http://www.nytimes.com/2010/03/18/opinion/18kristof.htmlAccess, Access, Access
By NICHOLAS D. KRISTOF
Published: March 17, 2010
First, a question: When in American history did life expectancy improve the most?
Was it the late 1800s, when anesthesia made surgery easier and far more common? Was it the 1930s, when antibacterial medicines became available? Or recent decades, when CAT scans and heart bypasses proliferated?
The correct answer is: none of the above. While data differ and the statistics aren’t fully reliable, a good bet is that the best answer is the 1940s. In that period, life expectancy increased about seven years.
Indeed, American life expectancy appears to have been longer in 1942, 1943, 1944 and 1945 — even as hundreds of thousands of young Americans were being killed in World War II — than it had been when America was at peace in 1940.
A prime reason is that with the war mobilization, Americans got much better access to medical care. Farmers and workers who had rarely seen doctors now found themselves with medical coverage through the military, jobs in industry or New Deal programs.
In short, great health care is often less about breakthrough technologies than it is about access. And for all the disagreements about President Obama’s health care proposal, let’s focus on this: it unquestionably would increase access, while its defeat would diminish access.
Most of American history has seen a steady increase in access to first-rate health care. But we’re now seeing a reversal of this long trend. A new report has found that one-quarter of Californians are now uninsured.
The reason for the declining access? Our politicians’ ignominious failure over the last half-century to provide universal health care, despite the efforts of Democratic and Republican presidents alike to pass it. It’s astonishing that Republicans today are lined up overwhelmingly against a health care package that is more modest and moderate than one that Richard Nixon proposed in the early ’70s.
If Republicans succeed in killing Mr. Obama’s reform package, the share of Americans with medical coverage will continue to drop. The Robert Wood Johnson Foundation estimated this month that if significant reforms do not pass, the number of uninsured Americans could grow by 10 million over just the next five years.
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The tide of history has taken us and other Western countries toward steadily greater access to medical coverage — until recent reversals in the United States. Put aside quarrels over the mechanisms used to pass the bill, and focus on the central question of Americans’ access to decent medical care. On that issue, those trying to kill this health care reform proposal are simply on the wrong side of history.