"Universal healthcare now!" must be the Democratic motto in 2018

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A century of efforts going into Universal Healthcare - Chronology

Teddy Roosevelt, Republican - "Let me add that the health and vitality of our people are at least as well worth conserving as their forests, waters, lands, and minerals, and in this great work the national government must bear a most important part.”

It wasn’t until he ran for President again in 1912 as a Progressive that his platform would include the idea of  a more nationalized healthcare idea. Roosevelt’s concept was labor based, with burden for costs shared between workers, employers and the government.   It was indeed progressive, and was not embraced by those who saw it as competition to making money with medicine. The American Medical Association (AMA) was also deeply and vocally opposed to the idea which it labeled "socialized medicine"

FDR -  In 1933, Franklin D. Roosevelt asked Isidore Falk and Edgar Sydenstricter to help draft provisions to Roosevelt's pending Social Security legislation to include publicly funded health care programs. These reforms were attacked by the American Medical Association as well as state and local affiliates of the AMA as "compulsory health insurance." Roosevelt ended up removing the health care provisions from the bill in 1935 (Social Security bill).

In January 11, 1944, in his address, Roosevelt suggested that the nation had come to recognize and should now implement, a second "bill of rights. (1 of which was guaranteed Healthcare along with education, good jobs) - The right to adequate medical care and the opportunity to achieve and enjoy good health

Harry Truman - Truman’s plan for national health insurance in 1945 was strongly committed to a single universal comprehensive health insurance plan that included all classes of society, not just the working class. The chairman of the House Committee was an anti-union conservative and refused to hold hearings. Senior Republican Senator Taft declared, “I consider it socialism. It is to my mind the most socialistic measure this Congress has ever had before it.” Taft suggested that compulsory health insurance, like the Full Unemployment Act, came right out of the Soviet constitution and walked out of the hearings. The AMA, the American Hospital Association, the American Bar Association, and most of then nation’s press hated the plan. The AMA claimed it would make doctors slaves, even though Truman emphasized that doctors would be able to choose their method of payment.

What Truman could pass - The National Mental Health Act (1946) became law on July 3, 1946. It established and provided funds for a National Institute of Mental Health (NIMH). The Act made the mental health of the people a federal priority. It was inspired by alarm at the poor mental health of some draftees and veterans, and was demanded by veterans and their families

Truman writing how AMA was sabotaging it (the Fair Deal) with lies about socialized medicine -



In 1946, the Republicans took control of Congress and had no interest in enacting national health insurance. Truman responded by focusing even more attention on a national health bill in the 1948 election. After Truman’s surprise victory in 1948, the AMA thought Armageddon had come. They assessed their members an extra $25 each to resist national health insurance, and in 1945 they spent $1.5 million on lobbying efforts which at the time was the most expensive lobbying effort in American history. They had one pamphlet that said, “Would socialized medicine lead to socialization of other phases of life? Lenin thought so. He declared socialized medicine is the keystone to the arch of the socialist state.”

JFK - Campaigned on Medical Care for the poor & old (Medicare & Medicaid essentially) but couldn't get it passed.

LBJ - Congressman Aime Forand introduced a proposal in 1958 to cover hospital costs for the aged on social security. The AMA undertook a massive campaign to portray a government insurance plan as a threat to the patient-doctor relationship. In the entire history of the national health insurance campaign, this was the first time that a ground swell of grass roots support forced an issue onto the national agenda. The AMA countered by introducing an “eldercare plan,” which was voluntary insurance with broader benefits and physician services. In response, the government expanded its proposed legislation to cover physician services, and what came of it were Medicare and Medicaid. The necessary political compromises and private concessions to the doctors (reimbursements of their customary, reasonable, and prevailing fees), to the hospitals (cost plus reimbursement), and to the Republicans created a 3-part plan, including the Democratic proposal for comprehensive health insurance (“Part A”), the revised Republican program of government subsidized voluntary physician insurance (“Part B”), and Medicaid. Finally, in 1965, Johnson signed it into law as part of his Great Society Legislation, capping 20 years of congressional debate.

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1970's - In February 1970, Representative Martha Griffiths (D-MI) introduced a national health insurance bill developed with the AFL–CIO. In April 1970, Senator Jacob Javits (R-NY) introduced a bill to extend Medicare to all developed after consultation with Governor Nelson Rockefeller (R-NY) and former Johnson administration HEW Secretary Wilbur Cohen. In August 1970, Senator Ted Kennedy (D-MA) introduced a bipartisan national health insurance bill developed with the Committee for National Health Insurance founded by United Auto Workers president Walter Reuther, with a corresponding bill introduced in the House the following month by Representative James Corman (D-CA).

In January 1971, Kennedy began a decade as chairman of the Health subcommittee of the Senate Labor and Public Welfare Committee, and introduced a reconciled bipartisan Kennedy-Griffiths bill proposing universal national health insurance. In February 1971, President Richard Nixon proposed more limited health insurance reform—a private health insurance employer mandate. In October 1972, Nixon signed the Social Security Amendments of 1972 extending Medicare to those under 65 who have been severely disabled for over two years or have end stage renal disease (ESRD).

In April 1976, Democratic presidential candidate Jimmy Carter proposed health care reform that included key features of Kennedy's universal national health insurance bill. In December 1977, President Carter told Kennedy his bill must be changed to preserve a large role for private insurance companies, minimize federal spending (precluding payroll tax financing), and be phased-in so not to interfere with balancing the federal budget. Kennedy and organized labor compromised and made the requested changes, but broke with Carter in July 1978 when he would not commit to pursuing a single bill with a fixed schedule for phasing-in comprehensive coverage.


2000's - In 2001, a Patients' Bill of Rights was debated in Congress, which would have provided patients with an explicit list of rights concerning their health care. Many interest groups, including the American Medical Association (AMA) and the pharmaceutical industry came out vehemently against the congressional bill. Basically, providing emergency medical care to anyone, regardless of health insurance status, as well as the right of a patient to hold their health plan accountable for any and all harm done proved to be the biggest stumbling blocks for this bill. As a result of this intense opposition, the Patients' Bill of Rights initiative eventually failed to pass Congress in 2002.

A century of effort has gone into this - From Teddy Roosevelt to FDR to Truman to LBJ to Ted Kennedy - All fighting for Universal Healthcare !

The President who will able to get a Single Payer/Medicare for all types enacted will be by default be one of the greatest POTUS in history & will be providing the biggest tribute to all these people in their graves!

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Is universal health care the same thing as single payer? I support the former, but resist the latter, unless there is no other way to do it, that will not cost a lot more money (other than money which funds drug research).

They do not need to be the same, and universal health care can be operated with a multi-payer system. In Germany there are over 100 funds that insure most of the population, paid for by a combination of employer, employee and government contributions. The premium is fixed for individuals in these funds independent of risk. There is also an opt-out provision for qualified individuals to pay a tax and buy insurance independently of the regulated funds, but those individuals can be charged based on risk.

Thank you. Do you think the German model has merit to consider for the US?

Health Insurance is compulsory for people living in Germany. Any1 under 50,000 Euros is forcibly provided with a public Health Insurance plan with a federally decided set of benefits. The above 50,000 Euros is around 11% odd of the population. So 90% are in a forced Single Payer within this system & the rest have to get Private Insurance. Employees pay a tax on salary if they are under 50K, similar to a pay-roll tax as under a  US government! There is around 15.5% tax (Employer + Employee) on people to finance the public insurance.

Germany has a LONG history of health insurance & conservative governments are staunch supporters of such welfare programs & are not much dissimilar to the US Democrats of today. It is also too much instability & chaos to transition into a different system when something is working for years! Multi-payer in US will also cause big tax hikes & have some of the same problems to sell to people as Single payer (Tax increases). In addition, it creates another massive problem - Government deciding an income level for people to get public healthcare which will be a massive debate (difficult to sell to people) & forced intrusion. And it will be easier to dismantle by conservative governments held by the GOP who can play around with the income level & decrease it so much to make it render non-universal. Or you can have a Multi-payer where everyone gets some insurance & the rest is through purchase of secondary plans. Now that will be even more vulnerable & will result in plans which are trash & cover little requiring everyone to purchase private Insurance. The situation in Germany is very complex & transitioning across income & plans isn't perfect. For example, let's say your income falls from 70K to 30K, you may find it difficult to immediately get a public plan. It can cause chaos if implemented not correctly in US & damn well conservatives won't support it fully.

Single-Payer is the most simplistic, universal & by far the cheapest solution & every other universal plan would require tax increase too (ACA subsidies also required some tax increase on wealthy people). USA already has a multi-payer system of sorts, a modified Single payer called Medicare & private insurance. The only difference is this multi-payer system is not universal ! Not only does Medicare not generate huge profits to increase costs, but the administrative costs of Medicare is around 2% vs 17% of Private Insurance! This is a bit of an easy choice really !

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There is a silver lining to the fact we don't yet have universal health care -we have an opportunity to create a health care system that deals with the drawbacks of both single-payer and multi-payer models.  

There's already a multi-payer system, it's just not universal. There is no mixture of Single Payer & Multi-payer. It is either a Single payer & if it not be default it is a multi-payer system. There's no 1.5 Payer system of sorts.

I already made a lengthy post talking about the basics of Multi-Payer, Germany's healthcare system & how Multi-payer has significant drawbacks (including the major problem of Single Payer - High Tax hike) , harder to administer/implement, problems of market failure & change of plans/income levels, harder to achieve consensus even within the Dem party about essential benefits or fixed income levels, easier to dilute & render non-universal by a GOP & is on the whole a more expensive proposition !

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When 20-30M don't have coverage, how on earth can it be Universal? While the ACA may have expanded coverage, it would probably never have guaranteed universal coverage. Let us look at the most optimistic version of the ACA, kind of what Obama though would happen -

Medicaid Expansion in all states (& then maybe a 2nd round later if need be)  to cover the additional 5-6-7-8M initially or god knows how many people in the GOP states which refused. A Public option which will bring increased competition & will thus lower private profits & bring down premiums. A penalty on the un-insured which will raise money & most importantly may force more people to buy insurance & expand a poll having more, young healthy people.

In Germany, everyone is forced to get insurance which Obama couldn't force, so he thought that penalty would do it partly (which was totally naive). The Medicaid expansion optional decision totally pulled the rug under him. And ofcourse the public option failed which also created large monopolies (or too less competition). You had a large pool of healthy n young people with lower risk of falling ill or requiring medical treatment staying away & the pool became increasingly unhealthy with too much power concentration among the Insurance companies with too little competition.

ACA didn't really look at the root cause of high premiums & did nothing to decrease administrative costs (rather increased it) & check massive private profits, which would have decreased costs. Even a Public option could have been made optional by the Courts which defeats the whole purpose, many people won't buy from exchanges & I am not even sure how great a public plan would work (no major details provided of how it will work out).

Drug affordability like some controls, regulations, allowing drug imports, bulk negotiation was totally left off the table. The ACA in itself was the multi-payer approach. Also, the whole deal about 50 employee organizations have to give mandatory insurance was too much on small businesses. I mean it is better surely than employees not getting any healthcare. But it is still not a good idea, people are dis-incentivized to change jobs & many of these businesses have low bargaining power & the root causes of high cost doesn't change.

On the whole, atleast it build a discussion about nitty gritty's about healthcare & the need to cover most/all & was definitely a push towards universal or atleast expanded healthcare coverage (apart from the good features of the law).

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I think there will be a divide between support for a strong public option and full on single payer. I don't think the system or the country is ready for single payer. The ACA only really deals with individual market and single payer would be dealing with employer sponsored plans + individual market.

Public Option is less popular in many polls than a Single Payer/Medicare for all. The ACA in its current form will likely be dead by 2020 & Republicans will pass some compromise version protecting pre-existing & Medicaid expansion so that could kill the whole Public option debate! Besides if the Dems get 60 Senate votes, it will be foolish to not get a Single Payer, the easiest, cheapest, least complex, universal version which can NEVER be repealed by Republicans like Social Security, Medicare, Medicaid, Minimum Wage, etc!

And a public option still won't solve many problems of the ACA, the insurance attached to employer which is terrible for job mobility, entrepreneurship, creates added hassles  & even prevents some businesses to grow. You still have the same problems of cost & public option even if it gets 60 votes may likely be made optional like the Medicaid expansion (who knows what the Courts will say if the states resist n file lawsuits), we don't know what the public option looks like, how many people will get through exchanges etc.

It surely is quite a lot better than the current version of ACA but it won't guarantee universal coverage - Millions will still be uninsured & costs may or may not fall down significantly ! But if you are a conservative Democrat, public option could be an answer but progressives should push for a Single Payer !

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Middle class Americans save big in Single Payer with around 400-500B $ in flat out profits & administrative costs only. Besides it is the biggest boost for middle class/suburban folks as it delinks their healthcare from job, allows them to start a new venture, shift jobs easily & this job mobility will boost the employment market, will free small companies of the 50 employee rule & additional hassles & costs ! It guaranteed covering everyone sub-urban middle class folk at a cheap cost !

It will definitely cause massive issues with the Insurance companies who will lose 100's of Billions of $ & many high paying useless fat cat jobs & they will throw everything to stop this! That will be a massive fight !

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That because the vast majority of people don't know the details of single payer/medicare for all. Both single payer/medicare for all will call for a tax increase across the board. Granted the tax increase will replace the premium hikes, but I just don't know how you can sell that to suburban Americans.

Firstly there's some working class & low income suburban groups here as well who are reliable Dem voters. Then there's middle class suburbans already pay very high premiums & don't get subsidies & are getting killed in this system ( the average median family income is around 50K & the 50-150 K odd range are not being benefited under ACA in terms of premiums). And some of them(200/250K) are even paying the Obamacare penalties, Obamacare taxes & are not getting anything.

So I don't know how they really benefit from this current system which hurts them even more. They people who will be negatively affected due to high payroll taxes will be the people earning above 250K or 200K at worst & most of these people will not support ACA or Universal healthcare - Around 95% of the people will be saving money in a Single Payer as will most suburban folks!

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I think eventually we will have something like the Australian healthcare system with Gov't run insurance and private insurance co-existing and competing.

ACA was the default run system most similarity to the Australian system with a similar penalty on people not buying insurance (with a payroll kind of tax in addition) , a Medibank with a 30% share which is essentially a modified public option. The community rating basis of Pre-existing conditions was also somewhat borrowed from the Australian model. The conservatives twice pledged to sell Medibank which would have ended the public option (but lost the elections). The government also produces subsidies for all private insurance plans regardless of income now (big government subsidies for everyone) although I think conservatives are pushing for income thresholds which will increase prices for middle class. There is a lot of government support through the general budget which comes through overall taxes & there's subsidised medicines, subsidies this n that. So for the Australian system to work well, taxes have to further raises in the US in the general budget! Around 70% of the health expenditure in Australia is government investment with big chunk coming general federal revenue.

And the GOP would not only introduce means testing & but play around with income levels (beyond which there is tax/penalties/subsidies) but will play around with the coverage given too (over which you can take private plans) & reduces it to a level that makes coverage meaningless & may take away subsidies provided for everyone. The ACA without the employer healthcare issues is somewhat similar to the Australian system. And it will never be universal in US & there's 0 chance of it being permanent - It is too easy to destroy & difficult n much more complex to make it anywhere near universal & affordable in the complex setup now!

The reason FDR said he created a separate Payroll tax n account for Social security was to make it individually solvent & free from swindling & debt problems in a General budget.