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Government Involvement in U.S. Health Care
Theme Overview
Two incidents, both made famous in progressive economist Paul Krugman's New York Times column, revealed the profound misconceptions surrounding the inclusion of a "public option" in any health care reform legislation.
In the first, a man at a South Carolina town hall meeting warned Republican congressman Bob Inglis to "keep your government hands off" the government program Medicare.
And in the second, an editorial in Investor's Business Daily solemnly informed its readers that British subject Stephen Hawking "wouldn't have a chance" in Britain because Britain's National Health Service would look at his "physical handicaps" and say his "quality of life" was "essentially worthless."
Town hall meeting on health care, Montana (8/14/09)
(© 2009 Getty Images, Inc.)
A warning to the government not to get involved in a government program and a lecture on the horrors that a renowned scientist would suffer if he lived in the country where he's spent his whole life suggest that some opposition to increased government involvement in health care is based on something besides a careful analysis of the facts. If so, where does the opposition come from? And what makes it so intense?
In our Fall edition of History Happenings, explore some of the arguments for and against increasing the role of the government in the U.S. healthcare system. Then after you've read these new student lesson plans and activities from History Study Center, SIRS Decades, World Conflicts Today, and ProQuest Historical Newspapers (Graphical Edition), decide for yourself how involved the U.S. government should be in ensuring health care for its citizens.
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Making the Case for Change
History Study Center
In the current debate over health care in the United States, few people dispute that there are significant problems with the system.
Most agree that health care is too expensive, that not all citizens have equal access to care, and that there is waste and inefficiency. However, what is less certain is what we should do to address these problems. Are the problems so severe that we need to fundamentally overhaul the way medical care is delivered and paid for in this country? Bill Clinton thought so (see column on right).
President Clinton greets senators following his 1993 speech to a joint session of Congress in which he proposed a national health plan.
(© 1993 Getty Images, Inc.)
In this new activity from ProQuest's History Study Center, examine some of the rhetorical strategies President Clinton used to attempt to convince the nation that we need a system that guarantees affordable health care to all Americans.
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Reform and the Role of Government
SIRS Decades
At the heart of the ongoing debate over healthcare reform in the United States is the extent to which government has a responsibility to help people in need.
Opponents of government intervention complain about inefficiency, loss of choice, and a growing budget deficit.
Those who favor a larger government role suggest that government has a responsibility to help the disadvantaged, protect the public against powerful corporate interests, and to ensure equal access to something as basic as health care.
This debate over the proper role of the federal government is not new. When the U.S. government created its social security program in the 1930s, there were similar concerns about government expansion.
Promotional posters from the Social Security Board
In this new activity from SIRS Decades, check out advertisements that were used in the early 20th century to promote the government's social security program and ponder their relevance to the healthcare debate today.
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Class Conflict in Colombia
World Conflicts Today
Disagreement over the role government should play in promoting the well-being of its citizens is certainly not unique to the United States.
Indeed, while the passion Americans feel about the topic may fuel heated arguments among friends and name calling among politicians, the stakes are much higher in at least one other country—Colombia—where passionate disagreement over the government's role in society has been a key factor in a long-running civil war that has killed thousands.
AUC Paramilitaries Training in Southwestern Colombia
(© 2003 Getty Images, Inc.)
In this new activity from World Conflicts Today, read about the class conflict at the root of Colombia's bloody war while analyzing the rhetoric used by supporters and opponents of governmental solutions to social problems.
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Bill, Hillary, Harry, and Louise
ProQuest Historical Newspapers
"I, for one, personally admire you."—Orrin Hatch (Sept. 29, 1993)
Quick—which hugely influential liberal politician dedicated to enacting universal health care was Utah's Republican senator Orrin Hatch addressing?
If you said Hatch's former colleague in the senate, the late Edward Kennedy, you would have made a good guess, but you would be wrong. No, Senator Hatch was actually addressing former first lady Hillary Rodham Clinton, who President Clinton had put in charge of reforming health care.
If this surprises you, it's likely because healthcare reform has turned into such a viciously polarizing topic of debate. But back in the summer of 1993, when Senator Hatch was expressing his admiration for First Lady Clinton, the atmosphere was far more congenial.
This was the period during which Hillary Clinton appeared with four Republican senators, including soon-to-be-presidential-candidate Bob Dole, at a day-long forum on health care. At that forum (trial sign up), Dole complimented Clinton on her "flexibility," and Senator John Danforth warned against "over-emphasizing" what he felt were only minor points of disagreement between Republicans like himself and the White House.
When Clinton went before Congress to explain and defend her ideas for healthcare reform, the reviews were practically unanimous in their praise. "Off the charts" and "a political 10" was how Washington Post columnist Meg Greefield described the First Lady's performance.
And, writing a week after Clinton's "hit appearances on Capitol Hill" had left Congressional committees "dazzled," New York Times reporter Adam Clymer described how awestruck participants at a town hall meeting at Brown University had lined up just to "shake her hand or offer praise."
Hillary Clinton is hugged by sick children
(© 1993 Getty Images, Inc.)
The admiration for Clinton seemed so pervasive that Georgia congressman Newt Gingrich's assessment of her plan ("if you are 55 and you need kidney dialysis, you die") seemed totally out of synch with the popular and congressional moods.
Then the doubts started to creep in, and the early compliments were turned on their heads. A process that had once been described as open and inclusive was now regarded as secret and sinister; a plan that aimed to bring costs down was dismissed as impossibly expensive; and, above all, a law that explicitly guaranteed the rights of Americans to pay for whatever health services they wanted from whichever doctor they liked was represented as one in which the government would decide who got what treatment and where they would get it from.
The perception of the Clinton plan had changed so much by early 1994 that, in the January 31 edition of the New York Times, Adam Clymer started an article "Is there enough passion and political skill behind President Clinton's health care plan to get it, or something close to it, passed? In the nation's capital, there are doubts."
By the summer of 1994, there were more than doubts. On August 9, Hillary Clinton all but admitted defeat when she vowed that the issue of health care was "not going to go away, no matter what happens." And before the month was out, the White House acknowledged it didn't have the votes for major healthcare reform (and turned its attentions elsewhere).
Today, as healthcare reform is once again dominating the headlines, the term "Hillarycare" has become an insult that requires no elaboration.
So where did it all go wrong? How did the giddy optimism that greeted Hillary Clinton's ideas about healthcare reform turn into vitriol?
In an interview with the New York Times, given shortly after the defeat of her plan, Clinton discussed the reasons for that defeat. In her opinion, the biggest mistake proponents of universal health care made was underestimating the commitment, sophistication, and dedication of their opponents. Clinton says they were not ready for these attacks and so allowed falsehoods—like the one that convinced patients the government was going to tell them what surgeries they could and could not have—to spread.
Other journalists and analysts have pointed to other factors, such as an improving economy that made people feel less concerned about their ability to keep their existing health insurance; developments overseas—like the ill-fated intervention in Somalia—that prevented the president from throwing his full weight behind his wife's healthcare initiative; a change in strategy among Congressional Republicans who saw the political benefit of defeating one of the Democrats' signature pieces of legislation; and a sense among some Americans that health care needed some tinkering but nothing like the far-reaching changes the First Lady was proposing.
Activity:
Read these humorous poems, the first by Clinton-ally-turned critic Bob Dole and the second by the Democratic National Committee. Both poems make reference to Harry and Louise. Harry and Louise were the fictional couple who appeared in Health Insurance Association of America (HIAA) ads designed to turn people against the Clinton plan.
Search for "Harry and Louise" and health care and read through 10 or more of the articles that appear in your results list. Then write your own poem about Harry and Louise, in which you take a position for or against the government playing a more active role in health care today.
To make use of the links in this lesson, get trial access to Historical Newspapers.
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