Tuesday, October 1, 2013

We, the People ...

Well, I was on a roll. Ideas for blog posts abounded at every turn and interaction of my world. Life was good! And then, American politics absolutely threw me for a loop. The workings or rather, the non-workings of our Congress is just beyond comprehension. They drove me to drink, rather than write! But, enough ostrich action. Here we go.

So, conservatives, libertarians, insurance and pharmaceutical companies and the American Medical Association (AMA) don’t like the Patient Protection and Affordable Care Act. Not surprising, they didn’t like the Health Security Act of 1993. Actually, they haven’t liked any approach to health care reform since forever. Well, notably beginning in the 1930’s.

Franklin D. Roosevelt wanted to include publicly funded health care programs as part of the Social Security legislation. The American Medical Association went ballistic and opened their coffers to oppose any and all things connected with universal health care. The stage was set for the entrenchment of a deep political fear of any organized and well-funded opposition to health care reform. A fear that is ongoing and further instigated by today’s political organizations and lobbyists (not the mention the Supreme Court’s deregulation of political contributions by corporations, and, politicians themselves).

In the 1940’s, legislation was passed to support third-party insurers, mostly hospitals that offered their own insurance plans. The first of these plans became Blue Cross. After World War II, industrialist Henry Kaiser expanded the organization he had formed during the war to a nonprofit organization open to the public, with a structure similar to a contemporary HMO except for the nonprofit part (I found it interesting that The Henry J. Kaiser Family Foundation has the mission of “filling the need for trusted information on health care issues,” including global policies. http://kff.org). I’m still finding it hard to know who to trust. But, they are worth the read.

In 1949, President Truman attempted to make universal health care a part of his Fair Deal legislation. No dice. And once group premiums paid by employers became a tax deductible business expense in 1951, third-party insurance companies became the primary providers of access to health care in the U.S.

The legislation that established Medicare and Medicaid passed in 1965 under President Johnson’s administration. Still opponents, especially the AMA and insurance companies, opposed the legislation on the grounds that it was compulsory; it represented socialized medicine; it would reduce the quality of care; and it was 'un-American.’” Sound familiar?

In 1970, Senator Ted Kennedy introduced a bipartisan national health insurance bill—without any cost sharing—developed with the Committee for National Health Insurance founded by United Auto Workers (UAW) president Walter Reuther, with a corresponding bill introduced in the House by Representative James Corman. Congressional hearings were held for health care reform for the first time in 20 years, but no universal health care bill passed the Congress. But, reforms extending Medicare coverage in 1971 were signed into law by President Nixon.

In 1974, President Ford called for health insurance reform. AMA opposition during this period moved the conversation to a voluntary tax credit plan. However, with the change in the Congress after the 1974 elections, the AMA strategized in 1975 to support an employer mandate proposal instead of their tax credit plan.

By December of 1977, President Carter had removed the support he had given to universal health insurance when he was a candidate for the presidency. He told Ted Kennedy that the bill needed to be changed to preserve a large role for private insurance companies, minimize federal spending, and be phased-in so not to interfere with balancing the federal budget. Reverberations from this position are included in the arguments set forth in opposition to today’s Patient Protection and Affordable Care Act.

Over his political career, Ted Kennedy fought long and hard for health reform. In 1985, COBRA was passed to give some employees the ability to continue health insurance coverage after leaving employment. The Clinton Administration made health care reform an essential part of its policy initiatives. During the Bush Administration there were a number of proposals offered to ensure the quality of care of all patients by preserving the integrity of the processes that occur in the health care industry. None of these were successful. Guess who, once again, opposed their enactment?

Bringing us back to the now and the continuing saga of health care reform in the United States.

Perhaps it is time that We, the People of the United States of America, step outside the hype of political parties, the AMA, insurance companies, and corporations and take the time to envision exactly what health care should look like in the richest country on the planet.
  • Should every American be able to depend on affordable and accessible, quality health care regardless of economic status?
  • Should every American have access to preventative maintenance of their health, regardless of economic status? 
  • Should every American have health insurance as a protection against emergency, unrestricted by the circumstance of age, or when you became sick, or what is making you sick?
Government becomes involved in these questions because of the word “every.” The policies and laws of the federal government should be designed to nurture the well-being of Americans, every American. Well-being begins with health and impacts all sectors of the society.

Opponents to the Patient Protection and Affordable Care Act have failed to answer any of these three essential questions in the affirmative. Instead, they present arguments about cost and entitlement; complications and problems, but not once have they offered approaches to these elements so that the questions can be answered “yes.”

If these questions are not relevant to the naysayers, so be it. It means that their vision of America is a very unpleasant, narcissistic, greedy and oppressive vision. It is not a vision based on the reality of this country, which has prospered by the blood, sweat and tears of every American, regardless of their economic status. Theirs is a vision that should not be accepted or allowed. But that will ultimately depend on the will of We, the People ...

1 comment:

  1. Opponents to the Patient Protection and Affordable Care Act have failed to answer any of these three essential questions because their opposition has nothing to do with the act itself, but rather a need to see the administration fail in every attempt it has made to pass any and all meaningful legislation. What we are witnessing right now in congress is the right wing element no longer able to hold their breath for fear that with the ACA fully functioning, their constituents may turn blue.