Health reform’s conservative roots
Dom
Bismarck are contained in Moritz Busch's book, "Bismarck: Some secret
pages from his history," Macmillan, New York (1898) Vol. II, p.
283-284. On page 283, Bismarck also described his social legislation
as "'practical Christianity,'' and Bismarck called this program
''Staatssozialismus'' when he made the following accurate prediction
to Busch: "It is possible that our policy may be reversed at some
future time when I am dead; but State Socialism will make its way."
Another translation of this accurate prediction is: "'It is possible
that all our politics will come to nothing when I am dead but state
socialism will drub itself in.' (Der Staatssozialismus paukt sich
durch.") [Werner Richter, ''Bismarck'', G.P. Putnam's Sons, New York
(1965) p. 275]
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http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/11/18/health_reforms_conservative_roots/
Health reform’s conservative roots
By Rich Barlow | November 18, 2009
TALK RADIO is in a lather over “socialized’’ medicine. So are
Republican leaders. Protesting the percolating reforms in Congress,
House Republicans recently sponsored a rally at which some held signs
decrying “National Socialist Healthcare.’’ Some conservatives even
insist that mandatory health insurance envisioned in the
congressional
bills would be unconstitutional.
Time for a history lesson: Mandatory national health insurance was
invented by an anti-socialist conservative in Germany during the
laissez-faire Gilded Age.
In 1883, Otto von Bismarck instituted the world’s first compulsory
health care scheme, requiring workers to get insurance from private
carriers through their employers, paid for by a payroll tax. Sound
familiar? The similarities between the Iron Chancellor’s vision and
the broad outlines of the proposals in Congress - and, indeed, our
current employer-based system of health care - offer valuable
lessons.
Bismarck was Fox News’s kind of guy. He loathed socialism, to the
point of banning socialist meetings and literature distribution. His
social reforms, including mandatory health insurance, were meant to
deflect socialism, not enact it.
Bismarck harbored the conservative notion of government’s limited
role, providing a safety net for the needy. “The actual complaint of
the worker,’’ he said, “is the insecurity of his existence; he is
unsure if he will always have work, he is unsure if he will always be
healthy and he can predict that he will reach old age and be unable
to
work.’’ He stiff-armed those who confused concern for such people
with
socialism. “Call it socialism or whatever you like,’’ he said.
Would a German-style system work here? Whether it’s constitutional to
require that all Americans have health insurance may have to be
thrashed out in court. Philosophically, though, the libertarian
argument - in a free country, we shouldn’t force people to buy
something they don’t want - deserves a two-word Bismarckian retort:
national security.According to the Kaiser Foundation’s Commission on
Medicaid and the Uninsured, people without insurance are less likely
to get preventive care than the insured and “are more likely to be
hospitalized for avoidable health problems and experience declines in
their overall health.’’ If many Americans were sickened by terrorist
tampering with, say, our water supply, we’d all agree that protecting
them from that preventable attack was a matter of national security.
Protecting them from preventable illness, and its potentially ruinous
financial consequences, is as well.
2009 isn’t 1883, of course. Bismarck’s law mandated coverage only for
certain low-income workers. Today, with expanded coverage, Germany
wrestles with escalating health care costs - as do we and all
industrialized nations, including those with single-payer systems so
beloved by liberals. That’s an argument for pursuing cost controls
that the current bills don’t include. It’s not a good argument for
inaction.
Our reform may include a public plan to compete with private ones - a
bane to many conservatives. But even the Democratic House could
muster
votes only for a neutered public option. It’s possible, as Cornell
economist Robert Frank argues, that passing reform will bring the
conservative, and valid, ideal of price-cutting competition to
American health care. Frank reasons that insuring millions of
additional people will only ratchet up the pressure to curb costs by
emulating the United States’ most efficient health care providers,
like the Mayo Clinic - plans that operate their own hospitals and put
doctors on salary, rather than pay them for every test and procedure
they order, regardless of medical value.
Indeed, one major difference between German health care and our
system, including the reform proposals, is that their insurers, while
private, are non-profit. Germans are happy with their system, and why
not? Care is excellent, while premiums and administrative costs are
well below ours. German doctors do complain about being underpaid.
Still, they’re making a solid middle-class living, as a report on
“Frontline’’ about different health care systems noted earlier this
year.
The health care reforms before Congress aren’t perfect. But they
clearly aren’t socialist. Conservatives who insist otherwise share
something with liberals who insist that only single-payer systems can
work. Both should have stayed awake during high school history class.
Rich Barlow is a freelance writer from Cambridge.