A Marshall Plan For America

Posted on | July 30, 2020 | 7 Comments

Mike Magee

Yesterday close to 300 registrants signed up for a webinar sponsored by my Jesuit alma mater, LeMoyne College, titled “The Birth of the Medical Industrial Complex in America, and How Covid-19 Has Made the Case For a National Health Care System”. The college’s motto, “Greatness meets Goodness”, speaks highly of their value system, especially during these challenging times.

During the one hour Zoom presentation, questions flowed in over the chat line which you’ll see reflected in future posts. But the first question asked was, “What do you feel is the most important action step that needs to be taken to start enacting wide-spread change?”

My answer was, “Vote in November.”

I followed that quick response with what I would describe as “A Marshall Plan for America.”

During the presentation, I had shared the fact that, as America’s burgeoning Medical Industrial Complex coalesced in 1950 to beat back President Truman’s plans for a national health care system for our citizens, American taxpayer dollars financed the Marshall Plan construction of national health systems for our two vanquished enemies, Germany and Japan.

In a Rand Corporation post-mortem on nation building some decades later, scholars remarked that, “Nation-building efforts cannot be successful unless adequate attention is paid to the health of the population.”

In the re-build of Germany and Japan under the Marshall Plan, we elected to start with a health plan – in part because we recognized that all other social determinants – justice, housing, nutrition, education, clean air and water, transportation, safety and security – would be enhanced in the process.

We understood that this 1948 infusion of what would today amount to $128 billion would engender trust, improve health and productivity, and process fear and worry which might otherwise undermine the establishment of a civil society and stable democracy.

In answering yesterday’s question, I suggested that we as American citizens essentially face a challenge of similar magnitude.

In rejecting Trump, we are battling the dual scourges of a badly mismanaged pandemic response and the fires of historic and systemic racism. But in addition, we are opening the doors to a cultural and political awakening that could be “A Marshall Plan for America.”

The health care underpinnings of such a plan were driven deep into our cultural soil over a decade ago and have survived relentless attempts to unearth and destroy. These include fundamentals: Health is essential and a universal right. Universal health coverage is necessary to assure population health. All health plans must include comprehensive benefits. Patients with pre-existing conditions must be protected. Our most vulnerable populations are a top priority.

Upon these anchors, and now the sacrifices of over 150,000 Americans dead in part because of Trump’s incompetence, we  see revealed the basic “next-step” building blocks of a new deal for America.

Universality: Coverage for all – shared responsibility and risk.

Strategic Planning: Multi-year national health priorities layed out by a truly representative governance body.

Efficiency: Streamline payments, annual negotiated budgets, strict oversight, standardized national billing and payment systems.

Transparency: No DTC advertising. No kickbacks inside PBM’s. No data profiteering. Industry funded academic researchers must register as lobbyists.

Local Control of Delivery: Federal standards with local autonomy. Public insurance is primary. Private insurers are secondary and supplemental.

The unleashing of a Marshall Plan for America could be triggered by the offering of a “public option.” The response of parents of adult children, employees on skimpy employer based plans, newly covid unemployed, underinsured, uninsured and vulnerable will further strengthen our national resolve and advance our evolution towards unification, peace and productivity.

As Trump and Covid have made clear, “a thousand points of light” is no more a substitute for “good government” than it was for our vanquished enemies following World War II. As we did for them then, we must now ask the difficult question “How do we make America, and all Americans healthy?”

And then build out the answer – from the bottom up.

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