Health care history one of missed chances
By Dan Townsend
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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