If the last 40-odd days of health care hysteria serve any intellectually viable purpose, it is to ratify the Thomas Theorem on self-fulfilling prophesies: If men define situations as real, they are real in their consequences. Indeed, like the famous “toilet paper panic” from the 1973 oil crisis and the more recent Obama ammo-hoarding ammo shortage, if you build a canard, crafty or crude, they will come. In hordes.
So, hoisting the nearly lifeless and catatonic body of the Affordable Care Act onto our autopsy table, let’s cut in with zeal to see if we might irrigate the purposeful infection and perhaps even save the lives of millions of Americans in the process.
Everything Old Is New Again
The first notable discovery in our potential post-mortem of the ACA is that we find the notion of national health care to actually be 159 years of age. Indeed, both houses of congress passed the Bill for the Benefit of the Indigent Insane in 1854, only to have President Franklin Pierce veto the law; Pierce strongly believed any social welfare measures should be left to the states, a rodent’s refrain we 21st century folk continue to hear several times each day.
In a lightning strike of irony, the first successful instance of a form of national health care occurred just after the Civil War, with the 1865 arrival of the Freedmen’s Bureau, through which the government constructed 40 hospitals, employed over 120 physicians, and treated well over one million sick and dying former slaves. Oddly enough, it is those very red, recipient, former slave-holding states that are most in need of better health care, whilst their leaders in DC fight hardest to keep constituents sick and dying.
From the commencement of the American Century through WW2, various incarnations of reasonable national health care plans rose and fell like so many zombies, including but not limited to: the 1912 Theodore Roosevelt Plan; the AALL Bill of 1915; the Committee of the Cost of Medical Care, 1926-32; the Social Security Act of 1935; the Wagner Bill of 1939; the Wagner-Murray-Dingell Bills of 1943; the Fair Deal plans and Hill-Burton Act of 1946.
Of Truman’s efforts, Sen. Robert Taft (R-OH) remarked “I consider it socialism. It is to my mind the most socialistic measure this Congress has ever had before it,” and the AMA quipped “Would socialized medicine lead to socialization of other phases of life? Lenin thought so. He declared socialized medicine is the keystone to the arch of the socialist state.” The AMA went so far as to spend over $1 million to defeat national health care. Sound familiar?
1950 found life expectancy at 68.2, infant mortality at 29.2 per thousand live births (43.9 for black children), a crude death rate of 9.6 per thousand and heart disease leading the charge to the bone yard with 355.5 deaths per 100,000 of population. If these statisticians could see into the future, they would have recoiled at the 2012 CDC findings that 45,000 Americans per year would die for lack of health insurance and that uninsured, working-age Americans would have a 40 percent higher risk of death than their privately insured counterparts. Had they learned the New England Journal of Medicine would rank the US 37th in health care in 2010, they may have fainted.
So back to the mid-century, undaunted advocates and fans of public health in specific and life in general continued their efforts for decades through Johnson’s Medicare and Medicaid of 1965, the Javits Plan of 1970, the Nixon Plan of 1974, the Medicredit Plan of 1976 and numerous proposals from the late Sen. Edward Kennedy (D-MA). Indeed, cutting deep into the older tissue of the ACA, we find not the withered carcass of a Kenyan-born Islamic commie, but the hearty bipartisan embodiment of mutable American values like decency, dignity, stability and community which could still serve to render us the hope of the world. Or not.
The Arkansas Traveler
Enter William Jefferson Clinton, nee Blythe, a man so attuned to the pain of others he once lined the bed of his 1970 El Camino with Astroturf to ease the ride for his female passengers. Arriving in DC with his bride in 1993, Clinton immediately resuscitated national health, proposing a universal health care plan as part of reforms which would also require employers to insure all employees through a government-regulated marketplace of HMOs. At the exact same time, GOP Senators including Chuck Grassley, Orrin Hatch, Bob Bennett and Kit Bond pushed for passage of the HEART Act, a universal coverage plan that instead contained the individual mandate suggested by the conservative Heritage Foundation.
Neither law passed, and both Clintons suffered a flaying from Rush Limbaugh and numerous conservative groups, the US Chamber of Commerce, big pharma, and the insurers. The GOP took back the House while the Man From Hope grew ever more wily. For our purposes, two chief lessons emerged; the GOP was A-O-K with the individual mandate and both Clintons were widely recognized as expert at promoting themselves and turning a withering triangulation of fire upon unsuspecting friends if it suited them.
Moving right along to 2006, in order to flesh out a meager public vitae on the way to the White House, Gov. Mitt Romney (R-MA) went back to the individual mandate well, bringing universal health care and the health connecter exchange to his adopted state of Massachusetts. While running for POTUS in 2008, Romney even enjoyed kind words from then-Senator Jim DeMint (R-NC), who clearly praised Romney’s ability to “take some good conservative ideas, like private health insurance, and apply them to the need to have everyone insured.” Yet just a few short weeks ago we heard DeMint warn “the law is economically unstable, financially irresponsible and harmful to hardworking Americans.” Huh?
Speaking to his sole and shining gubernatorial achievement on the campaign trail in ’08, Romney himself said of the individual mandate, “I’m proud of what we’ve done. If Massachusetts succeeds in implementing it, then that will be the model for the nation.” Four short years and nationwide passage of the self-same plan later, 2012 finds the same Romney vowing repeal of the job-killing abomination, breathily claiming “It’s telling you you have to buy something, and the government should not impose a mandate for us to buy something.” Say what?
What a Difference a Day Makes
Coasting to breezy victory on the snowy wings of hope and change, the current POTUS took up the now 100-year-old cause of universal health care and reform. A bipartisan gaggle of Senators, including Democrats Max Baucus, Jeff Bingaman, and Kent Conrad, and Republicans Mike Enzi, Chuck Grassley, and Olympia Snowe met for 60 hours over the course of 31 sessions to formulate a plan reasonably certain to work and absolutely certain to pass. The earliest consensus gathered around the now-famous individual mandate, private insurance and free-market principles.
However, displaying a stunning lack of honor, courage, empathy, decency and institutional memory, the GOP immediately began cries of foul, howls of unconstitutionality and threats of filibuster or worse for any bill containing the GOP born-and-bred concept of the individual mandate. Sen. Mitch McConnell (R-KY) even warned his troops of any support for any solution, to wit “It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out.” Heaven forbid they should do their jobs, “figure it out” and deliver health care to millions of uninsured Americans in the process, right?
Meanwhile over at the White House Forum on Health Care in March of 2009, the seeds of betrayal were being laid by the very insurers who now stand to gain seven million new paying customers in 2014, but today are frantically screwing their individual policy holders for both fun and profit. Speaking to Obama’s fears of opportunistic cancellations and policy changes nearly five years ago, America’s Health Insurance Plan’s (AHIP) clever CEO Karen Ignani famously assured the new POTUS “We want to work with you, we want to work with the members of Congress on a bipartisan basis here. You have our commitment. We hear the American people about what’s not working. We’ve taken that very seriously. You have our commitment to play, to contribute, and to help pass health care reform this year.”
No sooner had Ignani crept away to her limo, when the $173 million PR shit storm she helped conjure hit the national fan. Myriad distortions, fabrications and flat-out dirty lies spewed from any and all willing sources, including but not limited to: the health care law has “death panels;” the health care law rations care; Muslims are exempt from the health care law; Congress is exempt from the health care law; Obamacare provisions will allow “forced home inspections” by government agents; “illegal’s” will all get free health care; Obamacare is the largest tax increase in the history of the world; a “hidden” provision in the health care law taxes sporting goods as medical devices, and my new personal favorite, Obamacare will question your sex life, either forcing or forbidding contraception, whichever is worse for you.
Sometimes I Feel Like a Motherless Child
Notwithstanding obstruction, sabotage, slander and latent sedition, the Senate ultimately passed the ACA on Christmas Eve, 2009 by a strict party-line vote of 60-39. The House followed suit by a score of 219-212, and the SCOTUS declared the law constitutional in 2012 over the shrieks of the self-interested and 27 GOP attorneys general. As plainly imperfect as it is, this is the law the GOP, medical establishment, business community and insurance industry helped shape and craft over the course of many long years. This is the law bearing the marks of as many “free- market” concessions as could be made without sacrificing its very purpose. And this is the law whose crib death repeal could mark the ascendancy of a malicious tea party wing and eventual corporate feudalism in the US.
Yet, in 45 short days, because of IT glitches caused in no small part by craven GOP penury and red state insolence, off-hand assurances made by a weary intellect at war with ignorance, and the shameless, heartless duplicity of feckless insurers cancelling policies in an orgy of avarice, certain members of the President’s own party are peeing themselves while waving the white flag of cowardice. Worse yet, such apologists have enjoyed covering fire from Mr. Clinton in a display of cynicism raised to a morbid art form.
I simply can’t believe that after this treacherous trail of tears, after millions of Americans have already enjoyed immeasurable benefits from this law, after nearly 50 hopeless GOP attempts to kill the law and deny so many millions some measure of health security, we find ourselves graveside. That after over 100 years spent dragging this exasperating republic kicking and screaming through the last century and into 21st., so many sworn to work for the public good are so selfish and weak they’re ready to just up and quit.
You’re better than this. We’re better than this.
A tail-end baby-boomer, Bill Urich was born in Cleveland to a grade school teacher and her Navy vet husband, and reared in Greater Detroit. Working his way through school primarily at night, Mr. Urich holds a Bachelor’s in Journalism, Phi Beta Kappa, and a Juris Doctorate from Wayne State University.