Wendy Moore's review of the failure in 1917 of a well-thought-out
plan for health insurance in America makes instructive but also sad
reading. The sad story continues. Franklin D. Roosevelt proposed to
overhaul American health care as part of the New Deal. This failed, as did
plans for reform sponsored by Richard Nixon.
The Medicare plan for the elderly was introduced in the early 1960's
despite a storm of opposition, particularly from the American Medical
Association (AMA). Medicare was represented as creeping nationalisation
and certain to ruin American medicine. The AMA became quite hysterical
about government intervention in health care, and made outrageous claims,
notably that national health legislation had "destroyed" the "once fine"
practices of Medicine in Britain and Sweden. The AMA claimed to be
protecting the interests of patients and preserving the excellent
standards of American medicine, but it was widely believed that the AMA
was more concerned with protecting doctors' incomes. Despite the AMA's
objections, Medicare was approved and became an important factor in the
economics of many American medical practices. If a move was made to repeal
Medicare, there would doubtless be a shriek of protest from the same AMA.
In the Clinton era, the Democrats controlled the Senate, the House of
Representatives and the White House, but the Clinton Health Plan was soon
dead in the water. The original concept was that there should be universal
coverage by health insurance; those who could not afford the premiums
would have their insurance paid for by the government, which would be
cheaper than paying for their medical care, for example by Medicaid. There
were multiple reasons for the plan's failure, not least because President
Clinton appointed his wife to instigate the plan and this flagrant
nepotism was not appreciated. The manner in which Hillary Clinton went
about the task was not popular either. For example, when her team visited
one Florida city, 70 academics and others were interviewed but no
physicians were consulted. When the plan was foundering, Congress
demonstrated inspired hypocrisy by defining "universal coverage" as 95 per
cent, thus leaving 15 million Americans uninsured. It is just as well that
the plan failed.
President Obama's ambitious health reform plan also seems likely to
fail. His claim that reform will simultaneously cut costs and improve
health care is not credible. The same claim was made 60 years ago for the
NHS in Britain and the predicted result never happened.
Reforming America health care can be likened to draining the Pontine
Marshes. Mussolini did achieve this, but only by the mechanism of
dictatorship, which is too high a price to pay.
Rapid Response:
American Health Insurance: a long sad story.
Wendy Moore's review of the failure in 1917 of a well-thought-out
plan for health insurance in America makes instructive but also sad
reading. The sad story continues. Franklin D. Roosevelt proposed to
overhaul American health care as part of the New Deal. This failed, as did
plans for reform sponsored by Richard Nixon.
The Medicare plan for the elderly was introduced in the early 1960's
despite a storm of opposition, particularly from the American Medical
Association (AMA). Medicare was represented as creeping nationalisation
and certain to ruin American medicine. The AMA became quite hysterical
about government intervention in health care, and made outrageous claims,
notably that national health legislation had "destroyed" the "once fine"
practices of Medicine in Britain and Sweden. The AMA claimed to be
protecting the interests of patients and preserving the excellent
standards of American medicine, but it was widely believed that the AMA
was more concerned with protecting doctors' incomes. Despite the AMA's
objections, Medicare was approved and became an important factor in the
economics of many American medical practices. If a move was made to repeal
Medicare, there would doubtless be a shriek of protest from the same AMA.
In the Clinton era, the Democrats controlled the Senate, the House of
Representatives and the White House, but the Clinton Health Plan was soon
dead in the water. The original concept was that there should be universal
coverage by health insurance; those who could not afford the premiums
would have their insurance paid for by the government, which would be
cheaper than paying for their medical care, for example by Medicaid. There
were multiple reasons for the plan's failure, not least because President
Clinton appointed his wife to instigate the plan and this flagrant
nepotism was not appreciated. The manner in which Hillary Clinton went
about the task was not popular either. For example, when her team visited
one Florida city, 70 academics and others were interviewed but no
physicians were consulted. When the plan was foundering, Congress
demonstrated inspired hypocrisy by defining "universal coverage" as 95 per
cent, thus leaving 15 million Americans uninsured. It is just as well that
the plan failed.
President Obama's ambitious health reform plan also seems likely to
fail. His claim that reform will simultaneously cut costs and improve
health care is not credible. The same claim was made 60 years ago for the
NHS in Britain and the predicted result never happened.
Reforming America health care can be likened to draining the Pontine
Marshes. Mussolini did achieve this, but only by the mechanism of
dictatorship, which is too high a price to pay.
Competing interests:
None declared
Competing interests: No competing interests