Past is Prologue: Improving America’s Health through 11 Presidents and Counting
At this time of reflection, transition, and uncertainty, I find it both critical and comforting to take a step back and consider where ReThink Health and the Rippel Foundation have been and where we are going.
In 1953, the year the Rippel Foundation was founded, Dwight D. Eisenhower was president. In the 1960s, when the Foundation’s first president, Julius A. Rippel, began writing about the critical need to redesign our health system and focus on health as well as health care as a way to solve the economic and social challenges of the times, Lyndon B. Johnson was president. In the 63 years the Rippel Foundation has been working to improve the health of all people, America has had 11 presidents and we’re transitioning to number 12.
The Kaiser Family Foundation’s Timeline: History of Health Reform in the U.S provides an interesting historical perspective on health policy. It begins with Teddy Roosevelt and his Progressive Party’s endorsement of social insurance, including health insurance, as part of its platform. In 1953, Dwight D. Eisenhower created the Department of Health, Education, and Welfare, while also opposing “socialized medicine.” In 1974, Richard Nixon proposed the Comprehensive Health Insurance Plan, and when George W. Bush was president, Congress passed the Deficit Reduction Act of 2005, making significant changes to Medicaid premiums and benefits.
Past is prologue. Health—and how to improve our nation’s health—has been at the center of national policy debates for well over 100 years. And this much is true: through republican and democratic administrations, and regardless of red states v. blue states, our health system has failed the American people. If we insist on business as usual, the health system will continue to fail us. No matter the president, this challenge remains—and, so does an opportunity.
Over the past 10 years, ReThink Health, the Rippel Foundation’s primary initiative, has been working to radically shift the national dialogue around health and health care, calling for the wholesale redesign and transformation of our health system. We challenge visionary leaders across the country to see a dynamic, interdependent system of all the factors that contribute to health, rather than a series of unrelated issues and challenges that trigger a piecemeal approach to fixing the problem.
At ReThink Health, we try to demonstrate what it will take to improve our overall health (which ranks quite poorly compared to other developed countries); significantly reduce costs (which are twice that of these same developed countries); enhance the quality of healthcare while reducing inequity (a key driver of high costs and hospital use); and improve the productivity of our population (a key to our global competitiveness).
Only by addressing these seemingly intractable challenges from a systems perspective will we free our abundant resources to invest in jobs, roads, schools, and so much more given health’s growing percentage of our GDP. That’s right, an abundancy—not a scarcity—of resources. No new funding, earmark, block grant, or allocation is needed. None.
As I write this, I am keenly aware that our country is deeply, deeply divided. There are some who are celebrating, hoping that this new administration will be attentive to their urgent and real economic needs. Others are afraid that the gains we have made on so many fronts will be lost forever, and that fear and hatred rather than compassion will rule the day. Make no mistake: racism, misogyny, and xenophobia should be condemned whenever and wherever they rear their ugly heads.
But change is never easy. And disruptive change takes time. We are in this for the long term because that’s what it will take. Remember, we started this journey in 1953 and we are still here. We at Rippel and ReThink Health, together with our partners throughout the nation, will dig in and continue with the difficult but necessary work of reimagining and transforming our health system. To do otherwise would be to admit defeat, and we are optimists at heart.