Sunday, March 21, 2010

Some Historical Perspectives on National Healthcare

Randall Stephens

Teddy Roosevelt campaigned on health care in his 1912 Progressive Party bid for the presidency. Makes sense. He needed a little medical assistance after surviving a gunshot wound/assassination attempt in Milwaukee: "Friends, I shall ask you to be as quiet as possible. I don't know whether you fully understand that I have just been shot; but it takes more than that to kill a Bull Moose. . . . The bullet is in me now, so that I cannot make a very long speech, but I will try my best."

The Progressive Party platform of 1912 declared: "We favor the union of all the existing agencies of the Federal Government dealing with the public health into a single National health service without discrimination against or for any one set of therapeutic methods, school of medicine, or school of healing with such additional powers as may be necessary to enable it to perform efficiently such duties in the protection of the public from preventable diseases as may be properly undertaken by the Federal authorities . . ."

Two decades later FDR seemed to have thought a national health bill was one bill too many for his already ambitious alphabet soup initiatives.

It then fell to FDR's accidental successor to give it a go. "In my message to the Congress of September 6, 1945, there were enumerated in a proposed Economic Bill of Rights certain rights which ought to be assured to every American citizen." So began President Harry Truman's address to Congress on November 19, 1945.

One of them was: "The right to adequate medical care and the opportunity to achieve and enjoy good health." Another was the "right to adequate protection from the economic fears of . .. sickness ...."

Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health. Millions do not now have protection or security against the economic effects of sickness. The time has arrived for action to help them attain that opportunity and that protection. . . .

Our programs for public health and related services should be enlarged and strengthened. The present Federal-State cooperative health programs deal with general public health work, tuberculosis and venereal disease control, maternal and child health services, and services for crippled children. >>>

Didn't work out. Some Republicans equated it with communism and the American Medical Association came out against it.

Indeed, longstanding opposition to federal involvement in health care squelched most efforts. The American Medical Association again stood firm against Lyndon Johnson's landmark 1965 health insurance program. The AMA's chief players backed Barry Goldwater's 1964 campaign, making their criticism loud and clear. The AMA fiercely opposed Medicare. And in the early 1960s, Ronald Reagan warned that after the passage of such a national program, "We will awake to find that we have socialism."

Calvin Woodward offers some useful historical context on the current battle in the Sunday LA Times.

To history, it is likely to be judged alongside the boldest acts of presidents and Congress in the pantheon of domestic affairs. Think of the guaranteed federal pensions of Social Security, socialized medicine for the old and poor, the civil rights remedies to inequality.

Change is coming, it now appears, but in steps, not overnight. . . .

In contrast, on June 30, 1966, after a titanic struggle capped by the bill signing a year earlier, President Lyndon Johnson launched government health insurance for the elderly with three simple words, as if flicking a switch: "Medicare begins tomorrow." >>>

See also: the Boston Globe's (Associated Press) rather interesting timeline of health care legislation; A PBS timeline from Healthcare Crisis; and Jonathan Chait, "Health Care Reform And History," TNR, March 19, 2010.

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