Published September 30, 2013
Tuesday, October 1, 2013 is a red-white-and-blue letter day on the calendar of American history.
Love it or hate it, today’s start of public marketplaces for individual Americans to buy health insurance is to quote Vice President Joe Biden, “a big bleeping deal.”
Teddy Roosevelt campaigned for a national health care system over a hundred years ago. Even today’s harsh critics of “Obamacare,” admit the high cost of American health care is a financial burden on families as well as big companies and in need of repair.
That’s why today is so historic.
After more than half a century of efforts to catch up with other industrialized, modern democracies – Canada, Israel, Great Britain, France, German and Australia – America comes to the starting line with its own national health care system.
In Britain a poll earlier this year found the 65-year-old national health care service is more popular than the Queen or the Beatles.
The years of effort to get to the starting line with its own form of national health care in the United States reads like an epic political novel. There are bitter charges of socialism, even communism. And 2010 saw the rise of the Tea Party movement in a last-ditch effort to stop the reform coming to life today.
A major fight in Congress followed before the law passed. Even then it had to survive a challenge in the Supreme Court. And then President Obama, the man behind the plan, was elected for a second time.
But along the way there are some very strange twists to the story:
The conservative Heritage Foundation, now one of the leading opponents of the president’s reform plan was the first to come up with the idea of an ‘individual mandate’ for all Americans to have health insurance.
In the 1990s, Republicans Newt Gingrich and Bob Dole presented it as the alternative to Bill and Hillary Clinton’s health care proposals.
But today Heritage is in a leading role to kill the health care act because it contains their idea for the ‘individual mandate.’
The latest chapter in this amazing story begins with President Truman.
He called on Congress to approve a national health insurance plan in 1945. Truman’s based his political pitch on children, saying every American boy and girl deserved an education and a guarantee of health care.
When President Johnson created Medicare in 1965, national health insurance plan for seniors, he signed the bill at the Truman Library in Missouri. President Johnson gave President Truman the first card. LBJ said the idea for national health insurance “all started really with the man from Independence.”
In the 1970s, President Nixon backed a plan to have employers pay for health benefits or fund a government program.
In the ‘80s, President Reagan agreed to let people keep their insurance for a time after leaving a job; By the 1990s, President Clinton tried but failed to put national health care plan to work; and in 2005 President George W. Bush added prescription drug benefits to Medicare.
On the state level, Massachusetts Gov. Mitt Romney led the way in 2006 with a plan that has won strong support from state doctors and residents. The plan is popular. Even the Massachusetts Taxpayer Foundation praised ‘Romneycare’ as “well-thought out.”
And now – October 1, 2013 – President Obama’s Affordable Healthcare Act opens health insurance marketplaces on-line to allow 47 million Americans without health insurance to shop for a healthcare plan and possibly get government help paying for a plan.
Beginning today the American public gets directly involved with the unprecedented plan to deal with one of the nation’s major problems since the beginning of the Republic – the high cost of health care.
Over the past few decades, health insurance costs have risen dramatically – well above the rate of inflation – largely due to what economists call the “free rider” problem. The uninsured do not pay into the health insurance system so when they get sick and need health care, the cost must be spread among people who do have insurance in the form of higher premiums.
The individual mandate effectively eliminates that problem, bending the cost curve and ultimately lowering health care costs for all Americans.
Apart from the individual mandate, the Affordable Care Act has already helped millions of Americans.
Some quick facts that have been put out by the White House and the Department of Health and Human Services:
All of this is unprecedented. Love it or hate it, for better or worse, health care will never be the same in America again.