Upon signing the Social Security Act of 1935, FDR declared that it was “a cornerstone in a structure which is being built but . . . is by no means complete.” It would not be finished, he held, until the government guaranteed Americans a “right to adequate medical care and the opportunity to achieve and enjoy good health.”
Franklin Roosevelt was unable to complete the structure — he lacked the political support for government to seize control over health care. Barack Obama was determined to finish what his progenitor had started.
In pushing for Obamacare, President Obama followed FDR’s playbook to the letter. Social Security had been sold on the premise that people must be forced to save for retirement; Obamacare was sold on the premise that people must be forced to buy health insurance. FDR had smeared opponents of Social Security as cold-hearted enemies of the old; Obama would smear opponents of Obamacare as cold-hearted enemies of the sick. FDR found it necessary to hide the true costs of Social Security from the public; Obama had the audacity to sell Obamacare as a means of lowering health care costs.
More perplexing, Obamacare’s opponents have followed the playbook of their predecessors — those who lost the debate over Social Security during the 1930s.
Want to predict Obamacare’s future? Look at Social Security’s past.
When FDR began pushing for Social Security, his proposal was seen as radical, which it was: He wanted to create an American welfare state. Yet the central argument he offered for Social Security was hardly novel: Elderly Americans were among the country’s most vulnerable citizens, and it was America’s moral duty to guarantee them a secure retirement. To oppose Social Security was to oppose helping old people.
How did the opponents of Social Security respond?
Some Republicans shouted that Social Security was socialism, which the New Dealers easily brushed off as fear-mongering (never mind that Bismarck, who created the modern welfare state, admitted that his program was partial socialism).
Others, including Roosevelt’s 1936 presidential challenger, Kansas Gov. Alf Landon, conceded that a welfare program for the elderly was a moral imperative to achieve “social justice,” assured the country that the president was acting out of benevolent impulses, and only quibbled over the details of FDR’s law, particularly its enormous cost. Whereas Roosevelt’s program would give handouts to a huge proportion of elderly Americans, the Republicans countered with a less ambitious plan targeted only at the elderly poor. Roosevelt won.
Once the Social Security Administration started dispensing handouts in 1940, opposition to the program virtually evaporated. Almost no Republicans were willing to advocate taking handouts away from Americans who were putatively in need. By the time Eisenhower assumed the presidency, Republicans as often as not were the ones proposing to expand Social Security.
So what can we expect from Obamacare? A pessimist might say that it too is now set in stone and Republicans will be working to expand it come next election cycle. We aren’t quite there yet. But any challenge will need to drop the focus on the program’s cost and its poor implementation, and expose it as immoral.
How? First, by defending the free market against those who would blame it for problems, such as the high cost of health care, that are in fact created by government intervention.
Second, opponents will have to make a clear distinction between an individual’s voluntary decision to support people and causes he cares about, and the moral premise underlying the welfare state: that a person’s need entitles him to support by others. In a free society, we can help others when we value them, but government cannot force us to sacrifice for others. But the welfare state forces our hopes and dreams to take a backseat whenever anyone presents us with an unfulfilled need. If an ambitious young adult is saving up to buy his first car, and Obamacare dumps an inflated health insurance bill in his lap to subsidize the elderly, that is not charity: That is immoral.
Finally, opponents of Obamacare have to offer an inspiring moral alternative: a fully free market, in which individuals are free to take care of their own health care needs, in which they are free to contract with health care providers in whatever way they judge best, and in which those who want to help others are free to do so voluntarily.
Until and unless we embrace such a crusade, Obamacare is here to stay.