Sixty years and still stumbling
Editor’s note:
Here is an unsigned editorial which appeared in the Dec. 8, 2005 issue of The Catholic Messenger, newspaper of the Diocese of Davenport, Iowa.It was startling a few weeks ago to be reminded that universal health insurance is an idea whose time came in this country 60 years ago. One of the most controversial ideas in our political life for half a century was first proposed by President Harry Truman in 1945, shortly after the end of World War II. It wasn’t Hillary Clinton’s brainstorm, as some people might have imagined.
Sister Carol Keehan, president and CEO of the Catholic Health Association and a Daughter of Charity, reminded us of this history in comments last month noting that 45.8 million Americans live without the security of health insurance. This is a failure in social justice that Catholic Church leaders have noted for a long time. Unfortunately, we seem likely to continue failing.
At first, in the 1950s, universal health coverage was resisted and demonized as "socialism" in disguise. Then the idea fell off the political map as the civil rights revolution heated up, Vietnam soured the national mood and the Cold War simmered constantly in the background. Meanwhile, a large complex of medical insurance and drug businesses developed at the same time that medicine itself was becoming more technical and businesslike. When Bill Clinton was elected president in 1992, after the collapse of the Soviet Union, it seemed possible to revive the idea of universal health coverage. But life had become so complex and complicated by this time that ideas for coverage seemingly had to be complex, which made it easy for opponents to confuse the public and ridicule and defeat the effort started by Clinton.
And nothing has gotten simpler since.
It will be extremely difficult to generate the political will needed for universal health care. The most rational-sounding way toward that goal would look something like Medicare for all — Medicare as originally designed, a single-payer national system. But this would mean the end of the private insurance business, with vast consequent personal and economic disruption. Rather than let this happen, we are more likely to muddle along with a mixed private-public system that leaves millions of people — usually those who got a poor start in life — at the margins of health care: never secure when need arises, hesitant about questions and checkups, suffering the consequences of attention not given because the person is not economically valued.
Until we can do better we ought not to boast about health care in the United States.