In the first interview in a series on health care reform, Allan Lichtman puts the current reform debate in historical context. A professor in the Department of History, Lichtman is a frequent national political commentator and the author of White Protestant Nation: The Rise of the American Conservative Movement.
Have politics and health care in the U.S. always been so intertwined?
The combination of the two is absolutely nothing new. Politics have been a part of health care since at least the turn of the 20th century, when government began to involve itself very deeply in the welfare of individuals. Woodrow Wilson, FDR, Eisenhower, Truman, and every subsequent president have dealt with issues involving health care.
Do current health care reform debates echo those of the past?
Definitely. In fact, as part of his fair deal program more than 50 years ago, Harry Truman proposed a universal health care program. It didn't pass, but it certainly was debated at the time, and the debate was not dissimilar to our current one. He was attacked for promoting socialism, organized medicine solidly lined up against him, and he was unable to get unity in his party for the program.
More recently, Bill Clinton made health care reform and universal coverage top concerns during his first term. He received much the same type of opposition as President Obama is receiving today, and, as a result the bill was never even brought to the floor. This failure contributed to the Republican landslide of 1994, when they took over the House of Representatives and the Senate for the first time since 1946.
In 1993–94, the conservatives went after the health care program as a means of bringing down Clinton. It's not as though they were concerned about health care reform. They wanted to achieve a Republican comeback, and when they did so, they paid little attention to health care reform.
It's the same thing with the current debate. Conservatives are not seriously pursuing alternative reform plans or bipartisan agreement. Again, their goal is causing a big defeat for Barack Obama and making a comeback in the midterm elections of 2010.
What needs to happen for the current reform efforts to be successful?
Most importantly, President Obama needs to take charge of the reform efforts and come up with a plan. People basically need to know what is in this bill. He also needs to show how this plan will help the 250 million Americans already covered by private insurance and government programs and well as the 50 million who are uninsured.
As long as there are many versions of reform plans circulating, it opens the doors for all sorts of scare tactics and it becomes open warfare. It is always easier shooting something down than upholding it. That is how the politics of fear works. As the Democratic Party has expanded, it has necessarily become more diverse. As a result, you have a good number of conservative democrats who don't see eye to eye with the president on this. No one is going to get exactly what they want. Any plan is not going to be the ideal one for everyone. So the Democrats need put aside their egos and realize it's in their interest and in the country's interest to make this thing happen. Otherwise, it is going to be a disaster again for the Democratic Party.