What Was Obamacare Really About?

What Was Obamacare Really About?
Byron York
Monday, April 05, 2010

It hasn't attracted much notice, but recently some prominent advocates of Obamacare have spoken more frankly than ever before about why they supported a national healthcare makeover. It wasn't just about making insurance more affordable. It wasn't just about bending the cost curve. It wasn't just about cutting the federal deficit. It was also about redistributing wealth.

Health reform is "an income shift," Democratic Sen. Max Baucus said on March 25. "It is a shift, a leveling, to help lower-income, middle-income Americans."

In his halting, jumbled style, Baucus explained that in recent years, "the maldistribution of income in America has gone up way too much, the wealthy are getting way, way too wealthy, and the middle-income class is left behind." The new healthcare legislation, Baucus promised, "will have the effect of addressing that maldistribution of income in America."

At about the same time, Howard Dean, the former Democratic National Committee chairman and presidential candidate, said the health bill was needed to correct economic inequities. "The question is, in a democracy, what is the right balance between those at the top ... and those at the bottom?" Dean said during an appearance on CNBC. "When it gets out of whack, as it did in the 1920s, and it has now, you need to do some redistribution. This is a form of redistribution."

Summing things up in the New York Times, the liberal economics columnist David Leonhardt called Obamacare "the federal government's biggest attack on economic inequality since inequality began rising more than three decades ago."

Now they tell us. For many opponents of the new legislation, the statements confirmed a nagging suspicion that for Barack Obama and Democrats in Congress, the health fight was about more than just insurance -- that redistribution played a significant, if largely unspoken, part in the drive for national health care.

"I don't think most people, when they think of the healthcare bill, instantly think it's a vehicle to redistribute wealth," said pollster Scott Rasmussen. "But we do know that people overwhelmingly believe it will lead to an increase in middle-class taxes, and we do know that people are concerned that it will hurt their own quality of care, so I think their gut instincts point in that direction."


By talking openly about redistribution, Baucus and others have gone seriously off message. Democrats knew there was no way they could ever sell a national healthcare bill to a skeptical public by basing their case on income inequality. That's one reason they went to such lengths to argue -- preposterously, in the view of most Americans -- that the bill could cover 32 million currently uninsured people and still save the taxpayers money.

After Baucus' statement, I asked a Democratic strategist (who asked to remain nameless) whether fighting income inequality was one of his goals in supporting the legislation. Never, he said. "That's what the tax code is for."

"It was not to take something away from rich people; it was to provide something to people without coverage," he continued, making a distinction between striving for universal coverage and seeking to redistribute income. But he quickly saw that Democrats talking about redistribution could be politically damaging, echoing the controversy that erupted when candidate Obama famously told Ohio plumber Joe Wurzelbacher, "When you spread the wealth around, it's good for everybody."

"'Redistribution' is an easy charge to make," the Democrat said. "I'm not surprised that it's an argument critics make; what I'm surprised at is that Democrats are making it."

This week, the DNC group Organizing for America offered a commemorative certificate to supporters who helped pass the healthcare bill. The certificate said, "We achieved the dream of generations -- high-quality, affordable health care is no longer the privilege of a few but the right of all."

The privilege of a few? It is widely accepted that about 85 percent of all Americans have healthcare coverage, and the overwhelming majority are happy with it. There's simply no way anyone could plausibly claim that health coverage is the privilege of a few.

And yet that is the bedrock belief of some who supported the healthcare makeover. So it's no wonder that we're hearing about health care as the redistribution of income. Of course, we're only hearing it after the bill has passed.