The Danger of Killing Health Care Reform From The Left

Matthew Yglesias has made an important point about the strategy of the “progressive block” to attempt to block any form of health care reform which does not meet their ideological goals. This now includes blocking plans which might serve the goals of health care reform if they do not include  a public option. An example of this was seen yesterday when they attacked an extremely sensible statement from Rahm Emanuel who argued that “The goal is non-negotiable; the path is.” I have used the Clinton’s as an example in criticizing the strategy of opposing any reform plan which the left does not consider to be perfect. Hillary convinced Bill to veto any bill which differed from the ideas of HillaryCare. As a result nothing was able to pass and the number of uninsured and under-insured has grown tremendously. Yglesias notes an even earlier parallel.

Yglesias points to a report on a plan proposed by Richard Nixon back in 1974 which is similar to what the Democrats are proposing today:

“It was an extremely extensive plan, as I remember, that would have given universal coverage” for health care, recalled Rudolph Penner, a former director of the Congressional Budget Office and economic official in the Ford administration.

Nixon introduced his Comprehensive Health Insurance Act on Feb. 6, 1974, days after he used what would be his final State of the Union address to call for universal access to health insurance.

“I shall propose a sweeping new program that will assure comprehensive health-insurance protection to millions of Americans who cannot now obtain it or afford it, with vastly improved protection against catastrophic illnesses,” he told America.

Nixon said his plan would build on existing employer-sponsored insurance plans and would provide government subsidies to the self-employed and small businesses to ensure universal access to health insurance. He said it wouldn’t create a new federal bureaucracy.

The Nixon plan won support from a Time magazine editorial on Feb. 18, 1974, which noted that “more and more Americans have been insisting that national health insurance is an idea whose tune (sic) has come.”

Considering his support for HMO’s I would have reservations about a plan advocated by Richard Nixon without seeing further details, but it is remarkable that we are still struggling this many years later over a way to do what every other industrialized country manages to do and enable all citizens to have access to affordable health care. The plan was not killed by conservatives but by those on the left who hoped for something better:

Despite the heated politics of Watergate, national health-care legislation was proceeding in Congress thanks to a compromise brokered by a young Democratic senator from Massachusetts, Edward Kennedy, a Nixon nemesis.

But then, according to a 1974 political almanac published by Congressional Quarterly, the AFL-CIO and the United Auto Workers lobbied successfully to kill the plan. Unions hoped to get a better deal after the next elections.

Yglesias concludes by saying essentially the same thing I have said on this topic in previous posts:

In retrospect, that particular iteration of the progressive block strategy doesn’t look so smart. And it’s possible that this time around, too, it’ll turn out that the votes aren’t there for a bill with a strong public option and the votes aren’t there for a bill without one either.

In retrospect, Emanuel was right and the liberal bloggers attacking him were wrong when Emanuel stated his concentration on the goals of health care reform as opposed to any specific path. For the past eight years we criticized George Bush and the Republicans for governing from the extreme right without compromise. Similar demands from the extreme left are no more rational.

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  1. 1
    Eclectic Radical says:

    As someone on the left critical of current health care reform ideas kicking around Congress, I feel a need to respond in some manner. I write on the topic a great deal and I have specifically attacked the two congressional plans of which I am aware… Teddy Kennedy’s and the conservative Republican Medicare reform bill. The latter is an unfunded mandate that everyone buy insurance, offering only relatively meaningless tax credits that top out below the higher deductibles of some of the cheaper, lower quality plans on the market. If I have a $7000 deductible (and that is not unheard of among very bad plans) then a $5000 tax credit for my medical expenses is still going to leave me with $2000 of medical bills I can’t pay and my insurance company won’t pay. If I receive all of my taxes back every year because I am below the minimum rate, or if I receive the Earned Income Credit, then no tax credit does me any good. The people who most need help are given no help by the Republican plan. In addition, the Republican plan includes explicit language that would defund Medicare while raising rates and rationing care to force seniors into the private insurance market.
    The Kennedy plan, on the other hand, fails to address one of the biggest problems in the health care system by attempting to burden American business (which is already steadily retreating from its share of the health care costs of its employees) with even more of the national health care bill. I’m hardly the biggest fan of the American corporation, but mandated employer health care creates a de facto tax much higher than any corportate taxes about which neocons and libertarians complain.
    If reform is not meaningful, then there is little point to reform. It is important to be honest and forthright about the problems with current reform plans being discussed in order to motivate the voting base to press for meaningful reform.
    That said, I am not demanding absolute implementation of every one of my ideas now. I am simply writing on the facts of the plans that exist now and pointing out why we need to do better. The left is not going to kill any reform bill that makes steps in the right direction. We want things to improve and we’re more than happy to compromise to see real improvement.
    The problem is that, right now, ‘reform’ consists of tweaks to a failed system rather than even the first steps to implementation of a new system. Voices for real reform are not being heard, and voices arguing for real reform are being accused of blocking it. Meanwhile, the right continues to claim that very minor and insufficient tweaks being offered by plans like the Kennedy plan are horrifying socialized medicine experiments.

  2. 2
    Ron Chusid says:


    “The left is not going to kill any reform bill that makes steps in the right direction.”

    That is not necessarily the case. There are many people who say they will vote against any plan without a public option. It is possible to have a reform bill which, while not perfect, does move in the right direction without a public option. If they use public plans as a litmus test we very well could have a situation where a reform bill that makes steps in the right direction is killed by the left.

  3. 3
    Jim Z. says:

    I agree with Eclectic Radical except that I wouldn’t by any stretch consider his position as “radical.” This site is clearly staking out a position on health care that amounts to no real change at all. The “left” as you call it, offers by far the most practical of the approaches because it holds the most systemic understanding of both the health care problem itself, and its impacts upon the federal budget. The nation just can’t get to a resolution of these twin problems unless and until profit is removed from the “insurance” part of health care (not from the direct pfovision of health care). If Congress’, Obama’s and a majority of citizens are unable or unwilling to get to that understanding, then we will founder. This matter is too important to leave in the hands of the existing monied lobbies, but that appears to be where it’s at right now.

  4. 4
    Eclectic Radical says:

    A reform bill without a public option would certainly have to have something in it to fill the role of a public option in increasing the availability of health care to those to whom it is currently unavailable, and creating more affordable and higher quality options for existing health insurance consumers unhappy with their coverage. Alternatives to a public option could be very tricky and far less effective. I do have to admit, I would certainly oppose an unfunded mandate with no support but inadequate tax credits meaningless to anyone who can afford health care and useless to anyone who can’t,  as the GOP offers.
    The problem is that the bills being thrown around Congress now do NOT make steps in the right direction. When people cannot afford health insurance and insurance companies do not adequately cover their customers, passing a law mandating that all Americans buy health insurance does not address the problems either of access to coverage or of access to care.
    The threat to health care reform is not from the left. It’s from ‘reformers’ totally uncommitted to any reform of the system. If no one actually presents a meaningful reform bill (and so far, none of the plans discussed in the Senate have been meaningful) one cannot blame ‘the left’ for killing health care reform. One can only blame the ‘reformers’ who failed to actually produce reforms. Our health insurance industry is a major part of our current health care crisis, and forcing all of America into their arms does not strike me as a solution to that crisis. Even with a public option.
    This is a tremendously important issue, and while we should not dismiss genuine reform because it doesn’t go far enough, we should not be so desperate to pass ANY health care bill that we do not genuinely enact health care REFORM. So far, there isn’t any health care reform for the left to kill. There is a Democratic bill, not yet finished, that would force Americans to buy health insurance from the HMOs and PPOs mangling health care now and there is a Republican bill, which no one but hard right conservatives supports,  which would force Americans to buy health insurance from the HMOs and PPOs mangling health care now. Where is the reform?
    I am bothered less by the lack of a public option (French health care has shown that a public option is not necessary, I will agree with that) than by the direction current health care reform is taking even if public options are included. The current plans would leave access to health care exactly where it is now: dependent on ‘insurance’ purchased from people who cannot make a profit AND provide quality care. Everything currently under discussion seems like it would help the insurance companies more than the people who need health care.
    It works both ways. While people can be blamed for not supporting health care reform, legislators can also be blamed for not enacting reform worthy of support. I come from one state which mandated that everyone buy auto insurance and live in another. In neither state do all insured drivers have meaningful auto insurance, and plenty of drivers do not comply with the law. The mandates have not solved the problems they were meant to address. We need something more than a similar mandate to buy health insurance.
    So far, we aren’t getting it.

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