Jimmy Carter on Health Care President of the U.S., 1977-1981

1977: Incremental approach instead of universal coverage

In November 1977, Carter made it clear that he had no intention to hammer out a legislative proposal. The moment called for bold leadership and swift action built around a single piece of legislation. We continued to work toward that end. And Carter continued to slow down the process. By the summer of 1978, I felt that the president was squandering a real opportunity to get something done. The Jimmy Carter who had declared that he wanted mandatory and universal coverage and had a plan that was nearly identical to mine had now been replaced by the President Carter who wanted to approach health insurance in incremental steps, over time, if certain cost containment benchmarks were met--and after the 1978 midterm elections.

Across-the-board cap on hospital charge annual increases

Jimmy Carter also focused on inflation when he became president in 1977. Even though he had supported universal coverage during his campaign, President Carter decided that his first foray into health care would be an attempt to rein in costs, not expand coverage. In the previous decade, the consumer price index had increased by 79.7%, while hospital costs had risen 237%. President Carter proposed an across-the-board cap on hospital charges that would limit annual increases to 1.5 times any rise in the consumer price index.

Pushed national health-insurance bill

National health insurance addresses gross inequities on poor

The buffer between expensive medical care and patients' ability to pay at the time of illness is provided by insurers. Many people have no hesitation about unnecessarily entering a hospital, receiving expensive diagnoses while they are there, staying an extra day or two, and accepting the most elaborate service and treatment. Some even see it as a way to get back their investment in the insurance premiums.

At that point, both doctors and hospital owners benefit, while the patient is an unwitting contributor to higher medical costs and inequitable distribution of medical care. From the enormous profits, unnecessary hospital facilities can be built. Normal competitive restraints on excessive costs are almost nonexistent.

Lost to lobbyists on hospital-cost containment law

I was never able to succeed in this effort, which would have saved the American people more than $50 billion (!) in the first 5 years-after leaving the hospitals free to raise their prices 50% faster than the prevailing inflation rate. In the final showdown, Congress was flooded with money, in the form of campaign contributions from the health industry.

Liberal on National Health Insurance

Supports national health insurance

Let me outline for you some of the goals of the next administration in the area of health [insurance]:
• We must have a comprehensive program of national health insurance.
• We must have government reorganization that will end the bureaucratic fragmentation that now frustrates any hope for a rational and effective national health care policy.
• We must encourage alternative delivery systems such as HMOs and rural group practices.
• We must clean up the disgraceful Medicaid scandals.

Supports more funding for education & research

Let me outline for you some of the goals of the next administration in the area of health [education and research]:
• We must stress health and nutrition education. Our public schools could do more to teach our young people the dangers of drinking, smoking, using drugs, overeating, and eating the wrong kinds of food.
• We must mount a renewed attack on cancer and other diseases caused by toxic chemicals in the environment.
• We must continue and expand biomedical research and be sure that it serves the health needs of all our people.
• We must encourage nursing home standards of safety, sanitation, and care, and we must encourage programs that will serve elderly people in their own homes whenever possible.
• Finally, we must, by scholarships, by loans, and by other means, provide medical education to more students, for minority and low-income families and also to more women, and we must encourage young health professionals to train and practice in rural and inner city areas.

Nationwide comprehensive mandatory health insurance