Playing Health-Care Politics

Originally posted: May 29, 2009

Greencastle, Ind. – John Dittmer is a native Hoosier, born in Seymour, got his doctorate in history from Indiana University, taught for the last years of his career at DePauw University. But the middle years — call it the formative period of his career — were spent in Mississippi. This was the time of the civil rights struggle, and the Dittmer family bore witness from a post at Tougaloo College. The book he produced from that experience, “Local People,” won the prestigious Bancroft Prize for distinguished historical scholarship.

Dittmer’s most recent book, “The Good Doctors,” is the story of a group of health-care professionals active in the Deep South at the height of the civil rights movement. Social justice in health care is the main story, but going forward, Dittmer chronicles the two most recent efforts, and failures, to achieve national health reform in the United States.

The first was in the early 1970s, when President Richard Nixon, concerned to collar rapidly rising medical costs, proposed the Family Health Insurance Program, a free-market solution. At the time, a far more popular rival entry was Sen. Edward Kennedy’s Health Security Act, a single-payer plan to provide free, comprehensive health care to all Americans. Coalescing in opposition to beat back Kennedy, the American Medical Association and pharmaceutical and insurance lobbies raised the awful, un-American specter of “socialized medicine.”

The ensuing deadlock meant comprehensive health-care reform stalled, and to this day Kennedy believes that if he had been more flexible a deal might have been struck. Ever since, “Don’t let the perfect be the enemy of the good” has been the motto of Kennedy’s legislative strategy.

In 1993, health-care reform next made it onto the national agenda with Hillary Clinton at the helm. National polls showed two-thirds of the public favored a single-payer program, run by the government and financed by taxpayers, like the national health-care plan of Canada or our own Medicare. Once again the private health-care providers regrouped, using a massive lobbying and public relations effort to slander the Clinton plan.

Depicting ordinary Americans at the dinner table, Harry and Louise were omnipresent in a television campaign sponsored by the medical industry. The couple lamented the intrusion of faceless government bureaucrats denying them a choice of doctors and forcing long waits for appointments. A second stage of the medical industry’s PR at the time was to demonize the Canadian national health-care system, a socialized medicine plan, it was said, which features delays for surgeries and a shortage of beds, producing widespread public dissatisfaction.

Always the main tactic, as Dittmer shows in “The Good Doctors,” is to massage Americans’ fear of socialized medicine. During the debates over the Clinton plan in the early 1990s, former Canadian Prime Minister Brian Mulroney visited DePauw University, where I had an opportunity for a lengthy conversation about the ongoing mischaracterizations of his country’s health-care plan. Citing public satisfaction levels of more than 90 percent, Mulroney put it bluntly. “Pay no attention to the propaganda,” he said. “We’re not problem free in Canada, but any politician who proposed ending the Canadian system would be dead in the water.”

So, why, we might ask, has President Barack Obama changed his mind? He always has claimed to be in favor of a universal, single-payer health-care system, and polls show that more than 60 percent of the public still shares that position. However, Obama now is consorting with kingpins of the health-care industry, whose basic motive is to keep things as they are. “Everything is on the table with the single exception of single payer,” says Max Baucus, the Democratic point man for health care in the Senate.

Think about what Mulroney said and ask yourself this: If universal health care run by the government and financed by the taxpayers doesn’t work, if it’s nothing but socialized medicine, why didn’t any of the last five Republican presidents get rid of Medicare?

The answer: because they would have been dead in the water.

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