30 Mar 2010

National Healthcare Passed and Repealed Before

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W. James Antle III reminds us that a complex, poorly understood national health care bill was already passed only to be repealed, decades ago.

Unlike President Obama’s recent health care handiwork, the 1988 law was a genuinely bipartisan achievement passed by lopsided margins. It was signed into law by a Republican president, Ronald Reagan. It offered all kinds of new benefits, including expanded coverage of hospital stays, at-home care, and prescription drugs (the act was in some respects of a forerunner of Medicare Part D).

The Medicare Catastrophic Coverage Act was nevertheless repealed a year later. No change in partisan control of Washington was necessary—the repeal was passed by a Democratic Congress and signed into law by another Republican president, George H.W. Bush. The repeal turned out to be most popular with the elderly voters who had demanded the new benefits in the first place.

Why? In addition to creating new benefits, the reform also imposed staggering new costs. Those costs fell most heavily on the senior citizens who were supposed to be the program’s biggest constituency. But, congressional Democrats were astonished to learn, many of these seniors were happy with their existing coverage and resented having to pay a new tax to fund this expansion of government—costs which kicked in before many of the benefits.

Sound familiar? The similarities don’t end there. Members of Congress also had to hear from angry mobs opposed to the legislation, otherwise known as their constituents. The most memorable such incident occurred on Aug. 17, 1989, when House Ways and Means Chairman Dan Rostenkowski (D-Ill.) held a meeting in his district to sell seniors on the benefits of the catastrophic coverage act.

Instead of being won over by their powerful congressman, the angry seniors waved protest signs and ran him out of the room. As Rostenkowski fled, they shouted “coward,” “recall,” and “impeach.” One elderly woman wearing heart-shaped glasses even threw herself on the hood of Rostenkowski’s car to keep him from leaving.

Rostenkowski got out of the car and tried to escape on foot. The crowd chased him for about a block before his driver came to whisk him away. Imagine what would be said if the Tea Party movement did something like that. Instead the protest was organized by one Jan Schakowsky, then director of the Illinois State Council of Senior Citizens, now a Democratic congresswoman and chief deputy whip for House Speaker Nancy Pelosi.

The protest made the national news and graced the front pages of newspapers. It also had its desired affect—the catastrophic coverage act was repealed within three months.

The 1988 legislative debacle did not resemble this year’s bill with respect to partisanship or initial public support. Democrats had no problem getting Republican votes, and the public was behind it.

However, 1988 does resemble 2010 with respect to the same kind of irresponsible drafting of a dreadfully large and complex bill that was voted into law without serious consideration of its costs and effects. It backfired then, and a lot of people would predict that the new health care bill will prove in practice similarly distressing to many of its intended beneficiaries.

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One Feedback on "National Healthcare Passed and Repealed Before"

jim campbell

Well today, it was announced by MedScape that effective April 1 Medicare cuts begin, 21%. Posted at my site. Nice work, Jim



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