Dr. Tom: A Brief History of the U.S. Government and Healthcare, Part I …

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By Dr. Tom Kluzak

You will probably be surprised to learn that the first U.S. president to propose any form of government-sponsored healthcare was a Republican. OK, technically a former Republican.

Teddy Roosevelt served as our 26th president from 1901 to 1909, after which his hand-picked successor, William Howard Taft, was elected. Returning from a safari and European tour, Roosevelt found himself unimpressed with Taft’s performance and sought the Republican nomination in 1912. Rebuffed, he founded the Progressive Party, which included in its platform the provision of limited health insurance to low-wage earners. (Sorry, I know this is upsetting to modern Republicans, but it is true; look it up. You can take some solace in the Progressive Party’s alias: The Bull Moose Party).

At the time, labor unions and insurance companies opposed the healthcare provision but — isn’t history full of surprises? — it was supported by the American Medical Association.

Anyway, Teddy ended up splitting the 1912 ticket, giving the win to Woodrow Wilson and the Democrats who would become the Southern Democrats; the Republicans stuck with Taft and others who eventually gave birth to our modern Republican Party.

Medical care continued to generate considerable discussion, with the Committee on the Cost of Medical Care, formed by a group of philanthropic organizations, issuing 26 volumes of research and 15 smaller reports between 1926 and 1932. The AMA finally woke up, calling one of the committee’s reports “a radical document that advocated socialized medicine,” saying it was an “incitement to revolution.” Of course, at the time, “socialism” and “communism” were pretty much interchangeable and carried a much worse connotation than today’s Bernie supporters would accept.

In the meantime, a group of school teachers in Dallas contracted with Baylor Hospital in Dallas to provide specific health services at a predetermined monthly cost, the forerunner of Blue Cross plans.

A lot was happening elsewhere in the mid part of the 20th century but healthcare reformers kept trying, introducing the Wagner-Murray-Dingell Bill in 1943 that called for compulsory national health insurance paid for with a payroll tax. Introduced yearly for 14 years, it never passed.

Something else happened in 1943, though, that would have far-reaching effects. A war-time wage freeze was in place at the time but the War Labor Board ruled that fringe benefits, including health insurance, were not covered by the freeze. Coming on the heel of the Revenue Act of 1939, which made health insurance an employee tax exclusion, this ruling wedded health insurance to employment in what has become the longest-lasting marriage on record.

Despite efforts by Roosevelt, Truman and others, it took until the 1960s to seriously consider a national program. It didn’t happen without a fight, though, and the AMA was right there leading the charge, protecting the freedom of the American people without regard to the pocketbooks of doctors. They even hired a television actor with a mellifluous voice to record an LP (something you played on a turntable) in which he said he feared he would be telling his children in his “sunset years what it once was like in America when men were free.”

The efforts of Ronald Reagan failed, however, and Medicare was passed and signed into law by President Lyndon Johnson in 1965.

Next time: From President Nixon’s proposal of an affordable care act to the real Affordable Care Act and beyond.

Please come: April 8 has been designated a National Day of Action for Improved Medicare for All and we will celebrate it with a Healthcare Forum at the Library starting at 2:15 p.m. Bring your thoughts and facts so we can all become more informed citizens.

Dr. Kluzak, an Idyllwild resident, is board certified in Anatomic Pathology, Obstetrics and Gynecology. He also is a freelance photographer for the Town Crier.

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