You have reached your limit of free articles this month.

Enjoy unlimited access to SpringfieldNewsSun.com

Starting at just 99¢ for 8 weeks.

GREAT REASONS TO SUBSCRIBE TODAY!

  • IN-DEPTH REPORTING
  • INTERACTIVE STORYTELLING
  • NEW TOPICS & COVERAGE
  • ePAPER
X

You have read of premium articles.

Get unlimited access to all of our breaking news, in-depth coverage and interactive features. Starting at just 99c for 8 weeks.

X

Welcome to SpringfieldNewsSun.com

Your source for Clark and Champaign counties’ hometown news. All readers have free access to a limited number of stories every month.

If you are a News-Sun subscriber, please take a moment to login for unlimited access.

COMMENTARY: For 100 years, the markets have failed on health insurance


After eight years of listening to Republicans raging against the Affordable Care Act, after hearing countless promises to deliver better versions of health insurance, including Donald Trump’s insistence that he would give us all more for less, and after watching Congress voting to repeal the ACA, were you surprised that “Ryancare” would take health insurance away from 20-million-plus Americans?

You shouldn’t have been, not if you know anything about the history of health insurance in this country. Republicans have insisted that “market-based” health insurance will deliver better care at lower costs. But for roughly 100 years, the market failed to do that, and it failed spectacularly.

Though Theodore Roosevelt was the first to campaign for a national system of health insurance, it wasn’t until the 1920s that the government stepped in where the private market refused to tread. Specifically, Congress created the Veteran’s Bureau in 1921 primarily to address the health issues of the doughboys returning from World War I who were not able to get treatment for their injuries. The Veteran’s Bureau, among other things, established a network of hospitals to care for these men.

RELATED: Charles Krauthammer on the real world of Obamacare repeal.

Both President Franklin Roosevelt and his successor, Harry Truman, proposed national health care programs, and both proposals died in Congress amidst fierce opposition from those, like the American Medical Association, who wanted a health insurance system instead.

So what emerged after the Second World War was health insurance for veterans – and a lot more of them now – provided by the government, and private insurance for everyone else, usually attached to your job. Unions fought hard to have health insurance packages as part of their contracts, and big corporations could afford the cost of providing insurance to their employees.

The obvious problem with this cobbled-together approach was that it left out millions who were neither veterans nor in the workforce. Like the poor and the unemployed. And even more so, the retired and the elderly. They often faced illness with nothing.

That’s why Congress invented Medicare and Medicaid in the mid-1960s. Medicare in particular has worked as it was intended to, and most elderly people who use it depend on it, even if they don’t always understand how it’s funded. Who can forget that angry woman in South Carolina in 2009 screaming at her Congressman: “Keep your government hands off my Medicare!”

MORE COMMENTARY: Ohio farmers toiling under unfair tax burden.

In the last quarter of the 20th century, therefore, the private sector was responsible for providing health insurance to anyone who wasn’t poor, a veteran, or retired. Only it didn’t. Plenty of small employers couldn’t afford health insurance plans for their workers, and plenty of those plans refused to carry you if you had a pre-existing condition or didn’t pass your physical exam, or they capped coverage in ways that made getting sick unaffordable.

So as a consequence, by 2008 roughly 40 million Americans did not have access to or could not afford private-market health insurance. All while standards of medical care continued to rise. Diseases that were a death sentence a generation ago are now routinely cured, but only if you have health insurance to cover the treatment. The private sector, in essence, was making basic decisions about who lived and who died, based purely on who could afford the premiums.

The Affordable Care Act was necessary precisely because those people had no other way to access health insurance. It wasn’t an intrusion into a market that was working, so much as it cleaned up the mess left by our ad-hoc private insurance system.

So the next time you hear a politician talk about a “market-based solution” to health insurance, dial 911. The market has had 100 years to provide a solution, and it has failed to do so.

IDEAS & VOICES ROUNDTABLE: Local police chiefs talk about gun crime, possible solutions.

Steven Conn is the W. E. Smith Professor of History at Miami University.



Reader Comments ...


Next Up in News

Mural connects Clark County recycling center, neighborhood with kids
Mural connects Clark County recycling center, neighborhood with kids

A new light source on West Main Street will shine continuously — it runs on paint instead of electricity. A mural completed this week by members of Project Jericho and a noted artist will not just brighten the neighborhood, but also make the Clark County Solid Waste District’s building more identifiable and its mission clearer. RELATED...
Trump seeks $52B increase in defense spending
Trump seeks $52B increase in defense spending

The Trump administration unveiled a $639.1 billion defense budget proposal Tuesday that it says is a step toward restoring military readiness levels that would boost the number of airmen in uniform. As part of the budget, however, the administration is asking for a new round of military base closures in 2021. RELATED: Trump budget calls for $3.6T in...
Tampa Bay mayor’s joke about shooting media, watch them ‘cry like little girls,’ falls flat  
Tampa Bay mayor’s joke about shooting media, watch them ‘cry like little girls,’ falls flat  

  A Florida mayor’s joke about firing blanks from a machine gun at the media has landed him in hot water.  Tampa Mayor Bob Buckhorn, who joked about pointing the gun at reporters as part of a military exercise, said he has told that same joke before but it didn’t get much criticism until he told it again at a Special Operations...
Police: Manhunt underway for killers who lured 2 people in Craigslist-type transaction
Police: Manhunt underway for killers who lured 2 people in Craigslist-type transaction

A multiagency manhunt is underway for the people who allegedly killed two men during a robbery in Georgia. Sheriff Joe Chapman said the two men were lured to Clegg Farm Road in Social Circle, Georgia, on Monday to be robbed. They ended up being shot. Tire marks can be seen where a truck veered off the road and crashed into the fence. Investigators...
Elderly man memorializes wife by continuing her blanket sewing charity
Elderly man memorializes wife by continuing her blanket sewing charity

An elderly man is keeping his wife’s memory alive by sewing blankets for those in need. “I just felt there was a need,” said Clayton Shelburne, 88, of Zionsville, Ind. “I enjoy doing it. If my wife was here, she would be happy I’m doing this too.” For 10 years, Clayton and his wife, Delores, spent their free time...
More Stories