One of the most outstanding achievements of Barack Obama’s tenure as president was the political battle to enact the Affordable Care Act. Despite the continued hostility from the conservatives who derisively referred to the ACA as Obamacare, 20 million Americans without health insurance became enrolled. Nonetheless, about 30 million Americans are still uncovered. Undoubtedly, a major issue in the 2020 presidential election is whether the conservatives will be able to block the more generous health coverage proposals from the Democrats.
Resistance by conservatives has made the U.S. the only industrialized nation without universal health care. This position is contrary to the history of civilized nations. While the development of medical cures was once primitive, the ancient Greeks and Romans built hospitals for their citizens. In the middle ages the Catholic Church in Europe established hospitals. As long ago as 1518 Henry VIII established the Royal College of Physicians to develop standards for the practice of medicine in England.
What went wrong to bring Americans to the current inhumane perspective? One opinion is that the development of medical technology became expensive and that they were then viewed merely as commercial products rather than miracle cures or magical medical devices available to all.
An early apparatus in 1816 was the stethoscope that enabled doctors to hear the sound of a patient’s heart or lungs, but it was not until the end of the 19th century that the X-ray machine revealed the condition of the patient’s bones. Inventions in the 20th century facilitated medical treatment: the EKG procedure (1903); the defibrillator (1947); the pacemaker (1958); and the CAT scan (1971).
The pharmacologists were also hard at work once Louis Pasteur proved in 1870 that most disease was caused by germs. In 1928 the super antibiotic penicillin was approved. A cure for yellow fever followed in 1935, the polio vaccine came in 1952, and the mumps vaccination was developed in 1967. The inventiveness to sustain human life continues.
The problem confronting society is how to encourage the invention of significant medical developments, yet assure their availability to the public at an affordable price. This conundrum is further complicated by the fact that many innovations require financing grants directly from the government or from foundations that rely on tax exempt status for donations. Ironically, the working class patient might be unable to afford a medical procedure or a pharmaceutical regimen when he or she as a citizen is part owner of the process.
Another reason for the failure to maximize health care is reluctance of the affluent to pay taxes to finance health benefits for blacks and Latinos. Even today, eight former Confederate states with large black populations do not agree to extend Medicaid coverage. This leaves blacks and poor whites in those states with no health insurance protection.
However, the most pernicious reason for opposition to universal health care is the Darwinian reluctance to assist those who are not inspired by available business opportunities to earn a sufficient income to provide for all their needs. Too many conservatives believe in a winner-take-all economy.
Having enjoyed the availability of health coverage under Obama’s ACA, working class voters are expected to respond to a campaign by the liberals to improve their health coverage. But with so many working class voters supporting conservative issues, the political backing for improved ACA cannot be assured.