HEALTH CARE/Joan Retsinas

Gratitude Time

It’s gratitude time. On this officially sanctioned day Americans pause to thank a deity - we can pick the one we please (one of the basic freedoms to celebrate) - for the bounty of the table, the peace of the moment, the love of family, however we define our blessings (that definitional freedom represents another blessing).

Sometime between the turkey and the pumpkin pie, we reminisce, gratefully.

As the nation pauses on the cusp, maybe, of comprehensive universal health coverage for all citizens, it is time to celebrate 80 years of government meddling. And time to thank all the legislators who voted “yes” when health care legislation crossed their desks.

Whip back to 1938. Fresh from the Elixir Sulfanilamide disaster of 1937, when 105 patients in 15 states died from a touted, but not well-tested, elixir, Congress pondered the wisdom of demanding that drugs be tested before being marketed. The populace was angry. But for many companies, profits were at stake. So was the sacrosanct divide between public and private sectors. Two key opponents in the Senate represented North Carolina, the home of Vick Chemical (maker of VapoRub), and Missouri, the home of Lambert Pharmaceutical (maker of Listerine). Opponents of the legislation yelled “socialism.” Fortunately, a majority of Congress voted for the Food Drug and Cosmetics Act, the precursor to today’s Food and Drug Administration. Today all drugs must pass muster, proving both efficacy and safety, before making their way to market.

Seven years later, in 1945, Congress faced legislation, proposed by President Harry Truman, for national health insurance. Not surprisingly, opponents raised the specter of “socialism,” and the measure died. Congress compromised. It passed the Hospital Survey and Construction Act of 1945 (Hill Burton Act). In 1945 40 % of counties in the country had no hospitals. Hill-Burton poured federal dollars into hospital construction. Over the next thirty years, the federal government had subsidized one-third of all hospital projects in the United States. While the law did not extend insurance coverage to Americans, the law did stipulate that those hospitals receiving Hill Burton funds had to give free care to indigent patients. (The law allowed the continuation of a segregated hospital system – that would not change for another 20 years). In 1970 Congress unanimously passed a three-year extension of Hill Burton. Objecting to giving “grants,” rather than “loans,” President Nixon vetoed the legislation. Congress overrode his veto (76 to 19 in the Senate, 279 to 98 in the House).

In 1965 Congress took up national health insurance – not for everybody, but for seniors and the disabled. Half of the nation’s seniors had no health insurance; and however fervently industry lauded its commitment to providing health insurance for workers, seniors and the disabled were effectively out of the workforce. Medicare seemed a solution. Conservatives opposed it. Ronald Reagan (1961) warned: “If you don’t [stop Medicare] and I don’t do it, one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” Senator Robert Dole, running for President (1996), bragged that he had voted “no.” The American Medical Association weighed in against the bill. Lobbyists reminded legislators of their campaign ties. The final votes followed party lines: Senate Democrats voted 57 yes, 7 no, 4 abstain; Republicans voted 13 yes, 17 no, 2 abstain. On the House side, Democrats voted 257 yes, 48 no, 8 abstain; Republicans, 70 yes, 68 no, 2 abstain.

To all the legislators who through the decades have voted to improve the health of Americans, thank you.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, November 15, 2009