A Short History of the Affordable
When the affordable care act was being argued the
first time by the Supreme Court, the arguments concerned the
constitutionality of the “mandate.” Pundits everywhere pointed to
George Washington’s mandate that every able bodied citizen keep a
weapon and ammunition ready.
This was known as the Second Militia Act of 1792.
It first had to pass the House and then the Senate and was signed
into law by George Washington. Here is part of its text:
"That every citizen, so enrolled and notified, shall,
within six months thereafter, provide himself with a good
musket or firelock, a sufficient bayonet and belt, two spare
flints, and a knapsack, a pouch, with a box therein, to
contain not less than twenty four cartridges, suited to the
bore of his musket or firelock, each cartridge to contain a
proper quantity of powder and ball; or with a good rifle,
knapsack, shot-pouch, and powder-horn, twenty balls suited
to the bore of his rifle, and a quarter of a pound of
powder; and shall appear so armed, accoutred and provided,
when called out to exercise or into service..." [http://healthcarereform.procon.org/view.resource.php?resourceID=004740]
The argument was nearly as old as our country; that “the
nation's founders" had no problem requiring citizens to enter into
“‘George Washington thought that a purchase
mandate was OK,’ says Ian Millhiser, a legal policy analyst at the
liberal Center for American Progress.”
We have found our precedent: a mandate requiring citizens
to “purchase” something. What all the pundits missed, apparently,
was that two years previous to this act, there had been another
mandate that is even more apropos of our health care debate: Congress
had mandated that
ship owners buy health insurance for their seamen. Again, it was
signed by George Washington, the Father of our Country. [GEORGE
WASHINGTON SIGNED THE FIRST HEALTH INSURANCE MANDATE!]
So as you can see, the Affordable Care Act finds
its roots way back in the early history of this country.
I am quite sure everyone has heard the phrase
“legislating from the bench.” This is when judges choose capriciously
(at least to those who disagree with the decision) to support a law
which others might not find constitutional.
When up for Senate confirmation, we often hear
Supreme Court candidates use the term “stare decisis,” a legal term
meaning that person will make his/her determination according to
“precedent.” If it happened previously, then he/she must go along
with it in new cases she/he rules on. “Legislating from the bench”
ignores (or seemingly ignores) precedent and is a political decision
that people agree with or disagree with along political lines.
Chief Justice Roberts, in his decision (the first
time the ACA came before his court), chose the
precedence of “taxation” over all these other arguments. Since the
government has a right to tax (it’s in the Constitution) he chose to
call the mandate a tax.
From Our History of Medicine Pages
So now we know that our health care mandate goes
all the way back to 1790. Health care in the US, back in those early
days, was not expensive. Nobody filed bankruptcy over health care
bills. In the year 2000, half of all bankruptcies involved health
Keeping in mind that the Affordable Care
Act is a “free market” solution, back in the early 1800s the free
market kept health care costs down. If you’ve not read our History
of Medicine pages, I can point out, briefly, that in “The
History of Medicine – The Revolutionary War,” (where
we acknowledge our
beloved president George Washington is killed by his physicians) that one of the signers of the Declaration of Independence, Dr
Benjamin Rush, warned us about health care freedom back then:
"The Constitution of this Republic should
make special provision for medical freedom. To restrict the
art of healing to one class will constitute the Bastille of
medical science. All such laws are un-American and
despotic." He went on to say: " Unless we put medical
freedom into the constitution the time will come when
medicine will organize into an undercover dictatorship and
force people who wish doctors and treatment of their own
choice to submit to only what the dictating outfit offers."
In our article “The
History of Medicine – 1800 – 1850,”
you’ll learn one reason the American Medical Association formed was that
medical doctors were going broke having to compete with homeopaths,
Native herbalism, and midwives. Then in the early 1900s, the Flexner
Report came out (a subject I had planned to cover years ago but…)
and the birth of modern medicine in America took off wiping out
herbalists, homeopaths, and medical schools that admitted women and
blacks. (A few black medical schools were allowed to stay open since
many white doctors didn’t like having to treat black patients.)
Today, we have the dystopia Dr Rush warned us
about. With a monopoly on the medical field, the cost of medicine
rose over the years and people have been calling for health care reform for nearly one
As you can see from the article published in the
NY Times, “a compulsory health insurance system” was being called
for way back then. In fact, Teddy Roosevelt called for health care
reform even earlier.
But it was right about this time, our entry into
WWI, that there started quite a bit of blowback about “universal
Remember that we just told you that one of
the reasons the AMA was formed was because doctors were having
trouble making a living. With the advent of WWI and the world
suddenly being overwhelmingly aware of Bolshevism, and the AMA
promulgated enough anti-communist rhetoric to kill off any chance of
universal health care for years to come. In fact, Roosevelt had
wanted to include universal health care in the New Deal but the
AMA fought back so hard that he pulled it out thinking it would
destroy the chances of Social Security ever passing. [A
Brief History: Universal Health Care Efforts in the US]
Every president since Roosevelt spoke about
health care for the American people. The opposition always won.
WWII the term “socialized medicine,” with all the “communist”
associations of that era, was used by opposition to any and all
health care reform
Ronald Reagan Speaks Out Against Socialized
Reagan helped sell a lot of things back then,
including cigarettes and Boraxo.
As previously stated, since WWI, opposition to health care reform got
a lot of mileage from their anti-socialism, anti-communism campaigns,
but it was at this time that a very
powerful grass-roots movement, pushing to get health care to our
aging population, made so
much noise that the AMA could not counter it with the usual
arguments using the big "isms" or that that “the government was coming between you and your
doctor” [the same argument we heard all through the ACA debates]. They were
eventually cornered into creating their own plan called “Eldercare,”
which, under LBJ, eventually became the bipartisan Medicare bill.
Until the ACA, in 1965, when LBJ signed
Medicare/Medicaid bill into law, this was the greatest progress made
to date in the struggle for universal health care. A few changes to
enhance the programs have been made over the years, but mostly,
those opposed to health care for the people (and huge profits for
providers) have been slowly chipping away at the system. In fact,
one recent change has crippled the entire system with introduction
of Medicare Part D, which was a huge and expensive giveaway to the
pharmaceutical industry. Many critics have said that it was aptly
named because that’s the “grade” they would have given it: D.
Following LBJ’s Medicare Bill,
President Nixon signed into law the federal HMO Act
in 1973, which he told
the American public would expand access to health care. However, the
“White House Tapes” show a different story. In secret talks between
Nixon, John Erlichman, and Edgar Kaiser, we learn “how Kaiser has
manipulated our government and the public into believing an
untruth. It appears that President Nixon knowing full well that
Kaiser was not being honest with their presentation of the HMO
thought he was using this to his advantage. Unfortunately it has
taken decades for this to become public knowledge which is a shame.
President Nixon knew from the time of this conversation that Kaiser
was for-profit and he also knew that they are able to profit because
the incentives are toward less medical care, because—the less care
they give them, the more money they make." -
Mr. Erlichman quoting Edgar Kaiser to President Nixon on February
17, 1971.” [The
And today we know that “managed care” was exactly
that: less care and more profit.
In 1974, Nixon became another president to
propose a “mandate.” You see, at that time, many of the problems
facing President Nixon were the same problems facing President
- Insurance did not cover preventive care
- Families and individuals without adequate care could go bankrupt
over medical bills
- The system was wasteful and inefficient, constantly inflating
medical costs that were passed on to the consumer.
Thus much of what Nixon proposed eventually ended up in the ACA.
You can read Nixon’s speech here:
Nixon’s Plan For Health Reform, In
His Own Words. Nixon’s troubles and
resignation put a quick end to these plans and his mandate, but the
mandate did not die.
The next great push for health care reform came under President
Bill Clinton when he put his wife, Hillary in charge of designing
it. It was in this process that Hillary learned all about partisan
politics because, like most of us, she was shocked to find out that
anyone would come out against health care reform. The entire
industrialized world all had health care; all of them, except us.
The fact is, there is only one ostensible reason anyone would be
against health care reform or universal health care, and that is
money. If it’s going to cost you money or lose you money, you’re
going to fight it. The insurance companies, AMA, private physicians,
and HMOs all came out to fight universal health care. However, there
was one more reason to fight universal health care: politics. One party did not want to see the other party succeed.
William Kristol headed up the push that led to the destruction
of the Clintons’ health care plan. You might remember Kristol as one
of the people who was wrong on just about everything concerning our
invasion of Iraq. Kristol sent memos to the minority party (at that
time) often. Here is one of them entitled: "Defeating President
Clinton's Healthcare Proposal" 12/93
The long-term political effects of a successful... health care
bill will be even worse — much worse... It will revive the
reputation of... Democrats as the generous protector of middle-class
interests. And it will at the same time strike a punishing blow
against Republican claims to defend the middle class by restraining
I hate partisan politics. This country got to be the leader of
the free world by people working together, not against each other.
Yes, there were problems with the Clinton plan, but there are
problems with every health care plan. The biggest problem of them
all, however, is NO health care at all.
Millions of Americans are just a pink slip away from losing their
health insurance, and one serious illness away from losing all their
savings. Millions more are locked into the jobs they have now just
because they or someone in their family has once been sick and they
have what is called the preexisting
condition. And on any given day, over 37 million Americans—most of
them working people and their little children—have no health
insurance at all. And in spite of all this, our medical bills are
growing at over twice the rate of inflation, and the United States
spends over a third more of its income on health care than any other
nation on Earth. [Bill
Clinton’s health care speech to a joint session of Congress on
September 22, 1993]
Opponents spent upwards of $50 million to fight the Clinton
health care plan.
To counter HillaryCare, the Republicans
brought into the conversation something the
Heritage Foundation (a right-wing think tank) came up with, and as
we’ve seen already, they were neither the first nor the last to
suggest it: the individual mandate. [Original
1989 document where Heritage Foundation created Obamacare’s
At this time, a “free market” solution was preferable to
“government control of health care” which HillaryCare wasn’t. But
the truth has never stood in the way of a good story, and the people
soon believed that HillaryCare would destroy the planet, give
everyone tooth decay, and turn all your gold jewelry into brass
(exaggerating, but what the people believe and what actually is are
oftentimes universes away from each other). Opponents spent
somewhere between $14 and $20 million on these cute Harry & Louise
anti-HillaryCare television commercials that beat the American
public over the head with this phrase: When we let the government
choose, we lose.
Here is a great (cute) compilation of these ads contrasted with the
I was going to give a short history of the individual mandate (as
we’ve already discussed above), but I found a lovely site with all
that right here:
History of the Individual Health
Insurance Mandate, 1989-2010
The opposition won. The American public lost. However, the
biggest winner in this whole thing was the phrase: "Big Government."
It’s a totally meaningless phrase, and I’ll show
you why, but meaningless phrases exist all around us. "Support The
Troops" is a meaningless phrase because it says nothing about our
policy of murdering and maiming innocent men, women, and children in
a country that was never a threat to us. Everyone supports the
troops. Not everyone supported invading Iraq. Today even fewer
people support it. Everyone supports the troops, but it's veterans
who saw their hospital budgets cut at the same time that veteran
suicide rates rose to the highest point in our history. [And today
(7/20/15) I just read in the news that female veteran suicide rates
are just as high today as the men's rates.] "Support the troops" is
meaningless and empty.
The phrase “Big Government” won big, ended the Clinton plan
forever, and ushered in the first completely Republican Congress
since the mid-fifties, who gained popular support with their “Big
I call it BS because historically, those who claim government
is too big and that government is
the problem have always been the same ideologues who've grown the
government bigger, making it a problem; A self-fulfilling prophecy
based upon the partisan politics that I despise so richly.
In partisan politics, one side will always blame the other side
for what it (the calling side) is doing. It’s a lot like the
Freudian concept that states we hate traits in others because we
first see them in ourselves.
So, as a minor digression, let’s take a look at the two battling
One says government is the problem, hates big government, hates
regulation, and hates spending.
The other says that government is the solution, loves to grow the
government, establish regulation, and loves spending. They are the
“tax and spend” party.
Hates Big Government
Loves Big Government
Took Office 1981, total debt: $1
Took Office 1993, total debt $4.8 trillion
Left Office 1989 , total debt: $2,9
Left Office 2001, total debt $5.7 trillion
The main point her is this: "Big Government" is an empty, meaningless phrase.
I'm not about to start a fight with anyone right
now because I know some people will have all sorts
of arguments to explain the discrepancy above, but that is what
partisan politics is all about: arguing minutia. Let's just end this
with a little sign that was on Harry Truman's desk: "The buck stops here."
If we could rid ourselves of partisan politics, there would be no
big government or small government but rather: Good Government or
government that serves the people.
Who Created The Affordable Care Act
Some have claimed that Nixon created the Affordable Care Act.
Close, but nope. Some claim the Heritage Foundation created it.
Again, close, but nope. Some have
said that RomneyCare is ObamaCare. Really close, but nope. Sure, the ACA (Obamacare)
was designed after
Commonwealth Care (RomneyCare) as Roberts mentioned in his latest
ruling, but there are minor differences.
And keep in mind that how the ACA was originally designed has
very little to do with what it turned into. For one thing, it was
designed after they took Single Payer off the table.
We often hear that Obama had a super-majority (60 votes), so he
could have done everything he wanted to do. In a perfect world,
maybe, but not in reality. Someone got to Joe Lieberman and he
refused to vote for anything unless Single Payer was off the table,
so suddenly 60 votes turned to 59 votes, and that wasn’t filibuster
It doesn’t take much money to buy people in Washington. Just a
little goes a long way. This is one reason why an investment in
Washington gives a return that is greater than any investment
anywhere else in the world. This is also one reason most Americans want to get money out of politics.
We know what was proposed and how it was designed, but how it
came about is a whole nother story. The minority party at the time
had no intentions of voting for it at all, for all the wrong
They hated to see their opposition do anything for the American
public. The American public likes things done for them and
politicians who do that get more votes. And sadly, after President
Obama was elected (on the night of the inaugural ball), the
opposition got together (this is fact, not fantasy) to make sure
Obama was a one term president, and that they would stop anything he
tried to do.
As I said, it is now common knowledge about that meeting, and in
fact, Newt Gingrich actually admits it in this video:
Since President Obama was elected, the Senate has set a record in
their number of filibusters. That is another sad, partisan fact.
Many people hate the ACA because they hate Obama. This is quite
obvious in the anecdotal studies in which people were told what was
in Obamacare and then told what was in the Affordable Care Act and
people liked the ACA better than Obamacare even though they are the
exact same thing.
I hate partisan politics. This is not how my country was built,
but it sure looks like how it will be destroyed. A house divided
against itself cannot stand.
And so, we have a bill, a health care bill, that no one from the
opposition will vote for and without a Super Majority in Congress
will never pass, so what does Congress do? It asks the opposition
party to help design the health care bill.
I don’t get it. Nobody from the opposition will vote for it so
why allow them to help create it?
And we wonder why so many of the American public were against it.
Obama Steps In
Even the president doesn't mind the ACA being
called Obamacare. He was very instrumental in its design and in its
passing. He met with key members of Congress regularly to guide
them, and many of his supporters who would later say he "caved" or
that he "gave in" to corporate demands simply don't know how
politics is conducted in this world.
Obama wasn't about to see this bill fail. He was
keenly aware of the history of health care and how the industry can
kill something they don't like, so he met with leaders of the health
care and insurance industry. He negotiated deals, shook hands, and
twisted a few arms, and though some today still say he caved, he got
the job done and got a bill created that would pass in both the
House and Senate and land on his desk with no opposition from the
So for people who hate Obama, well, that's their
problem. Many continue to hate Obamacare because they hate Obama;
that is, until they need it. [Handyman who would rather go
blind than sign up for Obamacare begs for money in crowdfunding
appeal after his eyes started bleeding.]
Bring On The Detractors!
Do you remember what everyone called the Great Lie of 2009? “If
you like your doctor you can keep your doctor.”
I’ve researched this and it wasn’t much a lie at all; it was
stupid wishful thinking and it affected only around 4% of the
You see, nowhere in the ACA was it written that you would have to
change doctors. That was not anywhere in the bill.
But it was left up to the insurance companies, and when you leave
anything up to insurance companies, they will do what they can to
cut costs and raise profits. That is exactly what all businesses do,
and the ACA was a free market solution that put a lot of decisions
in the hands of business: the insurance industry. So feel free to
call it the biggest lie of the year. What really matters is if it
affected you. If it didn't, no big deal. If it did affect you or
someone you love, then it's a big deal. And though you can continue
to scream "LIAR" as loud as you can, it was the insurance companies
that took away your doctor, not the ACA.
The ACA was inevitable. It had the votes, it was going through,
but it was attacked as if it was a plane full of suicide bombers.
Being a journalist, I like to get the facts straight.
attacks on Obamacare/ACA were ridiculous, wishful thinking at best, but
mostly nowhere close to the truth:
Healthy people won’t sign up
You won’t be able to choose your plan
Government control of health care
A politician will come between you and your doctor
It will explode the federal deficit
Premiums will shoot through the roof
Jobs will be lost
And they even continue on today. Sure, it’s not perfect. We
really needed single payer or a public option (Medicare for all).
And while everyone focused on “If you like your
doctor . . .." they seemed to be oblivious to the biggest lie of them all
told by 90% of the media: "A majority
of Americans were/are against it (still today)."
This is where the manipulation of statistics
comes in, so pay attention. For example, because I
prefer single payer, I’m listed as being against the ACA. So
everyone who wanted Single Payer or a Public Option is listed as
being against the ACA. They are not against the ACA; they wanted more,
but they are willing to start with the ACA. It's quite simple.
People are not against something that doesn't turn out as good as
they had wanted. The American people got "something" and that
something will save thousands of lives.
Congress has voted over 50 times to kill the ACA. This was a
total waste of money by the party that proudly waves the flag of
fiscal responsibility. It was a waste of time and money when
they could actually be doing something of consequence (like funding
the repair of our infrastructure) and a truly laughable waste of
energy since the
President would have to sign that piece of legislation.
Before the Supreme Court
Twice it’s been before the Supreme Court. The first time for the
mandate and had an outcome few could have predicted. Justice Roberts
gave the deciding vote, calling the mandate a tax.
Many conservatives cried out that Roberts was a traitor to
conservatives, but few people realize just who Justice Roberts is
and know little about his record. When he was up for Senate confirmation, I took a
look into his record. When a person fighting a corporation came
before his court, you could bet the bank that he would rule in favor
of the corporation.
When the mandate was up before the Supreme Court, Justice Roberts
followed suit. He did not rule in favor of the people. He ruled in
favor of the insurance industry (corporations) and their profits
shot up the very next day.
The second time, this most recent time, the ACA went before the
Supreme Court because of a “writing” error in the bill. This error
could have been fixed quite simply by Congress sitting down and
re-writing the things that had been written in error. And, with the
majority of Americans now on the side of the ACA because it has
helped some 17 million of them, many who have been fighting it since
it first passed were secretly wishing the court would not kill it,
because they didn’t have an alternative plan and their constituents
love their health care.
And this time, Justice Robert was also the deciding vote, making
the most logical decision I’ve ever seen from the Supreme Court: he
voted for the “intent” of the bill, not the logic or illogic of the
writing. And again, the very next day, insurance companies’ stocks
shot up on Wall Street.
And still there are those in Congress who are
working to destroy it by trying to kill the Medical Device Excise
Tax. Killing it, of course, would a give-away to the industry. It would save
them billions. So why not
The Medical Device Excise Tax is helping to pay for the ACA and keep costs down.
So, I’m going to have to conclude this here saying: It’s not
perfect. We truly need a “public option” or single payer. People
everywhere point to the health care systems around the world and find fault with the best of them, but aren’t we America? Aren’t we
the country that is supposed to do things better than all those
No, it’s not perfect, but it’s health care and it’s a start.
The Present State of the ACA
More people are insured right now than have ever been in America.
According to Gallup, the uninsured rate has dropped to its lowest point in recent history. In just January of this year,
9.5 million signed up.
Premiums have come down. Of course they would because this is a
free market solution in which insurance companies are not allowed to
fix prices, thus they must compete for our business and prices come
It has created jobs. According to
Forbes, by June of 2014, nearly a million new jobs opened
up in the health care industry, and in the last year alone, 408,000
new jobs have opened up because of the ACA.
The overall costs of the ACA, which we were told would bankrupt
our nation, are down and the CBO (congressional budget office [non
partisan]) says costs are now 11% less (over the next 10 years) than
what they predicted just last January. [Obamacare’s
projected cost falls due to lower premiums under health care law,
The only death panels so far have been in Arizona, where bureaucrats
have determined who gets organ transplants and who doesn’t, but
is a statistic that should open your eyes widely:
A Matter of Priorities or The Real Cost
of Not Having Health Care
The US has spent $500 million per victim of foreign terrorist
attacks, but less than $10,000 per person with cancer.
Your odds of being killed by a foreign terrorist are less than
your odds of being killed by lightning, yet states are refusing to
extend Medicare to their people and causing between 7,000 and
17,000 fellow Americans to die early deaths.
Is that logical? or fiscally responsible? or
Do you really understand that? Do you see the disconnect? We’re
spending trillions of dollars on our military to protect our people
(supposedly) but we’re not extending Medicare (costing the state
nothing initially) to protect our people and save the lives of 7 to 17 thousand Americans.
This is from January of 2014, and these states have left nearly 8
million Americans uninsured, but you can bet that all of those
states have people in Washington who are giving away your money to
the military industrial complex to protect us from … terrorism.
And refusing to extend Medicare to its people is NOT about saving
In Texas, not extending Medicare
has cost them $5.5 million. Not
extending Medicare to the people is a political move only, one which
most of us don’t understand, but somehow someone sees political
benefit in it.
The real terrorism in America is that we let our people in
Washington get rich while they make their friends rich while slowly
killing off their constituents while pretending that terrorists are
the problem. (Now that’s a mouthful.)
So, do you really think the ACA is a “train wreck?”
Lowest uninsured rate in 40 years
Lowest Health Care Inflation rate in 50 years
Reduced deficit because it’s $300 billion cheaper than expected.
Sure, it’s not perfect, but it is saving lives and we all need to
focus on the real problems in this country instead of letting
Washington and the media scare us into fighting ghosts.
Or look at it this way:
Worldwide Causes of Death (2010 stats):
64% chronic illness
16% infectious disease
4% water (polluted)
That leaves 4% for all those other things killing us, including
terrorism, which is around .011%. How much money have we budgeted
for chronic illness? Or for infectious disease? Or for hunger? Or
for cleaning up and delivering safe water?
Yet we put billions and billions and billions into our bloated
military budget to battle over .011% of deaths due to terrorism.
But states won’t extend Medicare to save American lives, even
though it costs them nothing up front.
This is not a situation that makes people proud.