Guest commentary: Health-care reform ... missed opportunity

“For of all sad words of tongue or pen, The saddest are these: ‘It might have been!’”John Greenleaf Whittier

A radio pundit recently mentioned that the idea of universal health care in the United States goes back to the 1970s. He didn’t add that it was then the project of former President Richard Nixon.

Nixon introduced his Comprehensive Health Insurance Act in 1974. In his State of the Union Address that year, Nixon said he would propose a sweeping new program that “will assure comprehensive health-insurance protection to millions of Americans who cannot obtain it or afford it.”

The legislation would build on employer-sponsored plans, and not just those in large companies, but in every company, with government subsidies (shudder) available to small businesses and the self-employed to ensure total coverage. One of the many aspects of Nixon’s plan that has relevance today was his call for tighter state regulation of insurance companies for approval of plans and rates, adequate disclosure and annual audits. Another plus: the plan would require no new taxes.

Thirty-five years later, that straightforward plan looks increasingly good against the melange of efforts by five committees in Congress. Even present-day liberal spokesmen like Paul Krugman, the Princeton Nobel Prize winner in cconomics who doesn’t hesitate to stick his stiletto into Republicans, called the Nixon plan “stronger” than current proposals. Writing in The New York Times, he goes on: “It is doubtful whether health-care reform, even if we get it — which is by no means certain — will be anywhere near as good as Nixon’s proposal, even though the Democrats control the White House and have a large congressional majority.”

Former senator Hillary Clinton’s health-care proposals during her failed campaign for the presidential nomination mirrored the Nixon plan with its foundation on the existing private-sector system, plus tax credits and government subsidies to get everyone under the umbrella. She echoed Nixon when she declared that the plan is not government-run: “There will be no new bureaucracy.”

So why didn’t it pass into law? Among powerful interests that opposed it were the American Medical Association (socialized medicine!) and especially the labor unions. Also, Nixon was up against a Democratic Congress, but in the many retrospectives on the late Sen. Edward Kennedy’s career, no skill was more highly praised than his ability to “reach across the aisle” to get important legislation passed.

This time, however, he apparently stayed in his seat on the left of the aisle. Kennedy was also lauded for his concerns and expertise in the area of health care, and indeed he had his hand in much health-care legislation — but not universal coverage.

Many of the recent rehashes of Kennedy’s career report that he declared his greatest regret was his failure to work with Nixon to craft a bipartisan approach to universal health care. I could find no confirmation of this in his posthumously published memoir, “True Compass.” In it there is no mention of the Nixon plan at all, and just half a sentence recounting that, after being abroad in 1974, he turned his attention to other matters, “health care and national health insurance, for example ... .”

Why didn’t he work with Nixon? At least part of the answer lies in scandal on both sides. Watergate was boiling over, and the Democrats smelled the opportunities to have their own way about almost anything. The unions were holding out for a single-payer plan and they, plus Kennedy, thought they would have a chance for that after the next election. However, such publications as the Boston Globe and The New York Times were raising new questions about Kennedy’s Chappaquiddick scandal of five years earlier, and Kennedy announced he would not be running for president.

Follow-up efforts at resurrecting health-care reform by presidents Gerald Ford and Jimmy Carter were feeble. It’s too bad the two leaders didn’t get together to pass Nixon’s bill. The seven subsequent presidents and 17 Congresses could have tweaked the legislation over the intervening 35 years to perfect universal health coverage based primarily on the private sector, supplemented by Medicare and Medicaid. Every American might have had decent health-care coverage today.

Huston is a retired magazine editor and writer living in Bentley Village. When Nixon’s plan was introduced he was editor of a magazine for physicians. “I ruefully admit I opposed it then,” he says. He may be reached at

© 2009 All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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