What The History Of Health Reform Teaches Us About Today’s Efforts

The New Health Dialogue is rolling out a series of posts analyzing the history of health reform. The first installment reviews the efforts of reformers during the Progressive Era. “A combination of poor timing, organized and fierce opposition, and dissension within the ranks of the reformers all prevented health insurance from becoming part of the New Deal,” the blog quotes author Paul Starr as saying:

Roosevelt was apparently so enthused about a national health care program that he intended to campaign on it during the 1938 midterms. However, he chose not to, preferring to defer until the 1940 presidential campaign. Unfortunately, by 1938 and 1940, it was too late. It’s no accident that the vast majority of the New Deal—creation of Fannie Mae, Social Security, the Civilian Conservation Corps, and the Tennessee Valley Authority—came into being during Roosevelt’s first term. The landslide election of 1932 swept giant pro-Roosevelt majorities into Congress and left the conservative opposition neutered, easing the way for an enormous burst of legislative activity. But by 1936, and especially 1938, the opponents of the New Deal—conservative southern Democrats and Republicans supported by the business community—had gathered enough strength to stop the New Deal in its tracks. But that period, Roosevelt’s second term, was when the New Dealers who had agreed to leave health insurance out of Social Security finally made their push.

Obama has certainly learned from the mistakes of his predecessor. As New Health Dialogue observes, Obama “is striking while the iron is hot, making comprehensive health reform an immediate top priority in a way it never was during the New Deal…President Obama has explicitly and repeatedly linked health reform to economic recovery, rather than viewing them as separate challenges [and] he is forcefully committing his political capital to the issue in a way that Roosevelt did not.”

Moreover, despite all of the sabre rattling we’ll hear about the Democrats’ ‘unprecedented’ plan to allow government to “take over” health care, the history of past efforts to reform the health care system or even a review of the government’s role in regulating the economy (or providing health care) strips today’s reforms of any grand originality or conspiracy. The precedent of providing ‘Social Security’ to every American senior, paved the way for Medicare and Medicaid; what was once described as ‘socialized medicine’ — the government providing health insurance — became part of the American experience.

And so it is today. Obama’s hybrid approach builds on the employer based system and strengthens public health programs. It recognizes that the fault lines in the health care debate and the current health care system were born from a long and complicated history. Obama and the Democrats will introduce a plan that is not a product of ideology. Rather, it will be cognizant of the history of the present system. It will be as radical as Medicare, Medicaid, and the VA.