Why the U.S. has no national health system

Editor’s note: Joel Wendland-Liu is an associate professor of the integrative, religious and intercultural studies department at Grand Valley State University in the U.S.
Trump’s promise to “sign a health care plan within two weeks” in an interview back in July, which he didn’t deliver, shows that health reform remains an urgent issue for millions of Americans.
As many as 12 million workers in the U.S., since the economic collapse, do not have health insurance. Many millions more go without stable coverage or face costs so high that they often choose to go without needed medical care. As many as 50 million American workers have been out of work since the COVID-19 pandemic began in March. Most health insurance for people under 65 comes through employer-sponsored insurance benefits. When a worker loses their job, they lose their insurance benefits.
Some get coverage through other household members, through stop-gap programs, and Medicaid programs expanded under Obamacare. The cost of stop-gap plans is so high; however, they offer little benefit. And many state-based Medicaid expansions under Obamacare were blocked by Republican-dominated states that opposed it on ideological grounds.
One notable exception is Oklahoma. This year, despite Republican Party dominance, Oklahoma passed a ballot measure to Medicaid benefits to 200,000 low-income adults. A decade after Obamacare’s original passage!
For the past three-plus years as president, Republican Party leader Donald Trump has tried to dismantle Obamacare, notoriously lashing out at his allies in Congress and the Supreme Court who refused to overturn the law.
Despite Republican congressional majorities in the first two years of his term, Trump refused to act on health reform. Instead, he started a trade war with China. He shifted resources around in the Pentagon budget to build part of a wall on Mexico’s border. It remains a laughingstock monument to xenophobia.
This past week, Republicans presented their worship of Trump in the form of a substance-less national convention. The Trump worship ceremony delivered no plans, platform, or solutions to the major problems confronting the U.S. today.
Least of all did Trump or his allies present solutions to the crisis of public health and the failed health insurance mess.

Why does the U.S. allow itself to continuously fall into a health crisis where millions lose access to coverage when the economy and employment numbers dip?
A national insurance program that leaves no one out, is immune to recession, and is free of competing party squabbles makes sense.
The answer lies in the twin poisons of racism and anti-communism. As New York Times journalist Jeneen Interlandi reports, the first attempt at a federally-supported medical care system was started in the closing years of the U.S. Civil War as smallpox epidemics ravaged military camps that housed self-liberated former slaves.
Military medical professionals and abolitionist health experts built numerous hospitals and clinics. They made medical care a feature of their work in the Freedmen’s Bureau. But because these facilities served primarily black, formerly enslaved men, women and children, they were underfunded and allowed to languish into insolvency.
After the collapse of Reconstruction and the reinstallation of white supremacy in the South, white politicians habitually resisted public systems that might threaten to end racial segregation, such as public schools and public health systems.
Their influence in Congress was so powerful that in the 1940s when a bill proposing a national health insurance plan went up for a vote, President Franklin Roosevelt gave it only mild support. He relied on this bloc of southerners for some of his major policies and didn’t want to alienate them. They had written into labor and Social Security laws rules that excluded occupations such as farm labor and domestic labor from benefits of the new reforms.
Southern politicians took these steps specifically because they wanted to prevent black people from accessing the benefits of labor unions and Social Security retirement programs. They blocked the attempt at a national health insurance law for precisely the same reason.
In 1948, President Harry Truman advocated strongly for a national health insurance law. This time, the racial segregationists in Congress aligned with the Republican Party anti-communists, uniting those two issues. In this new political front against a national health system, they raved about how a national system would allow Soviet-style communism to penetrate the U.S.
Racist hatred of black people and ideological hatred of socialism fueled the political movement against a national system that makes sense. As a result, they left U.S. workers to struggle with a bloated, expensive, inefficient insurance mess for 70 years. Today, we get empty promises from Trump for fantasy laws while millions are left with only a hope they don’t get sick during a pandemic that has killed almost 180,000 of their neighbors, friends, and family members.

Cgtn.com