Why National Health Insurance Matters So Much To The Right

Samuel Gompers, founder of the AFL-CIO

There was a time, not so long ago to those of us who are old, when health insurance was generally provided by employers as a fringe benefit as part of a negotiated contract between the employer and the employees' union.  Over the years employers' interest and lobbying groups, collectively known as the Republican Party, used their control of state legislatures and the US Congress to undermine and eventually destroy the American labor movement primarily by passing so-called 'Right to Work' laws, state by state. 

Union membership among American workers fell from over 70 percent in the 1950's to less than 8% today.  Ironically most of those few remaining union members are public employees, notably teachers and the federal civil service.  Union membership and activity in the great mass of those workers working for corporate employers has all but vanished.

[I must note here the admirable and even heroic exceptions of the nurses and the hotel workers.]

The undermining and destruction of the unions was greatly facilitated by the transfer of manufacturing to non-union Southern states and, when even those states started to see unionization, the transfer of manufacturing overseas.  Workers in industries like steel, glass, autos, mining, and manufacturing generally, had been the bulwark of the American unions.

Their jobs are now done in China and other low-wage countries like Vietnam.  China has so far been immune to unionization because its Communist Party claims to already represent the workers.  In practice the Chinese Communist Party represents and protects Chinese workers about as much as the Republican Party represents and protect American workers - which is to say not at all.  Presumably the same is true of "Communist" Vietnam as well.

A second development by which the Republicans, with the connivance of the Democrats, undermined American workers' ability to organize into unions, has been keeping the immigrant population of tens of millions of Mexican workers illegal.   

Kicking them out would mean the end of the supply of cheap labor so that isn't going to happen.  Legalizing them would mean that they would no longer be quite so cheap so that isn't going to happen either.  So the fiction has been invented and perpetrated that there is something wrong with the border and that there just seems to be no way to keep them out.  Never mind that Canada effortlessly keeps them out by fining employers who knowingly employ illegal immigrants.  Never mind too that the US had such a law too but the Republicans gutted it by reducing the fine from a thousand dollars a day per illegal worker knowingly employed to ten dollars a day, an amount too small for the government to bother to enforce.

One does not have to be any kind of Marxist to regard these as huge victories for the corporations and their owners and managers and correspondingly huge defeats for the workers and their unions.  With the decline in union membership has come a corresponding decline in employer-provided health insurance.

During this same period and before, Presidents since Teddy Roosevelt just over a hundred years ago have attempted some sort of national medical insurance plan but it has always been stymied and defeated in Congress.  Now, a century of striving for Americans to have national health insurance has finally found fruition in the Affordable Care Act, quite justly called Obamacare because it is the signal and historic landmark for which his presidency will be remembered.   Even though it is carefully crafted to involve corporate insurance companies and free markets as much as possible, it is nevertheless a government program.

Which is a reversal in part of the historic victory of the corporations and their owners and managers in transferring the costs of health care from the corporations onto the workers or, failing that, to deprive them of health insurance entirely.  It is those who see their mission in Congress as to defend the class interests of the wealthy who are intent on fighting this to the end, even when the corporate interests themselves have agreed to the bill, and now law.

Dates of Adoption of Universal Health Care

1878  Germany

1939  New Zealand

1948  Britain

1955  Sweden

1956  Iceland

1956  Norway

1961  Japan

1961  Denmark

1964  Finland

1968  Canada

1974  Australia

1970's - 90's gradual implementation in Austria, Belgium, France and Luxembourg

1978  Italy

1979  Portugal

1983  Greece

1986  Netherlands

1988  Spain

1989  South Korea

1995  Israel

1995  Taiwan

1996  Switzerland

2013  United States of America

Many other countries have some form of universal health care as well.  (I remember being unable to become a citizen of Chile about 15 years ago because of their fear that immigrants would go there in part to take advantage of their health care system.  Which was exactly my intention.)

The list above can be read two ways.  One, the more obvious to most, is that all the developed countries of the world have adopted some form of universal health care twenty to sixty years ago.  But another is that the foreign countries of the world have one by one fallen into the sink of social decay and loss of self-reliance and fallen prey one by one to the siren song of socialism.  Only America has stood steadfast against the tide of moral rot.

The fact that the United States has lagged decades behind even countries like Portugal, South Korea, and Taiwan can be seen as a national disgrace that we are so far behind all modern and developed countries.

But it can also be seen as a shining example of American Exceptionalism.  When we say, "Everyone in Europe has it", they say, "Exactly!  The decadent corrupt Europeans have it.  And we as Americans must not, if only so as not to become the feckless, state-coddled, irresponsible, ingrate weaklings that the Europeans have become."  People of this mind see Obamacare as the strong entering wedge of European socialism, weakness, hedonism, and decay, the end of American Individualism.

To those who see the United States as its Puritan founders did, as a City on a Hill, a shining beacon and example to all the world, Obamacare means becoming like all the others, the worldling Europeans.

I think it worth noting that Obamacare is crafted to minimize the citizen's contact with the government.  It merely provides efficient markets in which the citizen can buy health insurance from private insurance companies.  It is also very much worth noting that the only reason the Affordable Care Act passed at all is that the insurance companies bought in on it.  Had the insurance companies strongly resisted, it could not have been enacted.

But the fight, which could conceivably have been a debate about principles, about how to deliver public services without compromising American Individualism has become mere nasty obstructionism.

The President is not wrong in calling the Tea Party opposition ideological.  It is ideological for the reasons I have given.

To the Tea Party radicals I would rejoin, had the Congress to which Teddy Roosevelt appealed adopted universal health care in 1908 when he asked them, American Exceptionalism would have appeared as American leadership in social progress and humanitarianism and social efficiency.  Instead it appears as laggard rationalizations and selfish excuses.