Governmental role in health care vexing GOP

WASHINGTON — There’s considerable irony in the sudden and desperate quest of Republicans in Congress to repeal and replace Obamacare, in light of the party’s longstanding dread and disdain of government involvement in any sort of national health care.

For decades, the GOP war cry of “socialized medicine” was a unifying theme and the backbone of conservative resistance to all aspects of Democratic liberalism. Republicans conjured all sorts of bugaboos, such as hostile Washington bureaucrats making medical decisions that should be left to doctors, to sway opinion against it.

The notion reigned among Republicans that a person’s health care was a private concern between an individual and his or her personal physician, with Uncle Sam staying out of the way, whether in terms of treatment or manner of payment for it.

From the earliest days of Franklin D. Roosevelt’s New Deal concept of public responsibility for the general welfare of all Americans regardless of income and social status, the Republican Party pushed back hard, preaching individual responsibility and, in its harshest terms, every man for himself.

The Great Depression had ushered in a public imperative for community responses to unemployment, poverty and associated social ills. Government cures such as welfare relief and social security benefits for the elderly gained broad acceptance in liberal thought and policy. But many conservatives dominating the Republican Party clung to their opposition to what they saw as unnecessary and excessive government intrusion into the lives of Americans.

“Socialized medicine” endured through the 1930s and beyond as a prime GOP banner in the political and philosophical wars between the two major parties. Succeeding Democratic administrations fought a long, uphill struggle in the field of national health care. They most notably failed during the Bill Clinton administration when the president turned the challenge over to his wife, Hillary, who wasn’t able to produce a bill that could be enacted.

Throughout this time, the private health insurance industry, solidly supported in the Republican Party, fiercely and effectively defended its role in providing coverage against liberal efforts to enlarge government’s role in facilitating and financing broader public health coverage. Not until 2010 did Democratic President Barack Obama finally win congressional approval of an historic Affordable Care Act, soon contemptuously dubbed Obamacare by its partisan critics.

The Republican Party quickly set its sights on eradicating it. Although the Democratic plan ran into heavy trouble during implementation stage, millions of Americans did sign up. But major growing pains in the plan, and rapidly rising costs to enrollees, soon spurred fueled a GOP crusade to “repeal Obamacare.”

But many of the millions of enrollees eventually began to have second thoughts about losing their new health care, as problem-laden as it was. As a result, the Republican war cry was broadened to “repeal and replace Obamacare.” Soon it became clear that many GOP enrollees didn’t want the baby thrown out with the bath water.

Donald Trump made repealing Obamacare a prime campaign promise. After he took office, House Republicans in two tries slapped together a bill, and the Senate Republicans have now vowed to pass their own version. Yet Senate Majority Leader Mitch McConnell finds himself hard-pressed to find enough Republicans to pass it, as protesting recipients of Obamacare packed the hall outside his office Thursday and were hauled or wheeled away by U.S. Capitol police.

In a bizarre turnaround, the party historically against “socialized medicine” is struggling to enact a version of it, fearful of losing the support of millions of covered enrollees who desperately want some manner of government-run and government-financed health care. An earlier Congressional Budget Office estimate said 24 million would lose their coverage if the House bill passed, and the CBO assessment of the Senate version is nervously awaited.

Accordingly, GOP control of the Senate and even of the House in the 2018 congressional election could be at stake if the party fails on its pledge to scuttle Obamacare, with speculation growing that Trump’s hold on the Oval Office itself could be in peril from disappointed supporters and other voters who already have had enough of what the last election has wrought.

Editor’s note: Jules Witcover’s latest book is, “The American Vice Presidency: From Irrelevance to Power,” published by Smithsonian Books. You can respond to this column at