10.13.09

A Short History of Health-Care Disasters

With Tuesday's vote in the Senate Finance Committee, President Obama's push for health-care reform came closer to final passage than any president’s in history. And it’s quite a history. The Daily Beast looks at Obama's predecessors, from Teddy Roosevelt to Bill Clinton, and how close they got to the finish line.

Teddy Roosevelt, 1912
Theodore Roosevelt was the first U.S. president to float a version of universal health care, though he didn’t do it until he was out of office. After declining a second term, Roosevelt challenged incumbent William Howard Taft in 1912, losing the Republican primary but running as a candidate for the self-created and short-lived Bull Moose Party. Roosevelt’s progressive platform advocated health insurance for all Americans alongside other liberal ideals such as women’s suffrage, but none of his plans made it out of the starting gate; Roosevelt lost the election to Woodrow Wilson.

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AP Photo

FDR and Truman, 1934 - 1950
In the midst of the Great Depression, illness was one of the largest and fastest-growing causes of poverty, and FDR gave the Committee for Economic Security the task of drafting a program to deal with both this problem and the economic crisis at hand. However, in spite of a Democratic majority, Roosevelt feared that that health care would sink the broader Social Security Act. A second attempt at national health insurance led by Sen. Robert Wagner (D-NY) and Rep. John Dingell Sr. (D-MI) failed in 1939, due in part to concern in the medical community and backlash against government expansion. Toward the end of his life in 1944, Roosevelt proposed a Second Bill of Rights that would have included "the right to adequate medical care and the opportunity to achieve and enjoy good health." But he died before he could turn his attention to its passage. (Footage of the speech recently appeared in Michael Moore's film, Capitalism: A Love Story.) After Roosevelt's death, Harry Truman tried to pick up the mantle, but a difficult economic environment, anger over the Korean War, and paranoia about communism kept a bill from ever coming close to passage.

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National Archives, Newsmakers / Getty Images

Richard Nixon, 1974
Somewhere in an alternative universe, Richard Nixon was the most successful liberal president who ever lived. The president spent years negotiating with Sen. Ted Kennedy, who favored a single-payer universal health-care plan, while promoting his own Comprehensive Health Insurance Plan, which would have required employers to provide basic health coverage while insuring the unemployed and poor through a Medicaid-like program. "Now, for the first time, we have not just the need but the will to get this job done. There is widespread support in the Congress and in the Nation for some form of comprehensive health insurance," Nixon said in a 1974 speech.

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One problem: The Watergate scandal was raging and wrecked Nixon's career, eliminating the political capital needed for reform. At the same time, opposition from unions holding out for a more progressive plan bled its support on the left. In the end, legislation never made it to a committee vote. Presidents Ford and Carter lacked the popularity and economic environment to push through universal health care; Ronald Reagan, who had warned even Medicare would lead to socialism in the 1960s, ended the whole discussion. Kennedy later said that his obstinacy in dealing with Nixon until it was too late was his single greatest regret.

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Bill Clinton, 1993 - 1994
President Clinton took office with a majority in the Senate and House and reforming health care was a key plank of his 1992 campaign. But universal health-care legislation never even came up for a vote in either legislative branch. What happened? Political observers offer a litany of reasons. In Congress, Democrats were split between those on the left, like the late Sen. Paul Wellstone (D-MN), who favored single-payer coverage, and those on the right, like the late Sen. Daniel Patrick Moynihan (D-NY), who were afraid of disrupting the current system. The White House’s strategy of charging Hillary Clinton with drafting a bill gave Republicans a convenient target. Conservative groups as well as the health and insurance industries also employed effective advertising campaigns against the bill, like the “Harry and Louise” ads. The legislation's best hope of passing was likely Senate Minority Leader Bob Dole's (R-KS) longtime support for health care reform, but with the 1996 primaries in sight, he decided not to cross party lines to support the president. In 1994, Senate Majority Leader George Mitchell (D-ME) declared that the bill didn't have enough votes to overcome a filibuster—or even enough to garner a simple majority. After Republicans took the Senate and House in 1994, it was all over for health care until President Obama's push.

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Pete Souza / Getty Images

Barack Obama, 2009
"I am not the first president to take up this cause, but I am determined to be the last," President Obama said in his September address to Congress. Seeking to avoid Bill Clinton's difficulties achieving a politically viable bill, Obama left it to Congress to draft a health-care plan, although he offered broad guidelines on what such a bill should include. So far the strategy appears to be paying off. On Tuesday, the Senate Finance Committee passed a bill, joining the Senate HELP committee and the relevant House committees who have also reached agreements. While battles loom ahead over how to pay for the plan, how generous subsidies should be for middle class Americans to purchase insurance, and whether to include a public insurance option, Obama's plan for health-care reform is now the closest to the finish line of any of his predecessors' attempts by far. All signs point toward Democrats sticking together, and possibly adding the support of Republican Sens. Olympia Snowe (R-ME) and her colleague Sen. Susan Collins (R-ME).