Whatever one thinks about Obamacare as a policy, much of the opposition to it displays all the historical misunderstanding discussed here. Obamacare opponents, with varying degrees of histrionics, have decried it as an unprecedented intrusion of the federal government into the private sector.
In fact, since the turn of the 20th century, health care has been among the most federally subsidized areas of American life and at a host of levels.
The federal government provided money for hospital construction, especially in the under-served South, and it has provided the training for countless doctors, nurses, and public health professionals. Between 1947 and 1971, to take one example, the Hill-Burton Hospital Survey and Construction Act provided almost $4 billion in federal funds (matched by state money) and added 500,000 hospital beds in almost 11,000 hospital projects.
Likewise, the pharmaceutical industry has relied for years on the basic research sponsored by the National Institutes of Health among other agencies. Between 2003 and 2013, fifteen Americans have won the Nobel Prize in Medicine. Exactly none of them did their path-breaking research in the private sector. They all received public support of one kind or another.
If you’ve ever wondered why the Centers for Disease Control are located in Atlanta and not Washington, the answer is that they started out in 1946 as a federally sponsored malaria control effort, when malaria was still endemic to parts of the South. It’s hard to imagine that the “Sun Belt” would have taken off in the post-war years if all those new arrivals had to spend their time swatting malarial mosquitos.
In fact, the Affordable Care Act itself is not only an outgrowth of the Great Society or even the New Deal. It can trace its origins back to the health care system created after the First World War for veterans returning from that war .
One might not like Obamacare, but its lineage, like so many other government programs, is all-American.
Why All the Fuss?
Given the history of the federal role in fostering the economy, education, health care, transportation, communication and more, why do so many Americans seem to resent our government with such vehemence?
One answer is that Americans like their government hidden from them. Steeped in myths of rugged individualism, we don’t like to believe that we’ve had any help achieving what we’ve achieved.
So while Americans have never been eager to support public housing for those who need it, few of them thank the federal government for subsidizing the mortgage on their own house. Likewise, these people see funding for public transportation as a waste of money even as they drive down interstate highways extravagantly paid for with federal money.
When Lincoln Center officials renamed the New York State Theater after David Koch, they not only honored a donor but they hid from the public the public source of the theater in the first place. Come to think of it, perhaps that’s exactly what Koch intended.