Las Cruces Sun-News Health Care Editorial

Commentary

Health care history one of missed chances

By Dan Townsend

Guest column

Enemies of universal health care derisively refer to the ver­sion being implemented by the Obama Administration as “Obamacare,” as though any­thing including the name Obama is beneath contempt and unworthy of their sup­port. History of this issue in the United States is a chronicle of missed opportunities, result­ing in, at present, the least effi­cient and most expensive (dou­ble the cost, by most estimates) health care system in the devel­oped world.

For those interested in facts on the subject, it is worth not­ing that Native Americans had no concept of “fee for service” regarding health care in their communities, though it was the custom to “gift” the medicine man for a successful outcome. Puritan communities in the Massachusetts colonies worked tirelessly to promote sanitation, quarantine those with com­municable diseases and em­ploy remedies, whether brought from Europe or borrowed from the natives, to the limit of medi­cal knowledge of the time.

There is evidence that the Dutch colony of New Amster­dam built the first hospital in North America. Clearly the communities mentioned consid­ered health to be an essential community concern.

The British Navy financed shore facilities for fleet health care with an assessment on the wages of sailors and offi­cers starting in 1624. The as­signment of doctors to all fleets started soon afterward, result­ing in, among other things, mandatory administration of lime juice to combat scurvy, which was a major factor in Britain’s rise to the pinnacle of naval power.

The U.S. copied the British example and added the require­ment that merchant ships en­tering U.S. ports be assessed for the health care of merchant seaman, resulting in a network of seaman’s hospitals, later to become part of the U.S. Public Health Service.

Civilian populations in the U.S. experienced repeated deadly outbreaks of diseases due to poor sanitation through the 18th and 19th centuries. The influx of immigrants to fill the ranks of industrial labor re­quired strenuous efforts to co­ordinate public health efforts and provide public water sup­plies, sewage and waste collec­tion services in our cities.

Finally, in 1917, a joint effort, formed of the American Asso­ciation of Labor and the Ameri­can Medical Association House of Delegates, promoted a sin­gle- payer health system for the U.S., using the model of that of Germany put together by Chan­cellor Bismarck in 1883. The plan, otherwise likely to be im­plemented, had, however an un­expected problem.

A major part of the insur­ance market at that time were “burial insurance” policies, meant to insure that the sub­scriber would be spared the in­dignity of what was known as a “pauper’s burial” — usu­ally unmarked in desolate “pot­ters fields,” otherwise populated by deceased prisoners, the “in­sane” and the indigent or un­identified homeless.

The 1917 plan provided for a “death benefit,” there being no Social Security at the time, which the insurance industry considered a threat to its prof­its from the sale of burial pol­icies. World War I provided an excellent excuse to sabotage the whole project by depicting it as a “Prussian menace” at a time when people were so incensed about German military atroci­ties in Belgium, the use of poi­son gas and submarine attacks on civilian shipping, that Dashc­hund dogs were kicked to death on the streets of America.

Of course, the chaos and ter­ror felt by massive fatalities re­sulting from the flu epidemic of 1918 was a lesson in the con­sequences of not having coor­dinated health care in the U.S.. But by that time, the Univer­sal Health Care plan of 1917 had been scuttled.

Future efforts toward uni­versal health care were painted with the label of “socialism” as universal health care became a platform in the agenda of the Bolshevik regime in Russia and the socialist Weimar Republic which succeeded the wreckage of Kaiser’s Germany.

Captain Harry S. Truman, whose Missouri volunteers faced German troops benefit­ing from 30-plus years of Chan­cellor Bismarck’s Universal Health Plan in World War I, as President offered the “Truman Health Plan” in an address be­fore Congress in November, 1945.

His reasons were compelling. So poor was the health of young men reporting for military ser­vice in both World Wars I and II, one-third were rejected. He was also concerned with the sit­uation of veterans of World War II and their families who were losing VA health benefits imme­diately upon separation from the service as our services were demobilized.

President Truman’s plan en­visioned a single system allow­ing veterans and civilians to seamlessly access their health care needs, with a large enough customer base to absorb pre-ex­isting conditions and the dis­tinction between “service con­nected” and more mundane health challenges without pen­alties and delays. Ironically, many enemies of Universal Health Care are pro­posing providing veterans with resources to enable access to ci­vilian health care service in the face of VA system deficiencies. President Truman’s ghost must be enjoying this.
Dan Townsend is a resident of Las Cruces

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