“The Clinton Health Plan (1994), the Affordable Care Act,
GOP Politics, and Chief Justice Roberts”
GOP Politics, and Chief Justice Roberts”
Dateline: July 8, 2015
At about the time that the Clinton Health Plan was introduced to
the Congress in the fall of 1993, through the American Public Health
Association I was recruited to be a “Designated Speaker for the Clinton Health
Plan.” Of course, as a left-winger I had been a “Single-Payer” supporter
for many years. Some of my friends and colleagues on the health care
field were outraged that I would do such a thing. But my position was a
simple one. While the CHP was highly complex and hardly perfect, the
intent of the Act was to get most U.S. covered by some kind of health insurance
in a fairly highly regulated system. A simple, government-run,
single-payer system, it wasn’t, but: for millions of U.S. citizens it was far
better than what they had (too often, nothing).
Further, and equally importantly, I felt that it was the only
alternative to what was the then-looming total takeover of health care
financing by the private, for-profit health insurance companies. (I must
say that I was also pleased that the CHP looked something like a
something-short-of-single- payer proposal that I had published back in 1981 [1,
2]. At the same time, I doubted very much that any of the CHP framers had ever
seen my fairly obscurely-published proposal. Certainly, I had received no
calls about it.)
It is well-known that the Clintons ran a totally terrible campaign
in support of their proposal. (And P.S., after its defeat the for-profit
health insurance industry did take over the U.S. health care financing
system.) Not only did the CHP lose in the Congress, but the Republicans
used it politically to take over the House of Representatives in 1994, in what
was widely known as the “Gingrich Landslide.” Little known is that it was
hardly a landslide. Altogether, the GOP candidates for the House took 18%
of the eligible vote while the Democratic candidates took 17%. But how
the media handles such events is another story. Also little known is that
the CHP looked remarkably like a plan for National Health Insurance that in
1973 was introduced into the Congress by the then-Senate Minority leader Bob
Dole, on behalf of the Nixon Administration.
On that occasion, Dole gave a speech, the introduction of which, on
what was wrong with U.S. health care and what needed to be fixed, could almost
have been used to introduce the CHP. This time around, of course it was
Bob Dole who led the successful charge in the Senate against the (very
similar) CHP. I (and perhaps others) attempted through channels, to
inform the CHP leadership of this anomaly, but the political point was
never taken up by the Clintons. In fact all through the spring of 1994,
as the plan was being hammered by the Repubs. and their allies, by the famous
“Harry and Louise” ads and a bunch of other stuff, the CHPers essentially sat
on their hands, much to the frustration of those of us who were out in the
field trying to promote it. Why the Clintons did virtually nothing I have
never understood. But why the Repubs. were so totally against it, even
though it looked much like the Nixon Health Plan, was very obvious: politics. Ironically…The ACA (“Obamacare”) is MUCH less ambitious than the Clintons’
1993 plan.
In December, 1983, just as the Clintons’ campaign for the CHP was
getting underway, Bill Kristol (yes, that Bill Kristol), circulated a
FAX (no widely-used email back then) to about 1200 top and (not-so-top) Repubs.
around the country. But what route of delivery I have never known, but a
copy happened to come across my desk. Kristol made it absolutely clear,
briefly and precisely, that the Repubs. had to defeat the CHP, not on the basis
of whether it was good or bad for health care in the United States, but for political
reasons. If the Clintons were allowed to get the CHP or some reasonable
facsimile of it (like the Nixon Health Plan, with which Kristol may or may not
have been familiar) into law, he said, the Democrats would be in control of
politics in the U.S. for quite some time. Which brings us to Repub.
politics and the Affordable Care Act (the ACA or “Obamacare”).
The ACA is MUCH less ambitious than the CHP. Although it has
provided health care financing for some several millions of U.S. who did not
have it previously (or had totally inadequate insurance), essentially it
provides a massive-subsidy/expansion-of- market for the now-dominant, highly
profitable, private health insurance industry. At the same time, it
provides another very profitable health care sector, Big Pharma, market
protections. Furthermore, just as the CHP was modeled in part on the
Nixon Health Plan, so, as is well-known, the ACA was heavily modeled on
“Romney-care” in Massachusetts. In fact the Obama folks thought that by
doing that they might be able to protect themselves from Repub. attacks.
HA! It happens that among the strongest supporters of the ACA have been
the private health insurance industry, Big Pharma, and the big hospital chains,
for the most part Repub. supporters. BUT, don’t you see, the misshapen
ACA was being put forth by a Democrat. Then, the Repubs., in their
eagerness to make it totally abominable to their white, racist, “birther” base,
hooked President Obama’s name on to it. And what was it all about?
Politics of course. In America, the eternal game of short-term advantage in a
corrupt power system.
Obamacare (ACA), a new iteration of “Romneycare”, provides a massive-subsidy/expansion-of-
Virtually echoing what Bill Kristol had to say in that December,
1983 FAX, (but in more colorful language) at a meeting of right-wing
power-brokers at the American Enterprise Institute shortly after the ACA passed
in 2010, one Michael Greve, a board member of the Competitive Enterprise
Institute (sic), had this to say about it (3): “This bastard has to be killed
as a matter of political hygiene.” Nothing about the nature of the
Act, about what it did or didn’t do, about how many, or few, U.S. citizens
would get health insurance coverage without making any major changes in the
U.S. health care system. It had to be “dismembered,” “tarred and
feathered,” “strangle[d],” (Greve’s words), for political reasons.
Greve’s people then went on to find the famous (mis-drafted) “four words” that
almost led to the Act’s undoing before the Supreme Court. But then the
Right-Wing was (seemingly) undone by Chief Justice Roberts.
Oh, the outrage, the calumny, the threats of impeachment, that
came pouring forth from the Repubs. and the Right. “How could he do such
a thing — to us?” Well, Mr. Greve, et al, the Chief Justice was just
playing politics, to the benefit of the Repubs. (see just below).
The Supreme Court playing politics, you ask? Nah. Couldn’t
be. Really? In my last semester at Columbia College in 1958, I took
a course in U.S government that focused on the Constitution and the Supreme
Court (subjects with which I have been fascinated and have studied ever
since).
The most important book that I read at the time was Nine Men: A
Political History of the Supreme Court of the United States from 1790 to 1955,
by Yale Law School Professor Fred Rodell (New York, Random House, 1955).
Prof. Rodell clearly established that throughout its history the Supreme Court
has been first and foremost a political institution. Further, as
it happens, Prof. Rodell established that for most of its existence its
principal function has been to protect the rights of property (p. 78).
The current case for the understanding of the Court as a political institution
which for most of it history has defended right-wing interests, is excellently
made by Senior Fellow at the Center for American Progress Ian Milhiser’s “Injustices:
The Supreme Court’s History of Comforting the Comfortable and Afflicting the
Afflicted,” (New York: Nation Books, 2015).
Historically, as a political institution, the chief role of
the US Supreme Court has been as a protector of the rights of private property.
This has made the Supreme Court a de facto rightwing instrument.
And so, getting to the politics of his decision, here was Roberts,
another in the long string of GOP-appointed right-wing Chief Justices, making a
very political decision, on an Act that he was likely very viscerally opposed
to (just as he, a very strict Catholic, was obviously viscerally opposed
to legalizing gay marriage across the country). But on this one, as it
happens, even if folks like Greve don’t understand it, the decision vastly
benefits the Repubs. If the obviously Repub. Supreme Court had overturned
the law on an obviously Repub.-led challenge to it, especially using an
obvious drafting error to do so, causing millions of U.S. to lose their
[precarious] health insurance, that would hardly stand the Party in good
stead in 2016. At the same time, upholding the Act gives the Repubs. a
very clear 2016 target to shoot at. And, once having recovered their
breath, they will. They are already readying their guns and stock-piling
their ammunition. To which ammunition
was added by the current news that because of a variety
of features of the Act (which we won’t get into now), for 2016 health insurance
premiums are going to sky-rocket.
Some non-Rightists
think that the Court is “moving leftward.” Un-uh. When examined closely,
both “liberal decisions,” on the ACA and on gay marriage, benefit the Repubs.
electorally by giving them, as I said, very clear targets to shoot at. On
the important stuff for the ruling class — the decision gutting the
EPA’s role in combatting global warming through controls on burning coal
— and to benefit the Repubs. by the gutting of the Voting Rights Act,
— they are clearly acting on the reactionary side of the equation.
On these important decisions, once one looks past the surface, there is
the Court again, in the words of Ian Milhiser “Comforting the Comfortable and
Afflicting the Afflicted.”
And so, getting to the politics of his decision, here was Roberts,
another in the long string of GOP-appointed right-wing Chief Justices, making a
very political decision, on an Act that he was likely very viscerally opposed
to (just as he, a very strict Catholic, was obviously viscerally opposed
to legalizing gay marriage across the country). But on this one, as it
happens, even if folks like Greve don’t understand it, the decision vastly
benefits the Repubs. If the obviously Repub. Supreme Court had overturned
the law on an obviously Repub.-led challenge to it, especially using an
obvious drafting error to do so, causing millions of U.S. to lose their
[precarious] health insurance, that would hardly stand the Party in good
stead in 2016. At the same time, upholding the Act gives the Repubs. a
very clear 2016 target to shoot at. And, once having recovered their
breath, they will. They are already readying their guns and stock-piling
their ammunition. To which ammunition
was added by the current news that because of a variety
of features of the Act (which we won’t get into now), for 2016 health insurance
premiums are going to sky-rocket.
Some non-Rightists
think that the Court is “moving leftward.” Un-uh. When examined closely,
both “liberal decisions,” on the ACA and on gay marriage, benefit the Repubs.
electorally by giving them, as I said, very clear targets to shoot at. On
the important stuff for the ruling class — the decision gutting the
EPA’s role in combatting global warming through controls on burning coal
— and to benefit the Repubs. by the gutting of the Voting Rights Act,
— they are clearly acting on the reactionary side of the equation.
On these important decisions, once one looks past the surface, there is
the Court again, in the words of Ian Milhiser “Comforting the Comfortable and
Afflicting the Afflicted.”
Senior Editor, Politics,
Steven Jonas, MD, MPH is a Professor Emeritus of Preventive Medicine at Stony
Brook University (NY) and author/co-author/editor/co- editor of over 30 books.
In addition to his role with The Greanville Post, he is a Contributor for American
Politics to The Planetary Movement, a columnist for BuzzFlash@Truthout, a “Trusted Author” for OpEdNews, and the Editorial Director of and a Contributing Author to The Political Junkies for Progressive Democracy. Dr. Jonas’ latest
book is The 15% Solution: How the Republican Religious Right Took Control
of the U.S., 1981-2022: A futuristic Novel, Brewster, NY, Trepper & Katz
Impact Books, Punto Press Publishing, 2013, http://www.puntopress.com/ jonas-the-15-solution-hits- main-distribution/, and available on
Amazon.
References:
1) Jonas, S., “Planning for
National Health Insurance by Objective.” Policy Studies Journal, Vol. 9, No. 2,
Special #1, 1980-81.
2) Jonas, S., “Planning for
National Health Insurance by Objective: The Contract Mechanism,” chap. 8 in
Straetz, R.A., et al., Eds. Critical Issues in Health Policy. Lexington, MA:
D.C. Heath and Co., 1981.
3) Toobin, J., “Hard
Cases,” The New Yorker, March 9, 2015, p. 27)
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