What if we were to re-write history to meet our political agenda? Well, apparently this is what the New England Journal of Medicine is doing to rush healthcare reform in an article titled The Lessons of Success — Revisiting the Medicare Story by David Blumenthal, M.D., M.P.P., and James Morone, Ph.D.
The article describes the history of passage of the Medicare bill in 1965 and the great lengths that President Johnson went to see it passed. The historical narrative in middle of the article makes for a great read, but provides no balance or support for their conclusions which is that to pass health care reform speed is of the essence.
According to liberal think tank writer Maggie Mahar, Healthcare fellow at the Century Institute as quoted in the Huffington post. The Medicare debate and legislation went on for years:
Nevertheless, those beating the drum for Universal Coverage now seem to be winning the debate in many circles.
The authors, Dr. David Blumenthal and James Marone, not only "revisit" the story of how Lyndon Johnson turned Medicare proposals into law; I am afraid that they also revise history: Blumenthal and Marone argue that LBJ fast-tracked Medicare through Congress and that Obama should follow his model: "Speed is of the essence."
But the truth is that before LBJ became President, John F. Kennedy had worked on Medicare for 18 months. JFK began the fight in January of 1961. And by "the end of the 1961 session of Congress, the tempo of the Kennedy administration's Medicare campaign began to pick up," reports Peter A. Corning in The Evolution of Medicare — From Idea to Law, a book Corning wrote while memories were still fresh in 1969. A few weeks later, Health, Education and Welfare Secretary Ribicoff publicly pledged "a great fight across the land" for Medicare. Medicare was a featured topic around the country in late October at a series of 14 White House-sponsored regional conferences."
Gallup polls showed public support running as high as 69 percent. "By far the most important cause for optimism during the spring of 1962, though, was the progress of behind-the-scenes negotiations between administration strategists and the members of the Ways and Means Committee," Corning writes.
"The climax of the public debate came in the spring of 1962. On Sunday, May 20, President Kennedy spoke to a crowd of nearly 20,000 elderly people in New York's Madison Square Garden, while other administration officials addressed similar rallies in 45 cities. The President's speech was broadcast live over three television networks to an estimated home audience of 20 million persons. Two days later, the AMA's Dr. Edward Annis replied in a network speech broadcast from the same platform used by the President, but with the Garden auditorium dramatically empty, to symbolize the AMA's "underdog" stance." Estimates suggested that 30 million people watched Annis' speech.
Two months later, the full Senate voted on the bill, and Medicare was defeated 52-48. Once again the AMA had steamrolled the opposition. But Kenney had laid the groundwork for passage, both in Congress, where many liberal Republicans now supported the idea, and throughout the country.
Surprisingly, Blumenthal and Marone do not mention Kennedy's work in their NEJM article. This is because they are intent on sending a political message to President-elect Obama "speed is essential. Johnson knew this in his bones. The savvy health advisor will turn to the president-elect the day after the election and tell him, ' Hurry up, we're almost out of time for health reform.'"
To reinforce their message, the article's authors must pretend that LBJ drove Medicare through Congress single handedly, full-speed ahead., in a year or so.
In fact, LBJ inherited a Medicare campaign that was not dead, only dormant.
Following Kennedy's assassination, LBJ built on the work that JFK had done, using grassroots support for a martyred president to make his case.
But it wouldn't be easy, even for LBJ. In November of 1963, LBJ began work on Medicare; in July of 1965. Johnson finally rammed his bill through Congress. This was neither a quick nor an easy process. And it was hardly an example of gentlemanly "bipartisan compromise."
Johnson threatened everyone — Democrats and Republicans alike. LBJ had spent much of his adult life in Congress. He knew where the bodies were buried, and he was capable of being absolutely ruthless. Moreover, in contrast to Obama, LBJ enjoyed a landslide victory in 1964 — the largest plurality in U.S. history. He had the wind at his back.
Even then, it took him 19 months to achieve his goal — 19 months on top of the 18 months that JFK already had invested in the campaign.
If you are going to re-write history to meet your objectives you should be prepared to face fierce opposition even from your natural allies.
Blumenthal writes: that speed is essential. Johnson knew this in his bones. In contrast, Bill Clinton waited for 9 months to introduce his Health Security Act in 1993, (for a serious historic document how could you have failed to mention that Clinton had a secret committee, held secret hearings and left out everyone except those who agreed with him – not exactly a democratic process – and nine months is not a long time to wait to introduce a bill during your first term in the office – Johnson was already president for some time before his 1964 landslide election) which allowed his opposition to mobilize and defeat him (we don’t see a huge opposition to healthcare reform, if anything the forces are lining up in the favor of reform).
The savvy health advisor (David wants a job in the administration) will turn to the president-elect the day after the election and tell him, "Hurry up, we're almost out of time for health reform." (What is the substance for being almost out of time? I am not sure this argument holds much water. What is the rush to replace a whole system of healthcare representing close to 10% of our Gross Domestic Product? A serious author would demand that this requires some more thought, also a good idea it will last.)
In order for this country to see real healthcare reform, all parties should sit down at the table that severs the American People, as both patients and taxpayers.
In the past bi-partisan commissions have been set up to come up with recommendations that have lasting value and serve the American People.
Serious Health Care Reform needs time, it needs input, and to be completely thought out.
If our oath is to do no harm, then what is the harm in waiting and getting real input, and coming up with real solutions.