I'd like throw a new thought into our current national
debate about health care, by looking back in time to the Rural ElectrificationAct of 1936. This Act was established
during the Great Depression to provide farms and other rural locations with
inexpensive electricity, for lighting and other purposes. Why did Congress bother to pass this
law? We had reached the point in society
where electricity was necessary, but the
market cost to install and service electrical lines out from cities to rural
locations was prohibitively high. TheREA was set up as a subsidized loan program, with loans going to governments
and local co-ops, but not directly to individual consumers. These days, the REA has evolved to add pilot
programs for high speed (gigabit) Internet to rural areas of the U.S.
Fast forward to the early 1960’s, and health care for
seniors. At that point, health care for
senior citizens had become like electricity for rural citizens a generation
earlier: necessary, but too many were beingpriced out of the market. The solution
was Medicare, which was a subsidy like rural electrification funding, with
funding being a “single payer” model to caregivers, but it wasn’t done as a
loan. Still, it was done to solve a
problem that the free market was having trouble addressing, and Medicare has
been viewed as a popular success since it became law in 1965.
Medicaid, which came later, and then the Affordable Care Act
of 2009 attempted to address similar issues, but with a different
population. Rather than focus on groups
defined by geography or age, this time the concern was health history and/or
economic status. Those with pre-existing
conditions or lack of sufficient financial resources were being priced out of
the market. Medicaid and the ACA attempt
to make necessary health care affordable for these groups of people. It has been a mixed success, as we know, and
now Congress is considering repealing the ACA.
But, let’s go back to the REA for a moment and imagine if
that had been a more recent creation with a more recent President. Here’s a paragraph from an alternate reality
version of Time magazine:
In order to achieve
universal electrification, Obama and the Democrats passed the Rural
Electrification Act. At the time the
Rural Electrification Act was passed, electricity was commonplace in cities but
largely unavailable in farms, ranches, and other rural places. The Republicans
branded it "ObamaPower" and did everything they could to prevent its
proper implementation, including court cases, filibusters of related bills, and
the famous "You Lie!" moment in Congress. They ran on repealing ObamaPower, and
remarkably won seats from the rural districts most likely to benefit from the
Act.
