National health insurance has been on our agenda for a very long time, much of the push coming from the most conservative segments of our political spectrum. Take for example this excerpt from a February 6, 1974 speech from uber-conservative Republican President, Richard Nixon:
Without adequate health care, no one can make full use of his or her talents and opportunities. It is thus just as important that economic, racial and social barriers not stand in the way of good health care as it is to eliminate those barriers to a good education and a good job.
Three years ago, I proposed a major health insurance program to the Congress, seeking to guarantee adequate financing of health care on a nationwide basis. That proposal generated widespread discussion and useful debate. But no legislation reached my desk.
Today the need is even more pressing because of the higher costs of medical care. Efforts to control medical costs under the New Economic Policy have been Inept with encouraging success, sharply reducing the rate of inflation for health care. Nevertheless, the overall cost of health care has still risen by more than 20 percent in the last two and one-half years, so that more and more Americans face staggering bills when they receive medical help today…
Early last year, I directed the Secretary of Health, Education, and Welfare to prepare a new and improved plan for comprehensive health insurance. That plan, as I indicated in my State of the Union message, has been developed and I am presenting it to the Congress today. I urge its enactment as soon as possible.
The plan is organized around seven principles:
First, it offers every American an opportunity to obtain a balanced, comprehensive range of health insurance benefits;
Second, it will cost no American more than he can afford to pay;
Third, it builds on the strength and diversity of our existing public and private systems of health financing and harmonizes them into an overall system;
Fourth, it uses public funds only where needed and requires no new Federal taxes;
Fifth, it would maintain freedom of choice by patients and ensure that doctors work for their patient, not for the Federal Government.
Sixth, it encourages more effective use of our health care resources;
And finally, it is organized so that all parties would have a direct stake in making the system work--consumer, provider, insurer, State governments and the Federal Government.
Congress did not accept the President’s proposal, so a number of states, including Massachusetts, implemented their own versions of his proposals in later years. In 2006, RomneyCare was signed into law by GOP governor Mitt Romney, and the citizens of this New England state became the beneficiaries of a healthcare program that looks a lot like Obama’s Affordable Care Act. In July 2009 USA Today, Romney wrote an op-ed in which he urged Obama to follow Massachusetts’ lead and adopt the mandate: “Using tax penalties, as we did, or tax credits, as others have proposed, encourages ‘free riders’ to take responsibility for themselves rather than pass their medical costs on to others.” Big stuff for the Republican standard-bearer in the last presidential election, even though he subsequently disavowed his own program to appeal to the ultra-conservative Base he needed to get nominated.
RomneyCare worked; so its provisions were fairly closely followed when ObamaCare was drafted: “The problem for Romney is that there are no fundamental differences between the two laws. Both programs create exchanges where private insurers compete. Both require individuals to purchase insurance. And both subsidize those who can’t afford it. It’s a relatively new way of extending coverage. Massachusetts was the first place it was adopted, and the Affordable Care Act was the second. The two laws are, in the words of Jonathan Gruber, who helped design both the Romney and Obama plans, ‘the same [$&^%!!] bill.’
“[The individual mandate] is the part of the Affordable Care Act that really enrages Republicans… It’s an essential part of both plans. The only difference between Romney’s mandate and Obama’s is that Romney’s plan levies a harsher penalty on people who don’t buy insurance: $1,200 versus Obama’s $695…
“Both plans subsidize people who can’t afford to buy insurance on an exchange. The only difference is that Massachusetts gives more money to fewer people (anyone earning up to 300 percent of the poverty level), while Obama’s plan gives less money to more people (anyone earning up to 400 percent of the poverty level)…
“[B]oth plans require employers to provide insurance, and again the differences are marginal. In Massachusetts companies with 11 or more employees must provide insurance or pay a $295 penalty per employee. Under the Affordable Care Act, companies with 50 or more employees must offer insurance or pay a $2,000 penalty per employee. Romney’s plan affects smaller businesses; Obama’s levies harsher penalties.” The DailyBeast.com, March 6, 2012. So why is the Affordable Care Act such an easy lightning rod for conservatives?
Illinois Senator Barack Obama electrified the 2004 Democratic National Convention with his powerful speech. His 2008 presidential campaign was highlighted by one heart-pounding speech after another. In 2010, he accomplished what his Republican predecessors had failed to implement, a new national healthcare law pejoratively labeled Obamacare, the repeal of which has become the cornerstone of the majority of GOP candidates in the approaching mid-term election. Such a great speech maker? Still? Or does he just talk a good game… to a point?
Do you really (really?) understand the provisions of the Affordable Care Act? Did the great orator Obama remotely explain to you how it worked? Did he even understand it himself (“You can keep your existing plan” faux pas)? Oh, he really failed there, didn’t he? What’s worse, he got it passed and then just let go… apparently not having enough interest in the implementing process to make sure his signature legislation would actually work when it came online. It clearly did not remotely live up to its potential, and most certainly hit walls and big bumps the minute it launched. While it could easily be fixed, resistance in the Congress makes that reality almost impossible. Obama’s missteps just became too delicious for the GOP to overlook, even if the provisions of the law they hate was born of their own strong Republican efforts.
Today, the skepticism among those remaining uninsured eligible to participate in the program reflects President’s Obama’s mishandling of his own healthcare platform: “Fifty-six percent of those who identified as uninsured in a new poll conducted in February by the Henry J. Kaiser Family Foundation, a research institution, had an unfavorable view of the health care reform law, compared to just 22 percent who said they view it favorably. The uninsured now see Obamacare less favorably than they did when the enrollment period began in October.
“As recently as September, more uninsured approved of the law than disapproved… The survey results illustrate just how deep a hole the Obama administration is in when it comes to gaining the support of those the law is most intended to benefit. Indeed, the new findings show the uninsured feel worse about the law than the public at large. Thirty-five percent of Americans approve of Obamacare and 47 percent are against it, according to Kaiser.” Huffington Post, February 26th. The can and should be fixed, but someone still has a huge job in explaining that law sufficiently to America. We still waiting!
I’m Peter Dekom, and it’s nothing short of amazing how the holy grail of a political party later becomes their worst nightmare!
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