Kennedy and Nixon as partners on health care reform

Feb. 15, 2013 — All in all, “Managed Cost, Mismanaged Care” is pretty accurate — with one big exception. I know that congressional health care leaders (at least in 1971) did not view HMOs and national health insurance as an either-or proposition. Kennedy viewed a national network of non-profit, tightly defined HMOs to be a complement to a single-payer national health insurance program, and expected the passage of HMO legislation to be accompanied by NHI [national health insurance] legislation. And no matter what Nixon may or may not have been taped saying, other leaders in the administration (such as Robert Finch, Lou Butler, and Elliott RIchardson, Finch’s successor as the secretary of Health, Education, and Welfare) also viewed reform of the delivery system (HMOs) as a complement to, not a substitute for, reform of the health care financing system.

Kennedy and Nixon were certainly political rivals and had little use for each other, but on this point Kennedy and the Nixon Administration agreed. Work with the Nixon Administration on NHI continued into 1974, even after the HMO Act of 1973 passed and was signed into law. It was finally killed in the House Ways and Means Committee, in 1974, due primarily to pressure from the insurance industry and the usual fear of “socialized medicine” by the American Medical Association. Other factors included: apathy from a weakened and finally absent Nixon Administration, an ambivalent and then resistant labor movement, [and] disinterest by the public.

— Philip Caper, M.D.  (Brooklin, Maine)