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The Right Prescription
The Reformer's Folly
Barack Obama's rush to reform America's health care system is stalled as legislators and citizens grapple with the fiscal and political ramifications of the $1.5 trillion bill now on offer in Congress.
With Democratic majorities in the House and Senate plus his personal popularity and much acclaimed powers of persuasion, it astonishes that barely six months into his presidency, health care reform, one of Obama's paramount domestic goals, is in peril.
Adding to the surprise, the plurality of Americans -- 71 percent according to a recent Gallup Poll, believes the country's health care system should be overhauled. But reform and statism are not mutually exclusive. And Americans have never been comfortable with the notion of socialized medicine, which many believe despite Obama's protests otherwise, will be the ultimate product of the coming "reforms."
In fact, for nearly a century presidents have been promising to cure the country's ills with government-run health care and at just about every instance their schemes have been dead on arrival.
Franklin D. Roosevelt was the first to dream of national health insurance. (Though his cousin Theodore's 1912 quest for the White House included a call for the "protection of home life against the hazards of sickness.") In 1934, Roosevelt predicted the nation would "come to this form of insurance soon or later." The president favored sooner: the Social Security Act, as initially envisioned included national health insurance. This, however, would have made the already controversial program an even harder sell. Straining to hold back the grandiosity of his ambitions, Roosevelt scrapped the health care concept. When the Social Security Act was singed into law in 1935, all that survived of Roosevelt's original vision were small grants to states for rural and handicapped health programs.
The idea of nationalized health care languished until the next decade when Roosevelt's successor, Harry S. Truman renewed the call for universal coverage in 1945. Senators Robert Wagner and James Murray and Rep. John Dingell (who had previously collaborated on an insurance proposal) then drafted legislation that would federally subsidize hospital construction, institute national health care standards and create a national health insurance program in which citizens would cough up a monthly fee, while the government would pay doctor bills and compensate for lost wages.
The resulting bill, known as W.M.D. (named for Wagner, Murray and Dingell) arrived in 1946. Even though Democrats held both of its houses, the legislation sputtered and died in Congress as its opponents' criticism of the health insurance language of the bill as socialism resonated with the public in the midst of the Cold War. Truman repeatedly renewed the call for national health insurance during the remainder of his presidency but had little to show for his efforts when he returned to Missouri in 1953.
A decade later in Missouri, and with Truman in attendance, President Lyndon B. Johnson signed the Social Security Act of 1965, creating Medicare and Medicaid. These programs represent the first large-scale government run health care initiatives in U.S. history, though they were less ambitious in scope – covering only the elderly and some of the nation's poor -- than previous proposals.
They also represented a new incremental strategy that took into account the public's resistance to government involvement in medicine and aimed to assemble nationalized insurance bit by bit, while avoiding any associations with socialized health care. Even the legislation's language stated "Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine…"
Still, Johnson and House Ways and Means Chairman Wilbur Mills struggled mightily to secure the bill's passage in one of the most liberal and Democratically dominated Congresses in history. In fact, Medicare and Medicaid were such risky political and fiscal propositions that Johnson fudged their cost and feasibility and pitched them as modest and affordable interventions to help vulnerable Americans.
The programs have grown exponentially since their creation and belied all of their creators' most optimistic projections: for example, in 1965 the government estimated that Medicare Part A (the program's inpatient hospital care provision) would cost $9 million by 1990. The actual cost was $66 billion. Medicare is now shouldering an $84 trillion unfunded liability and will be bankrupt by 2017.
But Medicare and Medicaid were immediately well received. Because of this, in the early 1970s, Democrats sought to expand the program to cover the entire country. With this in mind, President Richard Nixon, who had endorsed a national health insurance plan as a Representative from California in the 1940s, used his fifth and final State of the Union Address to propose a "sweeping new program that will assure comprehensive health-insurance protection to millions of Americans who cannot now obtain it or afford it."
Introduced in February 1974, Nixon's plan, the Comprehensive Health Insurance Act, would be financed jointly at the federal and state level to provide coverage for the nation's uninsured. But it would do so by building off of insurance plans instead of creating a costly new bureaucracy. Nixon was careful to distinguish his plan from those "that would put our whole health care system under the heavy hand of the Federal Government."
After a series of compromises, the plan was eventually meshed with aspects of competing proposals in Congress, but organized labor, hoping to broker a better deal with a new and presumably more liberal Congress after the 1974 midterm elections, or a Democratic president after the 1976 election, refused to support the plan. The proposal collapsed as the Watergate scandal subsumed the presidency and, for the moment, the prospect of universal coverage.
Enter the Man from Plains. Jimmy Carter's 1976 bid for the White House included a pledge to create a "comprehensive program of national health insurance." But battling stagflation, in-house politicking -- especially between the Department of Health Education and Welfare and the White House, and continued opposition to a national plan, Carter moved slowly on health care reform -- too slowly for some. He initially proposed any reforms be phased in and implemented gradually. Senator Edward Kennedy, who then, as now stood as Congress' chief advocate of a nationalized health care, rejected this approach and introduced his own plan for universal coverage.
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Appleby| 7.31.09 @ 7:07AM
The American people are by and large impossible to move when they have made up their minds. How long has the benevolent despotry tried to cram the dollar coin and the metric system down the countrys throat, and failing? Americans individually cannot be forced to accept things they choose not to accept.
Socialist medicine is one of these things.
You cannot enforce a law that everyone has decided not to obey. There are just too many of us to catch.
America will Go Galt and you will know there is defiance going on but you will not be able to do a thing about it. The official doctors will be people you do not want within fifteen feet of you, and you will not be able to find the good doctors -- but we will. Blessed indeed will the family be who has a nurse, nurse practitioner or nurses aide in its ranks! Everyone will know who and where they are -- but you government ninnies will not. Underground medical treatment bunkers will take on the Speakeasy mantle and not only will the people be treated, there will be no tax.
The really big error everybody of the socialist persuasion makes, and that started with King George, is the assumption that they can MAKE Americans do things they do not wish to do.
Good luck with that. And watch for those Dont Tread On Me flags, t-shirts and bumperstickers.
Rocco| 7.31.09 @ 7:15AM
Appleby,
You're on a roll today. I like it, and agree wholeheartedly. Best of all, you're right!
Robert Rosencrans| 7.31.09 @ 7:30AM
During the entire time the collectivists called for nationalized health care, the non-nationalized health care system developed into one of the best health care systems in the world.
Pat Spooner| 7.31.09 @ 7:39AM
Regarding Obamacare, why should I and hundreds of millions of other hard working Amercian taxpayers have to pay for medical care for millions of individuals who smoke, drink excessivley, overeat and are obese, do not excerise or otherwise take care of themselves, use illegal drugs, all the while refusing to work to get an eductaion or just refusing to work period?
I came from a family of poverty from Northern Miane but my parents supported and encouraged my brothers and I to study in school, work hard to get a decent education and to put our noses to the grindstone wherever we worked to do right and be honest. Becasue of that they and I have been able to get ahead - I believe that everyone in this country has an equal opportunity to succeed to the best of their ability, but they must want to and they must work for it. Obamacare must be voted down; now and in the future. This county, and in particular our federal and state governments, must get back to basics, the bear minimum. Governement cannot continue to steal everything from working people or there will be no one left working.
It is time to enact term limits, we cannot contiue to allow elected representatives to become lifetime politicians - nobody is that good, nobody is that great, nobody is that important that they should be granted a lifetime politiocal position - that only gives them license to steal and the attitude that they are deserving of whatever they can take.
stephanie| 7.31.09 @ 8:15AM
Thank you Thank you Thank you Appleby.
Your post is real and correct.
And it gives me hope.
Deborah D| 7.31.09 @ 8:37AM
There's a Health Care rally getting ready to take place in NC over the next week. A bus tour of the state. Here's info and if you know anyone in NC, pass it along: http://americansforprosperity.org/073009-north-carolina-bus-tour-focus-putting-patients-first-health-care-debate
Deborah D| 7.31.09 @ 8:40AM
Oh, forgot to mention -- Appleby, I love the way you think!
And, Pat Spooner -- your story is the All-American story, I certainly can relate (coming from a family of 8 children -- husband a family of 9 children) -- what we were given was the gift of freedom. Our parents taught us to value hard work and education and independence and self-reliance. Let's hope your story and mine still resonates.
Becky| 7.31.09 @ 9:03AM
It will be just like cash for clunkers. The government owned car companies are matching the government rebate making their cars more attractive to buy (Gm and Chryler are adding up to $4,500, making the discount $9,000 for them). A govt run insurance policy will have the same advantage, that is, they won't worry about making it break even, let alone profitable. The program was underfunded, some dealers are running out of cars, worry about the long wait in being reimbursed, changing of the rules. The used market for lower income shoppers is being destroyed, the true junkers are still cluttering the landscape, so the environment has not been helped.
Like all goverment programs, national health insurance will be underfunded, heavily weighted to their favor, and unable to deliver to meet demand. Cash for Clunkers lasted less than a week before they realized they aren't sure what they are doing.
I see another auto crisis before we have a health care crisis.
Appleby| 7.31.09 @ 9:24AM
I had a fire-breathing Daddy who could quote you chapter and verse from the Constitution, which he learned in a two-room prairie schoolhouse in the 1930s when his father could spare him from the farm. Daddy died in 2008 and I have picked up the flag and the sword before it could hit the ground.
Fortunately I was educated before university became a jobs program or a place to get stinking drunk and/or pregnant; I was the first member of my family on either side to finish university and that, in those days at least, carried a lot of responsibility.
Daddy said all his life, "Comes the revolution!" and I am ready to organize the resistance in my neighbourhood when the time comes.
Remember, you are not Canadians! Our ancestors who left the Old Country would have told you that the cowards never started and the weaklings died on the way. You whose families made it here are still the creme de la creme. The time has come to show those ancestors that you get it.
The individual is still a majority. When they say "You must" say NO.
Just remember, never look King Zero in the eye. Don't be a prop or a token in his war on the USA.
Point at him and laugh, then walk on by. Nothing to see, folks, move along.
Deborah D| 7.31.09 @ 10:41AM
Appleby -- I remember my Dad in the 1960's railing against welfare. My Dad, father of 8 children, who had to quit high school as the oldest of 10 children during the depression to go to work to help his Dad put food on the table for the other nine. My father, who as a carpenter worked hard all of his life, did not understand why he had to work all that much harder to support other people who were capable of work. God rest his soul.
RM| 7.31.09 @ 12:43PM
The government can't run a cash for clunker program but they want us to put our health care into their hands. I'll retire to bedlam.
Howard| 7.31.09 @ 1:00PM
Once again, another generation of Best and Brightest Harvard men are being frustrated by the inability of us simpletons to agree to their programs; which after all are for our best.
stephanie| 7.31.09 @ 1:08PM
Pockets of resistance are popping up all over the country. "Patriot" groups are organizing via the internet. MeetUp is a site where you can find these groups. Here in Hampton Roads and Richmond we have busses rented to go to Washington on Sept. 12 for a demonstration, (Tea Party) and it looks like thousands have committed to be there to let their voices be heard. I hope you will join us there. Those who cannot come to DC, organize one in your local. Maybe the MSM will pay attention this time.
Pat Spooner| 7.31.09 @ 5:23PM
Deborah D., thank you for your kind comments and may God bless you, your family and this great country called America!
thelefthasthefacts| 7.31.09 @ 6:55PM
Americans individually cannot be forced to accept things they choose not to accept.
Socialist medicine is one of these things.
------------------
Appleby, you do realize that up to 50% of all money used to develop drugs come from taxpayers through the National Institute of Health.
Here's but one AP article from 2001 (you can find many more documenting this fact:
http://www.whale.to/m/drug.html
I know that because you despise socialized medicine you will now refuse to take any of these medicines. You will tell your doctor to prescribe only those drugs that were developed with 100% private funds through the mythical "free market" you still believe in. You'd rather die than take medicine that Castro would approve of.
Not only that, but then the drug companies make us taxpayers, who funded up to 1/2 their research pay full price to obtain the drug! I bet you like that part because they're just being clever capitalists.
In short, if you don't give up your socialized medicine, then your a pinko lib to the left of Michael Moore!
GG| 8.1.09 @ 2:00AM
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Robert| 8.1.09 @ 8:15AM
Today it's Cash for Clunkers. Tomorrow - courtesy of Obamacare - it will be Cash for Seniors.
Cash for Clunkers - the scheme awarding taxpayer money to those who trade in older cars - is a prototype for Obamacare, where a government entity called QALY, like Great Britain's already existing NICE, will determine whether your health or age qualifies you for medical care. Sick or old? You'll get fewer points and be denied medical care.
I don't see any great chasm between Obama giving you cash for trading in your old heap and Obama paying you for turning in your old man or old lady.
Chilling...imagining what this administration is capable of!
Louis Jenkins| 8.1.09 @ 9:42AM
So Franklin created this, and LBJ created that, well, now my friends, welcome to the world of bad corporate execs, bad ole' car makers who fly their corporate jets to DC (Look at Polosi's taxpayer supported jet), and now the bad ole' insurance companies. "It's almost immoral what they are doing," Pelosi said to reporters, referring to insurance companies. "Of course they've been immoral all along in how they have treated the people that they insure," she said, adding, "They are the villains. They have been part of the problem in a major way. They are doing everything in their power to stop a public option from happening." Let's bad mouth this group to get our way!! As millions have said, if this plan is so great why ain't those peck-- heads in DC gettin' on board with the plan instead of keeping the one she has? Pelosi is calling insurance companies immoral?
Health Savings| 8.1.09 @ 1:09PM
Well you have to give them credit - they never give up. Ha ha!
The Socialists, that is.
Get a health savings account plan: http://www.hsahealthplans.com
Marc Jeric| 8.2.09 @ 3:46AM
One of the main complaints against private health insurance companies is that they will not accept new customers with prior conditions of serious sickness. Well, let us see:
1) A fellow works 30 years without health insurance with no trouble; thus he has "saved" about $90,000 over that time - well, much more than that if he bought tax-free municipal bonds (about $200,000, or in the stock market about $2 million) ; then, after 30 years he would have this capital, all of it "saved" by his not paying for health insurance. Whether he saves or drinks it all up in bars with his friends does not matter - that's the value of his "savings. Then suddenly he develops cancer and wants to insure himself; if the company accepts him this will increase the rates of other insured customers. Better the company does not dare to inflict the costs of that irresponsible goon on me and my family; I have been paying that insurance for years and I do not want to pay his costs now!
2) Another eaxample; in California one can take up voluntarily the option to insure the house against earthquakes - it adds about $30/month to your premium. So now another fellow will not pay that premium for 30 years, saving himself about 30x12x30=$10,800 (again, investing those moneys in tax-free municipal bonds that amount would be worth some $21,000, or in the stock market some $200.000). Then an earthquake flattens his house and he wants the insurance company to accept his earthquake insurance now - after the fact. I say to hell with him - I do not want my rates to go up because of that irresponsible creep!
3) Most of us pay the car insurance - against damage, theft, uninsured motorist. A smart guy decides to avoid that cost; there is a small chance that a cop will stop him and ask for proof of insurance. But the fellow is a careful driver - and over 30 years he will have saved some $60,000 in "unnecessary" expenditures (or, when investing those "savings" in municipal bonds he would end up with a capital of $115,000, or again in the stock market some $1,200,000). Then one day a Mexican illegal without insurance totals his car; the fellow then wants to insure his car after the fact. I say to hell with him - I do not want my rates to go up to cover his irresposible behavior that "saved" him all that money.
So how valid is that complaint about health insurance companies not accepting prior conditions?
Dr. Gregory Garamoni| 8.2.09 @ 8:05AM
For a satirical take on this topic, check out "Hey, ObamaCare, are you up for a game of chicken?" at the end of the "Healthcare Humor" page of our website (http://www.doctorsonstrike.com). Here is a sample:
These left-winged birds of a feather nested conspiratorially together, secretly brooding until The First Hen finally laid her wonderfully wobbly, pink-hued, left-leaning egg that was warmly incubated until it haplessly hatched as a half-assed hatchling that would futilely try, but never quite fly. Unwilling to foresee its foreseeable failure to fly, the collectivists collectively clucked this cheerful collectivist chorus about this half-assed hatchling they had so happily hatched:
We’re in this together,
We’re birds of a feather,
Universal health care is here,
There’s nothing to fear,
The Collective will fight,
Health care’s a right,
Health care for all,
We’re ready to brawl!
This fowl plan soon came to be known throughout the land as HillaryCare.
###
Dr. Gregory L. Garamoni
Founder & Executive Director, Doctors on Strike for Freedom in Medicine
2304 Sawgrass Village Drive
Ponte Vedra Beach, Florida
904-631-3939
www.doctorsonstrike.com
garamoni at gmail.com
Jim O'Brien| 8.2.09 @ 9:47AM
The legislation pending in the House is designed to kill private insurance and force all of us into socialized medicine. It is an outrageous invasion of my Constitutional rights to life, liberty, and property. It will destroy the great health care we already enjoy, and it will make the national debt even more obscene than it already is. The government can't even figure out how to run the cash for clunkers (cars) program. How can it possibly plan medical care for over 300 million Americans from inside the Beltway (the American Kremlin)? I am opposed to ANY federal legislation which increases the government's role in medical care. What we need is less government involvement, and a return to the free market. Private enterprise created the thousands of innovative procedures and new drugs currently used to improve the quality of life. Government didn't do this, and it never will.
hoads| 8.2.09 @ 11:22AM
"In fact, Medicare and Medicaid were such risky political and fiscal propositions that Johnson fudged their cost and feasibility and pitched them as modest and affordable interventions to help vulnerable Americans."
This sentence should be highlighted. Read how deceitful propaganda was used to get Medicare passed: http://www.cato.org/pubs/journal/cj16n3/cj16n3-3.pdf
Excerpts:
"History shows that Medicare did not and could not achieve passage without the misrepresentation, cost concealment, lying, and
incrementalism to which its supporters ultimately resorted."
page 319 "The gulf between what the public thought and what was actually in the bill was enormous. The most pressing rationale for compulsory health insurance continually put forward by government officials and echoed by the public was the specter that responsible older people could be ruined financially by catastrophic illness. Yet neither the 1963 nor the 1965 proposal provided coverage for catastrophic illness."
page 321 "Another important underpinning of the “avoiding dependency” rationale was the widely trumpeted portrait of elderly Americans as an impoverished group whose plight made them a sympathetic object of tax-supported medical insurance. Misrepresentation of the financial condition of the elderly helped to paint this portrait, as government officials advocating Medicare repeatedly cited statistics showing lower incomes received by the elderly in comparison with other age groups. Yet the income statistics by themselves were misleading because they did not include asset ownership, and the elderly as a group had more substantial assets than other segments of the populace."
page 322 "Questioned about whether the 1964 bill represented socialism, Celebrezze directly addressed the issue of control, stating: “There is nothing in this bill which tells a doctor whom to treat or when to treat him. There is nothing in this bill by which the Government would control the hospital, and as I understand socialism, it is Government control and operation of facilities. . . . It is merely a method of financing hospital care, and that is all” (U.S. House Hearings
1963—64: 50). He added,
"We are a paying agency and I don’t see where you get any control of any kind out of that. Naturally,. . . there will be minimum requirements like these which are required now under Blue Cross. I see
no evidence where this would lead to control over the doctors [U.S.
House Hearings 1963—64: 54],
The AMA had a different view of the power of the federal purse.
AMA President-Elect Dr. Norman A. Welch testified that “It is axiomatic... that control follows money when the Government steps in”
(U.S. House Hearings 1963—64: 652; emphasis added)."
The Left is up to the same old tricks.
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1.http://booksteps.com/2008/07/16/i-know/#comment-171624
2.http://booksteps.com/2008/07/01/a-disturbing-trend/#comment-171625
3.http://booksteps.com/2008/04/03/john5-25/#comment-171626
4.http://booksteps.com/2008/03/28/john5-24/#comment-171629
5.http://booksteps.com/2008/03/27/john5-21-23/#comment-171630
6.http://booksteps.com/2008/03/24/john5-19/#comment-171627
7.http://booksteps.com/2008/03/21/john5-18/#comment-171628
8.http://booksteps.com/2008/03/13/john5-14-15/#comment-171631
9.http://booksteps.com/2008/03/10/kipling-on-cats/#comment-171632
10.http://booksteps.com/2008/02/08/john3-22-26/#comment-171635
11.http://booksteps.com/2008/02/06/john3-16-18/#comment-171636
12.http://booksteps.com/2008/02/05/john3-9-15/#comment-171654
13.http://booksteps.com/2008/01/31/john3-1-2/#comment-171639
14.http://booksteps.com/2008/03/08/john4-54/#comment-171641
15.http://booksteps.com/2008/03/06/john4-48-50/#comment-171655
16.http://booksteps.com/2008/03/05/john4-46-47/#comment-171642
17.http://booksteps.com/2008/03/03/john4-39-41/#comment-171643
18.http://booksteps.com/2008/02/28/john4-34-35/#comment-171645
19.http://booksteps.com/2008/07/02/the-purpose-of-humility/#comment-171647
20.http://booksteps.com/2008/06/30/sun-and-moon/#comment-171657
21.http://booksteps.com/2008/06/26/a-sick-mind-cannot-cure-a-sick-mind/#comment-171650
22.http://booksteps.com/2008/06/24/imagination-vs-reason/#comment-171651
23.http://booksteps.com/2008/06/13/insanity-check/#comment-171652
24.http://booksteps.com/2008/03/02/john4-37-38/#comment-171644
25.http://booksteps.com/2008/06/28/worse-than-materialism/#comment-171658
26.http://spectator.org/archives/2009/08/03/blue-dog-day-afternoon#comment_132077 1条
27.http://booksteps.com/2008/02/10/john3-27-30/#comment-171634
28.http://booksteps.com/2008/06/25/no-such-thing-as-a-careless-lunatic/#comment-171692
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