Health Care Will Become a Right, Just Like Water

Illustration by Ben Wiseman Close

Illustration by Ben Wiseman

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Illustration by Ben Wiseman

Having your heart operated on is different from getting a glass of water or a basic education. Yet they are related in that government once didn’t provide them for us.

As Americans wait for President Barack Obama’s health-care plan to be carried out, they might find some perspective, if not solace, in the history of the many national debates over what services government should offer.

The track record over the centuries is that government establishes a higher and higher baseline of essential services for its citizens. This has proved not only good for the people; it has proved beneficial for business, because healthy, educated people make better employers, employees, entrepreneurs and customers.

In the 18th and 19th centuries, New York and other big cities suffered from regular and debilitating epidemics of cholera and typhoid. The lack of sewers and clean water was suspected as a cause. A proposal in 1798 for a public water system failed after being undermined by Aaron Burr, the future vice president, and his Manhattan Company. The city opened its 41-mile Croton Aqueduct in 1842. Many leading citizens and businesses had opposed the expensive system as an unwise assumption of government debt and a nanny-state intrusion into what was regarded as a private responsibility.

A copy of the original Massachusetts law on compulsory education. Close

A copy of the original Massachusetts law on compulsory education.

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A copy of the original Massachusetts law on compulsory education.

Once in place though, it was a smashing success. Outbreaks of virulent disease dropped, and the project was a model for municipal water and (eventually) sewer systems all around the country.

Education Battle

The drive to establish public schools took place in this same period but it took longer.

It started during the American Revolution. In 1779, while war still raged with the British, Thomas Jefferson, as the governor of Virginia, introduced a plan for bare-bones public education. The bill in the House of Burgesses died without a vote.

In the 1800s, states issued powerful slogans proclaiming that reading, writing and ciphering should be a right of all. But going from word to deed proved arduous. Opponents of the idea, in language reminiscent of the health-care debate, said government didn’t have a right to take taxes out of their pocket to pay for the education of someone else’s child. Quaker, Lutheran and Catholic churches, which ran their own schools, regarded government-funded schools as intruding on their turf.

As with health care today (thank you, Governor Romney), Massachusetts led the way, first passing a public school law in 1827. Then from 1837 to 1848, Horace Mann, who held the essentially ceremonial post of Massachusetts secretary of education, became a national leader in promoting the establishment of “common schools” for everyone.

Pennsylvania passed its Free School Act in 1834. In another echo of the debate over Obamacare, there was a backlash, and voters elected a new governor and crop of legislators who had campaigned against it. The act was saved by Thaddeus Stevens, a state legislator who had won office opposing the act but who then switched positions. In a rousing speech, Stevens, who was later elected to Congress, chided his fellow legislators for voting, without debate, to give money to improve the breeding of pigs, but for being less willing to spend to improve the breed of man. He tied free schools to the new democracy.

“If an elective republic is to endure for any great length of time, every elector must have sufficient information, not only to accumulate wealth and take care of his pecuniary concerns, but to direct wisely the Legislatures, the Ambassadors, and the Executive of the nation,” Stevens said. “This is a sufficient answer to those who deem education a private and not a public duty -- who argue that they are willing to educate their own children, but not their neighbor’s children.”

Government Power

Mandatory schooling was a separate fight. Massachusetts again took the lead. In 1852, the state enacted a law requiring parents to send their children either to a public school or to an acceptable religious school, for three months a year. There were few provisions for enforcement.

The law was controversial, and no wonder. Here was the state entering the family’s home, and escorting the child out the door and into a classroom. The fears about mandatory public schooling were just as pitched as were those about government- managed health care and its “death panels.” Government was entering an area that was previously off-limits. It was not until 1918 that every state had a public attendance law.

Once established, though, universal public schooling, like clean water, became an unassailable right. Business became a strong supporter, profiting as it did from a workforce made literate at the public’s expense.

Yes, most of the action, both on education and waterworks, occurred at the state level. But Congress was also involved. It passed the Northwest Ordinance of 1787, which included, by the design of Thomas Jefferson, a system dedicating one of every 36 plots of land to public education. The Morrill Act of 1862 created land-grant colleges. Eventually, Congress would approve the G.I. Bill. It moved to protect water quality when, under President Richard Nixon, it enacted the Clean Water Act and created the Environmental Protection Agency.

This doesn’t mean debates on these subjects are over. Most people accept that government should have something to do with ensuring that people have schooling and clean water. But private water companies have emerged as competitors to municipal water agencies, and some reformers call for vouchers as an alternative to public schools.

The arc of history suggests that eventually Americans will accept the right to health care. It appears that the country is continuing its path of two steps forward, one step backward, in establishing a higher bar of essential services for its citizens. Time has shown that this progress is not only good for individuals, but will serve the needs of American business, as well.

(Alex Marshall, a senior fellow at the Regional Plan Association in New York, is the author of “The Surprising Design of Market Economies,” which will be published in September by the University of Texas Press. The opinions expressed are his own.)

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Today’s highlights: the editors on Washington’s inability to move on and Israel’s debate over Jewish settlements; Mark Buchanan on living cells as a model for a stable financial system; Margaret Carlson on presidential vacations; Peter Orszag explains why states will eventually expand Medicaid.

To contact the writer of this article: Alex Marshall at alex@rpa.org

To contact the editor responsible for this article: Katy Roberts at kroberts29@bloomberg.net

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