No president came into office with more conscious effort and energy for health-care reform than the former Governor of Arkansas, Bill Clinton. Historians suggest why FDR did not make health-care reform a part of his infamous New Deal legislation package. Historical documents and witnesses have commented that Roosevelt felt universal health-care coverage was too controversial politically and he feared the voter clout in America of the American Medical Association. Harry Truman publicly called for health-care reform, but knew he did not have the required votes to achieve success so he never introduced legislation to bring it about. LBJ, committed to enacting legislation for his vision for a Great Society focused on Medicare and Medicaid rather than tackling the monumental task of achieving universal coverage. This is critical, as no one understood how to get votes in Congress better than LBJ. He consciously chose healthcare for seniors and for some of the poor rather than losing the health-care argument over introducing comprehensive health-care reform. Interestingly, Richard Nixon most likely came the closest to passing a comprehensive health-care reform bill, but was forced to look away as Watergate unfolded around his administration. Jimmy Carter, handcuffed with rampant inflation and foreign affairs issues in Iran prevented him, like Nixon from introducing a requisite bill to bring about health-care reform.
Clinton exploded into the issue in his first 100 day agenda developing a bill in the White House and appointing his wife, Hillary Rodham Clinton in charge, raising the political ante higher than it had ever been. Clinton went so far to mention in his 1994 State of the Union address that he would veto any health-care legislation that did not propose universal coverage.
Yet, the Clintons and their advisors failed on a grand scale. They were naive in thinking that presidential power could achieve health-care reform in America. The Republicans and moderate Democrats, at the time, proved he and Hillary wrong in their Executive Branch of the government approach.
Today, we have legislation that is 5 years old that was created to achieve mandatory universal coverage and garnered the requisite votes to be signed by the president, Barack Obama. But, the politics of health-care still swirl, with the House of Representatives voting more than 40 times to repeal the Affordable Care Act. And we have The Supreme Court striking down the federal mandate for states to expand Medicaid to provide coverage to all Americans.
We find in America today a segmented health-care policy labyrinth too complex to dismantle to allow for universal coverage. We have the Veteran’s Administration, the Indian Health System, the Military Health Service System, Tricare, Medicare, Medicaid, and CHIP to name just the heavy hitters. The political common ground needed to dismantle this network of federal entitlements is unachievable in today’s partisan political arena. Now, the some 32 million still uninsured seek relief and the majority of states are refusing to even allow their state legislature to debate the expansion of Medicaid. Whomever is elected president in 2016 inherits a legacy of inactivity and political despair when it comes to making health-care a bona fide inherent inalienable right in America. For the moment, health-care access must be earned in America and if you are unable to create a mechanism for “earning” the right to care, we, as a nation simply say, too bad. You must go without.