gains, it was a small price to pay for human rights. The calculation made then is that the costs were worthwhile. The same is true of health care today.

Warren Is Right to See Health Care As a Civil-Rights Battle