Political Debates Over Health Care Go Back Decades

Jul 9, 2017
Originally published on July 9, 2017 6:20 am
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A MARTINEZ, HOST:

Republicans are still split on their party's plan to replace the Affordable Care Act. Senate Majority Leader Mitch McConnell said this past week that if he can't get the votes, his party will have to give up and work with Democrats to shore up the existing insurance markets under Obamacare. The issue of health care and the government's role in providing it has had Democrats and Republicans at odds for decades.

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MARTINEZ: When we're in need of a history lesson, we go to professor Ron. You know him as NPR's Ron Elving, senior editor and correspondent on our Washington desk.

RON ELVING, BYLINE: Health care has been a vital part of the national debate for more than 80 years and a major focus for Democratic presidents back to Franklin Roosevelt.

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FRANKLIN ROOSEVELT: Certain economic truths have become accepted as self-evident.

ELVING: This is FDR in his 1944 State of the Union Address, expanding on what he called a Second Bill of Rights for all Americans.

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ROOSEVELT: The right of every family to a decent home, the right to adequate medical care and the opportunity to achieve and enjoy good health.

ELVING: FDR was elected to a fourth term later that year with ideas for adding health care to the Social Security program he had signed into law a decade earlier. But he died just weeks into his new term, leaving his ideas and the White House to Vice President Harry S. Truman. Six months later, Truman would address Congress to lay out a plan for what he called a universal national health program. It was a theme he would emphasize throughout his presidency.

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HARRY TRUMAN: Then I asked this Congress to do something about the health of the people of this country. I asked them for health insurance. I asked them for hospitals.

ELVING: The idea appealed to many postwar families. And there were efforts underway in individual states, as well, such as North Carolina, where officials were embarrassed at how many state residents flunked the physical for the military service in World War II. The Tar Heels called it their Good Health Plan.

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DINAH SHORE: (Singing) Even Superman supports the good health plan. He knows what it will do.

ELVING: This is Frank Sinatra and Dinah Shore giving it a singing promo.

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FRANK SINATRA: (Singing) Spread the health alarm to every town and farm. And preach the good health view. It's all up to you.

ELVING: But in Congress, Truman's ideas met fierce opposition from Republicans and groups such as the American Medical Association. The AMA called Truman's plan socialized medicine and said his administration included, quote, "followers of the Moscow party line."

Republicans took control of Congress in 1946, quickly shelving the bill. And even when Democrats recaptured their majorities in Congress two years later, Republican resistance prevailed. Here's Senate Republican leader Robert Taft of Ohio talking about what would and what would not happen in the 81st Congress.

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ROBERT TAFT: I believe the 81st Congress will reject the extreme plans to destroy liberty and equal justice in the United States by new economic controls and new handout programs. I believe specifically that this Congress will reject the proposal for socialized and nationalized medicine.

ELVING: Taft did manage to stonewall the bill that year. And Republican resistance would hold firm.

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RONALD REAGAN: My name is Ronald Reagan. I have been asked to talk on several subjects that have to do with the problems of the day.

ELVING: Here's pre-presidential Ronald Reagan on the subject in 1961.

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REAGAN: One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It's very easy to disguise a medical program as a humanitarian project.

ELVING: Reagan at the time was responding to efforts to revive Truman's health care ideas under President John F. Kennedy.

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JOHN F. KENNEDY: The fact of the matter is that what we are now talking about doing what most of the countries of Europe did years ago. The British did it 30 years ago.

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ELVING: After Kennedy was assassinated, President Lyndon B. Johnson saw an opportunity to carry JFK's ambitions forward on a broad, bold scale, much as Truman had done with the goals of FDR. For Johnson, the focus was care for the elderly.

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LYNDON B. JOHNSON: Our older people are likely to be hospitalized three times as often as younger people. But their income is less than half that of people under 65.

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UNIDENTIFIED MAN: The final Medicare and Medicaid bill passed both houses of Congress by an overwhelming vote. President Johnson signed the bill, making it the law of the land July 30, 1965 in Independence, Mo., in the presence of former President Truman.

ELVING: To give credit to the man he called the father of Medicare.

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JOHNSON: But we wanted you to know, and we wanted the entire world to know that we haven't forgotten who is the real daddy of Medicare.

ELVING: And although controversial at its birth, Medicare has since become the country's most popular federal social program. In the years ahead, some believe Medicare may yet serve as the base for a universal health care program on a national scale much as envisioned by Roosevelt and Truman a lifetime ago. Ron Elving, NPR News, Washington. Transcript provided by NPR, Copyright NPR.