Important Conversations Bernie Sanders Apparently Doesn't Want to Have

As you may recall, in April, Senator Bernie Sanders declared that abortion rights were negotiable, and that support for legal abortion should not be a litmus test for Democratic candidates: "We have got to appreciate where people come from, and do our best to fight for the pro-choice agenda. But I think you just can't exclude people who disagree with us on one issue."

Only if that "one issue" is abortion, however — because he definitely has no objection to litmus tests on other issues.

Gabriel Debenedetti‏ at Politico: Sanders 'Litmus Test' Alarms Democrats.
Sanders has decided the moment is right to launch his proposal for the single-payer health insurance system that helped form the backbone of his presidential message. And Democrats who don't get behind it could find themselves on the wrong side of the most energetic wing of the party — as well as the once and possibly future presidential candidate who serves as its figurehead.

The Vermont senator himself has not explicitly said he'll support primary challenges to those who won't support his push for a so-called Medicare-for-all health care plan. But there are plenty of signs that Sanders and his allies view the issue as a defining moment for Democratic lawmakers.

"Our view is that within the Democratic Party, this is fast-emerging as a litmus test," said Ben Tulchin, the pollster for Sanders' White House run.

..."Any Democrat worth their salt that doesn't unequivocally say Medicare-for-all is the way to go? To me, there's something wrong with them," said former Ohio state Sen. Nina Turner, president of Our Revolution [which bills itself as "the next step for Bernie Sanders' movement"]. "We're not going to accept no more hemming and hawing. No more game playing. Make your stand."
Which tracks with the email Sanders sent to supporters last week, in which he said: "In order to pass a Medicare-for-all, single payer system we will be taking on the most powerful special interests in the country: Wall Street, the insurance companies, the drug companies, the corporate media, the Republican Party and the establishment wing of the Democratic Party." (Emphasis mine.)

Now, I am 100% in support of universal healthcare (which single-payer is one possible means of achieving; I'll come back to that). Anyone who has spent any time in this space knows that I have been a supporter of universal healthcare for all of the 13 years I have been writing here.

I have lived (briefly) in a country with universal healthcare, which I found to work splendidly; I am married to someone who grew up in a country with universal healthcare and who is a strong advocate for it; I believe that for-profit insurance companies don't prioritize health; I am angry that people with transgressive bodies are profoundly harmed by the current system; I resent that attaching health insurance to employment penalizes the under- and unemployed and depresses arts and entrepreneurship; and that's just the tip of the colossal iceberg that is my collective criticisms of the current U.S. healthcare system.

But I have some problems with Sanders' apparent intent to turn support for single-payer into a litmus test for Democratic candidates.

This is a problem. And it's a problem specifically with enacting universal healthcare via single-payer, because the "single payer" in that model is the federal government.

The Hyde Amendment already exists (and has existed since 1976), but it's not inconceivable that similar amendments to funding bills could be passed to limit federal funding of other medical procedures, especially for marginalized communities. Trans people and fat people, as examples, already struggle with private insurers to access all the care they need. Single-payer may not solve that problem. In fact, it could make it worse by further reducing options to access care.

We could end up with a situation in which abortion-seeking people, trans people, fat people, disabled people, and others are targeted for denial of care by a retrograde legislature, deeply entrenching privilege within the single-payer system.

To be abundantly clear: That is not an argument against universal healthcare. It is not even an argument against single-payer. It is an argument to have a frank conversation about how such potential harm could and would be prohibited under a single-payer system.

Maybe the truth is that it can't be — not in a country in which the legislature is empowered to pass amendments limiting the federal government's ability to pay for specific healthcare procedures.

One of the fundamental differences between the United States and most (or all) other countries that have single-payer healthcare (or universal healthcare of any sort) is that the major parties in the U.S. are not even in basic agreement that healthcare is a right.

For that reason, maybe single-payer isn't the best option for the U.S. That's a conversation we need to have, even and especially those of us who agree that universal healthcare is a worthy and necessary objective.

To fail to engage these serious and valid concerns is to, once again, ignore even the most basic intersectional analysis. And that's a problem.

Is single-payer the right plan? Are there ways to ensure that single-payer will be equally guaranteed for all populations? Can we make sure single-payer won't result in constant tumult for people with transgressive bodies, their access to care subject to the whims and decency of the Congressional majority?

These are conversations we need to have sooner rather than later. Marginalized people know how it goes when policy is enacted with a promise to build in protections for us later.

It doesn't go well.

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