Why Centralized Health Care Failed (Aka; How I Learned To Hate The System)

Why Centralized Health Care Failed (AKA; How I learned to Hate the System)

An old woman wakes up to the sound of coughing next to her. Her husband has been sick for weeks now, and his raspy wet choking seems to be only getting worse. She tries to go back to sleep, but she can't; her thoughts are filled with uncertainty and fear; they have no insurance, and they cannot afford to go to the hospital.

This is just one casualty of America's war with itself over Health care. As of this writing, American's health care system is a mess. Millions of American's currently live without health insurance, doctors seemed to be swamped with bureaucracy, and health care costs throughout the nation are skyrocketing out of control.

The reasoning behind the continued existence of this failed American health care enterprise is simple and disgusting; America has slowly chosen to enact governmental policies in order to protect us from ourselves. It is these systematic "checks and balances", along with a heavy involvement in corruption, which have effectively doomed centralized health care in America.

The Clinton Years

The early 90's was a time of fundamental change within governmental power in America which began when the Democratic party gained control of the presidency. Elected after a 1992 campaign promising health care reform, President Bill Clinton seemed to be the magic bullet to make universal health care in America a reality.

President Clinton's service in office saw two proposals which pose a great significance to health care. One, a broadly implemented health care reform package in 1993, and the 1996 Welfare Reform Act.

In 1993, Bill Clinton's administration proposed a significant health care reform package. Announced by President Clinton in an address to Congress on September 22, 1993, the package was anything but simple; running more than 1,000 pages.

The core elements of the reform bill consisted of both a belief in simplicity and business practice. By creating a universal insurance form, the Clinton administration hoped to simplify and reduce many of the bureaucratic costs associated with hospital expenses. Business wise, Clinton's proposal included an enforced mandate for employers to provide health insurance coverage to all of their employees through competitive but closely-regulated health maintenance organizations (HMOs). At its introduction, the plan seemed likely to pass through the Democratic-controlled Congress, After all, the bill was originally intended to be a bi-partisan effort. However, Conservatives and the insurance industry staged an effective and well-organized campaign opposing Clinton's "Health Security" plan and criticized it as being overly bureaucratic and restrictive of patient choice. The effort included extensive advertising criticizing the plan, including the famous Harry and Louise ad, which depicted a middle-class couple despairing over the plan's bureaucratic nature.

In the 1994 election, the Republican revolution gave the GOP control of both houses of Congress, ending prospects for a Clinton-sponsored health care overhaul. Comprehensive aims at achieving universal health care in the United States have not been seriously considered by Congress since.

Reeling from the defeat of their health care reform bill, in 1996, the Clinton Administration showed a renewed interest in cooperation with the GOP controlled congress and senate. The welfare reform movement reached its apex on August 22, 1996, when President Clinton signed a welfare reform bill, officially titled the Personal Responsibility and Work Opportunity and Reconciliation Act of 1996. The bill was hammered out in a compromise with the Republican-controlled Congress, and many Democrats were critical of Clinton's decision to sign the bill.

One of the the main provisions in Clinton's welfare reform bill was a time limit. Under the law, no person could receive welfare payments for more than five years, consecutive or nonconsecutive.

Another controversial change was transferring welfare to a block grant system, i.e. one in which the federal government gives states "blocks" of money, which the states then distribute under their own legislation and criteria. Some states simply kept the federal rules, but others used the money for non-welfare programs, such as subsidized childcare (to allow parents to work) or subsidized public transportation (to allow people to travel to work without owning cars).

Critics made dire predictions about the consequences of welfare reform. Many claimed that the five-year time limit was needlessly short, and that those who exceeded the limit through no fault of their own might turn to begging or crime. Others criticized the block grant system, claiming that states would not be able to administer the program properly, or would be too motivated by cost. Finally, it was claimed that although the bill might work in a booming economy like that of the 1990s, it would cause significant harm in a recession.

Supporters of the bill held that the five-year limit was a necessity, that allowing states to experiment would result in improving welfare, and that the number of people affected by the five-year limit would be small. These controversies have not been fully resolved.

The consequences of welfare reform are still being debated today. Welfare rolls dropped significantly in the years immediately after the passage of the bill. The original bill was set to expire in September of 2002; as of July, 2004, Congress had passed 7 temporary reauthorizations, generally of 3 months. Debate continues over Republican attempts to increase the