By MIKE MAGEE
In the second half of the 19th century, Emily Dickinson wrote a short poem that could easily have been a forward looking tribute to two American Presidents – one from the 20th, the other the 21st century.
Dickinson’s poem “A WORD is dead” is hardly longer than its title.
“A WORD is dead
When it is said,
I say it just
Begins to live
She certainly was on the mark when it came to President Franklin Delano Roosevelt’s signature legislation. FDR’s New Deal, extending from 1933 to 1939, ultimately came down to just three words – the 3R’s – Relief , Recovery, and Reform.
He promised “Action, and action now!” This included a series of programs, infrastructure projects, financial reforms, a national health care program and industry regulations, protecting those he saw as particularly vulnerable including farmers, unemployed, children and the elderly. And he wasn’t afraid to make enemies. Of Big Business, he said in a 1936 speech in Madison Square Garden, “They are unanimous in their hate for me – and I welcome their hatred.”
But he was also a political realist. And by his second term of office Justice Hughes and his Conservative dominated Supreme Court had begun to undermine his legislative successes and were threatening his signature bill- the Social Security Act. So FDR compromised, and in the face of withering criticism from the AMA, postponed his plans for national health care.
By June 11, 1944, a supremely popular 4th term President had found his voice again, and knew the words to use as he promised a “Second Bill of Rights” stating that the original was now “inadequate to assure us equality in the pursuit of happiness.”
Turning a phrase that is as lasting as it is powerful, he said, “Necessitous men are not free men.” And in his list of economic rights that he pledged to pursue, these two appeared:
• The right to adequate medical care and the opportunity to achieve and enjoy good health;
• The right to adequate protection from the economic fears of old age, sickness, accident, and unemployment;
Now, three quarters of a century later, a new President, pragmatic and opportunistic, is signaling once again that the time is right for change.
Following his recent address to Congress on April 29, 2021, President Joe Biden spent a good deal of time on the aisle in private conversation with Sen. Bernie Sanders. They’ve been talking a lot lately. In his speech he waded into health care with both feet, and found a way to link the ACA and Medicare.
He said, “The Affordable Care Act has been a lifeline for millions of Americans …And the money we save, which is billions of dollars, can go to strengthening the Affordable Care Act and expand Medicare benefits without costing taxpayers an additional penny. It is within our power to do it. Let’s do it now…We’ve talked about it long enough, Democrats and Republicans. Let’s get it done this year. This is all about a simple premise: Health care should be a right, not a privilege in America.”
Those last words, as Emily Dickinson would remind, “began to live” in 2009, when first delivered by the man on the aisle, Bernie Sanders.
Earlier in his speech, Biden reflects on an image he recently observed in Florida. “One of the defining images, at least from my perspective, in this crisis has been cars lined up, cars lined up for miles (in food lines)…I don’t know about you, but I didn’t ever think I would see that in America. And all of this is through no fault of their own. No fault of their own, these people are in this position. That’s why the rescue plan is delivering food and nutrition assistance to millions of Americans facing hunger.”
Those words also “began to live” many years earlier. On June 11, 1944, FDR said, “We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence. ‘Necessitous men are not free men.’ People who are hungry and out of a job are the stuff of which dictatorships are made.”
Roughly two decades later in 1966, Rev. Martin Luther King, Jr. mirrored the same words and linked poverty and health care, at the Poor People’s Campaign when he said, “of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
Those words continued to live a half century later, appearing in a 2017 New Yorker piece penned by celebrity physician author, Atul Gawande. The words were uttered by two former neighbors of his still living in Athens, Ohio, the hardscrabble town where he grew up in the Appalachian foothills.
The first said, “basic rights include physical security, water, shelter, and health care. Meeting these basics is, he maintained, among government’s highest purposes and priorities.”
A second voice added, “I think the goal should be security – knowing that, no matter how bad things get, health shouldn’t be what you worry about.”
Mike Magee, MD is a Medical Historian and Health Economist and author of “Code Blue: Inside the Medical Industrial Complex.“