WI: Cartercare

[JVM]

WI/AHC: Jimmy Carter Passes Universal Health Care

In April 1976, U. S. President Jimmy Carter proposed a health care insurance reform bill similar to those suggested by Senator Ted Kennedy, but three years later instead spoke in favor of a more limited reform - an employer mandate to provide private catastrophic health insurance plus coverage without cost sharing for pregnant women and infants, federalization of Medicaid to the very poor without dependent minor children and the addition of catastrophic coverage of Medicare. Senator Russell Long and the Senate Finance Committee supported this, but abandoned efforts due to budget constraints. He has maintained to this day, however, that the bill didn't pass because of Ted Kennedy, who ran against him in the Democratic primary in 1980.

What if Carter had worked with Sen. Ted Kennedy more closely to either build a plan he and Congress could agree on, or allowed Congress to pass the more liberal bill and sign off on it - or, in any case, in some way, Carter had passed universal health care reform legislation by 1980? Would he be a more popular president? Would Kennedy still challenge him? How would the American people react? How would it effect the Democratic primary? etc. etc.

 

[John Fredrick Parker]

You realize that Congress is the branch that has to pass the law, right? Even if Carter starts talking the issue up, that puts him at very best no closer to getting UHC passed than Nixon or Clinton were.

 

[Emperor Norton I]

You realize that Congress is the branch that has to pass the law, right? Even if Carter starts talking the issue up, that puts him at very best no closer to getting UHC passed than Nixon or Clinton were.

That's not an entirely fair set of examples comparative to this issue. Nixon didn't pass UHC because his healthcare system was opposed by Ted Kennedy and the Left, who wanted a national healthcare system. Clinton's came from the Right, in the post-Reagan political era whereafter the Republicans became what they are today and the hot button issues became hot button issues, the rhetoric and four letter words became what they are, etc.

Carter is in a distinct era, post Nixon and pre Reagan, with his own set of circumstances and challenges.

 

[JVM]

You realize that Congress is the branch that has to pass the law, right? Even if Carter starts talking the issue up, that puts him at very best no closer to getting UHC passed than Nixon or Clinton were.

No, I always thought the President wrote all the laws and the Senate Majority Leader signed them! Boy, am I sure embarassed!

I was intentionally vague because I don't know the details, but I believe what I've read is both Nixon and Carter failed to pass health care because the democratically-controlled Senate and House wanted more liberal versions of the bills than the incumbent President would be willing to sign. Nixon was a conservative and the fact he was even discussing health care is surprising enough. Carter was a moderate with a liberal senate and house who failed to pass even a kidney stone in office. There are huge repercussions for Carter's re-election campaign and legacy as a president if he achieves universal health care. For one thing, it gives him something to stand on come 1980.

 

[Emperor Norton I]

No, I always thought the President wrote all the laws and the Senate Majority Leader signed them! Boy, am I sure embarassed!

I was intentionally vague because I don't know the details, but I believe what I've read is both Nixon and Carter failed to pass health care because the democratically-controlled Senate and House wanted more liberal versions of the bills than the incumbent President would be willing to sign. Nixon was a conservative and the fact he was even discussing health care is surprising enough. Carter was a moderate with a liberal senate and house who failed to pass even a kidney stone in office. There are huge repercussions for Carter's re-election campaign and legacy as a president if he achieves universal health care. For one thing, it gives him something to stand on come 1980.

The Republican position on healthcare reform used to be the sort of thing Obama passed ... until he (Democrat) worked on and passed it.

 

[JVM]

The Republican position on healthcare reform used to be the sort of thing Obama passed ... until he (Democrat) worked on and passed it.

I've heard that before, yeah... it was just kind of my way of trying to get the focus back on Carter Besides, I think I made a Nixoncare thread before.

 

[John Fredrick Parker]

Carter is in a distinct era, post Nixon and pre Reagan, with his own set of circumstances and challenges.

Fair enough, but that doesn't change the fact that Carter "giving in" is the least of the hurdles HCR would have to face before passage. If Carter proposes a moderate plan like Nixoncare, he's still going to need the support of the Single Payer supporters, and vice versa; there is going to be a lot of intense White House leadership on this issue guiding the process before any serious bill of this level stands a chance. So at the very least, Carter actually has to care; he can't just be "giving in" and proposing a bill or something.

 

[JVM]

Edited the first post with more detail on what was actually discussed and/or proposed.

 

[John Fredrick Parker]

Ah, now this is more like it:

What if Carter had worked with Sen. Ted Kennedy more closely to either build a plan he and Congress could agree on, or allowed Congress to pass the more liberal bill and sign off on it - or, in any case, in some way, Carter had passed universal health care reform legislation by 1980?

Still, I'd guess that compromise legislation is more likely than SPHC being "allowed" to pass, so the question now is -- what would this compromise legislation look like? Maybe a kind of *public option* ("Medicare Buy-In Option"?) is thrown in.

 

[Umbral]

If the passed plan is anything like the better European ones, there are a lot more money floating around for other things from 1980 onwards, and a couple of million more americans.

 

[JVM]

Still, I'd guess that compromise legislation is more likely than SPHC being "allowed" to pass, so the question now is -- what would this compromise legislation look like? Maybe a kind of *public option* ("Medicare Buy-In Option"?) is thrown in.

With a Democratic House and Senate, I think that's completely possible, depending on if Carter himself would actually OK it.

 

[David T]

The basic problem is that in the 1970's liberals were insistent on a single-payer-type national health insurance. It took decades of defeat before they took the attitude of "we'll back anything that can pass Congress and brings us closer to universal health insurance, even if it works through private insurance." Ted Kennedy did not create the mindset of 1970's liberals on this issue, and he could not make liberals walk in lockstep if he compromised on it; he would instead be seen by them as abandoning his own stated principles, and theirs. We have to remember that the liberals did not anticipate decades of frustration; they had a powerful movement (the CNHI or Coalition for National Health Insurance) for universal health insurance, supported by a labor movement that was much stronger then than it is today; and they thought the future was theirs. If Ford was blocking them--well, he would soon be replaced by a liberal Democrat. (They didn't anticipate that Carter would be the Democratic nominee.) If Carter was blocking them--well, "By 1979, Kennedy was the universal favorite to replace Carter as the Democratic nominee in 1980. Polls put him ahead of both Carter and the Republican candidate Ronald Reagan by margins of 2-1. All Kennedy had to do, the CNHI advised, was enter the primaries, beat Carter, beat Reagan, and then he could push through congress the legislation he wanted." http://hnn.us/article/131473

As the same article notes,

"In office, Jimmy Carter’s biggest challenge was bringing down double digit inflation. In 1978, he proposed a budget that cut the deficit by reducing social spending. Facing mounting pressure by liberals, the administration endorsed an NHI proposal in July 1978. President Carter promised reform in three stages. The first—and the only ever defined—stage was a hospital cost-containment bill designed to deflate medical bills. Ted Kennedy was shocked. The administration made no commitment to comprehensive coverage and the cost-containment package was likely actually to raise the price of healthcare as doctors hiked other charges to cover any loss in revenues. Worse still, the administration insisted that any future program be run by private insurers: there would be no “public option” for consumers to buy from the government.

"Ted Kennedy denounced the Carter proposal and support for it in Congress collapsed. In this sense, it is accurate to say that Kennedy killed the bill. But Kennedy had no choice but to denounce it—it didn’t meet his own publicly stated conditions for reform and the CNHI wouldn’t stand for it...."

 

[John Fredrick Parker]

Yeah, if any President stood a good chance of getting UHC passed in the 1970s, it was Nixon. On the flip side, even if it does pass under Carter, the law is far from guaranteed the get the implementation it would need under President Reagan (could even suffer the same fate as this law -- just another "could have been" undermined by the rise of the Right).

 

[Plumber]

No

Jimmy Carter was the most incompetent President with Congress of the past 100 years. Even Harding and Bush's sign-anything is preferable to the infighting that underwent a Congress with Democratic majorities the world had scarcely seen before (mid-30s and mid-60s), and never since.

Carter's fundamental problem is that he was an outsider to the party. He had gamed the primary dynamic, but did not grow in office from a New South Governor in the state Nixon did best in to the leader of the Democratic Party. Clinton took notes off his failures. He even stole some of Carter's schticks, like the era of big government is over. Yes, Carter said something exactly like that.

By the standards of the times, President Clinton was to the left of President Carter, though. Carter never wanted UHC while in office, his original scheme was rhetoric aimed at the liberals. That's why he refused to work with Congress on the issue. And. Nixon? Nixon is on record commenting that it would be best for CHIP to fail, so he could hit the. Democrats for being stingy anti-Santa Clauses. Confuse the issue, like how the Tea Party did in 2010 with "OBAMA'S TARP!!!" He did not care for UHC, either.

You want UHC, elect anyone in the '76 primaries except Carter. And perhaps Wallace. Anyone else. It will happen. Carter won because he was the only candidate running in Iowa who wasn't liberal. He was the Romney of the race in that respect.

 

[LendleAlba]

the state that McGovern performed the worst in

McGovern got 24.65% of the vote in Georgia. It was one of his worst states, yes (top 3, in fact), but not the worst; that title clearly goes to Mississippi, where he got 19.63% of the vote.

 

[Plumber]

McGovern got 24.65% of the vote in Georgia. It was one of his worst states, yes (top 3, in fact), but not the worst; that title clearly goes to Mississippi, where he got 19.63% of the vote.

Nixon performed best in, sorry. Schmitz did better in MS than GA.
This makes the '76 swing in Georgia the largest in history.

 

[LendleAlba]

Nixon performed best in, sorry. Schmitz.

Not that either. He got 78.20% of the vote in MS and 75.04% in GA. (Though this still makes GA his 2nd-best state, and Nixon actually got a higher number of votes overall in GA compared to MS.)

 

[David T]

You want UHC, elect anyone in the '76 primaries except Carter. It will happen. Carter won because he was the only candidate running in Iowa who wasn't liberal. He was the Romney of the cycle.

Well, first of all, electing someone in the Democratic primaries does not guarantee that they will win the general election. Carter won ten of the eleven ex-Confederate states in November (as well as border states like Kentucky). I don't think any of his liberal opponents could have done that, and I am dubious that they could have gotten enough extra electoral votes in the North and West to make up the difference.

Second, there were still plenty of conservative Democrats in the Senate in those days, and a successful Republican/conservative Democratic filibuster of any UHC bill acceptable to the liberals is by no means impossible.

 

[JVM]

Alternate POD: Jimmy Carter slips in the bathtub in January 1976 and wakes up a liberal. Does that make things easier?

I'm kidding, of course. It's no secret that Carter was ridiculously incompetent, a conservative Democrat running and nominated in an election that favored in every possible way a liberal Democrat who couldn't work with Congress. All that said, I'd like to come up with a scenario where it can happen. My interest here is in seeing how it affect Carter's popularity and re-electability, and if it fails to help, what becomes of such legislation when Reagan enters office, etc.

 

[SLCer]

Well, first of all, electing someone in the Democratic primaries does not guarantee that they will win the general election. Carter won ten of the eleven ex-Confederate states in November (as well as border states like Kentucky). I don't think any of his liberal opponents could have done that, and I am dubious that they could have gotten enough extra electoral votes in the North and West to make up the difference.

Second, there were still plenty of conservative Democrats in the Senate in those days, and a successful Republican/conservative Democratic filibuster of any UHC bill acceptable to the liberals is by no means impossible.

Carter also blew a massive lead by incompetent campaigning. Had Udall or another more progressive won, it's entirely possible they don't see near the slide Carter saw in the summer and fall of 1976. Sure, if you look just at the electoral map as it was and compare it to what could develop with, say, Udall, your point is a good one. But that doesn't account for the potential of a better candidate not squandering near the lead Carter held in most polls.

Yes, Udall would not do anything in the south, but his western roots would certainly help him there. In reality, Ford barely won California by a bit over a point, Oregon by less than a point, Washington by four points, New Mexico by two points and Nevada by five points - so, it's not near out of the realm of possibility that Udall sweeps most the west, the northeast and defeats Ford.

Especially if he runs a better general election campaign than Carter. I mean, it took a great deal of incompetence to nearly blow the '76 campaign for the Democrats. So, it's not as if Carter was the only candidate who could have defeated Ford.

Ford Versus Udall:

Udall wins 294-244.

He may be able to get it done.

What's interesting is that liberals today glamorize Carter as the last true liberal president. He was liberal on energy and that's really about it.