Curing What Ails America’s Healthcare System

Geoffrey Kurtz is no fortune teller, but he’s willing to predict how the current battle over health insurance reform will play out. “It’s overwhelmingly likely that some kind of health insurance package will be passed by the end of this year,” he says. “The only question is—what will it look like?”

Actually, Kurtz has a pretty good idea. An assistant professor of Political Science in BMCC’s Social Science Department, he notes that four of the five reform packages that have been passed by the various Senate and House committees “are relatively similar,” and even the fifth, drafted by the Senate Finance Committee, “maintains the same basic framework as the others.”

While details have yet to be hammered out, all five proposals would make healthcare insurance available and affordable to millions of Americans who are currently without coverage, and “would contain some kind of consumer protection that would prevent insurance companies from dropping people or denying coverage if they get sick or change jobs,” Kurtz says.

Minimal impact on insurers
While the insurance industry has lined up with the Republican Party against health insurance reform as it is envisioned by President Obama and Democrat Congressional leaders, “all of the proposals would leave the private insurance industry intact, subject to additional regulations but otherwise unchanged,” Kurtz says. “Workers who are covered by employer health plans will keep their existing insurance.”

So why have President Obama’s proposals met with such fierce opposition?

“The Republicans in Congress, along with media figures like Glenn Beck and Rush Limbaugh, realize that if health insurance reform passes, it will permanently change the political landscape,” Kurtz says. “While the bills propose modest changes, and nothing like the single-payer system currently in place in Canada, passage could open the way for further reforms.”

There’s another reason for Republican intransigence: Passage could embolden Democratic Party voters, and further weaken the Republican Party. Kurtz explains: “Voting rates have historically been lowest among the core constituencies of the Democratic Party and higher among the core constituencies of the Republicans. Working people, poor people, young people, people of color and women tend to vote less often, on average, than those in other demographic groups. But in the last election, that changed. If that change becomes permanent—if people decide that their vote really can make a difference and that it can result in change, they’re going to keep voting—and that changes American politics in profound ways. The Republicans realize that even if this bill brings only modest changes, the long-term political stakes are very high.”

A legacy of reform efforts
In point of fact, the United States “is the only wealthy industrialized nation in the world not to have some kind of national healthcare system,” says Kurtz. But it isn’t for lack of trying. Healthcare insurance reform has been on the agenda of presidents as far back as Theodore Roosevelt, who served from 1901-1908.

“Franklin Roosevelt wanted to include a national health insurance policy in the Social Security Act of 1935, but held back because he was afraid Congress wouldn’t accept such a radical provision,” Kurtz said. “Harry Truman also tried to push through a bill in the 1940s, and Bill Clinton tried in the early 1990s, failing disastrously.”

In large measure, Clinton’s failure can be attributed to his insistence “on coming to Congress with a fully formed proposal that didn’t have universal support even among the Democrats,” Kurtz said. “Obama has done the opposite—he’s laid out a broad blueprint for change and then tried to stand back and let the House and Senate leaders sort out the details. While he has been pushing for his own version of reform, he has tried to play the role of mediator, arbitrator and organizer—and it seems to be working.”

Editor’s note: The interview with Professor Kurtz took place on Wednesday, October 14, 2009.