November 15, 2018
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A stroll down health care’s memory lane

“The time is at hand this year to bring comprehensive, high quality health care within the reach of every American. I shall propose a sweeping new program that will assure comprehensive health insurance protection to millions of Americans who cannot now obtain it or afford it, with vastly improved protection against catastrophic illnesses.”

Barack Obama in 2009?

Hillary Clinton 1994?

Ted Kennedy 1969?

That was actually Richard Nixon in 1974 proposing a national health care plan that looks, in some key respects, like the American Affordable Care Act of 2009.

The more recent plan has been nicknamed “ObamaCare” and is adored by some, despised by many others, and sometimes labeled as either a socialist, Marxist or communist idea, with, of course, a few Nazi references for good measure.

That would no doubt surprise Nixon, who fought in World War II and was one of the most ardent Cold Warriors of his era.

It’s really not news that the Republican Party has traveled some distance from the sort of plan Nixon once suggested.

But it is interesting to read Nixon’s speech and see how we are dealing with the same problems in 2012 as we faced in 1974.

Only some have greatly worsened.

Nixon, in his address to Congress, said medical care had become prohibitively expensive in ’74.

For instance, he said, the average one-day stay in a U.S. hospital had risen to more than $110 a day.

If medical costs had risen at the same rate as general inflation since then, a one-day stay in the hospital would now cost about $500.

If only. The average one-day hospital stay in the U.S. was $2,025 in 2010 and was even more in Maine: $2,117. That’s a 1,825 percent increase since 1974.

On the other hand, our incomes have also increased over that time.

Well, let’s take a look: The average household income in 1974 was $11,197. That would need to be $51,089 in 2011 to have the same purchasing power.

Unfortunately, average household income was only $49,445 in 2011, so we have lost a little ground while the cost of a hospital stay has increased nearly 20 fold.

Nixon pointed out two major problems with health care delivery in 1974.

First, he said 25 million Americans had no insurance at all and, often, the very people “who need it the most are most unlikely to obtain it.”

Nixon pointed out that many of those people actually work, but earn too much to be eligible for Medicaid. Others were “high-risk cases” who could not obtain insurance at any price, according to Nixon.

Second, the 37th president said many people have insurance, but that it was not “comprehensive and fully protective.”

He told Congress, “These gaps in health protection can have tragic consequences. They can cause people to delay seeking medical attention until it is too late. Then a medical crisis ensues, followed by huge medical bills or worse. Delays in treatment can end in death or lifelong disability.”

Nixon, apparently, did not see emergency room care filling this gap.

He laid out a three-part national health program:

First, he recognized that most Americans would continue to be covered through their employers.

Second, he suggested an “Assisted Health Insurance” program to cover low-income people who were not covered by their employers. The federal and state governments would help these people buy insurance.

Finally, he suggested an “improved Medicare Plan” covering those 65 and over.

And get this, Nixon said every American “would receive a Health-card. . . . This card, similar to a credit card, would be honored by hospitals, nursing homes, emergency rooms, doctors and clinics across the U.S.”

Bills incurred on the card would be forwarded to the insurer, which sounds remarkably like how some European systems operate today.

And what would this cost? Nixon predicted the average family would pay about $150 a year for health insurance, while the employer would pay approximately $450.

But here’s the real kicker to this story. At the insistence of fellow Democrats and labor unions, Sen. Ted Kennedy decided to oppose anything short of a single-payer health care system.

Feeling Nixon to be doomed by Watergate, they wanted to wait until Democrats took office and could impose their own plan.

The ultimate irony is that it took Democrats 35 years to accept what their foe, Richard Nixon, first offered so long ago.

Now that’s a long way for a party to travel.

Sun Journal, Lewiston (Nov. 21)

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