Six times in the past century -- during World War I, during the Depression, during the Truman and Johnson administrations, in the Senate in the 70s, and during the Clinton administration -- efforts have been made to introduce some kind of universal health insurance, only to be rejected. Each time, Americans have instead opted for a system of increasing complexity and dysfunction.
The above quote, found in Friday's BLOG Medicine, begs the question: Why?
A good place to start when looking for an answer can be found in Jill Quadagno's, One Nation, Uninsured: Why the U.S. Has No National Health Insurance. Quadagno is a sociology professor at Florida State University, where she holds the Mildred and Claude Pepper Eminent Scholar Chair in Social Gerontology. One Nation, Uninsured shows how powerful stakeholders like the American Medical Association (AMA), the American Federation of Labor (AFL), and the Health Insurance Association of America (HIAA), at various times over the last 60 years, have acted to keep health care financing out of the government's hands, effectively preventing every attempt to enact national health insurance.
In light of Michael Moore's recent shockumentary Sicko, a quote from Jonathan Cohn's review in the Washington Post of Quadagno's book is especially relevant (and prescient -- the review was done in 2005):
Quadagno's ultimate message seems to be that politics are more important than policy -- that progressives won't achieve universal coverage unless they learn to operate like the special interests of the right. She's probably correct -- which is why her richly constructed history could prove so handy in the months and years to come.
Given the breadth and depth of the various coalitions that have formed to promote change, we have reason to be optimistic that we are, indeed, at a tipping point for healthcare reform.■