Column: Congratulations, Conservatives, You Won

The dream of Richard Nixon, Ronald Reagan, Bob Dole, Newt Gingrich and Mitt Romney has now been realized. Their solution—their idea for universal health care has been passed by both houses, signed by the president and upheld twice now by the Supreme Court. Yes, they call it Obamacare. Yes, they strangely call it socialism. But yes, it was their idea.

And now it’s here to stay.

Market-based mavens, you’ve got your way. Time for celebration! Also time to stop calling Obamacare a bill. It’s a law now. It’s been the law for four years. And it was always your law.

Passionately opposed to socialized medicine, President Reagan called for a mandatory health insurance program while governor of California. It was legislation that sounded, well, sound, but was never going to be law. It was the “abolish the Fed” position of its day.

But Reagan did supply socialized medicine to the poor. Prior to Reagan’s presidency and his signing of the Emergency Medical Treatment and Active Labor Act, people with no means to pay could be turned away at hospitals. EMTALA was an unfunded mandate that led to astronomical health care costs over the next few decades. People who couldn’t afford insurance got health care in the ER and those who could afford insurance footed the bill. Which is, you know, socialism. The solution was to have an individual mandate to purchase private health insurance. But again, that was never going to pass.

In fact for over 40 years spanning seven presidents, American health care got worse and more expensive. At this same time other industrialized nations improved upon single payer models and hybrids of private and public models. Americans’ health care system devolved into a have and have not parable: Best in the world if you have money, worse than you could imagine if you don’t.

Politicians assured us we had the best health care system in the world. With a major asterisk. In 2000, the World Health Organization ranked us as 37th in the world (Colombia was 22nd). We paid more for less. An illness could cause bankruptcy. Our health system was very unhealthy.

But then came “change.” In the original proposal by Obama, the Affordable Care Act included a public option, referred to as “Medicare you can buy into.” This public option was wildly popular with doctors and supported generally by a majority of voters. It was a perfect way of creating competition in the market place, setting a bar for private insurance companies. It was also, as noted by its opponents, an easy transition into a single payer system, putting American health care on par with the rest of the industrialized world (and most emerging countries too). But the public option died in the Senate never making it into the final law.

The public option was dead. Now in this wake of this second Supreme Court decision upholding the existing compromised ACA law, the public option is cremated, buried and gone. There’s no political will for Medicare for all. The allegedly super-liberal-commie plan is the twice-upheld-by-SCOTUS law of the land.

President Ulysses S. Grant recalled the moment he received the surrender letter from General Robert E. Lee and wrote in his memoir: “I felt like anything rather than rejoicing at the downfall of a foe who had fought so long and valiantly, and had suffered so much for a cause, though that cause was, I believe, one of the worst for which a people ever fought, and one for which there was the least excuse.”

Grant refers to slavery as the worst cause for which people have fought. Conservatives vehemently fighting against their own idea—with no actual plan for its replacement other than the exact same plan with a different name—has to be the lamest cause for which people have fought. It’s time to stop that now.

The battle is over. The public option will never happen. Take a victory lap, Republicans.

Photo by Will O’Neill