Sunday, July 5, 2015

Happy Birthday Obamacare

Health reform turned one year old this week. It has certainly been a difficult year. Legal challenges, repeal efforts, and charges that it will destroy American health care with socialism. Has a new law ever had it so tough? The answer is yes. Just look at Obamacare's big brother, Medicare.

Happy Birthday Obamacare

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Health reform turned one year old this week. It has certainly been a difficult year.

Legal challenges, repeal efforts, and charges that it will destroy American health care with socialism. Has a new law ever had it so tough?

The answer is yes. Just look at Obamacare’s big brother, Medicare. When it was enacted in 1965, Medicare’s opponents didn’t just warn it would create socialized medicine. They predicted it would lead to an entire Soviet-style economy.

To see what they said, you can follow this link to one of their early ads. You may recognize the spokesman. Ronald Reagan was just beginning his political career.

The attacks didn’t stop when Medicare passed. As late as 1995, Senator Bob Dole boasted of his longstanding opposition, claiming that he knew from the start it would never work.

And Medicare enjoyed only modest support on its first birthday. Just 46% of Americans approved. That’s pretty close to the 42% for health reform today (see Kaiser Family Foundation’s latest poll).

Aside from the hyper-charged rhetoric and mediocre approval rating, Medicare faced a daunting implementation challenge. Congress gave the government just one year to put this massive new program into effect. That’s the blink of an eye compared to the three-and-a-half year lead time for Obamacare. Many thought they could never do it.

The government had to reach 19 million new beneficiaries (with no Internet to help), sign up 7,000 hospitals, contract with 48 private insurance companies to administer benefits, and meet with 2,000 physician groups. To do this, it opened 100 new offices and added 9,000 new staff. And all of this for a complex program that few people fully understood.

Despite the challenge, when it turned one year old, Medicare was ready to go. And most Americans are now glad that it did (Bob Dole notwithstanding). Today, it is wildly popular. 88% of Americans support it (see Harris Poll).

Even Ronald Reagan eventually came around. In 1988, he supported ones of the largest expansions of Medicare up to that time, touting it as crucial protection for the elderly.

In fact, Medicare does such a good job that some people don’t seem to understand it is actually a public program. They pleaded at town hall meetings a year and half ago to keep the government out of it. Not bad for something that was originally attacked as a form of socialism. Which goes to show what a valuable asset health care reform can be.

So, health reform’s supporters should take heart. Important social change rarely comes easily. But with time and effort, it can be a resounding success.

I can almost hear the slogan of the future – “Keep the government out of my Obamacare!!”

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Check Up covers regional health news and a wide array of healthcare topics from pharmaceutical happenings to patient safety. Read about some of our bloggers here.

Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
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