By guest blogger Robert Field:
Barak Obama didn't come up with the idea of reforming our health care system. Nor did it begin with Bill Clinton, Jimmy Carter or any other Democratic president. It started with Republican Teddy Roosevelt in 1912, and more recently with Richard Nixon in the 1970s, who was the first to consider an individual insurance mandate.
TR proposed universal health care in his presidential campaign that year. Over the next century, every president from Herbert Hoover on (with the one exception of Eisenhower) proposed a major reform of some sort. Obama's success follows almost 100 years of efforts by Republicans and Democrats, conservatives and liberals.
So, is this year's health reform drama different from those of the past? For the most part, the answer is no. In the Patient Protection and Affordable Care Act, we are seeing more an evolution of American health care than a radical departure from history.
The Obama plan leaves intact the basic elements of private health insurance, which has provided the bulk of coverage since the 1930s. Most of us below the Medicare age will continue to be covered by private companies. The plan closes the gap for people who are locked out of that system because they can't find an affordable policy.
Closing the gap in private coverage was the aim of the other health-minded presidents, as well. It was Lyndon Johnson's goal in 1965 when he pushed through Medicare and Medicaid, Nixon in 1973 in encouraging the growth of HMOs, Reagan in 1988 in creating Medicare catastrophic coverage (although it was later repealed), Clinton in his 1993 reform effort to guarantee coverage for all, which was unsuccessful, and his 1996 effort to expand coverage for low income children, which was successful, and Bush in his 2003 overhaul that created the Medicare prescription drug benefit.
Obama's plan closes the last piece of the gap, as it applies to everyone, but this is a natural extension of these earlier initiatives.
Every health reform proposal through the years has been complex, had a bumpy implementation if it was enacted, and been labeled "socialized medicine" if it was proposed by a Democrat. The end result in each case was expanded access to health care and a larger role for the private sector. Cries of "socialism" were regularly soon forgotten.
The Obama plan may or may not succeed. However, its fate will not reflect how much it departs from the historical trend of American health care. It will reflect how consistent it is with that trend.
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