Congress Must Courageously Collaborate for Our Health’s Sake
We can overcome our differences to act for the common good.
Medicare is an American success story. Today, nearly all US seniors have access to health care through Medicare, one of the great Federal benefit programs guarded by political leaders from both sides of the aisle. Since its inception in 1965, there have been subtle to dramatic improvements championed by Democrats and Republicans alike. These range from the Medicare Prescription Drug, Improvement and Modernization Act Part D Drug Plan to the Medicare Advantage options. Like Social Security, Medicare survives owing to citizens’ demand that lawmakers guard what they view as an essential benefit.
In 1965, it was very different. Almost 25 percent of our nation’s seniors had no access to medical care. Like today, health plans were secured largely through employment, and when people retired, they often lost their health insurance. Reading the narrative of early 1960's quotes from political figures regarding what is now seen as an essential program is eerily reminiscent of what is heard now about the Affordable Care Act (ACA). Taking a look back is particularly important as the Supreme Court hears oral arguments this week in a case that could lead to the ACA’s demise.
ACCESS TO HEALTH IS AN HISTORIC STRUGGLE
In 1961, actor and aspiring politician Ronald Reagan suggested in a recorded message that extending the Social Security Act to include medical benefits for seniors was tantamount to the rise of socialism in America, an attack that Wall Street Journal reporter Roger Lowenstein called a “stealth program” led by the American Medical Association to protect an economic status quo. Reagan encouraged listeners to join a letter-writing campaign to Congress with the message:
“We do not want socialized medicine…behind it will come other government programs that will invade every area of freedom as we have known it in this country until one day, as Norman Thomas said, we will wake to find that we have socialism.”
This resistance to change sounds identical to what we have heard for the past years, months, and days. Yet change happens, whether we want it to or not. No matter how strong or popular, people succumb to illness. Red and blue state residents alike face mounting medical bills and struggle to provide for their families. COVID-19 appeared around our world suddenly and turned great plans for the future to dust. Change doesn’t care if you’re not ready for it, nor if you will even acknowledge it. Change will come.
LIKE AGING, DISEASE, AND ILLNESS HAVE NO PARTY AFFILIATION
As written in Ecclesiastes, “There is a time to heal and a time to plant…” Politics at its best when its leaders — our leaders — work across the party aisle to address societal needs — to heal and to plant — and eventually harvest new ideas.
When we recognize that each of us is vulnerable, political certainty is tempered through harsh life experience and empathy. John McCain, with a perspective no doubt tempered by the empathy his brain cancer diagnosis gave him, courageously stepped forward to defend the ACA from repeal.
“We should not be content to pass health-care legislation on a party-line basis, as Democrats did when they rammed Obamacare through Congress in 2009. If we do so, our success could be as short-lived as theirs when the political winds shift, as they regularly do. The issue is too important, and too many lives are at risk, for us to leave the American people guessing from one election to the next whether and how they will acquire health insurance. A bill of this impact requires a bipartisan approach.”
COLLABORATION IS NOT A NICETY — IT IS A NATIONAL URGENCY
When Lyndon Johnson assumed the presidency after John F. Kennedy’s assassination, two groups of Americans were largely uninsured: the elderly and the poor. Medicare and Medicaid, bills — debated, passed, and perfected over time through bipartisan action — lifted people up from fear of suffering and poverty. Cornerstones of Johnson’s Great Society achievement, they remain bedrock some 55 years later.
Right now, we are facing a new problem. COVID-19 has left many millions who have lost their jobs uninsured or underinsured and — therefore — at heightened health risk.
A series of national surveys with some 13,000 people show that our nation is nearing the cliff of a secondary COVID-19 public health risk: unemployment. Just as Congress responded to the challenges faced by the nation’s seniors in the mid-1960s with Medicare, soon our elected leaders will need to tackle the needs of millions of Americans without health coverage.
In “The State of Health Insurance in COVID-19 America,” a survey conducted by Civis Analytics and released with Finn Partners, a stark picture of the future health of this nation is revealed as, increasingly, people lost health insurance when they lost their jobs due to the pandemic. Now, an estimated 36 million-plus Americans are uninsured, a trend that disproportionately impacts Black Americans; by September, more than a quarter (26%) were uninsured. This survey and others lay bare the problem of a far-reaching public health disaster resulting from systemic racism in America coupled with the consequences of an insurance system tied to employment.
As the adage goes: “The data are the data.” We cannot escape from the realities that we need to respond to societal cries for justice and access to care. And we have to recognize that even as we inch closer to the possibilities of a vaccine, that vaccination won’t fix poverty, nor the ill health with which it goes, hand-in-hand.
America’s health emergency calls upon elected and appointed officials to work together in order to address the needs of the people, regardless of how they vote. Collaboration is not a nicety when it comes to confronting illness — it is an urgency.
Democrats and Republicans fought mightily and vociferously debated the merits of a national health program for senior citizens and the impoverished in the mid-1960s, but they created it, nonetheless. While President Johnson is credited with the Great Society achievements, all members of the Congress and the Administration, and the Congresses and administrations that followed — those who rolled up their sleeves to make the process work, share the legacy of providing for people’s health needs.
Fifty-five years later, not much has changed; we still have it in us to make the choice to push through our difference to act for the common good. It’s time that we do this again, and help our most vulnerable realize a better, kinder, and greater society that meets people’s most basic needs and calls for care.
