National Consumers League

What Lessons Can We Learn from FDR on Health Care?


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By Sally Greenberg, NCL Executive Director This past week, I heard Frances Perkins’ biographer, Kirsten Downey, speak at Columbia University. Perkins, the first female Cabinet member who served faithfully during all of Franklin Delano Roosevelt’s four terms, got her professional start working for the National Consumers League. After hearing Florence Kelley, NCL’s first general secretary, speak at her college, Mt. Holyoke, Perkins was inspired to devote her career to improving the lives of American workers. Perkins is credited with shepherding through many of the New Deal programs we now associate with the social safety net: Social Security, unemployment insurance, workers compensation, Medicare, and Medicaid. She, FDR, and other members of his Cabinet were accused of being socialists and communists, of orchestrating a government takeover and other calumnies from the right. But an opinion piece I read this fall has me thinking about how Perkins and FDR might have been able to move legislation forward on health care reform. Jean Edward Smith wrote in the New York Times that:

... “President Obama’s apparent readiness to backtrack on the public insurance option in his health care package is not just a concession to his political opponents — this fixation on securing bipartisan support for health care reform suggests that the Democratic Party has forgotten how to govern and the White House has forgotten how to lead…. the principal legislative innovations of the 1930s were enacted over the vigorous opposition of a deeply entrenched minority. Majority rule, as Roosevelt saw it, did not require his opponents’ permission.”

Perhaps Smith is being a bit harsh on President Obama, but the difference in styles is interesting. Our President is intent on being a uniter — a good thing in a leader — but these days unity is pretty darn hard to accomplish. According to Smith, FDR didn’t aim for consensus with his enemies: “Roosevelt relished the opposition of vested interests. He fashioned his governing majority by deliberately attacking those who favored the status quo. His opponents hated him — and he profited from their hatred.” Add NCL’s Frances Perkins and Florence Kelley to the list of those vilified for their efforts to create a social safety net. Unlike Obama, FDR didn’t seek to unite – he used his opponents’ vitriol to shore up his side of the argument. As Smith notes, “To Congress, he [FDR] boasted of having ‘earned the hatred of entrenched greed.’ In another speech he mocked ‘the gentlemen in well-warmed and well-stocked clubs’ who criticized the government’s relief efforts.” And his programs — Social Security, Medicare, and unemployment insurance — to name the big ones — have stood the test of time. Most Americans couldn’t imagine this country without these essential social programs. Smith concluded that “Roosevelt understood that governing involved choice and that choice engendered dissent. He accepted opposition as part of the process. It is time for the Obama administration to step up to the plate and make some hard choices.” That’s a tough statement but one worth contemplating as we move forward on health care reform.