(By Fay Paxton, cross-posted at The Pragmatic Pundit)
“My name is Ronald Reagan. I have been asked to talk on the several subjects that have to do with the problems of the day. . . .
One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project. . . . Now, the American people, if you put it to them about socialized medicine and gave them a chance to choose, would unhesitatingly vote against it…..we are against forcing all citizens, regardless of need, into a compulsory government program….the consequences for “our children” would be dire: “we will sentence them to take the last step into a thousand years of darkness.”
And what was this frightful threat that Reagan perceived as “imminent”? Medicare.
It was the Truman Administration that began advocating medical care for the aged after a call for universal health care for all Americans was met with intense opposition. After a bill was introduced in Congress to create a Medicare program, the AMA immediately announced its opposition and worked tirelessly and successfully to prevent any such program from advancing in the Congress.
By 1960 a scaled-back bill was introduced in an effort to lessen resistance to the idea of government-provided health insurance coverage. It proposed to cover the costs of hospital and nursing home care, but not surgical costs or out-patient physicians’ services. The scaled-back version, “limited to the welfare population” became law. It is what we now call Medicaid.
With the election of President Kennedy came a renewed effort to introduce Medicare. The American Medical Association launched an extensive and well financed campaign against its enactment, with advertisements in newspapers. on radio and television spots, all deploying the usual cries of “socialism,” and the specter of federal bureaucrats in “the examination room.”
Under the banner of “Operation Hometown” the AMA propagandize through use of medical societies, speeches, news releases, articles and pamphlets on the dangers of “socialized medicine.” Then there was “Operation Coffeecup”, a series of coffee-klatches hosted by the members of the Woman’s Auxiliary. The get-togethers were depicted as spontaneous, grassroot events. Enter, Ronald Reagan.
At these clandestine gatherings, women received instructions on how to lobby against Medicare, launched a letter-writing campaign and listened to a recording called, “Ronald Reagan Speaks Out Against Socialized Medicine.”
Reagan’s involvement was revealed in an article by Drew Pearson in his Washington Merry-Go-Round column entitled, “Star vs. JFK,”:
Ronald Reagan of Hollywood has pitted his mellifluous voice against President Kennedy in the battle for medical aid for the elderly. As a result it looks as if the old folks would lose out. He has caused such a deluge of mail to swamp Congress that Congressmen want to postpone action on the medical bill until 1962. What they don’t know, of course, is that Ron Reagan is behind the mail; also that the American Medical Association is paying for it.
Reagan is the handsome TV star for General Electric . . . Just how this background qualifies him as an expert on medical care for the elderly remains a mystery. Nevertheless, thanks to a deal with the AMA, and the acquiescence of General Electric, Ronald may be able to out-influence the President of the United States with Congress.
Reagan and Conservatives preferred a state-level welfare program for the needy. They were against pending legislation that offered health care coverage to Social Security beneficiaries, favoring legislation that paid the medical bills of those on welfare, or those who could qualify as indigent given their medical expenses.
What irony, that Conservatives were in favor of welfare, while Democrats preferred the pro-work expansion tied to Social Security. Why this strange role reversal? Because Conservatives reasoned that covering the truly needy would limit the size of the program and the stigma of “poverty” would tamp down participation demands from middle class and upper class citizens. Afterall, who would want an association with a program meant for the poor and aged? It was a trade-off…a little more welfare for a lot less government.
While he would later deny it, Ronald Reagan was at the forefront of the argument against Medicare with many of the same arguments we hear today:
“The doctor begins to lose freedom. . . . First you decide that the doctor can have so many patients. They are equally divided among the various doctors by the government. But then doctors aren’t equally divided geographically. So a doctor decides he wants to practice in one town and the government has to say to him, you can’t live in that town. They already have enough doctors. You have to go someplace else. And from here it’s only a short step to dictating where he will go. . . . From here it’s a short step to all the rest of socialism, to determining his pay. And pretty soon your son won’t decide, when he’s in school, where he will go or what he will do for a living. He will wait for the government to tell him where he will go to work and what he will do.”
Government control of medicine was never what Medicare was about. It is a system for financing the costs of medical care that has nothing to do with medical practices. But then as now, this threat was the reliable boogeyman.
To be fair, the Medicare program does indirectly regulate aspects of health care by the effect of its reimbursement policies. But the same is true with private insurers. Blue Cross/Blue Shield decides it will not pay for certain medical procedures, or will only pay for a generic drug rather than a brand-name one. These decisions affect the practice of medicine by encouraging forms of practice consistent with reimbursement policies. So too with Medicare. But this is a far cry from the specter of an intrusive government presence in the examining room.
Republicans have a long-standing, deeply-held antipathy for both Social Security and Medicare. Not only did Reagan advocate making Social Security voluntary in the 1964 Goldwater campaign, but argued in 1975 that Social Security should be privatized. And we’ve all heard those before; we still hear those arguments today.
By 1980, this aspect of Reagan’s personal history had become a political liability and he denied having ever campaigned to destroy Medicare, but insisted he was trying to improve it. Perhaps, he was just acting.
All things considered, don’t be surprised if years from now, you see little old ladies donning hats with hanging teabags, carrying signs that proclaim: “Keep government out of my Obamacare”.