From Kaisercare to Hillarycare

If you happen to have been a reader of The Times in 1918, you’d probably be terrified to see the German-speaking Arnold Schwarzenegger linked to anything having to do with healthcare reform. Of course, times change, and so has the paper’s editorial stance on healthcare reform. In 1918 -- the earliest year in which The Times addressed healthcare reform -- any semblance of government insurance on the state or national level prompted warnings of creeping toward that hideous German autocracy our boys were fighting in Europe during World War I. At that time, California voters were asked to consider a state constitutional amendment (which ultimately failed) that would have instituted a form of universal healthcare -- or “compulsory insurance,” as the paper would unflatteringly call it for decades.

A few decades and a World War later, Times editors were again forced to consider healthcare reform, thanks to Republican Gov. Earl Warren’s proposal for state insurance during the 1940s. The paper, closely linked to the Republican Party at the time, was rhetorically cautious in its opposition to Warren’s healthcare plan -- a behavior it didn’t extend to Democratic President Truman when he unveiled a Warren-esque plan for the country in 1945. Both plans ultimately failed, but that didn’t stop The Times from persistently advocating against “socialized medicine” and singing the praises of private -- or “voluntary” -- insurance throughout the 1950s. True to form, The Times opposed President Johnson’s Medicare up to and beyond its passage in 1965.

By the 1970s, however, Times editorials sang a radically different tune on healthcare -- a position the paper held through President Clinton’s failed attempt to overhaul insurance in the 1990s.

So how did a newspaper that suffered from Hun fever almost a century ago creep toward the reform-minded stance of the ‘90s and today? Let the editorials speak for themselves -- all in Original Spelling and Grammar ®, of course.

January 19, 1918
COMPULSORY SOCIAL INSURANCE -- AN OUTRAGEOUS SCHEME FOR GRAFT ()

German paternalism under the form of compulsory health insurance is attempting to fasten itself on the labor and industry of California. A complete scheme of compulsory social insurance, as it is enforced in Prussia under the Hohenzollerns, is embodied in a constitutional amendment which will appear on the ballot for ratification in the November election. Of course it is presented in California first. Whenever an imported device of doubtful value comes to this country it is shoved through the California Legislature …

President Lott of the United States Casualty Company must have had California in mind when he said … “Compulsory social insurance is the latest advertisement of the reformer for revenue only, the latest device of some politicians who shine as philanthropists – while someone else pays for the lustre; both of whom are being aided by certain eminently respectable and altogether praiseworthy citizens.

The Times’ Hun-howling doesn’t ease up a few months later.

March 2, 1918
REVOLUTIONARY INSURANCE ()

For the past five or six years the subject of compulsory health (or sickness) insurance for wage-earners receiving less than $1200 per annum, has been discussed and agitated by sociologists and welfare workers of the United States …

Germany has been developing this system for nearly thirty years. The Imperial Insurance Commission has become one of the most important autocratic actors in German industrial life, and, indeed, in the political administration of German affairs. The system was inaugurated by Bismarck with the avowed purpose of saving workingmen from the influence of democracy. The cleverness of his politics has been amply proved by events -- there can be no question that the working of the state managed indemnity system has become one of the strong holds of autocracy upon the people, in fact, a GIGANTIC POLITICAL MACHINE, operated by the Kaiser’s boss politicians …

At any rate, voters should inform themselves before they decide to venture into the most far-reaching and revolutionary piece of legislation ever proposed in this country. Democracy itself is in the balance -- Autocracy and Bismarckian Paternalism are at the door.

Fast-forward to 1944, and Times editors were obviously thrown a curveball by a Republican governor displaying his liberal leanings by sending the Legislature a plan for state-administered health insurance. Note the editorialese tip-toeing statement, “His proposal raises questions that need mature consideration.” (Translation: We’re not sure of our position yet.)

Dec. 31, 1944
Gov. Warren Revives Health Insurance Proposal ()

In his proposal that the incoming Legislature provide a system of compulsory health insurance in California, Gov. Warren revives a place which, in principle, has been rejected at three recent sessions at Sacramento.

In announcing that he will sponsor a measure calling for prepaid medical care through a system of pay-roll taxation, the Governor emphasizes that he is not for State medicine, stressing the difference between his proposal and any scheme to put the doctors on a State pay roll or “pay for the medical and hospital expenses of the people out of public funds.” …

His proposal raises questions that need mature consideration. One is whether action is presently desirable in the face of the many uncertainties facinf the State economy in the coming transition to peace. Pay roll and other taxes already are nearing the point where they may handicap the efforts to provide a high level of wages and employment in the postwar years. Any tax-supported system of compulsory benefits tends toward political controlled paternalism and, in this case, is likely to meet with opposition from the younger groups of workers who, less in need of medical care, believe that health insurance should be on a voluntary basis.

The question needs more study that it has had and the Governor does well to provide extra time for it.

Later, the paper inches closer to opposing Warren.

Jan. 9, 1945
Gov. Warren’s Message to the Legislature ()

Health insurance is a complicated problem on which much has been said and much remains to be said, pro and con. There are at least two serious practical objections to the Governor’s program: first, that it is proposed to finance it by pay-roll taxes, which would increase the cost of production in California and put the manufacturing plants of this State at a competitive disadvantage with those of other States; and second, that California does not have enough physicians at present to carry it out, nor any possibility of increasing its medical roster under war-time conditions.

A few months later, The Times displays more skepticism of Warren’s tax-funded plan, calling on private doctors and other medical professionals to dissuade the public from government insurance and make their case for a better plan.

April 5, 1945
Report on Health Insurance Bills ()

… If the Legislature can evolve some plan to further the voluntary movement it might prove constructive. Every effort should be made to accomplish the desired objectives on a voluntary basis before resort to compulsory methods …

Even with provision that a compulsory health insurance pay roll tax measure would not be placed in effect during the war, the uncertainties surrounding the coming reconversion period in California do not make this a good time to launch such an experiment. Such a measure with its far-reaching social and economic implications should be subjected to thorough study before the Legislature attempts to pass on it.

Meantime the medical profession has an opportunity to exert more leadership and progressiveness than has marked it in the past in helping to solve this complex problem. Particularly in the field of health education, the doctors can an should exert a greater community influence in formulating community health programs designed to instruct people how to preserve health and to acquaint them with facilities available to them in case of illness.

Enter Democrat Truman and his national plan, and The Times lays out its position with more punch.

July 20, 1945
The Doctors’ Voluntary Health Plan for Nation ()

Now the physicians of the nation have advanced their own voluntary health insurance plan.

It is frankly an effort to forestall government action for socialization of medicine …

The public must be convinced that voluntary health insurance is better than regimentation.

And it must not be forgotten that socialized medicine is being advocated most vigorously by certain political elements who continually are conducting an all-out campaign for regimentation of this entire nation. These elements will not rest a minute. They have some sincere converts to their belief, but many of them are motivated by selfish aims …

Now the lines have been drawn.

The Family Physician vs. the Government Doctor.

In the final analysis the public must make its choice.

Four years later, with Truman still pressing his case, The Times forcefully articulates its anti-tax reasons for opposing the president.

May 1, 1949
The Complete Social Security ()

President Truman’s colossal social security program is not in the Congressional worlds. “Social Security” is used here in the broad sense -- in the cradle-to-grave sense of government assistance to almost everybody. The President outlined his program last January, and the with introduction of the health insurance legislation last Monday, all of the proposals are pending in bills which would provide the following things:

1 -- More old-age and survivor insurance for more people, with higher benefits.
2 -- Temporary disability insurance for workers sick or injured for more than seven days but not more than 26 weeks.
3 -- Permanent disability insurance for workers found incapable in any “substantially gainful work.”
4 -- Health insurance for 120,000,000 Americans.

Almost everybody would draw some benefit from this program at one time or another in his life -- and everybody would pay for it …

Overtaxation does not kill suddenly; the symptoms are not clear. It is an insidious disease, like cancer, and when its damage is discovered, it is usually too late to accomplish a cure. Meanwhile the patient suffers no pain, but rather an exhilaration; he usually has the delusion that he is getting something for nothing -- or very little.

That same year, the paper finally admits its opposition, in plain English, to Republican Warren’s plan.

March 20, 1949
Gov. Warren’s Health Plan ()

Upon careful study of Gov. Earl Warren’s program for a prepaid health service in California, and following discussions both with proponents and opponents of the plan, The Times, recognizing the sincerity of the Governor’s position and the worth-while objectives he seeks, nevertheless finds itself unalterably opposed to the basic principle involved -- compulsory insurance.

Somewhere a line must be drawn between responsibility of the individual and of government. Eventually America must choose between a free society and a regimented society …

In 1965, The Times laments the coming passage of Johnson’s Medicare program by warning of vast welfare programs to come.

April 12, 1965
Vote for Medicare Opens a New Era ()

The overwhelming House vote for a vast federal plan of medical insurance for the aged marks the ends of one era on the American domestic scene, and the beginning of another.

Always before Congress has rejected health insurance legislation for fear of embarking down a one-way street to socialized medicine.

Now the House has taken the plunge, and Senate approval appears only a matter of time …

President Johnson, as the prime mover behind this legislation, has the responsibility now for resisting any pressures to extend the medicare provisions to the other age groups …

The experience of European countries indicates that we are letting ourselves in for back-breaking tax burdens unless restrain is used on this new program.

In a way, the following editorial from 1971 fulfills The Times’ prediction of a paradigm shift to expansive government programs being taken for granted. It took The Times just six years to pull an about-face on a position it had held for almost five decades. The paper does, however, resign itself to its new stance more than taking up the mantle of national insurance.

February 22, 1971
Improve Health Care -- but How? ()

This year or next, Congress will almost certainly enact a comprehensive medical insurance plan to provide coverage for almost everyone in the country, along with supporting programs for improving the nation’s health care system

President Nixon has submitted his proposals for reorganization, Sen. Edward M. Kennedy and others have offered theirs. There is not argument about the need for reforms; everyone agrees our present system is unsatisfactory. Rather the debate will be on the scope and methods of change …

We all know what we want: better and more readily available health care at a reasonable cost. What remains to be decided is, as Henry James said, “the dear, deadly little question of how to do it.”

Less than three years later, The Times is more comfortable with its position, this time encouraging action instead of merely acknowledging the inevitability of reform.

Oct. 8, 1973
The Sad State of Health Insurance ()

The national health insurance plan introduced the other day by Sen. Russell B. Long (D-La.) and 13 other influential senators may or may not be the best answer to this country’s creeping health care crisis. If its introduction does nothing more than stir the Nixon Administration and House leaders out of lethargy, however, it will be a real public service.

Two years ago national health insurance -- covering not just poor people and old people but all of us -- looked like an idea whose time had come. The question had become not whether such a program was needed but what kind.

With The Times firmly ensconced in the reform-minded camp, the paper welcomes Bill and Hillary Clinton’s push for universal care.

Jan 27, 1993
Health Care Sent to Surgery

Health care costs are eating up a record 14% of the gross domestic product. That means the United States spends more on health care than any other industrialized nation--yet in one key health indicator, preventing infant death, it has slipped to a dismal 19th in the world. Thirty-seven million Americans have no health insurance. Thus Clinton must get a grip on runaway health costs if there is to be any hope of managing the nation’s budget.

There are big political risks for Clinton in putting the First Lady in charge of the team seeking to devise a health care proposal within three months. Yes, it shows he’s serious, but if the plan falls short, both of the Clintons will have to be prepared, to put it mildly, to take the heat. And if it falls short, questions will be raised about the wisdom of putting the President’s wife, an attorney not known as a health care expert, in charge of so crucial a project.

But those possibilities pale in comparison to the certain disaster that awaits if Clinton does not stick to his campaign promise to tend to the economy and overhaul the health care system. It’s a job almost as tough as curing the common cold. Here’s hoping the Clintons can offer the nation’s ailing health care system something at least as good as chicken soup.