THE POLITICS OF HEALTHCARE REFORM….He who does not know history is bound to repeat it.
There have been many attempts at health care reform. While defeat has been “over determined,” in almost every case there is a single group that is able to help ensure defeat.
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1913-14 ? Amazingly, the AMA supported universal health coverage but unions opposed it, thinking they could get a better deal by negotiating with employers themselves. World War I and anything German helped to defeat universal coverage too.
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1930s ? Franklin Roosevelt thought he couldn’t get universal coverage because it was too socialistic. He thought it was even harder than Social Security.
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1948 ? Harry Truman’s effort was defeated in large part because of the AMA.
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1964-65 ? Lyndon Johnson passed Medicare and Medicaid because his advisors thought universal coverage not possible. His advisors even told Johnson not to sign Medicare and Medicaid in Independence, Missouri, as a gesture to Truman, because they thought these programs would be labelled socialist medicine. Johnson rejected that advice, but the advice itself shows how tough the fight is.
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1971-72 ? The combined forces of Kennedy, Nixon and Wilbur Mills could not pass universal coverage, in part because liberals would not give Nixon anything and Wilbur Mills ended up in a sex scandal with Fannie Fox.
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1993-94 ? Clinton’s plan went down to defeat for many reasons. Hostility of business and insurers certainly played the biggest role, but liberal unwillingness to compromise with Sen. John Chafee (Lincoln Chafee’s father) was another.
There is always some group against universal coverage that’s able to prevent it from being enacted. Sometimes it is the AMA and sometimes it is liberal groups. To enact universal coverage we need to line up behind a plan even if it may not be our preferred plan.
For those who think single payer is still best, just look at Canada’s Supreme Court ruling today. The highest court there said that “the evidence in this case shows that delays in the public health care system are widespread and that in some serious cases, patients die as a result.” People are now expecting “a slew of lawsuits challenging provincial health care laws” in Canada. Opponents of single payer will latch onto this, interview Canadians upset with the system, and do another Harry and Louise.
