Political Coverage

Universal health care returns as a political issue. But will it ever happen?


It remains a national outrage that in the richest country in the history of the world, 43 million people are without health insurance. How come? Partly, of course, because universal coverage, however appealing as a notion (and right as a principle), is perceived as being too costly, too Big-Government, to sustain much political momentum. Bill Clinton’s spectacular failure, ten years ago, to get a comprehensive health plan through Congress stands as a warning to any politcian with ideas of overhauling America’s health care system.

Against these odds, and hoping to move the issue to front and center in an election year, the Institute of Medicine, a prestigious arm of the National Academies of Science, issued a report on Wednesday arguing that providing health insurance for all Americans is a national priority.

The report, the most detailed, authoritative examination of the subject to date, says, “The lack of health insurance for tens of millions of Americans has serious negative consequences and economic costs not only for the uninsured themselves but also for their families, the communities they live in, and the whole country,” and calls on Congress and the president to implement universal coverage by 2010.

The IOM doesn’t specify a method for achieving such broad health coverage, or attach a price tag (though it does estimate that the uninsured cost the country between $65 billion and $130 billion a year); instead, it outlines several principles the government could follow, and against which any political platform should be measured. The report concludes that universal coverage would, “enrich all Americans … in terms of improved health … greater economic productivity, financial security or the stabilization of communities’ health care systems.”

Tommy G. Thompson, the secretary of health and human services, gave the report a tepid response, saying its goals were unrealistic, but that the administration was “committed to helping as many Americans as possible, as quickly as possible.” However Bob Dole, former presidential candidate and erstwhile Republican leader of the Senate, told the press that the report was a important call to action. “If properly framed, the lack of coverage for 43 million Americans can be one of the big, big issues in the election,” he said.

The Bush administration may have not have plans to guarantee health care for all Americans, but the Democrats vying for office are making health care an important campaign issue, having, of course, the luxury of thinking big on the issue without having to deliver any time soon. The candidates disagree on how coverage should be expanded but all are attempting to gain some traction what they hope is a hot-button issue.

Dick Gephardt’s initiative would cover everyone, in part by offering large tax breaks to employers who offer insurance to their employees, at a cost of at least $214 billion a year. His plan would also offer federal health insurance for the unemployed. Howard Dean promotes his record, as governor of Vermont, of achieving near universal coverage of children, and likes to say, “This is not some crackpot liberal idea from Vermont — Harry Truman put universal health insurance in the 1948 Democratic platform.” His plan would cover most of the uninsured at a cost of around $90 billion, to be paid for in part by rolling back the Bush tax cuts. Dean likes to sell his proposal as the “most politically realistic.”

Joe Lieberman and John Edwards propose extending benefits to include all children. John Kerry advocates expanding coverage through the well regarded the Federal Employees Health Benefits Program. Dennis Kucinich and Rev. Al Sharpton propose a publicly funded, single-payer universal health care system, but none of the top candidates have made proposals that come near Clinton’s plan for ambition. Emory University professor Kenneth Thorpe, who helped Clinton draft his health care initiative, told the Tribune that today’s candidates learned from Clinton’s mistakes.

“Clinton wanted to fundamentally change how we get health insurance…These candidates are not trying to reinvent the wheel. One lesson we learned was not to take on the 180 million people who already have insurance and create a lot of anxiety…. The political strategy now is to build on what we’ve got.”

The Bush administration rejects the idea that spending more federal money is the best way to provide insurance for Americans. The president, in extending drug benefits last year, did succeed in completing the biggest Medicare expansion in 38 years, but doesn’t help the uninsured. According to a numbers breakdown in the New York Times Dean, Lieberman and Clark’s plans would cover about 31 million of the uninsured, Kerry 27 million, and Edwards 21 million. With the rate of the uninsured rising, such plans could become key issues in the primaries. But, as Clinton’s experience shows, when it comes to health care, talk is cheap, but universal coverage can be very expensive — politically as well as financially.

DOES IT FEEL LIKE POLITICS IS AT A BREAKING POINT?

Headshot of Editor in Chief of Mother Jones, Clara Jeffery

It sure feels that way to me, and here at Mother Jones, we’ve been thinking a lot about what journalism needs to do differently, and how we can have the biggest impact.

We kept coming back to one word: corruption. Democracy and the rule of law being undermined by those with wealth and power for their own gain. So we're launching an ambitious Mother Jones Corruption Project to do deep, time-intensive reporting on systemic corruption, and asking the MoJo community to help crowdfund it.

We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We want to dig into the forces and decisions that have allowed massive conflicts of interest, influence peddling, and win-at-all-costs politics to flourish.

It's unlike anything we've done, and we have seed funding to get started, but we're looking to raise $500,000 from readers by July when we'll be making key budgeting decisions—and the more resources we have by then, the deeper we can dig. If our plan sounds good to you, please help kickstart it with a tax-deductible donation today.

Thanks for reading—whether or not you can pitch in today, or ever, I'm glad you're with us.

Signed by Clara Jeffery

Clara Jeffery, Editor-in-Chief

We Recommend

Latest

Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate