In the spirit of reminding folks about political history beyond the past year or so, I thought it might be a good idea to recap what has happened with US healthcare reform over the current era of ‘neo’ politics. Nobody is old enough to have seen it all play out, but it is somewhat important to understand what was going on long before the word “Obamacare.”
Sort of like today, capitalism got out of control back in the 1930s and led to the Great Depression. President Roosevelt fixed it with liberal economic policies. He died wildly popular and was followed by Truman, who wanted to carry on his legacy by creating national health insurance laws. He was opposed by Congress but at least created the program that led to Medicaid. Presidents and Congress followed throughout history, expanding federal laws and creating the behemoths of Medicare and Medicaid. Even Nixon signed the biggest Medicare expansion ever.
An important side note about the 1980s; this is when Reagan started to really destroy the economy. Even though America’s economy expanded under protectionist policies, Reagan enforced a trend of global capitalism that makes more money for the people who already have it. It’s been carried through by conservative and neoliberal leaders since, thanks to the skyrocketing political power of big business. Despite all that, Reagan still made significant upgrades to Medicare and laws about medical facilities.
President Clinton started off with a proposal called the Health Security Act, which would have provided universal healthcare. That’s pretty cool! It was shot down by Congress after much drama. He did eventually somewhat expand Medicare and Medicaid. The problem is that, ever since Reagan destroyed organized labor in the 1980s, worker wages stagnated while healthcare and insurance costs rose.
Among the counter-proposals to Clinton’s universal plan, was a Senate bill called Health Equity and Access Reform Today(HEART). Just like Romneycare in Massachusetts, it is pretty similar to the Patient Protection and Affordable Care Act (ACA), which some call Obamacare. This is because they are all based on principles from a conservative think tank called the Heritage Foundation. It has been funny to see the Republicans struggle to replace a bill they should agree with.
The economic globalization of the Clinton years (see NAFTA) helped people lose their decent-paying jobs. Early in the Bush years, there began a growing focus on people going bankrupt because they couldn’t afford healthcare. Unfortunately, we’re permanently distracted by the Global War on Terror, so the military is our main jobs program now. It’s the only way many people have to get out of poverty, since it doesn’t require access to a quality education.
By the time Bush was on his way out, people rallied behind Obama. He called for a government health insurance program that would exist with private companies in a national exchange. This was his version of universal healthcare, which would guarantee coverage, but didn’t force any adult to be covered. Unfortunately, President Obama was convinced to lead with a much weaker bill that had no cost controls from the beginning, because he wanted bipartisan support so badly.
That was a bad idea, because Republicans had already decided to be openly hostile against Obama no matter what. Obama sacrificed the idea of a public option, instead creating a mandate that you must have coverage, to appease insurance companies in exchange for guaranteeing that coverage. This is true neoliberalism, when you shed your backbone in order to submit to corporations. We expected this kind of thing from Kerry, McCain, Bush, Clinton, Romney, etc…but not Obama. He got his centrist plan passed, without ever trying to really provide a public option. The Democrats proceeded to lose Congress. Nowadays, they are weaker at all levels of government because they stand for nothing.
We are now in the phase of far-right conservative backlash, created by a recent history of extreme ignorance and identity politics. The Republicans spent several years complaining about the ACA, yet they took a long time to produce half of a replacement. Their plan still has huge holes, and it’s too similar to the ACA to make anyone happy. Insurance premiums are going to keep going up unless they introduce a public option, but their corporate overlords won’t allow it. The Democrats are unfortunately the next strongest political party, but they are worthless opposition. Neither ‘major’ party has made an honest attempt to give Americans the access to healthcare they need.
The mean household income of most Americans has grown between 10-20% from 1980 to 2010. Medical costs grew by 241%! And people really think that we’re going to fix it with Health Savings Accounts and personal responsibility? If you think protests are annoying right now… wait until people start losing healthcare in large numbers. All because rich people care more about tax breaks than the stability of our lower socioeconomic classes.