Yeah.
Having some time on my hands, I authored a response that became a bit of a mini-history of healthcare reform efforts in the U.S., one I thought I'd preserve here. I've slightly reworked this version of it to make it more of a standalone piece (the original is here).
National health insurance initiatives started appearing in Europe in
the 1880s. In the U.S., the Socialist party under Eugene Debs began advocating
national healthcare in 1904; Theodore Roosevelt's Progressive party
adopted it in 1912 but Teddy lost the election.
The
original proposal for Social Security included health coverage but American Medical Association
opposition to this led FDR to drop it instead of imperiling the entire
SS effort. In 1939, New York Sen. Robert Wagner, the author of the
Social Security Act, first introduced what became known as the Wagner
National Health Act. This went through several evolutions in the new few
years to become the Wagner-Murray-Dingell bill, a comprehensive
national health program. When Harry Truman became president, he endorsed
it and the AMA launched the biggest campaign in its history up to then
to kill it. That campaign succeeded but the legislation become something of a fixture; it was reintroduced in every congressional session for years, and when it's sponsor John Dingell died, his son, John Jr., was elected to fill his seat and continued reintroducing it right up until 2010.
The
1950s saw the National Association of Social Workers (NASW) call for a
comprehensive national healthcare plan; it would continue to do so for
decades.
The
'60s, of course, saw the creation of Medicare. Upon its adoption, UAW
president Walter Reuther called for a national healthcare program and
created the Committee for National Health Insurance, which crafted a
model program that was subsequently introduced in the Senate by Ted
Kennedy. That same year, 1970, saw two other single payer bills
introduced in the body. Kennedy would, for years, continue to introduce versions
of his legislation, sometimes his own, sometimes in concert with others, and competing national health proposals
by Richard Nixon, Gerald Ford, Jimmy Carter and various legislators consumed the decade. In 1971, a then-obscure fellow named Bernie Sanders entered his first political campaign, a third-party bid for governor of Vermont. "There is absolutely no rational reason why in the United States of America today," he said, "we could not have full and total free medical care for all." In 1972, he jumped into another campaign, this one for U.S. Senate, on a platform that included "provid[ing] free and excellent medical and dental care for all." He has continued to advocate the same to this day. The '70s also saw, among so many other things, the Medical Committee for Human
Rights--the medical arm of the civil rights movement--launch a
campaign for national healthcare. In 1977, California congressman Ron
Dellums, in cooperation with the MCHR, crafted the National Health
Service Act, which would have created a full-blown British healthcare
system in the U.S.. Dellums reintroduced this legislation in every
congress until his 1998 retirement from the body. His successor,
congresswoman Barbara Lee, continued to reintroduce it into the present
century.
In
the 1980s, the issue was generally shoved to the backburner but the
decade also saw the creation of Physicians for a National Health
Program, which was and continues to be one of the major advocates for
single payer. By 1988, a majority of respondents were telling pollsters
they supported the idea; that same year, Jesse Jackson ran for president on a
platform that included it (Bernie Sanders, then mayor of Burlington, would endorse Jackson, citing this as one of his top reasons for doing so). The end of the decade also saw the
publication by the Heritage Foundation of "A National Health System For
America," the first link in a chain that would eventually morph into
Obamacare, and the creation by the House of Representatives of the
Claude Pepper Commission, established to study the healthcare issue.
The
1990s opened with that commission's report, which didn't endorse single
payer but was important for documenting the gathering healthcare
crisis and was prescient as to where it was likely heading. In 1991, only six months into his first term in congress, independent congressman Bernie Sanders introduced the National Healthcare and Cost Containment Act, which would have created a single-payer delivery system to be administered by the states. Hawaiian
Sen. Daniel Inouye introduced the NASW's proposed single payer plan, the
National Health Care Act, in 1992 and 1993. In '92, Michigan Rep. John
Conyers also introduced his first single-payer bill, the Health Care For
Every American Act. He would continue to tinker with this proposal over the years and
has reintroduced a version of it many times.
That same year saw both then-House Republican leader Bob Michel and, on the other side of the aisle,
Democratic congressmen Jim Cooper and Mike Andrews, working together,
introduce much less radical "managed competition" healthcare plans. In 1993, Washington
Rep. Jim McDermott introduced a single payer plan and Bernie Sanders and John Conyers became its original co-sponsors. McDermott too would reintroduce this plan repeatedly over the years; Sanders himself would craft and propose multiple single-payer plans over the decades to come as well.
It
was six months later that Hillary Clinton came along to become, in that Clinton cultist's narrative, "the first person in America to get the idea of a
federal government supported healthcare system to the national stage."
Clinton's plan as it emerged--popularly dubbed "Hillarycare"--was an industry-friendly "managed competition" plan largely lifted from that of Republican leader
Michel (who, himself, subsequently introduced a different plan). The notion that it was Clinton "who first brought [single payer healthcare] to the national stage" seems rooted in an odd but apparently popular myth that Hillarycare was a single payer plan. It, of course, wasn't, and Hillary Clinton has never, in fact, advocated single payer healthcare.[1]
Hillarycare led
to a flurry of competing Republican plans, the major one being the one that
would eventually become Obamacare. There were Democratic alternatives as well.
When Barack Obama became president, he endorsed that Republican plan. Various Republicans had, by then, advocated essentially that same plan for 15 years. Massachusetts Gov. Mitt Romney, who would later be Obama's Republican opponent in the 2012 presidential race, had actually enacted the plan in his state. Upon Obama's endorsement though, Republicans abandoned it as a monolith, dubbing it damnable "socialized medicine." Congress would pass it, Obama would sign it into law and it would go on to take a very bad healthcare situation in the U.S. and, for the most part, just make it worse.
Clinton cultists commonly argue that Obamacare was some sort of "first step" toward single payer. The cultist that inspired this piece argued that "Democrats have been steadily moving towards a single payer system through [Obamacare's] expansion of Medicaid," but that's
neither a "single payer system" nor was it ever even envisioned as
morphing into one. Nor, in fact, would it have ever become law if anyone involved would have believed that was even possible. As had happened with Clinton's deliberations in the '90s, single payer advocates were locked out of the process of crafting reform. The Medicaid expansion was just to help provide coverage to people at the bottom of the
scale in the context of preserving for-profit insurance. Obamacare put the
failed insurance companies on federal welfare, which, in turn, helps
subsidize their purchase of legislators and makes any effort at real
reform increasingly difficult. Obama's proposed
public option, the major innovation in his own initial
version of this plan, could have created a mechanism for a slow transition to single
payer--too slow to be particularly helpful--but Obama threw even it away in a backroom deal with hospital lobbyists in the earliest stages of the reform debate.
When, in 2015, Bernie Sanders, then a senator, introduced
his latest single payer plan, no one--not a single
senator--stepped up to co-sponsor it. Sanders' strong advocacy on this
issue throughout the 2016 presidential cycle and beyond has meant that public support of the idea has continued to grow and 1/3
of the Senate Democratic caucus has now gotten behind his latest single payer plan,
including all of the 2020 presidential hopefuls in the body. His
advocacy has paid off in the House as well. In 2015, John Conyers'
single player plan had only 49 co-sponsors; it now has 120, the most in
its history. Some of this support in both bodies will no doubt prove to
be opportunistic but Sanders has moved the needle. These facts certainly
present quite a contrast with 2016's Hillary Clinton, screeching
like some insane Alex Jones-ite monster about how single payer "will never, ever come to pass!!!"
--j.
---
[1] Hillary Clinton has never advocated any "universal healthcare" plan either, a phrase that is often used to obscure. Her support of "universal healthcare" is limited to falsely pretending as if the plans she has endorsed, all of which would indisputably have left millions of Americans with nothing, are "universal."
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