“So this is how the uninsured die. In a society filled with wealthy doctors and gleaming hospitals and state-of-the art medical gadgetry and the bulk of the world’s Nobel winners, it seems outrageous to allow Donny Ray Black to wither away and die without proper medical care.”
These are words written by John Grisham in his book, The Rainmaker, which was the story of a fresh-out-of-law-school attorney who couldn’t get a job and opened a solo practice. One of his two clients was a very young man named Donny Ray Black, who was dying of leukemia. Treatment was initially denied by his health insurance carrier on the grounds that he had a pre-existing condition: The flu.
The Rainmaker was published in 1995.
That was 15 years before the passage of the Patient Protection and Affordable Care Act (ACA).
But it was only one year after the GOP killed the Health Security Act (HSA), proposed by the Clinton Administration in November, 1993. The HSA resulted from recommendations put forward by a task force headed by First Lady Hillary Clinton.
The HSA was – like the Affordable Care Act – a lengthy document of more than 1,000 pages.
The matter of health care in this country is complex, and legislation addressing this topic is complex. Resolving some of those complexities will result in a long document.
It’s unfortunate, and even tragic, for this country that Republicans just hate to read lengthy documents. You might recall that many of them squawked mightily about the length of the ACA.
Like the ACA, the Clinton Health Security Act included an insurance mandate with subsidies for those too poor to afford coverage. Policies were to be obtained through regional health alliances established by each state – interestingly, these state alliances would purchase insurance coverage for the state’s residents, and the state alliances could set fees for doctors who charge per procedure. This seems to be an intriguing hybrid of a private system and a single payer (at least at the state level) system. The federal government would fund the state alliances for the administration of the plan for ten years.
The GOP’s opposition to the HSA was rapid and fierce. It was led by Bill Kristol, whose organization “Project for the Republican Future” released a series of policy memos against it to Republican leaders.
“The long-term political effects of a successful … health care bill will be even worse – much worse … It will revive the reputation of … Democrats as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government.” [emphasis added]
– Bill Kristol, Defeating President Clinton’s Healthcare Proposal (December, 1993)
The Heritage Foundation (that champion of the middle class) and the Health Insurance Association of America piled on, and the latter even ran an extensive advertising campaign, including what were called “Harry and Louise” television ads. They even called the plan “Hillarycare”. Sound familiar?
Stories were even run by outlets such as Time, CBS News, CNN, Wall Street Journal and others questioning whether a health care crisis even existed.
Faced with the rapid and far-reaching organized reaction from the GOP, even Democratic legislators weren’t convinced that health care needed to be reformed.
So the Health Security Act was withdrawn from consideration in Congress in November, 1994.
John Grisham’s The Rainmaker was published the next year. The movie, starring Matt Damon, Danny DeVito, Jon Voight and Mary Kay Place, came out in 1997. Although I think the book is better, it’s a pretty good movie and worth the two hours or so you’ll spend watching it, if you’re so inclined.
As we sit in January, 2017, it’s been a little over 22 years since the GOP forced the death of the Health Security Act.
In the intervening years, the GOP has not put forth a single serious health care plan at the federal level.
At the state level, though, the GOP governor of Massachusetts, one Willard Mitt Romney did sign state legislation that provided health care coverage to the residents of Massachusetts. Funny how it had a mandate and other components of the Health Security Act.
The ACA was passed in March, 2010 by a Democratic President and a Democratic Congress with no GOP support. It is complex and does many things, but as relates to benefits to individual people, it eliminated insurance coverage exclusions for pre-existing conditions. It removed lifetime insurance coverage caps. It allows parents to keep their children on their health insurance plans up to age 26.
The ACA is based in large part on the GOP health care coverage plan signed into law by GOP Governor Mitt Romney. Funny how that plan, though, is radioactive to the GOP in Congress. They cannot profess any admiration for it, because they loathe the ACA. Not on its merits, but for purely political reasons.
The House GOP first voted to repeal the ACA in January, 2011. Since that vote six years ago – and remember, this was before any premiums increased for any user – the Congressional GOP has voted to repeal the ACA on sixty-three additional occasions.
At no time has the GOP put forth a full plan to replace the ACA, even when they voted sixty-four times to repeal it.
The sixty-fifth time is the charm. At the behest of Donald Trump, incoming President, the GOP will repeal the ACA this month. With no replacement plan.
Because three trees make a row. Or, rather, sixty-four trees make a row. There’s a trend here.
The GOP has no plan to replace the ACA because they have proven to have no interest in addressing the problems of health care provisioning in this country, particularly as those problems affect actual American citizens.
They didn’t when they took out TV ads against what they called Hillarycare. And they don’t for what they decided to call Obamacare. They sure like to personalize health care legislation, don’t they?
If they had anything, they’d have shown it at some point in the last 22 years. For decades, the GOP has not even been interested enough to have begun to try and address the health care provisioning crisis.
They hate health care provisioning, period. To them, it’s every man (or woman) for himself (or herself). PERIOD.
With regard to health care, Donald Trump and the GOP will do everything possible to ignore the needs of the people of this country. This country which, as John Grisham wrote, is “filled with wealthy doctors and gleaming hospitals and state-of-the art medical gadgetry and the bulk of the world’s Nobel winners”.
This is not even arguable.
Then again, maybe John Grisham is just one of those celebrities who shouldn’t speak out about these matters.
If you agree that health care provisioning requires reform and that a viable ACA replacement is a must, you need to call your U.S. Representative and your Senators, particularly if they are Republican.
Take the five minutes to do it.