What has been widely-adopted by fifty four nations as a universal government-supported health care system was first proposed by a most unlikely arch-conservative, German autocrat in 1883. Today the success of such a health care model remains irrefutable -- except in the US.
Now recognized as the Father of the modern welfare state which included an old age pension (forerunner to Social Security), Germany's First Chancellor of a newly united nation, Otto von Bismarck, sought to avoid political unrest (such as the Paris Commune of 1871) as he shrewdly undercut the Socialists to win support of workers and stem the flow of immigrants to the US.
The concept of providing citizens with a compulsory national health care system actually dates back to Prussian conservatives of the 1840s who had strong social predispositions along with a sense of obligation to its citizenry. Unfortunately neither today's conservatives nor liberals in the US have exhibited a similar commitment to its people as those Prussian conservatives did over one hundred years ago.
Since then, the US, which considers itself as the 'indispensable' nation, the world leader of all other nations, a health care-for-all-public option has been left to a for-profit insurance industry of modern-day fast talking, hucksters -- not unlike those who expected to profit from the Affordable Care Act of 2010.
After WWI, any effort to establish a government sponsored health care system in the US became a target for red-baiting associated with 'socialism' and "communism.'
In 1915 , the American Association of Labor Legislation (AALL) introduced a bill that would provide coverage to citizens earning less than $1200 annually with costs shared among the insured, employers and government. Even the American Medical Association (AMA) initially supported the AALL although later backing off as many of its state affiliates did not support the legislation. The commercial insurance industry opposed the AALL and the AFL (American Federation of Labor) objected to the compulsory requirement (contained in all universal health care plans) as akin to communism.
In 1935, President Franklin D. Roosevelt's Social Security Act was forced to exclude a health care option to assure passage of SSA.
The Wagner-Murray-Dingell bill of 1943 would have provided comprehensive compulsory health care for all funded by payroll taxes but was overwhelmed by opposition from the AMA, American Bar Association, American Dental Association, Chamber of Commerce, American Hospital Association, Protestant and Catholic Hospitals and the American Farm Bureau.
In 1945, California Governor Earl Warren attempted to create a state sponsored health care program that was also blocked by the opposition.
Even as the 1948 campaign saw a landslide of Democrats elected to the 81st Congress, President Harry S. Truman's proposal for a bold comprehensive health care insurance plan for all American citizens was predictably defeated.
It took a Rhode Island Congressman in 1958 to focus on health care for the elderly which dramatically shifted the debate, pitting the AMA and insurance industry against senior citizens and members of the public who expected to someday become senior citizens.
As a result of compromise with the medical and insurance industries, Medicare/Medicaid were adopted in 1965 with former President Truman being awarded the first Medicare card. Although Medicare was not the all-inclusive thorough insurance plan Truman had envisioned, it has become (with its imperfections) a model of progressive health care enjoying enormous public support proving that capitalism did not collapse with a government-sponsored health care system.
At this point, it is worth mention that Canada also had no health care system for its citizens until the province of Saskatchewan stepped up in the early 1960's and adopted their version of what the Prussians had done the century before. Once the success in Saskatchewan was evident, other provinces adopted their public health care program as Canadians took to the streets and began an impassioned, vigorous national campaign, until the government acquiesced. Voila -- the Canadian Health Care System was born in 1984.
The Affordable Care Act was adopted in 2010 by a Democratically controlled Congress with the House of Representatives Progressive caucus vowing to never, ever vote for anything but a 'public option.' One by one they caved, having been persuaded that their new President's ability to function was at stake. Rep. Dennis Kucinich (D-Oh) was the last holdout. So again as before, politics was more important than providing the public with a functioning health care system.
With the health insurance industry standing prominently between the patient and their health care, the ACA's promise of "comprehensive reforms that improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices" has not lived up to the hype. As the fourth ACA enrollment period is scheduled to begin November 1st, its stability as a viable entity on which the public may rely for constant, reliable health care insurance remains questionable with double-digit premium increases, market withdrawal by some insurance providers and a reduction in services indicate that the Act has not stabilized sufficiently four years after implementation.
It comes as little surprise that a recent Health and Human Services report identified a 1.6 million 'drop out' rate of those who had signed up for subsidized coverage but failed to follow through with a paid premium. With eleven million participants still in the plan, enrollment has been lower than anticipated, customers have had more ailments than anticipated; thereby lowering insurance company profits more than anticipated.
In addition, the Kaiser Family Foundation's recent "Analysis of 2017 Premium Changes" found "steep" premium increases nation-wide. The Analysis, which focused on the lowest cost silver plans in thirteen US cities as the plan most often chosen by consumers, cited Denver with a 14 per cent increase since 2015 and an average monthly increase in premiums up from $266 in 2016 to $304 in 2017. According to Kaiser, the number of insurers participating in Colorado's Connect for Health exchange began at ten in 2014 and is expected to drop to seven in 2017.
Offering little reassurance to Colorado's 350,000 uninsured residents and 700,000 underinsured, the state's four largest health care providers have proposed double-digit premium increases to their individual plans that will leave more than 92,000 Colorado residents in pursuit of new health insurance coverage. Humana and United Healthcare, like any corporation dedicated to a profitable bottom line, are abandoning the individual market along the Western Slope of Colorado impacting 20,000 residents.
In an example of flawless timing, ColoradoCare (aka Amendment 69) easily qualified for the ballot after a wildly successful petition drive, is a health care system owned by the public through its payroll tax, and is poised to step in and provide a Medicare-for-all health care system for all state citizens pending voter approval on November 8th. Amendment 69 supporters designed a plan with no deductibles, no co-pay for primary care, no annual enrollment while eliminating unnecessary bureaucracy and a reduction of mushrooming administrative costs that will save an estimated $4.5 billion.
Whatever slim benefits of the ACA may exist, there remains the question of how the federal government can continue to allow its corporate insurance conglomerates to dominate health care as it continues to display a flagrant disregard for the American public's health needs as it has for more than a century. It would seem obvious that the goals of a for-profit health insurance industry and a publicly-funded health care system are mutually exclusive.
Push back to ColoradoCare is being organized by the awkwardly-named Coloradans for Coloradans funded by the Koch Brothers and other bigwigs and industry organizations that have a vested interest in the defeat of Amendment 69. They can be counted on to raise the same outworn threats and fears to bamboozle voters with the usual scare tactics that have been used in the past. The Colorado State Republican party, including its members of Congress and the State House and Senate have all announced their opposition to Amendment 69.
Unexpected opposition surfaced recently as NARAL Pro Choice Colorado announced it believes that, if adopted, Amendment 69 would restrict abortions based on an 1984 Constitutional amendment that banned state funds for abortions. Case law cited by a ColoradoCare attorney indicates that if adopted, Amendment 69 would supersede the 1984 statute. If passage occurs, NARAL may find that its job has been successful -- abortion rights will become universal.
Despite 'single payer' health care's inclusion in both the Colorado and national Democratic party platforms, that has not stopped key Democratic leaders such as Governor John Hickenlooper (D), former Governor Bill Ritter (D) and Senator Michael Bennett (D-Co) from lining up with the Koch Brothers and an impressive array of other pillars of the community in opposition to Amendment 69 -- just the sort of heavy hitters who have used their leverage to stymie, sabotage and derail a Universal health care system in the United States for the last hundred years.