There are many good critiques of my own critiques of Obamacare. Here is one, from David White, that stuck with me over the weekend. He is responding to my question, "Why is the radical approach—a health care expansion for the most vulnerable, or no health care expansion at all—ultimately wrong?"
I wouldn't say it's "ultimately wrong," but it's not the choice I'd make. The flip side of your morality question is "is it moral to deny a health care expansion for poor black people in NY and IL because poor black people in Mississippi won't benefit?" How much longer would we have to fight, how many poor NYers would die while we're trying to convince some Mississippi segregationist legislator to extend healthcare there? Is it wrong to help those NYers now, and set up the framework by which those Mississippians will be helped in the future when that fight is won?
My concern is—and remains—the fact that the expansion of the safety net comes at the price of delaying its extension to a segment of the population in which poor black and brown people are overly represented. I am convinced that within the next five to 10 years forces beyond morality will make the Medicaid expansion national. But in the meantime there will be a benefits gap. Again. But with that said, the question isn't, "Should we be horrified?" It's, "Why is arguing that we should have a health-care expansion for the most vulnerable or no health-care expansion at all ultimately wrong?" And I think David pretty much get its right.
History is instructive here. After the Civil War, the country extended the vote (nominally) to black men. Feminists and lefties (like me) have spilled much ink noting that women did not get the vote. The position of Susan B. Anthony and Elizabeth Cady Stanton—who'd fought for years as radical abolitionists—was basically "the vote for white and black women and black men, or the vote for no one." (An enraged Stanton later took this further and argued "the vote for white women above all." Things got worse from there with the cause being taken up by feminists like the inveterate racist Rebecca Felton and slightly less racist Frances Willard.)
In her book, When and Where I Enter, the historian Paula Giddings focuses on the debates among black men and women over the prospect of only half the community getting the vote while the other half remained disenfranchised. Giddings argues that black women ultimately supported the vote for black men because there was at least the possibility of influence within the home and family. Extending the vote to white women exclusively—in addition to boosting the power of the white revanchists—would not have offered the same prospect.
Was it "immoral" to advocate, as Frederick Douglass did, for the extension of the franchise to black men, but not to women? Or was it moral to take what could be gotten, and then continue to argue for the franchise extending to women? (As Douglass also did.) I've said before that I actually have a lot of sympathy for Anthony and Stanton. Still, the answer is clear to me. Douglass was right. Obamacare isn't perfect—but it's what we could get. The question remains whether we shall always have to "get" things in this same manner.
I should add on a personal note that I can run hot sometimes. I hope to remain that way, but it doesn't always make for the tightest thinking. Sometimes it even makes me dead wrong. I have said before that you should not come here with the expectation that I will be "right." I'm often not—and frankly I believe that this is true of anyone who writes. But I try my best to be honest with you and giving you my thinking as it stands in the moment, though it might well change in the next. I have a lifetime's worth of questions. (Why is the train to Boston as slow as the bus? What really makes planes fly? When will Peter Parker get his body back? Will we be racist to the end? Am I too old to learn French? Why does raw cheese taste so good?) Unfortunately, I have very few definite answers.