Whenever I hear someone punch the rugged ticket I tell them scary stories of my socialist pioneer great great grandparents and then swerve to Emerson’s actual original idea:
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ACA helped all of us a lot. In that pre-existing problems were mandated as covered. That brings down the cost of all insurance.
Because even if you pay less for a policy without a pre-existing clause you pay more when crap hits the fan. And it will hit the fan.
Most importantly ACA was crucial to having a sane Public Health Policy. It is expensive and unpleasant for everyone if the poor form a permanent disease pool of nasty lingering communicable diseases because they avoid crucial care from lack of funds and fear.
Bismarck and Disraeli understood this 150 years ago.
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Have a rec, David, for (almost) channeling my Dad and my “O” level history teacher. Who both credited Chancellor Bismarck for opening the door for the introduction of the NHS. Not specifically for the reasons you cite, though (which are probably the best outcomes)
Germany’s system was initially designed to introduce a pension for retirees after a working life of toiling away to help the newly unified Germany take its rightful place as a World power (no prizes for guessing … both my dad and history teacher fought in WWII)
This paved the way for the National Insurance Act in about 1911 and introduced a tax earmarked specifically for medical care for the workforce. It’s generally credited to the Liberal Chancellor of the Exchequer at that time (Dizzy was a Conservative) and, according to dad (a commited Socialist) was more to do with not being outdone by Germany, and fueled by anti-German senstiment, than any real social conscience. He was probably a bit biased😉.
Anyhoo, I suspect the historical nature of these moves…dating back to the 1880s…and the long standing acceptance of having money earmarked for this by direct taxation (and without a by-your-leave) is more responsible for the adoption of universal healthcare over there than anything contributing to the apparent myths of European collectivism or the American rugged individual.
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You are correct about the English Libs being the good guys and not Dizzy’s Conservatives, but i have long been fascinated by Disraeli and do remember reading a letter he wrote extolling Public Health (e.g., safe water, mass innoculations, health education, free visiting nurses and pre through post natal care, all subjects waaaay in advance of modern USA policies.
As to rugged individualism, that is a mis-construed and mis-quoted meme from Ralph Waldo Emerson that post WWII conservatives hijacked in service of screw the poor ideology. Find me more than a handful of entitled rich USAians who lives by rugged individual principles… Hah!
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Have you read anything by AJ Cronin? The Citadel and The Stars Look Down would be good starts if not. They’re classics that highlighted conditions in working class communities in a time of patchy access to generally poor quality healthcare. Credited with influencing the structure of the NHS. Probably correct too as Cronin and Nye Bevan were long time acquaintances from days working in S. Wales mining communities.
The BBC put out a serialised version in the early 1960s and dad…and by default, mum and I…watched it religiously on our newly acquired B&W television. Dead boring for me as a barely 10 year old.
The few wealthy people I know like that are socialists. Seriously. All heart.