Notes on a Theory…

Thoughts on politics, law, & social science

“The right to adequate medical care and the opportunity to achieve and enjoy good health.”

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Earlier today, Seth Ackerman was on Twitter quoting the 1960 Democratic platform opposing the idea of means testing in the yet to be enacted Medicare program.  I thought it was worth quoting here in full – with my own comments in brackets.


6. “The right to adequate medical care and the opportunity to achieve and enjoy good health.” [This is the 6th point in FDR’s Economic Bill of Rights, around which the ’60 platform was structured, and which you won’t hear almost any Democrats today mention.]

Illness is expensive. Many Americans have neither incomes nor insurance protection to enable them to pay for modern health care. The problem is particularly acute with our older citizens, among whom serious illness strikes most often. [It’s also unpredictable, and only partly under our control – exactly the sort of situation where social insurance is warranted.]

We shall provide medical care benefits for the aged as part of the time-tested Social Security insurance system. We reject any proposal which would require such citizens to submit to the indignity of a means test—a “pauper’s oath.” [This is what serious people like Dick Durbin ,Claire McCaskill and Jonathan Chait are floating today, claiming falsely it will help the program’s finances without acknowledging how it welfarizes the program, thereby undermining its political supports.]

For young and old alike, we need more medical schools, more hospitals, more research laboratories to speed the final conquest of major killers. [Today, the bigger problem is primary care, but it’s worth remembering the importance of federal aid in these three categories in the post-War period.]

Medical Care for Older Persons

Fifty million Americans—more than a fourth of our people—have no insurance protection against the high cost of illness. For the rest, private health insurance pays, on the average, only about one-third of the cost of medical care.

The problem is particularly acute among the 16 million Americans over 65 years old, and among disabled workers, widows and orphans. [That is, the problem was worst among those who could not work, since the existing system revolves around employer-provided health insurance, a system that itself grew up because federal tax law was designed to encourage it.  I emphasize this because that system has been weakening for a generation, as jobs have become less secure, and because we remain in a time of high unemployment, yet we’re still talking about weakening those parts of the system designed to support those who are less likely to be working.  Which makes no sense if you are concerned about people.]

Most of these have low incomes and the elderly among them suffer two to three times as much illness as the rest of the population.

The Republican Administration refused to acknowledge any national responsibility for health care for elder citizens until forced to do so by an increasingly outraged demand. Then, its belated proposal was a cynical sham built around a degrading test based on means or income—a “pauper’s oath.”

The most practicable way to provide health protection for older people is to use the contributory machinery of the Social Security system for insurance covering hospital bills and other high-cost medical services. [Here ‘practical’ means most efficient way to achieve the stated goal, as opposed to the way the term is usually used in our current political discourse–consistent with the interests of the wealthy and powerful.] For those relatively few of our older people who have never been eligible for Social Security coverage, we shall provide corresponding benefits by appropriations from the general revenue.

I like that part about the outraged demand from the public.  We need more of that today.

Written by David Kaib

December 8, 2012 at 4:26 pm

Posted in Uncategorized

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