How Current Healthcare Reform Talk Models That of Richard Nixon

Mark Borigini, M.D. Health Pro
  • He was vilified constantly over the course of his career. He was defeated more than once, only to come back victorious more than once. Political pundits called him "washed up" several times over the half-century he was in the public eye. Democrats to this day have a visceral reaction when they hear his name.


    But he is back.


    And as I write this blog this Christmas Eve, I sense that the ghost of Richard Nixon walks hand in hand with the ghost of Christmases past and-for one of the myriad of candidates this coming election year-the ghost of Christmases future.


    A recent article in the "New York Times" reminds us that our current crop of politicians are not above taking from the playbook of Richard Nixon when it comes to health care reform this festive political season.

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    The authors David Himmelstein and Steffie Woolhandler, professors of medicine at Harvard University, discuss how in 1971 Nixon tried to avoid the push toward a single-payer national health insurance by proposing that employers be required to provide health insurance for their workers; unemployed/poor families would have access to a Medicaid-like program which all Americans would be able to join by paying premiums which would be based on income.


    Democrats Hillary Rodham Clinton, John Edwards and Barack Obama have all proposed health care reforms which sound very much like those proposed by Mr. Nixon almost 40 years ago. Alas, these proposals are similar to measures which were adopted only to later fail in several states.


    In fact, Republican candidate Mit Romney attempted a variation on the Nixon theme in 2006, when he proposed fines to employers in Massachusetts which were thought to not be very significant, whereas fines on uninsured individuals were to increase to $2,000 in 2008. But Romney's reform efforts had no cost control mechanism. Legislators in Massachusetts lost the political will to enforce employer mandates as health care costs increased, or to supply a new health care insurance for the poor.


    It would seem that this "mandate model" for health care reform avoids challenging private insurance's control of United States health care. However, many experts feel that this makes no sense, as the reliance on private insurance companies will render universal health insurance coverage too expensive.


    The professors conclude that the Democratic presidential contenders do not face what they see is an indisputable fact: only a single-payer national health care plan can avoid the annual squandering of billions of dollars on bureaucracy. They feel the single-payer approach would allow for the redirecting of these billions of dollars to expanded medical care coverage.


    It remains to be seen if our Democratic friends are making a mistake in following a Nixonian approach to health care reform, as the authors from Harvard suggest.

Published On: December 27, 2007