It's like the Pinto gas tank: cheaper to let some drivers fry

The New Yorker notes that whenever health care has come up, conservatives have been against it:

“At present the United States has the unenviable distinction of being the only great industrial nation without compulsory health insurance,” the Yale economist Irving Fisher said in a speech in December. December of 1916, that is. More than nine decades ago, Fisher thought that universal health coverage was just around the corner. “Within another six months, it will be a burning question,” he predicted. Oh, well. What’s a century, give or take?

Health care has been on the docket longer than most Americans can expect to live, with or without it. “Let’s take a quick trip back in time,” Sheldon Whitehouse, a Democrat from Rhode Island, said on the Senate floor this past July, whereupon he proceeded to page through back issues of the Times, quoting headlines about the astronomical cost of health care in 1992, 1988, and 1979, all the way to 1955 (the year he was born), to read this timeless line: “As it does each year without fail, the government declared again this week that it is time to do something about the rising cost of medical care.” Health-care reform isn’t premature, Whitehouse insisted. It’s “55 years late.” (Or ninety-three. But who’s counting?) Last month, Congresswoman Sheila Jackson-Lee, a Texas Democrat, echoed the point that it was funny to call health-care reform “rushed”: “America has been working on providing access to health care for all Americans since the nineteen-thirties, the nineteen-forties, the nineteen-fifties, the nineteen-sixties, nineteen-seventies, nineteen-eighties, and the nineteen-nineties.”

True enough, but don’t forget the nineteen-tens. In 1912, the year after Parliament passed a National Insurance Act, the American Association for Labor Legislation (which Glenn Beck would surely call Bolshevik but was, in fact, a group of economists whose officers included Louis Brandeis, Jane Addams, and Woodrow Wilson) formed the Committee on Social Insurance, the brainchild of Isaac M. Rubinow, a Russian-born doctor turned policy wonk and the author of the landmark study “Social Insurance.” Rubinow hoped that “sickness insurance” would help eradicate poverty. It was also the next logical step after workers’ compensation, which the association had got passed in more than a dozen states. By 1915, Rubinow’s committee had drafted a bill providing for universal medical coverage. “No other social movement in modern economic development is so pregnant with benefit to the public,” the editor of the Journal of the American Medical Association wrote. The next year, Congress began debating Rubinow’s bill, which was also put forward in sixteen states. That’s why Irving Fisher was so optimistic. It looked like this thing was good to go.

In December, 1916, Fisher delivered an address titled “The Need for Health Insurance,” at a joint session of the American Association for Labor Legislation, the American Economic Association (he was president of both), the American Sociological Society, and the American Statistical Association. “Germany showed the way in 1883,” Fisher told his audience. “Her wonderful industrial progress since that time, her comparative freedom from poverty . . . and the physical preparedness of her soldiery, are presumably due, in considerable measure, to health insurance.”

You can probably already see where this is heading. The United States declared war with Germany in April, 1917. Health care was dead. Critics said that it was “made in Germany” and likely to result in the “Prussianization of America.” In California, where the legislature had passed a constitutional amendment providing for universal health insurance, it was put on the ballot for ratification: a federation of insurance companies took out an ad in the San Francisco Chroniclewarning that it “would spell social ruin to the United States.” Every voter in the state received in the mail a pamphlet with a picture of the Kaiser and the words “Born in Germany. Do you want it in California?” (“If you are opposed to a thing these days,” one frustrated health-care advocate wrote, “the cheapest way to attack it is to call it ‘German.’ ”) The people of California voted it down. By 1919, John J. A. O’Reilly, a Brooklyn physician, was calling universal health insurance “UnAmerican, Unsafe, Uneconomic, Unscientific, Unfair and Unscrupulous.”

And so it goes, and so it has gone, all the way to this year’s “socialized medicine.” In 1934, Rubinow published “The Quest for Security.” He urged F.D.R. to include health care in the New Deal. But by then the American Medical Association had switched sides. Government meddling in medicine, the editor of JAMA said, came down to a question of “Americanism versus sovietism.” In 1965, it was “creeping socialism.” Lately, it’s hard to keep track of whether health care for everyone is Bolshevism, Fascism, Nazism, or Communism. Odds are, though, that it comes from someplace you need a time machine to get to. Or at least an airplane. This year, Senate Minority Leader Mitch McConnell accused President Obama and his allies of “an audacious effort to Europeanize the country.”

Meanwhile, health care has grown more expensive, which makes reform harder. By now, the accretion of ineptitude begins to look like a tradition. The argument against health-care reform often amounts to a) it’s foreign and b) we have gone this far without it, thank you very much. The more time passes, the more it looks as if having no real health-care plan were the American way. That has led to some contorted logic: usually, reformers counter appeals to xenophobia by appealing to heritage. (When in doubt, deploy the Founding Fathers.) During the nineteen-forties, health-care reformers tried to make the claim that there was a precedent for health-care legislation. In 1798, John Adams had signed an “Act for the relief of sick and disabled Seamen”: state and, later, federal government officials collected taxes from shipmasters which were used to build hospitals and provide medical care for merchant and naval seamen. Government-sponsored health care wasn’t un-American, the argument went; Adams had thought of it. Unfortunately, that’s about as silly as arguing that the Second Amendment was written to provide for the purchase of AK-47s. It’s so crazy it only works if you’re well armed.