Home 2017 Races Northam in 2011 Debate: Healthcare Is a “Privilege,” NOT a Right

Northam in 2011 Debate: Healthcare Is a “Privilege,” NOT a Right


A bombshell dropped today in the Virginia Governor Election courtesy of a six-year-old debate question asked of Ralph Northam during his 2011 State Senate reelection campaign against Republican Ben Loyola. The question: “Do you believe that health care is a right or a privilege?” To which, as per the video below, Northam responds:

I believe it’s a privilege.

And let me clarify that.

If people can get up in the morning and go to work like I can, then it needs to be a privilege. They need to work for their health insurance, for their benefits.

If they’re disabled, I will take the shirt off my back to help them.

In the face of the House GOP’s pushing through the American Health Care Act of 2017 (AHCA, aka #TrumpCare (or, more accurately, the TCCLAAHCA: Trump Couldn’t Care Less About Americans’ Health Care Act) and the unified Democratic voice that we should fix and strengthen (not repeal) the Affordable Care Care (ACA, aka ObamaCare, and accurately, the ODCAAHCA: Obama Does Care About Americans’ Health Care Act), hard to imagine that most Democratic Party primary voters in Virginia support the framing of (even just basic preventive) health care as a “privilege” as opposed to a right (e.g., universal coverage as legitimate societal objective).

Ralph Northam, in the 2016 Democratic gubernatorial primary, has seemed to have the edge over Perriello when it comes to health care issues — doctor, track record on medical issues, support from abortion rights organizations, etc.  This video bombshell could put a serious dent in Northam’s healthcare “armor.”

Northam has had the challenge of explaining his past. Voting for George W Bush (twice) … Self-described “conservative.” Potentially never voted for a Democratic politician before his own election. This video adds to the challenge.

As per after the fold, this bombshell did not magically appear: the Perriello campaign sent it out to the press.


  1.  Full video here.
  2. Truth in disclosure, I explained my reasons for supporting Perriello in Choosing Tom.

Perriello press release:

From: Perriello Press <press@tomforvirginia.com>
Date: Tue, May 9, 2017 at 10:48 AM
Subject: Ralph Northam in 2011: Health Care Is a ‘Privilege’
To: Perriello Press <press@tomforvirginia.com>
Ralph Northam in 2011: Health Care Is a ‘Privilege’
Monday evening, Lt. Gov. Ralph Northam’s record “questioning” the Affordable Care Act came to light in a Washington Post report, which stated, “While seeking reelection to the state Senate in 2011, Northam offered tempered support for the law, expressing concerns with the tactics Democrats used to pass it and questioning if it went far enough to bring down the cost of health care.” In response, Northam’s spokesman told the Post, “He firmly believes that every American and Virginian has a right to affordable health care.”
But in 2011, when Northam was running for reelection to the Senate, a debate moderator asked him this question: “Do you think that access to quality health care is a right?” and Northam replied, “I believe it’s a privilege.”
Tom Perriello has been a consistent champion for health care reform. The Daily Beast called Tom “the most courageous man in DC” for taking the tough vote to expand access to health care to millions of Americans, regardless of political consequences. In Congress, he not only voted for health care reform; he fought for it, pushing to ensure pre- and post-natal care were included in the Affordable Care Act and even supporting a version of the law that included a public option. He also ran in a conservative district on the belief that access health care is a right, saying, “Every American deserves access to a doctor.” 
In a 2011 state Senate debate, at the height of the backlash towards President Obama over health care reform, Ralph Northam was asked whether he believes access to quality health care is a right. 
  • Moderator: “Do you think that access to quality health care is a right or should it be left to the market or charity?”, Northam: “I believe it’s a privilege.” [6th District Senate forum, 10/26/11]
  • Northam: “I believe it’s a privilege. And let me clarify that. If people can get up in the morning and go to work like I can, then it needs to be a privilege. They need to work for their health insurance, for their benefits. If they’re disabled, I will take the shirt off my back to help them.” [Vivian J. Paige blog, 40:00 mark, 10/29/11]

Northam also reportedly objected to being called a “key defender of the president’s federal health care law” in 2011.

  • “Among the Republicans who invoke Obama’s name for political gain is state Senate candidate Ben Loyola of Virginia Beach. He’s claimed his opponent, Sen. Ralph Northam of Norfolk, is a key defender of the president’s federal health care law and his ‘failed economic policies.’ Northam rejects that characterization.” [“Va. GOP eager to hitch Democratic opponents to Obama,” Virginian-Pilot, 10/19/11]
Northam refused to attend an event with President Obama in 2011.
  • “Republicans seem more excited than Democrats about President Barack Obama’s bus tour in Virginia this week, seeing it as another chance, weeks before the state legislative election, to link opponents to the president’s weak poll numbers and the slumping economy. Obama will speak at a Hampton military base today on the final leg of a three-day tour to promote elements of his jobs plan. As he arrives, Republicans say, members of his party in Virginia are retreating. They note that some rural Democratic members of the General Assembly have distanced themselves from Obama and his policies, while others have emphasized compromises they’ve made with Republican Gov. Bob McDonnell.Voters are understandably frustrated by partisan bickering in Washington, but they want state Senate candidates to explain how they’ll represent local interests in Richmond, Northam said. He won’t attend the president’s speech.” [“Va. GOP eager to hitch Democratic opponents to Obama,” Virginian-Pilot, 10/19/11]
Progressives, including President Obama, have long criticized the idea that health care is a “privilege,” not a right.
  • President Barack Obama, 6/7/13: “Quality, affordable care is not some earned privilege – it’s a right.”
  • Jonathan Chait, New York Magazine, 6/25/12: Health Care As a Privilege: What the GOP Won’t Admit — “Their reason for failing to defend their actual principles is obvious enough: That tens of millions of Americans deservedly lack a right to basic medical treatment is a politically difficult proposition. Thus, they oppose Obamacare without defending the indefensible conditions they actually favor. Their tactic of adding vague gestures toward unspecified future reforms has been so successful that news reports almost uniformly describe the Republican health-care stance as yet-to-be-determined, rather than an outright defense of maintaining health care as an earned privilege rather than a right.”
  • Sen. Bernie Sanders op-ed, 6/8/09: “Health care is a right, not a privilege”
Republicans have explicitly noted health care is a privilege and objected to the idea health care is a right.
  • Former S.C. Rep. and Heritage Foundation President Jim DeMint, Charleston Post & Courier, 8/18/09: “I think health care is a privilege. I wouldn’t call it a right.” 
  • Former Tenn. Rep. Zach Wamp, The Hill, 3/5/09: “Healthcare is a privilege…for everyone, frankly, it’s not necessarily a right.”
  • Former Texas Rep. Ron Paul, YouTube floor speech, uploaded 9/17/10: “Mr. Speaker, our government has been mismanaging medical care for more than 45 years. For every problem it has created, it has responded by exponentially expanding the role of government. Here are some points I’d like to have my colleagues consider. Number 1: No one has a right to medical care.”
  • Full Transcript of Ralph Northam’s Responses in the 2011 debate:

    38:07 HOST: Mr. Northam, what do you think of the Patient Protection Act passed by Congress and signed into law? Do you think access – this is a two-part question – do you think access to quality health care is a right or should it be left to the market or charity?

    38:20 NORTHAM: That is a great question. I wish we had more than two minutes to talk about it. As a physician at King’s Hospital, I’ve been there since 1992, I believe that our health care in this country is the best. We have people coming from all other countries to receive our health care. But our health care system is broken. I have tried to do things to help that. If you step back for just a second and look at the three areas of health care – the first is quality. We have good quality, I believe. The second is access, which we can improve on that. We have over a million Virginians without access to health care and to insurance.

    But the third, and the most important thing, is cost. And it is the cost of health care that is going to drive this country to its’ knees. And so the question was how do I feel about the health care reform bill. There are some good things about it, but it doesn’t do enough to address costs. It doesn’t do enough to address tort reform. It doesn’t do enough to address personal, people being responsible, personal responsibility. At the end of the day, what we need to do to address health care is move from what we have right now is a quantity based system to an outcome based system. And I have worked very hard, I don’t know if you have seen on Collie Avenue, there is a brand new academic building for the Eastern Virginia Medical School. We have the perfect template here in Hampton Roads to move toward a Mayo or a Cleveland clinic system to make health care what it should be to drive down the cost. And, Kathy, you asked question and I apologize.

    HOST: Do you think that access to quality health care is a right, or do you think it should be left to the market or charity?

    NORTHAM: I believe it’s a privilege. Let me clarify that. If people can get up in the morning and go to work like I can, then it needs to be a privilege. They need to work for their health insurance, for their benefits. If they’re disabled, I will take the shirt off my back to help them. In that situation, it would be a right. Thank you for the question.

  • Also see the following statements from the Northam campaign in response to the Perriello press release:

    “”Ralph firmly believes that every American and Virginian has a right to affordable healthcare, and he believes it is the responsibility of government to make sure they do.

    “He has led the fight for expansion of Virginia’s Medicaid program to provide affordable coverage to 400,000 Virginians, and worked in the legislature for Virginia to participate in the Affordable Care Act with its own state exchange.”

    “He voted against repealing the individual mandate. That vote alone, according to CAP, is about increasing universality. “

  • Elaine Owens

    This video could be Ralph Northam’s “maraca” moment. I understand (sort of) what Northam was saying…that people who work should try to get health insurance, and that people are responsible for those things they do that impact their health. But, his answer could have been made by almost any “moderate” Republican, if those creatures exist outside of Maine’s Susan Collins.

  • S. Lowe

    Since we’re cherry picking from 2011, this from wapo: Perriello’s actual profile is complex – he supports gun rights, has a mixed record on abortion and voted against Obama’s 2009 budget because he thought it didn’t do enough to address the deficit.

    Perriello said he doesn’t believe there’s any one formula for a winning Democratic campaign in Virginia.

    “I think pundits often overthink the ‘profiles,'” he said. “I think voters are often smart enough to have a gut reaction to the candidates, to say, ‘Here’s a guy who shares my values and can get things done.’

    By Ben Pershing | February 16, 2011; 3:15 PM ET

  • Anonymous Is A Woman

    Tom Perriello has taken a lot of flak from Ralph Northam’s supporters about his congressional votes back in 2009 and 2010. So, a certain amount of turnabout is fair play. Ralph Northam and especially his supporters, have been going around distorting Perriello’s record and also Northam’s to make it appear that Northam is the consistent, long time progressive candidate and that is simply not true. Indeed, even during his lieutenant governor’s race in 2012, he described himself as socially liberal and fiscally conservative. That is the same mold as Mark Warner, and other long time Virginia centrists. It is not particularly progressive. But I believe he may be evolving, just as lots of Democrats are. Just as a lot of Virginia voters are.

    His record, like Perriello’s, is more nuanced than it is being portrayed. Both have taken votes, made statements, and supported positions in the past that they no longer hold. Personally, I would rather see a candidate grow, learn, and change as long as they can explain why they are evolving. Their reasons matter. Perriello has addressed his reasons for changing, Northam has pretty much denied and ignored his real record rather than doing the same.

    Here is an example. In 2012, Northam was the only Democrat to vote with Republicans to deny coverage under the Virginia workers comp system to shipyard and dockworkers. That was HB 153,. That makes it seem like his 2011 position that health care coverage was a privilege and not a right was accurate at the time. Maybe he has changed it.

    But while Perriello has apologized for and explained his vote on the Stupak-Pitts amendment, as often as I bring up Northam’s vote against workers comp for shipyard workers, I have never, ever gotten an answer from any of Ralph’s supporters. Perhaps now that more of his record has been uncovered, somebody from his campaign will start acknowledging and addressing the fact that he, like Perriello, took votes in the past for which he is sorry.Recognition and acknowledgement rather than denial would be nice.

    • “even during his lieutenant governor’s race in 2012”

      That should be “in 2013”

  • Perseus1986

    The more I hear about and from Northam, the more I am convinced that he would be the weaker candidate against Gillespie in November. He’s shown himself to be a weathervane on many key issues, and rarely commits to anything other than vague standard party statements. Given his lack of political involvement until after 2004, and his voting for Bush in both elections, without any real documented post Bush transformation, makes it seem to me that he was just propped up in the state senate by someone to serve their interests, and his party loyalty and ability to reach out to more voters in rural Virginia, have allowed him to rise up to the Lieutenant Governorship.

    • Hugo Estrada

      How exactly would this make him weaker in November?

      • Perseus1986

        Being seen as a weathervane is often a weak point. Remember Kerry in 2004? And remember, it will most likely be Gillespie that the candidate goes up against, who has strong ties to the Bush camp and Karl Rove. They exploited Kerry’s changing positions on one issue to no end.

  • James Browd

    Let’s cut the BS. Northam helped write the bills to expand Medicaid and implement the ACA in Virginia. Instead of relying on this clipped answer, I’d encourage you to watch Ralph’s full answer where he talks about bringing down healthcare costs and expanding access. https://www.youtube.com/watch?v=95hfeNa-_YQ