Every time I turn on the news, pundits are giving their view of the proposed changes in Obama Care currently before the Congress. Depending upon which side they are on each has a different take on the issue and each looks at what happening through different lenses.
In my view this fight is just a continuation of a long disagreement between various factions on what the basic role of government is in terms of providing services to it’s citizenry.
One of the very early fights on the issue of assistance was due to the great flood of the Mississippi in 1927. Thousands upon thousands of people lost their homes and businesses along the banks of the river in that year. Calvin Coolidge, a Republican, was president and a great debate ensued in the country and in the Congress as to what responsibility the government had to help people. Eventually the question was answered in the affirmative and Herbert Hoover, Secretary of Commerce under Coolidge led flood relief operations. Eventually the Flood Control Act of 1928 was passed that funded a series of levies up and down the Mississippi to insure a similar event would not happen again. The flood cost the equivalent of almost a trillion of today’s dollars, with 700,000 people displaced and 500 killed.
The next great debate on government services ended in 1935 with the passage of the Social Security Act. Interestingly, in the Senate there were 15 Republicans and 15 Democrats who voted against the bill, but it became law in spite of vocal opposition.
A similar philosophical debate occurred for years before the 1965 passage of Medicare. The discussions began under Harry Truman, continued under Eisenhower and Kennedy but it was not until Johnson became President that Medicare was passed.
In the past 90 years government has continued to expand services to the American population, but in each instance there has always been a fight over it. Usually, but not always, it has been the Democrats who have wanted expansion and Republicans not so much. It has been more of a liberal vs. conservative fight historically then a pure political party fight. Even with those divisions, I believe we are better off when we have an almost equal representation between philosophies that then require the parties to come to some sort of agreement. What we had in the original passage of the Affordable Care Act was Democrats acting, without any support from the Republicans. The Democrats had the power and pushed it through. The ACA, interestingly enough, was based upon the Romney plan developed in Massachusetts. For 8 years the Republicans have railed against it and now, when in control, are bound and determined to bury it. Meanwhile the public wants a resolution that allows for affordable health care without worrying about the intricacies of how it is accomplished or what it might look like. My view is that eventually we must move to a Medicare-like program for all citizens. To get there depends upon the makeup of the Congress and Executive branch leadership, currently sorely lacking.
All I do know for certain, is with a US cost of health care at over 19% of Gross Domestic Product and the rest of the developed world at less then half of that, so far we have gotten health care policy very wrong. If in the end this thing goes south, either with a bad bill nor no bill, it may have the impact of another Mississippi flood.