Favorite

Health care: It’s time 

President Obama proved last week that he is shrewder than Harry Truman, Dwight Eisenhower, Richard Nixon and Bill Clinton, two Republicans and two Democrats who were canny politicians but who in sunnier times couldn't deliver universal health coverage.

Obama approached the challenge differently anyway by talking with unusual frankness about the costs, taxes and tough Medicare reforms to bring it about and inviting a bipartisan Congress to work out the details for him, the last a marked contrast to Bill Clinton's strategy in 1994 of handing Congress a 1,300-page bill choked with the minutiae of healthcare administration.

Let's hope Obama's is the political formula that finally works.

Truman called for universal health insurance in 1949 but the American Medical Association, the amalgamation of pre-Medicare docs who hadn't yet discovered how much they liked guaranteed reimbursement, poured millions into a campaign to stop it in 1950 and defeated six senators and a number of representatives who supported the Truman plan. It was the first model for special interests using congressional elections to stop a policy initiative. The lesson was that you shouldn't let an election intervene.

Eisenhower repeatedly urged a federal initiative to encourage the insurance industry to cover all workers by offering federal coinsurance, but it was too socialistic for Republicans and too anemic for Democrats and labor.

Nixon, in his last state of the union speech in 1974, proposed a universal health program very similar to the plans outlined last year by Obama and Hillary Clinton. It would have built on the existing employment-based insurance system and provide government subsidies to the self-employed and small businesses. He introduced the bill a few days later but Watergate soon drove him from office.

Clinton enjoyed the support of 59 percent of Americans for his complicated health plan in 1993 but after the Health Insurance Association of America and other interests spent more than $100 million on the campaign against it and flooded members of the House and Senate finance committees with campaign gifts, public support fell to 44 percent and the bill was dead.

President Obama passed the first test by rejecting the notion that you can't undertake a big expensive reform when the country is in the worst slump since the 1930s. If that were true, we would never have got Social Security, which by the way should have included mandatory health insurance for everyone but the AMA discouraged Roosevelt from doing it.

Rather than presenting Congress with a finished bill, Obama did the tough part. He would put aside $634 billion over the next 10 years to get it started, half from restoring taxes on very high earners and the other half by lowering subsidies to insurance companies, drug companies, home health agencies and hospitals for Medicaid and Medicare and by otherwise stanching the exploding costs of medical care. By tightening the bidding on the wasteful Medicare private insurance plans, which add 14 percent to the cost of treating a Medicare patient, he would pick up a nifty $176 billion.

But you negotiate how precisely to extend coverage to 48 million Americans, he told the congressional finance committees.

The insurance industry began ramping up for the fight immediately, but Obama seems to have a better team than Clinton did. Kathleen Sibelius, the smart and tough governor of Republican Kansas, will run it from the president's end as secretary of Health and Human Services. As insurance commissioner and governor she took on the insurance companies. Obama's health-care czar is expected to be Nancy Ann DeParle, a Rhodes Scholar who administered the Centers for Medicare and Medicaid Services in Clinton's final years and who has been a director of several big health-care companies. She came up in the rough and tumble of Tennessee politics.

There should be none of the naivete that dogged Clinton's health campaign.

Still, the argument will be that the country must not now undertake an initiative so large. Wait for better times, opponents will say. But the opposite is true. Nothing will do more for the country's long-term fiscal health than controlling health care costs and putting everyone into the system. Bloated health expenditures account for a good share of the federal budget deficits and waste in the private health sector is a huge drag on the economy. The United States spends twice as much per person on health care as other wealthy nations but with far poorer results, measured by life expectancy and infant mortality.

Arkansas's congressional delegation ought to take note of what it would mean for their constituents. Although Arkansas spends nearly a fifth of its state budget on direct health-care benefits, conditions are getting steadily worse for families. Even for the declining number of workers who have private or work-based insurance, premiums rose by 65.8 percent between 2000 and 2007 while median earnings rose only 11.6 percent. The trend is projected to steepen. Arkansas's median wage in 2007 was $22,692 but the average health insurance premium for a family was $10,534. Medical debts are the largest factor in bankruptcies.

A national solution is required. We may have a leader at last who can master the nasty politics of health care and get it done.   

Favorite

From the ArkTimes store

Comments

Subscribe to this thread:

Add a comment

More by Ernest Dumas

  • Trusting

    It is a Fourth of July ritual to appraise where we are in meeting the Declaration of Independence's promise to institute a government that would, unlike King George, secure human rights equally for everyone who sets foot on American soil.
    • Jul 6, 2017
  • Obamascare

    Republicans at long last may be about to see their most fervent wishes and wildest predictions materialize — millions of people losing their medical and hospital coverage, unaffordable insurance, lost jobs, a Medicare financial crisis, mushrooming federal budget deficits and fiscal crises across state governments.
    • Jun 22, 2017
  • Ethics upended

    Every week, Donald Trump finds another way to upend conventional ethics in government and politics. Here's one that has been in the making since the campaign but is reaching maturity in the Russian investigation: He is turning the heroes of government scandals into the villains.
    • Jun 15, 2017
  • More »

Readers also liked…

  • AEC dumps ALEC

    No matter which side of the battle over global warming you're on, that was blockbuster news last week. No, not the signing of the climate-change treaty that commits all of Earth's 195 nations to lowering their greenhouse-gas emissions and slowing the heating of the planet, but American Electric Power's announcement that it would no longer underwrite efforts to block renewable energy or federal smokestack controls in the United States.
    • Dec 17, 2015
  • No tax help for Trump

    The big conundrum is supposed to be why Donald Trump does so well among white working-class people, particularly men, who do not have a college education.
    • Aug 11, 2016
  • Dollars and degrees

    Governor Hutchinson says a high graduation rate (ours is about the lowest) and a larger quotient of college graduates in the population are critical to economic development. Every few months there is another, but old, key to unlocking growth.
    • Aug 25, 2016

Most Shared

  • So much for a school settlement in Pulaski County

    The Arkansas Democrat-Gazette's Cynthia Howell got the scoop on what appears to be coming upheaval in the Pulaski County School District along with the likely end of any chance of a speedy resolution of school desegregation issues in Pulaski County.
  • Riverfest calls it quits

    The board of directors of Riverfest, Arkansas's largest and longest running music festival, announced today that the festival will no longer be held. Riverfest celebrated its 40th anniversary in June. A press release blamed competition from other festivals and the rising cost of performers fees for the decision.
  • Football for UA Little Rock

    Andrew Rogerson, the new chancellor at UA Little Rock, has decided to study the cost of starting a major college football team on campus (plus a marching band). Technically, it would be a revival of football, dropped more than 60 years ago when the school was a junior college.
  • Turn to baseball

    When the world threatens to get you down, there is always baseball — an absorbing refuge, an alternate reality entirely unto itself.

Latest in Ernest Dumas

  • The ACA can be fixed

    Majority Leader Mitch McConnell threatened his 51 disciples in the Senate and his party with the gravest injury imaginable.
    • Jul 13, 2017
  • Trusting

    It is a Fourth of July ritual to appraise where we are in meeting the Declaration of Independence's promise to institute a government that would, unlike King George, secure human rights equally for everyone who sets foot on American soil.
    • Jul 6, 2017
  • Obamascare

    Republicans at long last may be about to see their most fervent wishes and wildest predictions materialize — millions of people losing their medical and hospital coverage, unaffordable insurance, lost jobs, a Medicare financial crisis, mushrooming federal budget deficits and fiscal crises across state governments.
    • Jun 22, 2017
  • More »

Event Calendar

« »

July

S M T W T F S
  1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31  

Most Viewed

  • Another Jesus

    If you follow the logic of Jason Rapert and his supporters, God is very pleased so many have donated money to rebuild a giant stone slab with some rules on it. A few minutes on Rapert's Facebook page (if he hasn't blocked you yet) also shows his supporters believe that Jesus wants us to lock up more people in prison, close our borders to those in need and let poor Americans fend for themselves for food and health care.
  • Pay attention

    If anyone thinks that a crisis with the Power Ultra Lounge shooting, then he hasn't been paying attention to Little Rock.

Most Recent Comments

  • Re: Another Jesus

    • And I quote: "Sounds like maybe some of those descriptors hit a little close to…

    • on July 21, 2017
  • Re: Another Jesus

    • Hey Bishop, when did God say "Grab them by the pussy?"

    • on July 21, 2017
  • Re: Pay attention

    • Well said. I believe that male mentors are another key way to connect our local…

    • on July 21, 2017
 

© 2017 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation