Since it was passed in 2009, the Patient Protection and Affordable Care Act, otherwise known as the ACA or Obamacare, has been repealed more than 50 times. Despite multiple efforts to repeal the ACA, it remains the law. In fact, according to a Quinnipiac poll according to which “56%” of Americans approve of maintaining the ACA in contrast to “17%” who support the American Health Act, the current replacement of the Republicans, some questions are starting to arise baffling (Quinnipiac), Why is there such a difference of opinion when it comes to government healthcare programs and what sowed the seeds that led to this campaign against the ACA? And are these forces the reason why the United States has never adopted a universal healthcare system like its other Western democratic counterparts? Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay The issue of universal healthcare, or access to healthcare for all citizens, usually at state expense, can be traced back to when most other nations implemented their own healthcare plans national around the 1940s. It was around this time in the 20th century that the universal health programs of Western democracies, such as the United Kingdom's National Health Service, began to take shape and capture the popular political imagination. With health insurance-focused Truman becoming president in 1945 after FDR's death, the creation of an American welfare state never seemed more likely. However, within a few years, public interest in a universal healthcare system would decline dramatically, and eventually any bill that sought to provide national health insurance would never make it out of committee, much less pass a vote of both chambers. of this drastic change can be seen in the actions of lobbying organizations and Republicans during that period. These groups have made use of common cultural fears, the political power of money, and social pressure to change the perception of a universal healthcare system in the American consciousness, ultimately dooming any major healthcare legislation from the start. These pressures from medical organizations like the AMA set the stage for the capitalist stronghold and fear tactics that are still used today to discourage healthcare legislation. As briefly mentioned above, the history of America's universal healthcare began and ended with the American population in the 1940s. President Truman, having been appointed president due to FDR's death in 1945, was intensely committed to national health insurance, but faced an uphill battle. In 1947, with Truman just two years into his first term and facing the Republican-controlled 80th Congress, he fought to get health care legislation signed into law. To make his dream a reality, Truman “appointed Oscar Ewing to head the Federal Security Agency (the precursor to the Department of Health, Education, and Welfare)” (Quadagno 2006, p. 29). Ewing's appointment as head of the FSA is where we begin to see the lobbying power of the American Medical Association and its opposition to national health insurance. The AMA had long been opposed to government action on health care, as they feared the uncertainty it would bring to the prosperous medical profession, and the AMA during this time was no different. The AMA's utter disgust with national health care was foreshadowed by Dr. Robins, a “member of theArkansas Democratic National Committee and high-level AMA official" who "warned Ewing before Senate confirmation that "the AMA might oppose Ewing's nomination if he gave" what the AMA saw as “the answer wrong” regarding health insurance (Quadagno 2006, page 29). Asked for the first time about his opinion on national health insurance during this confirmation hearing, Ewing managed to appease the AMA and obtain confirmation from the AMA. by stating that he did not know enough about the topic to oppose or be a favor of national health insurance. However, the AMA would not be satisfied with Ewing for long. With Ewing's confirmation, Truman charged him to use "all resources within the Federal Security Agency for vigorous and united action toward public understanding of the need for a national health program" (Quadagno 2006, pg 30). This mission led Ewing to create "the National Health Assembly" which Ewing hoped "would" ensure that he "[had] the people of the country with [him]" and Truman in pursuit of a government-supported goal. However, this 1948 committee remained on the friendly side of the AMA by not focusing on national health insurance and instead sought to get a read on American access to health care in general. The committee's work ultimately culminated in Ewing's writing of The Nation's Salute: a report to the president in September of that year that outlined not simply the country's health-related woes, but what Ewing saw as the best solution to solve them the population had "something approaching [to] complete insurance protection" and that, according to Ewing, national health insurance was the best solution to this problem. In his words, “the group purchasing power of people” through such a system would “help build a more effective organization to provide the best in prevention, diagnosis and treatment” and solve the problems of individuals who had a “power purchasing group of people" through such a system. problem... pay for medical treatment. And” it would create “a stable and secure financial base for health services” (Quadagno 2006, pg 30). with the National Health Assembly itself, which has not taken such a strong position on state healthcare. With the United States just emerging from the war with Nazi Germany, tensions with Communist Russia, and the British Labor Party just establishing the National Health Service, Republicans and the AMA responded to the threat of a national health program with tools of fear. and tax benefits. Chief among these concerns at the time was the brand new threat of fascist socialist governments or, even worse, the threat of communism creeping into the United States. With this knowledge, Republicans retaliated by painting a bleak and burdensome future for socialism in the United States with universal healthcare. They said that “it would only be a matter of time before Washington also moved in the field of education,” or in constitutionally protected areas such as freedom of “religion” or even “the press, [and] radio” to “freedom” itself” would be in total eclipse.”. Some even went further, suggesting that national health insurance was “an insidious communist plot” that involved using federal funds to support Moscow. To make matters even grimmer, this anti-American, red system A frightening fervor appeared just as Truman sought re-election. Instead of walking away from Ewing's health policy proposals, Truman responded by focusing even more attention on a health care billnational election in 1948" and contrary to expectations at the time, he won a second term with a Democratic-controlled Congress in tow (Quadagno 2006, p. 31-32 With the Democrats firmly in power and President Truman more popular than ever , “the AMA thought Armageddon had arrived” and pulled all the candidates.) The AMA would not only continue the Republican campaign against the threat of communism in America, but it would strike at the very heart of American life, the local doctor. The AMA “assessed its members an extra $25 each to resist national health insurance” through what they called the “National Education Campaign.” AMA used these funds to hire Whitaker and Baxter, a public relations firm that had successfully helped “the California Medical Association… eliminate” a similar “health insurance law” at the state level to direct during their national campaign (Quadagno 2006, pg 34). During this project, the AMA “spent $1.5 million on lobbying” and while $1.5 million might not seem that rich compared to the “$240 million” spent by drug companies “for lobbying purposes” in 2015, this AMA campaign was, at the time, “the most expensive lobbying effort in American history” (Doctors;Chon). With an obvious bag of money at their feet, the savvy duo of "Clem Whitaker and Leone Baxter...applied the tactics they had honed in California" with quick results, wasting no time in producing "poster" literature [ and] brochures” to “cartoons and materials for “state medical agencies.” All of this effort was in support of “keeping the public hostile to national health insurance.” In Whitaker's words, to take control of a situation, "you have to give it a bad name and have a Devil," but with "Truman...too popular" to be targeted, "Ewing [was] the perfect Devil " and there was no greater smear on Ewing's plan than to label “National Health Insurance 'socialized medicine'” (Quadagno 2006, p. 35). This stigma would remain, and with “anti-communist sentiment” continuing to grow with the early stages of the Korean War, there was no more poisonous pill for a bill than to associate it with anything even close to the socialist and communist policies of the United States. enemies. The AMA's campaign succeeded in introducing this new brand of national health insurance as socialized medicine into the American mind through pressure from its AMA members at the local level. The “AMA National Headquarters” even went so far as to get “every county” to start a “tough campaign” against socialized medicine, encouraging doctors to spread this propaganda-type message by writing letters and even asking doctors “ to turn to local newspapers to “make sure they were getting “the real facts.”' Additionally, doctors' offices were inundated with "copies of the booklet The Voluntary Way is the American way" along with "posters in the reception room with the caption " The Doctor: Keep politics out of the picture.” Any doctor who did not Don't play the game "risked being kicked out of membership... [and] risked losing appointments and referrals", which meant risking your neck for National Health Insurance also meant risking your business and career. With all this pressure coming from below, even Ewing “admitted….[that his] bill was not gaining any traction with Congress.” For all the fervor that Truman might have generated on the campaign trail, Ewing now found that he would "talk to a congressman" or other former insurance officialnational health system, and suddenly they would say "'you have no idea what political influence a doctor has in his local community, and I don't want them to turn on me” (Quadagno 2006, pag 35;38). The power of local doctors among patients was the final nail in the coffin, with the very concept of national healthcare rebranded, it seemed that the AMA's fog of misinformation had prevailed. This drastic change in public perception was so palpable that when Truman he first became president “in 1945, 75% of Americans supported national health insurance”; but “in 1949 only 21% favored” the same plan. This drop of more than 50 points shows how much power and influence exists within a well-funded lobbying campaign, and Truman's response would be a sentiment about the nature of lobbying that seems relevant even today Truman, after seeing his defeat, accused “the American Medical Association” of “distorting and misrepresent” its national insurance plan to the point that it became vital for politicians to “go out and tell people exactly what” the government was trying to implement. In a government, where money can speak so loudly, to the point of changing the meaning of what it means to be a politician, as the AMA did for Truman and his push for national health insurance, then there is an obvious power imbalance at play within our legislative system. To quote a congressman and national health insurance advocate at the time, Congressman John Dingell, the AMA had pulled off “one of the most cold-blooded lobbying operations in American history” and this precedent it had set, as well as the resulting success, they established a very dangerous norm that has led to our increasingly business- and lobby-friendly future (Quadagno 2006, pp. 38-40). While the AMA may have been the first major campaign against government action on health care, they were not the last. Indeed, as corporations realize their power to lobby Congress, as well as repurposing the fear and misinformation tactics perfected by the AMA in the 1940s, health care legislation like the ACA is being antagonized by corporations more than ever. companies in the sector. medical field. This antagonization of health care not only affects the voters who vote for our legislators, but it harms the legislators themselves. With the industry now spending “approximately $2.6 billion per year on lobbying fees” and the medical health services sector responsible for “$245,812,399” spent on lobbying in 2016 alone, the amount of money spent with the hope of influencing legislators now regularly “exceeds the combined House-Senate Budget” with no sign of slowing (Drutman; “Pharmaceuticals/Healthcare Products,” Open Secrets). This money has been a particularly persuasive force in changing perceptions of former President Obama's signature healthcare bill, the Affordable Care Act. Not only does opinion on the law change dramatically depending on one's party affiliation, with "the 80% of Republicans strongly disapprove" of the bill, even its name appears to be a source of confusion (All Things). In a poll conducted by Morning Consult, it was found that more than “35% of respondents… thought that Obamacare,” the derogatory Republican nickname for the ACA, “and the Affordable Care Act were different policies.” This states that, quite similar to the AMA's labeling of national health insurance as socialized medicine in the 1940s, today's lobbying groups and Republicans have labeled the ACA as Obamacare to spur similarly negative feelings in comparisons.