Look, we KNOW this bill isn’t perfect, people! We KNOW that. We know. We know. We know. We know. It’s not perfect. Got it.
In fact, for us proponents of a single-payer system, it sucks.
Did I mention we know that?
But we have to get a bill passed. We clearly need to fight tooth and nail to the bitter end to get as much of what could be considered good, progressive reform in there but we simply can not back down. If we do, we’ll sit here for another damn decade with an ever-growing number of people dying every day from lack of health care and we’ll see our premiums continue to outpace inflation while the “kill the billers” smugly point to their “success”.
Well, it’s time for a short history lesson. Three of the major progressive initiatives in the 20th Century started out imperfect, too. Social security, Medicare, and Civil Rights laws were sucky at the start and got better over time.
But we had to get them passed first.
Let’s start with Social Security. From teh WikiGodsTM we learn that the original legislation passed in 1935 was Majorly Sucky:
Most women and minorities were excluded from the benefits of unemployment insurance and old age pensions. Employment definitions reflected typical white male categories and patterns. Job categories that were not covered by the act included workers in agricultural labor, domestic service, government employees, and many teachers, nurses, hospital employees, librarians, and social workers. The act also denied coverage to individuals who worked intermittently. These jobs were dominated by women and minorities. For example, women made up 90% of domestic labor in 1940 and two-thirds of all employed black women were in domestic service. Exclusions exempted nearly half the working population. Nearly two-thirds of all African Americans in the labor force, 70 to 80% in some areas in the South, and just over half of all women employed were not covered by Social Security. At the time, the NAACP protested the Social Security Act, describing it as “a sieve with holes just big enough for the majority of Negroes to fall through.
Ah, yes. That bastion of progressive reform, social security, started out not covering women. And African Americans. And farmers. And maids and butlers. And government employees. And teachers and nurses and librarians and social workers.
Guess what? It does now.
In 1939 it became Pay-As-You-Go and the Social Security Trust Fund was created along with the FICA tax. They created the Aid to Dependent Children program and began including some women. Not all women, mind you. But some women.
In 1950 domestic labor, household employees working at least two days a week for the same person, nonprofit workers and the self-employed were added.
In 1954 hotel workers, laundry workers, all agricultural workers, and state and local government employees were added.
In 1956 disability benefits were added.
In 1961 retirement at age 62 was extended to men.
In 1962 dependent husbands, widowers, and children of women were allowed to collect benefits for the first time.
In 1972 benefits were increased 20% and cost of living allowances (COLA) were implemented.
There were further improvements made in the late 70s and early 80s as well.
Is it perfect? Nope. Has it gotten better and better over the years since 1935? Hell yeah, it has.
Here’s what Jonathon Alter has said about it:
History suggests that major social policy unfolds on a continuum. The Social Security Act of 1935 disappointed liberal New Dealers because what was called “old-age insurance” covered only about half the adult population. It excluded farmhands, domestics, employees of small businesses, and most blacks. That was because FDR needed the votes of Southern Democrats, the Blue Dogs of their day. (The bill cleared the House Ways and Means Committee with only one Republican vote)…If Nancy Pelosi can’t break Rahm Emanuel’s promise to Big Pharma’s Billy Tauzin this year, she can try to break it in the future. And Tauzin will lobby for more favors as the all-important new regulations are issued. Nothing in Washington is ever set in stone.
What about Medicare?
First passed on July 30, 1965, it had issues. (A partial timeline HERE.)
In 1972 disabled persons under age 65 and those with end-stage renal disease became eligible for coverage, services were expanded to include some chiropractic services, chiropractic services, speech therapy and physical therapy. Payments to HMOs were authorized. The Supplemental Security Income (SSI) program was established for the elderly and disabled poor and SSI recipients were automatically eligible for Medicaid.
In 1982 hospice benefits were added on a temporary basis.
In 1983 most federal civilian employees became covered.
In 1984 the remaining federal employees, including President, members of Congress and federal judiciary became covered.
In 1986 hospice benefits were made permanent.
In 1988 we saw a major overhaul of Medicare benefits which was aimed at providing coverage for catastrophic illness and prescription drugs. Additionally, coverage was added for routine mammography.
In 1989 catastrophic coverage and prescription drug coverage were repealed and coverage was added for pap smears.
There were further refinements in 1992, 1997, 1999, 2000 and 2003.
Is it perfect? Nope. Has it gotten better and better over the years since 1965. Hell yeah, it has.
And finally, we have Civil Rights legislation. That, too, has improved over time. Again, Jonathon Alter:
Similarly, the Civil Rights Act of 1957, immortalized in Robert Caro’s Master of the Senate, was weak tea. It had to be strengthened by the Civil Rights Act of 1964 and the Voting Rights Act of 1965.
And we’re still making progress vis a vis the addition of hate crimes for various groups since then.
So how does this all pertain to today’s debate about health care? Just this: those that are willing to take their ball and go home because this legislation is too far from perfect aren’t learning the lessons of progressive political history. It takes time to move the ball forward but if you don’t get the damn ball on the field, you never will.
I’m not saying we shouldn’t fight like bulldogs for the elements we want to see in the bill. We should. That’s worthy of our time and money and efforts and we should ALL be involved in that debate and fight. But to get this far and then see liberals walking away from the game demonstrates that they don’t know their history very well.
Let’s not forget the last time we tried something like this. It was in 1993 during Bill Clinton’s term. Nothing got done and it has taken us 16 years to start the ball rolling again.
It’s a cliche’ that those who do not learn history are doomed to repeat it.
It’s also very, very true.
I’m just sayin’…