Health Care – Right or Responsibility?

Eesha Pandit

In Tuesday's presidential debate, John McCain said health care is a matter of personal responsibility, while Barack Obama said it was a right. What does that mean for patients and health consumers?

"Quick discussion: Is health
care in America
a privilege, a right, or a responsibility?"

Posing that question during the second
Presidential debate, NBC’s Tom Brokaw asked the two candidates to reveal their
basic views about health care reform in America.

"I think it’s a
responsibility," responded John McCain. An unsurprising answer from the Senator from Arizona, given that his
approach places the burden on individuals to purchase their own health
insurance coverage in the open market, albeit with the assistance of a proposed
$5,000 tax credit.

He continued, claiming,

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"I think it’s a responsibility, in this respect,
in that we should have available and affordable health care to every American
citizen, to every family member. And with the plan that — that I have, that
will do that. But government mandates I — I’m always a little nervous about.
But it is certainly my responsibility. It is certainly small-business people
and others, and they understand that responsibility. American citizens
understand that. Employers understand that."

Brokaw then turned to Barack Obama, who replied,

"Well, I think it should be
a right for every American. In a country as wealthy as ours, for us to have
people who are going bankrupt because they can’t pay their medical bills — for
my mother to die of cancer at the age of 53 and have to spend the last months
of her life in the hospital room arguing with insurance companies because
they’re saying that this may be a pre-existing condition and they don’t have to
pay her treatment, there’s something fundamentally wrong about that."

Viewers who were participating in
a live CNN debate poll responded with an overwhelmingly positive
response to Obama’s declaration of health as a right. Why?

Today, about 46 million people
are without health care, and tens of millions are woefully under-insured.
Today, people stay in dead-end jobs just so they and their families can retain
health coverage. Today, women are still being denied health care if they’ve got
breast cancer and many others must fight to control their own pregnancies and
births.

In this environment, the
difference between a candidate who says that health care is "a right"
versus one who says that it is "a responsibility" is extremely
significant. McCain’s attempt to tie the Obama health plan to socialism,
in the vein of the "Harry and Louise" attack ads that helped sink health care reform in 1992, isn’t garnering the
support that he hopes. Instead, the Obama campaign is apparently succeeding in communicating that their plan does not turn health care into a government
program, but instead strives to insure that all children are covered and that
all adults get quality, affordable coverage.

Both senators noted the
"fundamental difference" between them on health care. Undecided voters in Ohio, women in
particular, noticed the difference as well and turned their dials toward Obama.

But what does it really mean for
Americans, for patients and health care consumers, if health care is a right?
If it’s a responsibility?

If a responsibility, it could be
a personal responsibility or a political one.

A look back at McCain’s earlier comments suggests that for him, health
care is a matter of personal responsibility. In fact, his campaign has said as
much. Back in April, CNN reported:

McCain’s
policy director, Douglas Holtz-Eakin, told reporters Monday night that as
president, McCain would fund public education programs and use "the bully
pulpit" to encourage health attitudes among children and adults.

He said a major plank of McCain’s health
care plan is simply "a focus on personal responsibility, and the kinds of
things that can help you get better outcomes just by taking care of
yourself.

Apparently, for McCain, health
care as a "responsibility" means taking care of yourself. And if health care is instead a right? Let’s
look at some examples of well-established rights.

Because we determine that
everyone deserves the right to a fair trial, we ensure that everyone
accused of a crime has access to a lawyer, regardless of whether or not they can
afford one. We hold a national system of public defenders and judges responsible for this.

Because we determine that
everyone has the right to speak their mind, we ensure that there are public places
and spaces for them to do so without threat of harm. We enlist public safety
officials and open spaces like our houses of Congress to foster civic
participation.

If health care is also a right,
then our government has a responsibility to ensure that we can
exercise that right — just the same as the right to a fair trial or free speech. In
this way, the right to health care implies a political responsibility, not
simply a personal one.

McCain’s argument that health care is a personal responsibility offers a complicated type of moralism. In his view, good employers should not be required to provide health care to their
employees. They should want to. From
a sense of duty and the kindness in their hearts, they will provide health care to their employees. Government’s role in all this, per
McCain, is to encourage their charity by offering tax incentives.

McCain asserted, "[What] is
at stake here in this health care issue is the fundamental difference between
myself and Senator Obama. As you notice, he starts talking about government. He
starts saying, government will do this and government will do that, and then
government will, and he’ll impose mandates."

To McCain’s accusation, Obama replied, "[The]
reason that it’s a problem to go shopping state by state — you know what
insurance companies will do, they will find a state — maybe Arizona, maybe
another state, where there are no requirements for you to get cancer
screenings, where there are no requirements for you to have to get pre-existing
conditions, and they will all set up shop there."

Then Obama pinned McCain’s
approach to health care onto his approach to the economy, his belief in
deregulation and the increasingly evident myth of the trickle down.

"That’s how in banking it
works," said Obama. "Everybody goes to Delaware, because they’ve got… pretty
loose laws when it comes to things like credit cards. And in that situation…the
protections you have, the consumer protections that you need, you’re not going
to have available to you."

"That," he concluded,
"is a fundamental difference that I have with Senator McCain. He believes
in deregulation in every circumstance. That’s what we’ve been going through for
the last eight years. It hasn’t worked, and we need fundamental change."

If Obama’s belief that health care is a right
wins him increased support from Americans
, especially from swing voters, this
could herald a major shift in American politics. A shift from thinking of health care as personal
responsibility to recognizing it as a right is, indeed, a fundamental change.
The fact that viewers responded so positively to Obama’s assertion that health care should be a right suggest that the country might just be ready for
this change. That is perhaps the most remarkable development of this election.

Women all around
the country tell the group I work with, Raising Women’s Voices for the Health Care We Need, that health care is a right. They say that they need help
in securing this right for themselves and their families. They tell us it is
not a mere matter of insurance policies and coverage concerns. Access to health
care affects their children, their partners, their parents, their ability to
work, to thrive, to take care of their families and themselves. Their very
well-being depends on it. If that doesn’t sound like the basis of a human
right, I don’t know what does.

Roundups Politics

Campaign Week in Review: ‘If You Don’t Vote … You Are Trifling’

Ally Boguhn

The chair of the Democratic National Convention (DNC) this week blasted those who sit out on Election Day, and mothers who lost children to gun violence were given a platform at the party's convention.

The chair of the Democratic National Convention (DNC) this week blasted those who sit out on Election Day, and mothers who lost children to gun violence were given a platform at the party’s convention.

DNC Chair Marcia Fudge: “If You Don’t Vote, You Are Ungrateful, You Are Lazy, and You Are Trifling”

The chair of the 2016 Democratic National Convention, Rep. Marcia Fudge (D-OH), criticized those who choose to sit out the election while speaking on the final day of the convention.

“If you want a decent education for your children, you had better vote,” Fudge told the party’s women’s caucus, which had convened to discuss what is at stake for women and reproductive health and rights this election season.

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“If you want to make sure that hungry children are fed, you had better vote,” said Fudge. “If you want to be sure that all the women who survive solely on Social Security will not go into poverty immediately, you had better vote.”

“And if you don’t vote, let me tell you something, there is no excuse for you. If you don’t vote, you don’t count,” she said.

“So as I leave, I’m just going to say this to you. You tell them I said it, and I’m not hesitant about it. If you don’t vote, you are ungrateful, you are lazy, and you are trifling.”

The congresswoman’s website notes that she represents a state where some legislators have “attempted to suppress voting by certain populations” by pushing voting restrictions that “hit vulnerable communities the hardest.”

Ohio has recently made headlines for enacting changes that would make it harder to vote, including rolling back the state’s early voting period and purging its voter rolls of those who have not voted for six years.

Fudge, however, has worked to expand access to voting by co-sponsoring the federal Voting Rights Amendment Act, which would restore the protections of the Voting Rights Act that were stripped by the Supreme Court in Shelby County v. Holder.

“Mothers of the Movement” Take the National Spotlight

In July 2015, the Waller County Sheriff’s Office released a statement that 28-year-old Sandra Bland had been found dead in her jail cell that morning due to “what appears to be self-asphyxiation.” Though police attempted to paint the death a suicide, Bland’s family has denied that she would have ended her own life given that she had just secured a new job and had not displayed any suicidal tendencies.

Bland’s death sparked national outcry from activists who demanded an investigation, and inspired the hashtag #SayHerName to draw attention to the deaths of Black women who died at the hands of police.

Tuesday night at the DNC, Bland’s mother, Geneva Reed-Veal, and a group of other Black women who have lost children to gun violence, in police custody, or at the hands of police—the “Mothers of the Movement”—told the country why the deaths of their children should matter to voters. They offered their support to Democratic nominee Hillary Clinton during a speech at the convention.

“One year ago yesterday, I lived the worst nightmare anyone could imagine. I watched as my daughter was lowered into the ground in a coffin,” said Geneva Reed-Veal.

“Six other women have died in custody that same month: Kindra Chapman, Alexis McGovern, Sarah Lee Circle Bear, Raynette Turner, Ralkina Jones, and Joyce Curnell. So many of our children are gone, but they are not forgotten,” she continued. 

“You don’t stop being a mom when your child dies,” said Lucia McBath, the mother of Jordan Davis. “His life ended the day that he was shot and killed for playing loud music. But my job as his mother didn’t.” 

McBath said that though she had lost her son, she continued to work to protect his legacy. “We’re going to keep telling our children’s stories and we’re urging you to say their names,” she said. “And we’re also going to keep using our voices and our votes to support leaders, like Hillary Clinton, who will help us protect one another so that this club of heartbroken mothers stops growing.” 

Sybrina Fulton, the mother of Trayvon Martin, called herself “an unwilling participant in this movement,” noting that she “would not have signed up for this, [nor would] any other mother that’s standing here with me today.” 

“But I am here today for my son, Trayvon Martin, who is in heaven, and … his brother, Jahvaris Fulton, who is still here on Earth,” Fulton said. “I did not want this spotlight. But I will do everything I can to focus some of this light on the pain of a path out of the darkness.”

What Else We’re Reading

Renee Bracey Sherman explained in Glamour why Democratic vice presidential nominee Tim Kaine’s position on abortion scares her.

NARAL’s Ilyse Hogue told Cosmopolitan why she shared her abortion story on stage at the DNC.

Lilly Workneh, the Huffington Post’s Black Voices senior editor, explained how the DNC was “powered by a bevy of remarkable black women.”

Rebecca Traister wrote about how Clinton’s historic nomination puts the Democratic nominee “one step closer to making the impossible possible.”

Rewire attended a Democrats for Life of America event while in Philadelphia for the convention and fact-checked the group’s executive director.

A woman may have finally clinched the nomination for a major political party, but Judith Warner in Politico Magazine took on whether the “glass ceiling” has really been cracked for women in politics.

With Clinton’s nomination, “Dozens of other women across the country, in interviews at their offices or alongside their children, also said they felt on the cusp of a major, collective step forward,” reported Jodi Kantor for the New York Times.

According to Philly.com, Philadelphia’s Maternity Care Coalition staffed “eight curtained breast-feeding stalls on site [at the DNC], complete with comfy chairs, side tables, and electrical outlets.” Republicans reportedly offered similar accommodations at their convention the week before.

News Law and Policy

Court Blocks North Carolina’s ‘Discriminatory’ Voter ID Law

Imani Gandy

“[T]he new provisions target African Americans with almost surgical precision," Circuit Judge Diana Gribbon Motz wrote for the court, describing the North Carolina GOP's voter ID law.

A unanimous panel of the Fourth Circuit Court of Appeals struck down North Carolina’s elections law, holding that the Republican-held legislature had enacted the law with discriminatory intent to burden Black voters and that it therefore violated the Voting Rights Act of 1965.

The ruling marks the latest defeat of voter ID laws passed by GOP-majority legislatures across the country.

“We can only conclude that the North Carolina General Assembly enacted the challenged provisions of the law with discriminatory intent,” Circuit Judge Diana Gribbon Motz wrote for the court.

HB 589 required in-person voters to show certain types of photo ID beginning in 2016, and either curtailed or reduced registration and voting access tools that Black voters disproportionately used, including an early voting period. Black voters also disproportionately lack photo IDs.

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Republicans claimed that the law was intended to protect against voter fraud, which has proven exceedingly rare in Republican-led investigations. But voting rights advocates argue that the law was intended to disenfranchise Black and Latino voters.

The ruling marks a dramatic reversal of fortune for the U.S. Justice Department, the North Carolina chapter of the NAACP, and the League of Women Voters, which had asked the Fourth Circuit to review a lower court ruling against them.

U.S. District Court Judge Thomas Schroeder in April ruled that plaintiffs had failed to demonstrate that the law hindered Black voters’ ability to exercise political power.

The Fourth Circuit disagreed.

“In holding that the legislature did not enact the challenged provisions with discriminatory intent, the court seems to have missed the forest in carefully surveying the many trees,” Motz wrote. “This failure of perspective led the court to ignore critical facts bearing on legislative intent, including the inextricable link between race and politics in North Carolina.”

The Fourth Circuit noted that the Republican-dominated legislature passed the law in 2013, immediately following the U.S. Supreme Court’s ruling in Shelby v. Holder, which struck a key provision in Section 4 of the Voting Rights Act.

Section 4 is the coverage formula used to determine which states must get pre-clearance from the Department of Justice or the District Court for the District of Columbia before making any changes to election laws.

The day after the Supreme Court issued its ruling in Shelby, the Republican chairman of the Senate Rules Committee announced the North Carolina legislature’s intention to enact an “omnibus” election law, the appeals court noted. Before enacting the law, however, the Republican-dominated legislature requested data on the use, by race, of a number of voting practices.

After receipt of the race data, the North Carolina General Assembly enacted legislation that restricted voting and registration, all of which disproportionately burdened Black voters.

“In response to claims that intentional racial discrimination animated its actions, the State offered only meager justifications,” Motz continued. “[T]he new provisions target African Americans with almost surgical precision.”

The ruling comes a day after the Rev. Dr. William J. Barber II, president of the North Carolina chapter of the NAACP and one of the primary organizers of Moral Mondays, gave a rousing speech at the Democratic National Convention that brought convention goers to their feet.

During a protest on the first day of the trial, Barber told a crowd of about 3,500 people, “this is our Selma.”