In 1948, Harry Truman pushed for a national nonprofit health insurance program in his successful, come-from-behind presidential campaign. When Truman’s plan was denounced as "socialized medicine" and "un-American" by the powerful American Medical Association, "Give ‘'Em Hell Harry" stood his ground, defending his proposal as "simple Christianity."
In 1965, when President Lyndon Johnson secured passage of Medicare (and Medicaid), he traveled to Missouri to formally sign it into law in Truman’s presence—declaring that "the real daddy of Medicare" was Truman. Medicare was federal health insurance for those 65 and older, but proponents hoped it was step one on the way to Medicare for all.
In the 1970s, it remained the Democratic Party's official position to support a federally-provided health insurance program for all ("single payer")—and its strongest advocate was the chair of the Senate Health subcommittee, Ted Kennedy. Supported by unions and seniors, Kennedy introduced a Medicare for everyone proposal in 1971: the "Health Security Act." Worried about the plan's popularity, President Richard Nixon countered with a supposed reform that would preserve for-profit, private insurance: the "Health Insurance Partnership Act." Kennedy declared, "It's really a partnership between the administration and insurance companies. It's not a partnership between patients and doctors of this nation."
In 1976, Jimmy Carter promised a national health insurance plan in his victorious campaign for the presidency. Kennedy later called it a "missing promise"—and their discord over healthcare continued through Kennedy's failed challenge of Carter for the 1980 Democratic presidential nomination.
As harsh neoliberal capitalism dawned in the Reagan '80s there was a sea change in the country and within the Democratic Party. Democratic leaders—calling themselves "New Democrats"—scarcely even pretended to resist greedy corporate interests. Those interests were invited into the party and into policy formulation.
Enter Bill Clinton.
By the 1990s, as day-to-day healthcare decision-making shifted from patients and their doctors to insurers and for-profit corporations, many physicians had joined the call for all Americans to get their insurance from a single federal plan.
But none of these physicians were invited to the table as the Clinton administration developed its "healthcare reform" policy under the leadership of first lady Hillary Clinton. The policy was largely created by corporate healthcare lobbyists and lawyers known as the Jackson Hole Study Group. The February 28, 1993 New York Times had a photo of the group beneath this headline: "Hillary Clinton's Potent Brain Trust On Health Reform."
In 1993, a Mother Jones writer accurately described the impossible task Hillary Clinton had been handed by the White House: Build a better, leaner, cheaper mousetrap (healthcare system)—but include a player piano (private insurance industry) in the middle of your contraption.
The goal of the Jackson Hole group was to devise a "reform" that kept the healthcare system in the hands of for-profit corporations. The plan that was ultimately developed—called"Managed Competition"—was so bureaucratic and complicated that the Clintons' 1,342 page bill never got off the ground.
At the time, Norman Solomon and I were the only nationally-syndicated columnists critically examining the corporate greed and elite policy-making that was dooming "healthcare reform." In one column, we wrote: "The imprint of the insurance industry is all over the managed competition idea. The Jackson Hole study group that originated the scheme is made up of big insurance companies like Prudential, Metropolitan Life, Aetna and Cigna, plus hospital and pharmaceutical interests."
We cited an article in which "Jackson Hole leaders bluntly argued that managed competition is the only way to avert a government takeover of 'health care financing' and the 'elimination of a multiple-payer private insurance industry.'"
We complained that the Clinton administration and mainstream media were ignoring a nonprofit single-payer insurance bill "endorsed by 95 members of Congress—plus groups like Consumers Union and Public Citizen." At the same time the Clinton bill went nowhere, the White House made sure that real reform—a streamlined plan not devised by Aetna, Cigna or Big Pharma—never got voted on.
What was true in 1993 is true today: Health insurance companies do not heal anyone. All they contribute to healthcare is excess bureaucracy for medical professionals, devious advertising, sales commissions—plus exorbitant profits ($10 billion in one quarter last year for the Big 8 insurers) and lavish executive salaries. Compensation for healthcare CEOs averaged $18 million in 2018.
Single payer doesn't just cut costs by eliminating the waste caused by a multiplicity of for-profit insurers—but also because the purchasing power of a federal plan can rein in pharmaceutical and other exploding costs.
Jump forward from the Clinton to the Obama years, and we saw a similar dynamic from Democratic leaders. Powerful healthcare lobbyists made sure that cost-effective Medicare for All would not even be considered, while these same lobbyists were at the table helping to devise "reform." Who was at the table explains why giant insurance and pharma companies have been so enriched in the last decade.
Don't get me wrong: It's a good thing that people with pre-existing conditions could get coverage under Obamacare (although too expensive) and that Medicaid was expanded (in the states where the GOP didn't block it). It's not a good thing that roughly 30 million people were left without health insurance before Covid-19, and that millions more were under-insured. And not a good thing that healthcare costs were hardly contained.
History teaches a clear lesson: The fact that our nation is the only advanced industrial country without universal healthcare cannot be blamed on Republican obstruction alone. It was also caused by Democratic leaders who've spent decades catering to corporate interests (while collecting their campaign donations)—and refusing to fight for universal coverage.
This history of Democratic obstruction and vacillation is why hundreds of elected delegates to next month's Democratic convention have put their foot down. They've signed a petition pledging to vote down the party platform if it "does not include a plank supporting universal, single-payer Medicare for All." The petition's initiator is Judith Whitmer, chair of the convention's Nevada delegation. She told Politico: "This pandemic has shown us that our private health insurance system does not work for the American people. Millions of people have lost their jobs and their healthcare at the same time."
By demanding of the party leadership what Harry Truman called for 72 years ago, Whitmer and other Democratic activists are indeed "giving 'em hell."