Author: Sparhawk Mulder
Did you know the United States almost had a nationalized healthcare system like Britain or Canada? It’s true! In the 1940s, the Democratic party under Franklin D. Roosevelt, and later under president Truman, pushed a number of bills into Congress which would put the government in charge of healthcare. None of the bills ever passed. At the same time, other countries were successfully passing very similar bills. Why didn’t the same thing happen in the U.S?
False reasons why they didn’t pass: size, poor quality, and bad precedent.
Of the many objections to the nationalization plans, the most common objections at the time were “the U.S is too big," “the healthcare would worsen," and “Russia tried the same thing and it failed." All three of these claims were and still are unsupported, and were not the reasons that bills like the Wagner-Murray-Dingell Bill were rejected by Congress. They might be some of the reasons why the general populace thought “socialized medicine” was a bad idea, but policy makers had different, stronger reasons to reject the nationalized plans. And though this plan was pushed mostly by Democrats, it wasn’t a super partisan issue: the bills weren’t blocked because of simple partisan animosity. Something stronger was at play.
The real reason why they didn’t pass: strong lobbying.
Multiple very large lobbies stood against the push for “socialized medicine." The new but still quite large insurance industry, along with the pharmaceutical and med-tech industries predictably opposed the bills. But there was some unexpected opposition, too: the American Bar Association, for example. Perhaps most notably, the AMA (American Medical Association) itself spent hundreds of thousands of dollars lobbying and advertising against the bills. Almost all of these oppositions claimed to be against nationalization bills because they were ineffective, but hot-mic clips and recollections from private meetings make it clear that these large private organizations’ main concern was their potential loss of power and income.
Evolution of the bills, and the modern-day push for nationalization.
After a decade of pushing for a nationalized plan, the Democratic party eased up on the gas, and instead began pushing smaller, more moderate plans. These eventually became Medicaid and Medicare.
Bernie Sanders’ popularity and the incredible cost of healthcare nowadays has revivified the conversation around nationalized (or “decommodified”) healthcare. But have the objections changed? Not really. It’s hard to tell where various lobbying groups stand now, given the drastic economic changes since the 'forties, but the publicized objections are the same as before. Luckily, the decades since their insertion in the public discourse have proven some of them false worries. America’s too big? China and Russia both have successful, effective public coverage. Poor quality? Ask any Canadian whether they feel they’d get more consistent coverage in the U.S. And as for bad precedent, even if we ignore the successful implementation in many non-authoritarian western European countries, we can still see effective precedent in the U.S’ own history: veterans, Native Americans, and orphans all get healthcare directly from the federal government.
The contemporary debate is of course more complicated than can be summarized in one paragraph, but with almost 80 years of precedent and new data and practice, perhaps now is the time to resume the conversation.