The ACP Advocate Blog
by Bob Doherty
Monday, March 9, 2009
Can Obama take the deja out of vu?
The current issue of Roll Call has a fascinating interactive timeline on legislative efforts in the United States to enact a national health insurance plan. The timeline goes all the way back to 1883, when German Chancellor Otto von Bismarck created the world's first national health insurance program.
The U.S. misadventure starts in 1915 (coincidentally, the same year that ACP was founded) when the "American Association for Labor Legislation proposes a 'model bill'" for compulsory national health insurance---with initial support from the American Medical Association! (As we all know, within a few years the AMA had switched to oppose any kind of national health insurance plan.)
Click on any of the highlighted dates, and a window will open with more information on what happened (or more often did not happen) that year.
The tool is a lot of fun for armchair health historians like me. Except for the four dreaded words that show up throughout the timeline:
"Congress rejects the plan."
1939: "Sens. Robert Wagner (D-N.Y.), James Murray (D-Mont.) and Rep. John Dingell Sr. (D-Mich.) introduce a national health bill in February. After hearings from April to July, the measure dies in committee."
1946: "The Wagner-Murray-Dingell measure is reintroduced. During April hearings before the Senate Education and Labor Committee, the sponsors carefully avoid the word 'compulsory' when discussing the legislation. Sens. Robert Taft (Ohio) and Joseph Ball (Minn.) and Rep. Margaret Chase Smith (Maine) offer a Republican alternative that provides grants to the states for medical care to the poor. The debate is repeated again in 1947 and 1949."
1974: "President Richard Nixon propose[d] a Comprehensive Health Insurance Act after calling for universal access to health insurance in his last State of the Union address. The plan builds on existing private employer-based health insurance, adding subsidies for the self-employed and small businesses. Congress rejects the plan."
1979: "Congress rejects Carter plan."
1994: Majority Leader George Mitchell abandons Senate reform efforts, marking the end of the Clintons' Health Security Act. Republicans take control of Congress in the November elections for the first time in 40 years.
Fast forward now to March 5, 2009. President Obama tells the VIPs at last week's White House summit:
"Health care reform cannot wait, it must not wait, and it will not wait another year."
If Obama is right, he will achieve something that eluded FDR, Truman, Kennedy, Johnson, Nixon, Carter, and Clinton.
Like Captain Kirk from the old Star Trek series, Obama must be so supremely confident in his abilities that he believes he can go where no president has gone before. Or he understands that something has fundamentally changed in the United States that makes the conditions for reform more favorable than at any time since Bismarck. Or maybe it is both.
Today's questions: Why do you think President Obama believes he will succeed when the history of health care reform in the U.S. is really a story of how "Congress rejects the plan" over and over again?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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