Although neither has been remembered kindly by history, Vietnam and Watergate forever tarnishing our memories of them, both Democrat Lyndon Johnson and Republican Richard Nixon left very successful domestic legacies. Johnson’s War on Poverty helped millions, Nixon established the Environmental Protection Agency, and both were instrumental in many of the civil rights gains and anti-discrimination laws of the time.
They also both understood the importance of healthcare, Johnson establishing Medicare in 1965 and Nixon expanding the program to those under 65 with long term disabilities in 1972.
They weren’t the first US Presidents to understand the need to help the uninsured. Republican Teddy Roosevelt called for a national health insurance system in 1912 but had almost all of his progressive policies blocked by an obstructionist congress. During his second term Democrat Harry Truman attempted the same, with the same result.
A smaller part of that bill signed by Johnson, mostly ignored at the time, was something called Medicaid, a program designed to provide federal funding help for state level assistance to those unable to obtain private health insurance. It goes by different names in each state, with different qualifying criteria and coverages, but the goal is the same – a means for unemployed, underemployed, disadvantaged and lower income people to have access to preventative and primary healthcare. It’s used in one form or another by one in five Americans at some point in their life and four out of ten children. Under the Affordable Care Act, ( Obamacare ), legislation influenced heavily by failed Republican proposals in the mid 1990s, eleven million people were added in the 32 states that chose to participate in the law’s expansion of eligibility.
Over a hundred years of debate, entire political parties and even individual lawmakers repeatedly changing positions and unable to come to consensus on whether access to healthcare is a “right” or a “privilege”, failure to agree on what burden society as a whole should take on to ensure that access. Unable to fully decide whether or not they actually give a damn about the people they were elected to represent.
In the meantime we continue to get sicker. The United States ranks dead last among the fifteen wealthiest nations when it comes to life expectancy, infant mortality rates and rates of chronic illness.
The good news, if you’re a stockholder that is, is that insurance companies continue to get richer. Sixty percent of Americans still receive their insurance through their employer but these costs and the amount expected to be contributed by employees towards these costs have increased every year for the past decade. Aetna, Anthem, Cigna, Humana and United Health Group, the five biggest for-profit insurers had a combined 4.5 billion dollars in net earnings for the first quarter of 2017.
Aetna, Humana and United Health are all leaving or have left the ACA exchanges now that sick people are actually going to the doctors and not being able to be denied for pesky things like pre-existing conditions. The other companies are making up for this lost money by raising premiums for Obamacare customers that don’t qualify for government subsidies by 25%, a number that was announced just prior to last year’s election.
It’s an absolute disgrace. I currently pay over $500.00 a month to insure my family of four and despite that, despite the fact that we are all blessedly healthy, outstanding healthcare bills now account for 30% of our total debt. When my daughter needed stitches in her chin the cost to me was significant enough to alter our summer plans. Seven stitches, placed not by a specialist but a physician’s assistant, at the hospital that I have worked at for almost twenty five years.
I cringe typing those words, aware of how incredibly fortunate I am to have that be our only sacrifice. It never occurred to me not to bring her in, but for a lot of families that would be a legitimate consideration. The number of yearly bankruptcies that are directly related to health care bills is impossible to verify and widely debated, but is accepted by most as being the highest precipitator.
We live in a country where millions remain uninsured, where those that have insurance are paying more and more while receiving less and less in return. Of those fifteen nations I referenced earlier, America is also dead last in doctor’s appointments made and kept. Those five insurance companies mentioned have spent 6.2 million dollars in government lobbying so far this year, pushing a new plan that seems to benefit absolutely nobody outside of their board rooms and a few mean old rich guys.
A hundred years after identifying the problem and we still can’t seem to get our act together, affordable or otherwise, and decide that taking care of sick people needs to be a national priority.