By Lynda Lamp
The GOP has had since 1912 to come up with a plan, no reason to rush it now!
The last week of September in 2017 is going to be another stressor for Americans. After we thought the “health care debate” was settled back in August when Senators Murkowski, Collins and McCain all voted no. That was to be the GOP’s “final repeal attempt” of the Affordable Care Act.
A very brief review of the history of government provided “health care” in America starts with President Teddy Roosevelt in 1912, who ran on a platform that included a national health care plan. Interestingly enough, Roosevelt was a Republican. The idea didn’t get any steam behind it until President Harry Truman, a Democrat, embraced it.
According to The Medicare Resources Organization:
“On November 19, 1945, seven months into his presidency, Truman sent a message to Congress, calling for the creation of a national health insurance fund, open to all Americans. The plan Truman envisioned would provide health coverage to individuals, paying for such typical expenses as doctor visits, hospital visits, laboratory services, dental care and nursing services.”
Truman’s desire was for a program that would cover all Americans of all ages. He was never successful. It wasn’t until President John F. Kennedy, a Democrat, discovered that according to a national study, 56 percent of Americans over the age of 65 were uninsured, that he pushed for a federal health care program. Although Kennedy’s Medicare Bill failed, the 87th and 88th Congresses passed more healthcare legislation in than any other time in American history. According to On The Issues:
…including landmarks in mental health and mental retardation, medical schools, drug safety, hospital construction and air & water pollution–but the President never got over the disappointment of this defeat [loss of his Medicare Act.]
President Lyndon B. Johnson, also Democrat, would get the credit for Medicare in 1965 and the following year Americans over 65 began to receive health insurance benefits.
The first significant change to Medicare occurred in 1972 when President Richard M. Nixon, a Republican mind you, expanded Medicare to include individuals under the age of 65 with long-term disabilities and people with end-stage renal disease (ERSD). It is interesting to note that applicants with long-term disabilities must qualify and in some cases wait extended periods before beginning Medicare, but people with ERSD can start as quickly as three months after starting treatment and are not required to qualify for disability insurance.
As a side note, what is this coverage for ERSD all about? Why did we have such high incidents of kidney failure? Renal disease is devastatingly expensive and debilitating. Nixon’s legislation served as a lifeline for Americans with kidney failure. This bill seems to mark the first singling out of a disease for coverage, but it wouldn’t be the last. In the early 2000s individuals with amyotrophic lateral sclerosis (ALS) and younger than 65 were given similar access to health care as those with ERSD. It’s interesting how just a few specific diseases get covered. To me, that seems inherently discriminatory and unfair. (It seems akin to thinking “oh, I hope if I get sick that I get ALS. Then at least I’ll have my health care covered.)
It shouldn’t matter what’s wrong with you; you shouldn’t have to worry about how you are going to receive care or how you can pay for that care.
In 1980, during the last year of Jimmy Carter’s Presidency, Congress passed the Omnibus Reconciliation Act of 1980 which expanded Medicare to include Home Health Services and also created Medigap (Medicare Supplement Insurance) to bring it under federal review. Jimmy Carter was a Democrat.
Following President Carter, under the Republican leadership of Reagan, Medicare was expanded. The expansion included multiple enhancements, including the addition of hospice care for the terminally ill.
The Shift Begins
Then in 1988, still under Regan, something happened. Reagan introduced the Medicare Catastrophic Coverage Act which was supposed to expand the coverage of Medicare. But the Act put the burden of financing certain aspects upon seniors themselves. There was such an upswelling of pushback from senior organizations around the country the legislation was repealed. The repeal occurred just a little over a year after being passed.
The major aspect of the Medicare Catastrophic Coverage Act was to cover prescription drug benefits. This coverage would have been the first major new service added to Medicare. But indeed what follows is more complicated and burdensome than should be necessary!
According to a report by the Health Affairs Blog:
In a new precedent, Medicare beneficiaries would have financed the new benefits in their entirety. The controversial “supplemental premium” –actually an additional amount of income tax to be paid by an estimated 40 percent of the elderly– would have been the primary funding source. The legislation established a maximum tax liability, which would have been paid by less than 10 percent of the elderly, at $800 per person ($1,600 for a couple). In addition to the supplemental premium, the Part B monthly premium, charged to all program beneficiaries whose incomes were above the poverty level, would have risen by four dollars.
Even after the phase-in period, beneficiaries could have borne significant expenses: the initial $560 hospital deductible; the $75 Part B deductible and 20 percent coinsurance payment until annual expenses of $1,370 were incurred; all nonassigned physician charges above what Medicare deemed to be reasonable; the first $650 or so of prescription drug costs; and 20 percent of all additional prescription drug costs during a year.
The description “Medicare beneficiaries would have financed the new benefits in their entirety” is the tell. From what I can see, it is the first sign of a significant shift in the hearts behind our government. No longer was there an act of service in our government but instead an act of self-protection.
The only part of the Act that didn’t get repealed was the “Buy-In” program that allowed folks 65 and older, or those qualified for disability to be covered by Medicare even if they never paid into Social Security. Known as Qualified Medicare Beneficiaries (QMB), Medicaid pays their premiums. This program was a lifeline to low-income Medicare beneficiaries and their families. By shifting some costs to the federal government, it helped It helped State’s Medicare programs survive. But what we were seeing were signals of the unsustainability of healthcare costs from the State’s point of view, another tell that the only way to sustain health care for all Americans is through a federal process single-payer system.
By the time Bill Clinton, a Democrat, became President in 1993 reforming the health care system was one of his first-term initiatives. He planned to deliver to Congress a solution that would guarantee health care for every American within 90 days of taking office. He gave the First Lady the project of coming up with the public relations and political pitch to get the bill passed. Bill appointed Hillary head of the Task Force on National Health Reform on January 25, 1993, just five days after being inaugurated. Bill had already figured out the policy framework; it was Hillary’s job to come up with the sales pitch, not the policy.
But in the days that followed things did not go well. The Health Security Act that President Clinton put together never even came to a vote. Historians cite many reasons for Clinton’s health care failure: The bill was too broad and hard to explain, there weren’t enough bipartisan efforts made to name a few.
But a different eye might see something else. The GOP disliked Hillary; she’s a woman for one thing. They disliked Bill too, and that didn’t help. The Whitewater Scandal didn’t help. Without rehashing the details, I’ll summarize the failure of “Hillary Care” as it had gotten dubbed. It was similarly catastrophic as Obama Care but in a reverse fashion. People wanted health care reform, and the sitting President who had promised it to them had failed miserably. By the mid-term elections of 1994, unhappiness over the failure to pass a healthcare reform bill left Americans disillusioned, and the Republicans swept into office. As is their fashion they made their sweep by politicizing personal aspects of their opponents. They are ruthless liars when they campaign.
James A. Morone, professor and chair of political science at Brown University and co-author of The Heart of Power: Health and Politics in the Oval Office wrote:
“The boomerang from the Clinton health care reform failure led, three months later, to the widest Republican midterm sweep in the 20th century (victories in the Senate, House, state legislatures, and governor’s offices in November 1994).”
It sounds like Obama’s first mid-term election doesn’t it? But in 2010 the sweep of Republicans was because the GOP was against the Affordable Care Act. They were against it for no other reason than it was put forth under Barack Obama. Remember Mitch McConnell declaring he would do nothing but to work to make Obama a one-term President. We should have taken him off the payroll at that moment. The Republican Party no longer wants us to have health care in any way shape or form; that movement began in earnest in 2010.
A Republican (Roosevelt) started the universal health care discussion over 100 years ago, and here we sit. On the brink once again of the repeal of The Affordable Care Act (ACA). This Act is a start towards the dream that so many have held for so long. A dream of a health care system for all Americans. While it is a far cry from what is sustainable or what will work for everyone right now, it is a start. The choice should have always been to repair it. It is hate that has stoked the calls for repeal. It was hated the first day, and it is hated today.
In 2007, Jonathan Coen wrote a book “Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price.” In it, Mr. Coen makes the plea for universal single-payer health care system regulated by the government.
It was evident then, as it is now, that profit-based health care is an impossible solution.
The End Game
Bernie Sanders, was an Independent masquerading as a Democrat when he ran for President in 2016. He made single-payer health care one of the cornerstones of his platform. Had there not been corruption in the Democratic primary election process Bernie might very well have been elected President.
Here’s something you can try when the stress of this week’s health care debate starts to get to you. Take a few deep breaths to settle yourself. As you do, try to draw your breath all the way down into your hips. You’ll probably find you can’t accomplish that and that your breath stops in your upper chest or maybe your middle. If so, just visualize it going the rest of the way down into your hips. See it returning upwards with your exhale. If you are feeling extremely stressed, you can repeat this breath process ten times (or longer). If you get pressed for time, you can repeat the breathing process just five times. Even once will at least mean you’re thinking of it. It’s a bit like magic. Repeated practice will begin to bring you peace.
If we can’t get peace from our government, we’re going to have to learn how to make peace for ourselves.
Oh, and don’t forget to call, write, fax, text, email or visit in person your Congressmen and let them know how you want them to vote.