Hard To Say Who Would Be Most Likely To Kill Medicare In 2021-- Trump Or Biden-- But I'd Guess Biden

The Economist's new poll from YouGov could signal choppy waters ahead for the NRCC. Their "Socialism!!!!" campaign is-- of course-- falling flat. Well, wait; it's isn't totally falling flat. The fascist and neo-Nazi base and hate talk radio fanatics and fans of Sean Hannity and Tucker Carlson love it. But that's not moving any dials when independents and conservative Democrats just laugh it off. That's reflected in the new polling that shows a generic congressional Democrat beating a generic congressional Republican by bigger numbers than anyone has seen in quote some time. In fact 48% of respondents say they're planning to vote for a Democrat for Congress next year. Just 37% say they plan to vote for a Republican. Last year 60,572,245 voters backed Democrats and just voted for 50,861,970 Republicans-- and that wasn't 37%; it was considerably more-- 44.8%. The Republicans lost a net of 42 seats (43 if you count the empty seat they got caught stealing in North Carolina). If the 37% holds, the Republicans will lose another 50 or so seats. Just keep screeching "Socialist!!!," boys.

Medicare celebrated it's 54th anniversary on Tuesday. LBJ signed the legislation on July 30, 1965, noting that "No longer will older Americans be denied the healing miracle of modern medicine." 50 years before that reformers tried, unsuccessfully, to pass a national health insurance program through state legislatures. It wasn't until FDR and a Democratic Congress was passing the New Deal that anyone seriously tried again. In fact in 1935, the Social Security bill initially contained a single line authorizing the study of health insurance which completely flipped out the American Medical Association (AMA), which was way more right-wing than it is now and which insisted that any government health insurance plan was an existential threat to financial and clinical autonomy of physicians. Roosevelt himself, worried that the fucking doctors could jeopardize Social Security’s enactment, ordered the line removed from the Social Security Act. In 1945 Truman tried revitalizing the push for universal health insurance but conservatives of both parties, with the backing of the AMA screaming about "socialism," had the clout the kill his hopes.

At that point liberals inside the Truman administration tried getting around the Republicans and Southern Democrats by pushing health insurance strictly for the elderly, who were more likely to need more medical services and were more likely to be uninsured and had much lower incomes, but who always voted.

It was a long building process. But only about half of the elderly had insurance before Medicare was finally enacted. Progressives were successful in capitalizing on the sympathetic reputation of the elderly as a group deserving of government help and in need through no fault of their own-- and as avid voters. The conventional wisdom was that by making Medicare a universal program open to all seniors, with eligibility for benefits earned through working, it would be possible to avoid the stigma conservatives always associate with welfare and any and all government programs that are designed to serve just poor people.

At first, the proposals only included hospital insurance-- and not anything to do with physicians' services, in the hope of shutting the AMA up. The proponents weren't trying to be incrementalists; they had no choice. Even into the late '50s, the AMA and conservative politicians were still screaming "Socialism!!!" and willing to fight to the death against enactment of even a weak version of Medicare. I grew up hating doctors because of this battle and seeing them as class enemies who needed to be fought and beaten. I never trusted any of the fathers of my friends who were doctors when I was a kid.

Early in 1964, Medicare was defeated in the Southern Democrat/Republican-controlled House Ways and Means Committee. Committee Chair Wilbur Mills (D-AR), a dysfunctional drunkard, opposed it. Too bad it was 8 years later that Mills-- drunk as usual-- was in a car accident and an infamous prostitute-- Fanne Foxe-- jumped out of his car and leaped into the Tidal Basin when the police approached. That weekened Mills' power over the committee, which basically controlled all financial matters before Congress.

The 1964 landslide for LBJ gave the Democrats enough votes in Congress so that a GOP/Southern Democrat (Blue Dog). Progressives moved to pass Medicare quickly-- and a far more robust version than the compromise with the conservatives and AMA had forced them into. Insurance for physicians' services were included, a great payback for the AMA for being such dicks for so many decades.

Wilbur Mills, still chairman of the committee, even though barely a Democrat and barely able to function because of his alcoholism, was worried Medicare would be expanded into a broader national health insurance program for all Americans, something like what Bernie is trying to pass and Biden and Trump are trying to stop. Mills added Medicaid into the mix-- giving states payments to finance care for low-income residents-- and thereby derailing calls for any version of Medicare for All at the time.

Medicare has always been seen by its proponents as a beginning, not as a final, perfect objective. When you hear conservative assholes--whether any garden variety Republican or jackasses like Biden, Delaney, Bullock, Tim Ryan or Frackenlooper-- moaning about how great it is and how untouchable it should be... hey, these were the people who would have been arguing not to piss off the king in the 1770s and arguing that the slaves like their lot in the 1850s and 60s. Remember, Medicare’s focus on only insuring the elderly was a political strategy designed to secure the passage of a federal health insurance program that was expected tow keep expanding until all Americans were covered. Robert Ball, one of the Medicare strategists and head of the Social Security Administration from 1962 to 1973: "We all saw insurance for the elderly as a fallback position, which we advocated solely because it seemed to have the best chance politically... we expected Medicare to be the first step toward universal national health insurance, perhaps with ‘Kiddiecare’ as the next step."

Because of a resurgence pf conservative power-- first Reagan and then Bill Clinton-- Medicare did not expand to children and the system was always on the defense as Republicans and Biden-type Democrats constantly threatened cutbacks. Progressives have a chance again-- thanks to general abhorrence of Trump among voters. Electing a Bernie/Elizabeth Warren ticket and more progressives to Congress, means Medicare-For-All sill be the reality Medicare was designed to be from the start. A Biden victory will be the beginning of the end for Medicare as he has always favored cutbacks and given an opportunity to make it part of a "grand bargain," like the one he negotiated with Paul Ryan and MoscowMitch while he was VP.