Trumpcare Revisited

Summary

Podcast Summary: The New Yorker Radio Hour

Episode: Trumpcare Revisited
Date: July 14, 2017
Host: David Remnick
Featured Guests: Dr. Ezekiel Emanuel, Jill Lepore, Edgar Keret

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Episode Overview

This episode of The New Yorker Radio Hour, hosted by David Remnick, revisits the ongoing debate around healthcare reform in America, focusing on Republican attempts to repeal and replace the Affordable Care Act (ACA), known as "Obamacare," during the Trump administration. The discussion features perspectives from Dr. Ezekiel Emanuel, one of the ACA’s architects, and a historical context provided by New Yorker writer and Harvard historian Jill Lepore. The episode closes with a lighter conversation about Israeli literature and musicals with writer Edgar Keret.

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Key Discussion Points & Insights

1. Inside the Healthcare War Room: Dr. Ezekiel Emanuel on Trumpcare

Timestamps: 01:20 – 13:13

• Emanuel’s Role & Meetings with Trump:
  Dr. Ezekiel Emanuel, former Obama advisor and one of ACA's architects, recounts his closed-door discussions with President Trump and his top advisors about the Republican health care repeal bill.

  • “The last time I met with him was the end of March, just before Paul Ryan pulled the bill because he didn’t have the votes. And I basically told him it was a terrible bill and would leave many people uninsured.” (Dr. Ezekiel Emanuel, 02:31)

• Evaluation of the Senate GOP Bill:
  Emanuel strongly criticizes the Republican bill, labeling it harmful and regressive:

  • “This bill is cruel, throwing 22 million people off insurance, creating uncertainty so that premiums go up.” (Dr. Ezekiel Emanuel, 03:10)
  • Only two positives: keeping young adults on their parents’ plan until 26 (benefiting mostly the upper middle class) and marginally increasing subsidies for the Medicaid gap.

• Critique on Policy Motivation:
  Emanuel points out the bill is focused more on tax cuts than health care:

  • “Well, actually, this bill is a tax cut for the wealthy. Forget down the line. You don’t need down the line. You’re getting rid of taxes where the rich have to pay an added 2.9% on their Medicare bill…” (Dr. Ezekiel Emanuel, 04:02)
  • He questions the motivations: "There isn't the logic that is focused on health care. That's quite clear. It's a logic focused on something besides health care." (Dr. Ezekiel Emanuel, 04:53)

• Challenges in U.S. Health Reform:
  Emanuel discusses "path dependence"—why the U.S. can't simply copy foreign health models, and the focus should shift from payment models to care delivery quality.

• Personal Perspective on Aging and Medicine:
  Emanuel shares his controversial view on aging and end-of-life care, reiterating that after 75 he would not take medicine solely to prolong life:

  • “I’m not trying to prolong my life after 75… My just hanging on and being a burden on my kids just to have more years. That does not seem valuable to me.” (Dr. Ezekiel Emanuel, 10:17)

• Audience Pushback:
  Remnick notes inevitable emotional responses, to which Emanuel replies:

  • “I would challenge them if that really is meaningful or if what they have done is narrow down what constitutes meaningfulness for them to accommodate their limitations…” (Dr. Ezekiel Emanuel, 12:11)

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2. A Century of Healthcare Reform Battles: Jill Lepore’s Historical Lens

Timestamps: 13:13 – 28:58

• Early U.S. Healthcare Reform Efforts:
  Lepore traces the roots of the debate to the early 20th century, with U.S. reformers inspired by European models:

  • “Universal access to health care in the United States was first seriously considered in the 1910s…” (Jill Lepore, 14:23)
  • Failure attributed to constitutional concerns and anti-German xenophobia post WWI.

• Rhetoric of Opposition:
  The attack on “socialized medicine” evolved, often stoking xenophobia and fears of statism:

  • "But the arguments against it always are xenophobic. First it's the Germans… then it's socialism, communism, Europeanism…" (Jill Lepore, 16:25, 17:01)
  • “It grants too much power over the individual to the state. So it’s statism, it’s collectivism…” (Jill Lepore, 17:01)

• Obstacles in the 1940s:
  Coordinated opposition by AMA and PR consultants Whitaker and Baxter turned public opinion against Truman’s universal care plan:

  • Example of successful messaging: “Nine months later they looked at the mail again and Americans were opposed to Truman's plan 4 to 1. And that was pretty much just the money that they spent making their argument…” (Jill Lepore, 23:38)

• AMA’s Shift & The Rising Cost of Delay:
  Doctors, once supporters of universal insurance, grew opposed as medical income soared, making reform costlier over time.

• Johnson’s Success with Medicare & Medicaid:
  LBJ’s politicking and the legacy of Truman’s efforts led to these landmark programs, described as flowering “into care for the sick and serenity for the fearful.” (Harry Truman archival, 24:42)

• Healthcare Backlash & Contemporary Crisis:
  Lepore notes the unprecedented nature of current efforts to strip away benefits, with political confusion and lack of clear advancement toward universal coverage:

  • “What I think is kind of terrifying about this current moment is that the enemy is now no longer foreign. The enemy is within the United States.” (Jill Lepore, 27:18)

• Hope for the Future:
  A challenge to Democrats: to reframe the argument for universal health care around the common good:

  • “…they would need to reclaim an argument about the common good… until they do, they cannot defeat even a weakened argument against health care.” (Jill Lepore, 28:18)

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3. Cultural Wrap-Up: Edgar Keret on Israeli Literature & Musicals

Timestamps: 29:03 – 35:13

• Israeli Literary Scene:
  Keret discusses new voices in Israeli fiction, highlighting a novel (“Waking Lions” by Ayelet Gundar-Goshen) and its complex moral questions.

• Musicals and Fatherhood:
  A personal reflection on taking his son to a musical (“Groundhog Day”), which challenges Keret’s skepticism about the art form:

  • “I've seen the movie and really liked it. The musical is kind of... different in a good way because... it actually is different and makes sense… because the premise is very philosophical.” (Edgar Keret, 31:55)
  • “When the show was over, he said, you know, dad, you were right. This was better than a film.” (Edgar Keret, 34:44)

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Notable Quotes & Moments

• On Healthcare Policy:

  • “This bill is cruel, throwing 22 million people off insurance, creating uncertainty so that premiums go up.”
    – Dr. Ezekiel Emanuel (03:10)

  • “Well, actually, this bill is a tax cut for the wealthy. Forget down the line.”
    – Dr. Ezekiel Emanuel (04:02)

• On Historical Rhetoric:

  • "But the arguments against it always are xenophobic. First it's the Germans… then it's socialism, communism, Europeanism…"
    – Jill Lepore (16:25, 17:01)

  • “Nine months later... Americans were opposed to Truman's plan 4 to 1. And that was pretty much just the money they spent making their argument.”
    – Jill Lepore (23:38)

• On the Arguments for Universal Care:

  • “…they would need to reclaim an argument about the common good... until they do, they cannot defeat even a weakened argument against health care.”
    – Jill Lepore (28:18)

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Timestamps of Important Segments

• 01:20 – Introduction to health care debate and interview with Ezekiel Emanuel
• 02:31 – 13:13 – Emanuel on ACA, GOP bill, personal medical philosophy
• 13:13 – 28:58 – Jill Lepore on the century-long history of universal health care debates
• 29:03 – 35:13 – Edgar Keret on Israeli fiction and discussing musicals with his son

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Tone & Style

The episode blends sober policy discussion and historical storytelling with moments of humor and personal reflection. Dr. Emanuel’s critique is direct yet measured. Jill Lepore’s analysis is detailed, theoretically rich, and delivered with a wry historical perspective. Edgar Keret’s segment is light, witty, and introspective, typical of his literary reputation.

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Takeaways

• The fight over health care in America is as much about identity, ideology, and history as it is about policy details.
• Efforts to establish universal coverage have been stymied more by powerful interests and rhetorical strategies than by lack of public support.
• The current debate reflects a century-old struggle—one that will require a new political rhetoric aimed at the common good to move forward.
• Even in moments of political turmoil, culture and family life continue, offering reminders of broader human concerns.

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For more, visit newyorkerradio.org.

Transcript

[David Remnick]

Hi, it's David Remnick. And just quickly before the episode, I want to thank all of you who took the time to write about our new format of two shorter podcast episodes a week. Here's Alexis from Woodside, California, who writes. The New Yorker Radio Hour is one of my very favorites. And I think it's great that you get the hour long time problem. It's like you read my mind. Likely lots of other listeners too. Aaron from Brooklyn writes, this is something a little vulgar and I'm not going to read it. And I and it kind of hurts my feelings anyway, Aaron, so let's forget it. But thank you because we do want to know how this is working out for you. And I want to remind you, especially.

[Interviewer/Host]

Those like David S. Who wants to know who thought of this ridiculous idea.

[David Remnick]

You can always get the full hour show exactly as you were hearing it [e-mail] okay, now let's get to it.

[Actor/Reader (performing historical quotes)]

Floor 38, they're trying to answer questions about upward mobility.

[Interviewer/Host]

Military strategist it was profiled brilliantly by somebody.

[Dr. Ezekiel Emanuel]

So I think if you could find.

[Historical Figure (Harry Truman, via archival audio)]

A subculture of people with a kind.

[Dr. Ezekiel Emanuel]

Of form of life on this planet.

[Interviewer/Host]

That we haven't really seen before.

[Narrator/Announcer]

From one World Trade center in Manhattan. This is the New Yorker Radio Hour, a co production of WNYC Studios and the New Yorker.

[David Remnick]

This is the New Yorker Radio Hour. I'm David Remnick. Since the day had passed the Affordable Care Act, Obamacare has been the clearest and biggest target of Republicans in Washington. The way Donald Trump was talking, Obamacare was going to be history the Monday after inauguration. But as we've seen, a repeal or replacement of Obamacare is much, much harder to do than to talk about an oncologist and health policy expert named Ezekiel Emanuel, everybody calls him Zeke, was one of the architects of the aca. He helped the Obama administration figure out just how to expand health care without exactly blowing up the national budget. And with the ACA on the chopping block, Emanuel is trying to influence what the Republicans can come up with to replace it. In this climate, it's almost impossible to have a cool headed conversation about health care. But Emanuel insists we've got to try. And he's had closed door meetings with the Trump administration. I spoke with Zeke Emanuel early last week as the Senate was poised to release a revised health care bill. Now, if I'm not mistaken, you met with President Trump about three times.

[Interviewer/Host]

So what were those conversations like?

[Dr. Ezekiel Emanuel]

Those conversations were quite good. The last time I met with him Was the end of March, just before Paul Ryan pulled the bill because he didn't have the votes. And I basically told him it was a terrible bill and would leave many people uninsured. It didn't address cost control. It was undermining of the market.

[David Remnick]

Does he have a grasp of the details?

[Dr. Ezekiel Emanuel]

He asked sufficient appropriate questions in the room. Was not just him, it was Price and Ryan and Pence and Mulvaney.

[Interviewer/Host]

So congressional leaders.

[Dr. Ezekiel Emanuel]

Yes. And we had a very thorough discussion, I would say, of the bill.

[Interviewer/Host]

You're being diplomatic.

[Edgar Keret]

Yes.

[Dr. Ezekiel Emanuel]

I mean, it's for the president to reveal the details if he wants to. I would just say, but why be diplomatic? I am not for. I'm not for this bill. So I'll tell you why I think I want to be diplomatic. I'm not for this bill. I've made it clear to everyone and I've said it on many media outlets. This bill is cruel, throwing 22 million people off insurance, creating uncertainty so that premiums go up.

[David Remnick]

This is the original Senate bill you're referring to, correct?

[Dr. Ezekiel Emanuel]

Eliminating the expansion on Medicaid, forcing the states to cover more of Medicaid, thereby denying them resources to put into other things like education, highways, infrastructure, I think is not a way forward.

[David Remnick]

Do you have the view, as many.

[Interviewer/Host]

Democrats do, that this bill is all about a setup to create a tax cut down the line for the wealthy?

[Dr. Ezekiel Emanuel]

Well, actually, this bill is a tax cut for the wealthy. Forget down the line. You don't need down the line. You're getting rid of taxes where the rich have to pay an added 2.9% on their Medicare bill and other taxes that they need to pay to support universal coverage. And I think the data are that someone like Warren Buffett makes millions of dollars. If this bill, if the Republican healthcare reform goes away and poor people have to pay a lot more, that is totally cruel. That is totally backwards.

[David Remnick]

But when you're in the room with them, when you were in the room.

[Interviewer/Host]

With Paul Ryan and other congressional leaders who are for such bills, they obviously don't see the bill that way or don't reveal themselves to see the bill that way. What is their log?

[Dr. Ezekiel Emanuel]

I can't tell you.

[Interviewer/Host]

You're totally bewitched by it.

[Dr. Ezekiel Emanuel]

There isn't the logic that is focused on health care. That's quite clear. It's a logic focused on something besides health care. This bill does not advance health care in this country. That's quite clear. There's no positive step. No positive step in this bill. Minus two, it keeps young people age 26 on their parents plan. Who benefits from that? Well, largely upper middle class kids. You know, I was giving a lecture at Yale in a class on healthcare. There were about, I don't know, 120, 130 kids in the class. I said, how many of you are still on your parents health insurance plan? 95% of the hands went up. Right. So the parents of kids at Yale are benefiting. Right. And then it does lower the ability to get subsidies down to 0% of the poverty line. Now it's 100% of the poverty line. So the people who are caught in the so called Medicaid gap, that is a state hasn't expanded Medicaid, but they can't get subsidies to buy insurance in the exchanges, they now can get some subsidies. Those are the two positives in this bill.

[David Remnick]

And that's it.

[Dr. Ezekiel Emanuel]

That's it. Everything else in this bill totally undermines healthcare and the healthcare system that we've built.

[Interviewer/Host]

Is there a medical system, medical economic system that exists in the world that you look at, you know, piningly? If only that were ours.

[Dr. Ezekiel Emanuel]

I'm gonna talk out of two sides of my mouth now, okay? So first of all, I don't like that question. The political scientists have this notion of path dependence. Once you go down one path, you've got all these institutional structures, legal structure, administrative things. We can't go out and say, oh, you know, Sweden, it's the best, we're just gonna take it and plop it down. In the United States, on the other hand, I am in the. My next book is an international comparison of 12 different healthcare systems. So to see what we can learn from all of them. And interestingly, this book is not about how we pay for healthcare so much. I mean, it does have an element that paying is important. But this book is about how do we at the coal face, how doctors interact with patients, how hospitals interact with patients, how nurses, and how can we change that? Because ultimately our poor performance in the healthcare space, you know, we don't do so well on infant mortality, we don't do so well on maternal mortality, we don't do so well on a lot of metrics. How do we change that? And that's something to do with the payment, but much, much more to do with how doctors are actually structuring the delivery of care in the office and in the hospital and things like that.

[Interviewer/Host]

Zeke, your book starts off with an extended, not anecdote, but story about an elderly woman named Ms. Harris. Tell me a little bit about her.

[Dr. Ezekiel Emanuel]

So Ms. Harris, when I saw her, was 95 years old. Now, she has very high and labile blood pressure, goes up and down as a result. She had some kidney problems. She also has heart failure. She was at her sister's house. It was a hot summer day, and she keeled over. Her sister, you know, calls 911. They take her to a nearby hospital. Doc in the emergency room determines she doesn't have a stroke, doesn't have a heart attack, but she has this rhythm thing called sick sinus syndrome. Sends her to a affiliated hospital a little further down with the cardiac unit, and they put in a cardioverter that is an implantable shock device and a pacemaker all in one device into her heart. When you ask her about it, it's very unclear that she actually consented.

[David Remnick]

Is the system failing her in some way?

[Dr. Ezekiel Emanuel]

She's getting a lot of care that it's not clear she consents to. One of the things that the palliative care nurse did almost immediately is ask her, well, would you want to go on dialysis if your kidneys failed? No. Would you want to go into the intensive care unit if something disastrous happened? No. As she says very prominently, you know, I'm ready for God to take me. And by the way, going to the doctor is a big effort for her. The only time she leaves the house is to go to her kidney doctor, order one of her two cardiologists. And it was quite clear she was dreading the need to ask a neighbor to drive her to the doctor. This was not what she wanted.

[Interviewer/Host]

Now, I gotta tell you, I remember Jon Stewart once saying, he said, you know, he's talking to somebody who is very stoic about their health care. And whatever he said, look, I'm Jewish, I get gas, and I go to a specialist, and.

[David Remnick]

And yet you.

[Interviewer/Host]

Zeke wrote an amazing article in the Atlantic some time ago saying that when you hit 75 and you're 59 now, correct, any medication that you might be on, you're gonna stop. Whether it's a thing like a statin or something minor or even something serious. That's it. Why? And what are you telling us?

[Dr. Ezekiel Emanuel]

So what I said is that any medication where the justification for taking that medicine is to prolong my life. Now, not every medicine is like that. Some medicines are to relieve pain. Some medicines are to relieve some other deprivation. My hearing's not perfect anymore. I survived three kids. How else could it, you know, you survived three kids unless your hearing's not perfect. So if I need a hearing aid, I would do a hearing aid. Or if I needed some pain relief, I'd do pain relief. But I'm not trying to prolong my life after 75. And, and partly, I think lives have.

[Interviewer/Host]

An arc, but they've gotten longer.

[Dr. Ezekiel Emanuel]

Not necessarily better. You know, if you look at the curve, low levels of dementia until about turns out 75, and then it shoots up. And at 85, it's, you know, between 33 and 50% of the population has dementia. And if you talk to the experts in Japan, everyone in 100 definitely demented. I think there are three components to a meaningful life. I'm not looking for happiness. I'm looking for meaningfulness and fulfillment. Meaningful work, meaningful relationships, and fun. It's quite clear if you look at the data for almost all of us, meaningful work will go down by 75. Very few people after 75 are productive in their work. Okay, so then you're left with fun and meaningful relationships. Interestingly, both requirements, pretty good cognitive function. And if you don't have that, then. And I don't want to risk being deteriorated and being a big burden on my kids. I think that would be the worst situation. My just hanging on and being a burden on my kids just to have more years. That does not seem valuable to me. And a life where the dominant thing is only fun or play or, you know, doing crossword puzzles, watching tv, reading a few books, seeing the grandkids once every month or something, that's not a meaningful life. I don't want that life. I don't think anyone should find that life fulfilling.

[David Remnick]

I guarantee you.

[Interviewer/Host]

I guarantee you. Zeke, when your article came out, or people listening now, you can almost hear the voices saying, now wait a minute. It's meaningful to me. I'm 82. I'm seeing my grandchildren on Tuesday. It's meaningful to me. You think that's diluted?

[Dr. Ezekiel Emanuel]

I would challenge them if that really is meaningful or if what they have done is narrow down what constitutes meaningfulness for them to accommodate their limitations, physical, cognitive and whatever. And that's, I think, part of the big issue. I think it changes your idea if you know that, you know, at 75, it's really going to be. I don't know that it's going to be over that I'm going to die, but it's going to be very different. My certainly ability to work and be productive that way is going to go down. And so I think you change how you approach the now and the living.

[David Remnick]

Dr. Ezekiel Emanuel, his new book is Prescription for the Future. By the way, we checked back with Emanuel after the Senate released its most recent bill. And he said the revisions, as far as he's seen, don't really change his opinion at all. We're going to stay on this topic. And in a minute, the long, strange.

[Interviewer/Host]

History of universal health coverage, a battle.

[David Remnick]

That'S been fought now for fully 100 years. It's the New Yorker Radio Hour. Stick around. You're listening to the New Yorker Radio Hour. I'm David Remnick. My colleague Jill Lepore is not only a great journalist here at the New Yorker, but she's a professor of history at Harvard and a terrific one. And we depend on her to actually know things.

[Interviewer/Host]

Jill, while Congress and the political class are slugging it out on a medical bill, it's worth going back to the history of this. Universal access to health care in the United States was first seriously considered in the 1910s, right where early healthcare activists were drawing inspiration from where?

[Jill Lepore]

Well, from their own experience. In the US The United States had all kinds of provisions for federal assistance after the Civil War. It spent a quarter of the federal budget on aid between 1880 and 1910, but especially from Europe, where sickness insurance had started in Germany in the 1880s. And in 1911, Parliament passed a National Insurance Act. And there was a lot of optimism in the United States during the height of the Progressive Era, before the First World War, that nationalized health insurance was pretty much on the docket.

[Interviewer/Host]

In the nineteen teens, it was on the docket. And where did it go? What was its fate?

[Jill Lepore]

It went down into the trash bin of history to be long forgotten. So it really was by about 1916 that the measure was had gained a lot of momentum. It had been introduced in a lot of states, especially in California. There was discussion in Congress and there were a few different obstacles. The chief one that didn't affect the UK and the reason for the delay so that the UK had adopted the reform in 1911. In 1912, the United States began to consider it. But the UK doesn't have a written Constitution. And our written Constitution was a real impediment for progressive reformers for all kinds of reform that was attempting to regulate the suffering of ordinary people under mass industrialism, that the Constitution hadn't foreseen that. And it was very difficult to imagine how to defeat constitutional arguments. People who are opposed to sickness insurance could call it unconstitutional. And so there was a question of whether or not there was going to be a need for a constitutional amendment. It involved all kinds of delays. So it really wasn't until 1916 that there was enough Momentum to get kind of over that constitutional hurdle. And then months after that, the United States entered the war with Germany. And the people who were arguing against insurance were able to successfully defeat it by pointing out that it was born in Germany.

[David Remnick]

Well, this is it.

[Interviewer/Host]

There were claims that universal health care would cause the Prussianization of America or that somehow insurance for all would give.

[David Remnick]

The Kaiser a foothold in California.

[Interviewer/Host]

What did all that mean?

[Jill Lepore]

It was very effective political rhetoric is what it mainly meant. And you can see how effective it was because people keep going back to it again and again. And if you look at the whole century between then and now of this struggle, sometimes people say, oh, we're rushing into health care, not rushing into anything. We've been doing this for a century. But the arguments against it always are xenophobic. First it's the Germans. Then by the time we get to the. What does that mean?

[Interviewer/Host]

It's the Germans. What do the Germans have to do with us? I have to say, this issue confounds me no end.

[Dr. Ezekiel Emanuel]

Why?

[Interviewer/Host]

What is wrong with universal health care? Why is it somehow un American?

[Jill Lepore]

It grants too much power over the individual to the state. So it's statism, it's collectivism. And what form of collectivism it is changes over time. Right? Because it's a specious argument. So either it's socialism, sometimes it's communism. By the time Obama was elected, then it was just sort of vaguely European, and now it's actually liberalism. But remember that this, actually, this debate started in the United States during the kind of heyday of Social Darwinism. So a lot of the people who opposed national health insurance were social Darwinists who just sort of felt like, hey, if you can't make it, this is survival of the fittest.

[Interviewer/Host]

Is there an element of Social Darwinism now?

[Jill Lepore]

I think there is. I mean, there's a kind of laissez faire kind of reborn free marketism that is fundamentally socially Darwinist. And the trick there is how insufficient have been the arguments made by the advocates of national health insurance because they're so easily cowed by these critiques of collectivism, as if republicanism isn't a form of collectivism, as if we are not tied as a nation by bonds of affection and community and solidarity and institutions, sacrifice and institutions that bind us to one another. Right. Like that's how people could be so easily silenced. I mean, you can understand at particular moments, like World War I, okay, we're fighting a war with Germany. It's going to be really hard to get this through. You can Kind of understand the heyday of the Cold War. Okay, if they're going to call it Stalinist, it's going to be tough for us.

[Interviewer/Host]

Well, let's pause that. In 1945, the Second World War ends. The governor of California is Earl Warren, who would eventually, obviously go to the Supreme Court. And Harry Truman and Warren both try to institute universal health care insurance. Was there something about that political moment that made both men think they could win?

[Jill Lepore]

There were two things about that political moment. There was the prosperity of the moment and the hopefulness of the moment. There was the GI Bill and the support that that had received. And GI Bill is nothing if not federal legislation that is essentially welfare for veterans. The idea that we have come out of the war with a sense of common cause, having defeated forms of collectivism and statism and cherished what makes the United States distinctive, the success of the New Deal reforms. Truman wanted to continue the New Deal with his Fair Deal.

[Actor/Reader (performing historical quotes)]

Personally, I have always understood that the Constitution of the United States imposes upon the government of the United States a responsibility with respect to the general welfare of its citizens. And certainly no one can pretend that good health is not a matter of first importance so far as the general welfare is concerned. That is why ever since I've been President, I have recommended programs which I believe will provide better medical, health and.

[Historical Figure (Harry Truman, via archival audio)]

Services for all our people.

[Interviewer/Host]

So as I understand it, Warren and Truman run into the most unlikely kind of opposition. They were sunk by a pair of consultants named Leon Baxter and Clem Whitaker, who ran an organization called Campaigns, Inc. Who were Whitaker and Baxter and what was their approach to politics?

[Jill Lepore]

They were both former newspaper people who had gone into the advertising industry at the outset in the 1930s. They eventually marry. They're this incredible team. They're both pistols. They run a newspaper feature service and they become incredibly successful running political campaigns as a kind of offshoot of their advertising agency. They are. They run to the right and they are hired by the American Medical association when Truman announces his national health insurance plan. Because their work in California defeating Warren's California health insurance plan was so phenomenally successful.

[David Remnick]

You know, Jill, the California State archives gave us a transcript of a 1950 radio spot produced by Whitaker and Baxter. And we've tried to recreate it. This is what we imagined. It sounded like.

[Actor/Reader (performing historical quotes)]

The American people are registering their firm and outspoken opposition to socialized medicine. Public opinion is rapidly crystallizing on the crest of a wave of resolutions opposing any form of compulsory, tax supported sickness insurance. Today, more than 5,000 national, state and Local organizations are on record and have advised their senators and congressmen in Washington that they want no part of any paternalistic, bureaucratically controlled system of political medicine. They have emphatically stated that their members are against compulsion or regimentation in any field. The millions of citizens represented by these groups are a mobilization of free thinking people who believe in the preservation of individual initiative and the American way of life. Today's private system of medicine has produced the highest health standards in the world. That system must be preserved.

[Interviewer/Host]

What do you make of that, Jill?

[Jill Lepore]

Well, remember this moment, right? It's the height, it really is the height of the fear of a worldwide communist conspiracy. So 1949, China becomes communist, Soviet Union gets the bomb. 1950, Alger Hiss, the Whitaker Alger's Whitaker Chambers hearings. People are convinced that the United States, the American way of life is under threat, that the Soviets are just about to take over, that the, the secret subversion of the American way of life at the hands of people in the State Department and in the federal government is part of a worldwide conspiracy. So Whitaker and Baxter very effectively play on those fears and a measure of just how successful they are and also of how much people wanted this reform. The first thing they did when they were hired to work on the national campaign was go to Washington and they talked to a lot of members of Congress and they asked if they could look at constituent mail and they read a whole lot of mail and they found that Americans wanted, favored Truman's proposal four to one when they started. They had a huge $3 million budget from the AMA. And nine months later they looked at the mail again and Americans were opposed to Truman's plan 4 to 1. And that was pretty much just the money that they spent making their argument, which was that Truman's plan, it was sort of like a domino theory, right? That this was the first step in the descent into socialism.

[Interviewer/Host]

So why did the ama, the American Medical association, which was for universal insurance during the Progressive Era, go to being opposed to universal insurance? What happened to the ama?

[Jill Lepore]

Medical expenses rose. And this is actually the great tragedy of the long delay of the United States federal government in actually finally facing this issue is with each passing year the cost of medicine rises and it's much more difficult to institute the reform, both because it's just more money at stake and it's hard to figure out where the money's going to come from, but also because doctors are making more money. And in the 1940s and 1950s, the AMA is hugely opposed because it's going to Doctors are making a lot of money and they would like to not have their pay limited by the federal government, by reimbursement. That's rates that are going to be set by the federal government now.

[David Remnick]

Eventually, President Johnson was able to expand health care coverage in the United States in 1965, creating programs that are still very much with U.S. medicaid and Medicare.

[Historical Figure (Harry Truman, via archival audio)]

I am so proud that this has come to pass in the Johnson administration. But it was really Harry Truman of Missouri who planted the seeds of compassion and duty which have today flowered into care for the sick and serenity for the fearful.

[David Remnick]

Jill, how was Johnson able to pull this off?

[Jill Lepore]

LBJ flew in deer meat from Texas to feed to members of Congress at breakfast that he held every week to get them to pony up to his legislative agenda. He would meet with them every week with a kind of poster board on an easel and give them just an incredible Texas breakfast with big slabs of bacon and eggs and toast. And he would make this chart and he would tell them exactly what they needed to do that week to get through the Great Society. And he had this, you know, he had this urgency about it. He knew that he had a limited amount of time he had swept into office. He had the sympathy of people because of Kennedy's assassination. And he got through these programs that he couldn't actually really run, but that he instituted with incredible effectiveness, right down to flying out to Missouri to sign the Medicare act in the Truman Presidential Library in front of Truman, who guy nearly wept. I mean, the beauty of that for Truman 20 years later, to see that this reform that FDR had tried to get through, that Wilson had tried to get through, that had been this long, simmering, lingering piece of American suffering was going to be addressed. LBJ knew what he was doing is the thing.

[Historical Figure (Harry Truman, via archival audio)]

In this town and a thousand other towns like it, there are men and women in pain who will now find ease. There are those alone in suffering who will now hear the sound of some approaching footsteps coming to help. There are those fearing the terrible darkness of despairing poverty despite their long years of labor and expectation, who will now look up to see the light of hope and realization.

[Interviewer/Host]

Well, we're looking at a situation in which people seem to not know what they're doing, especially politically. What do you make of the current effort to repeal Obamacare and maybe replace it with the American Health Care Act? Is it unusual for Congress to pass a bill which takes benefits from. Away from people? Has that ever happened?

[Jill Lepore]

I think you might think about Clinton's welfare to work plan, I think very much that was pitched as a rearrangement of a set of benefits. The scale of this. No, this is. This is its own particular crisis. I mean, what I think kind of terrifying about this current moment is that the enemy is now no longer foreign. The enemy is within the United States.

[Interviewer/Host]

Well, I guess it leaves us with the question, are you optimistic or pessimistic about the fate of universal healthcare? Has the argument to any degree, whether it's during the Clinton time or now during Obamacare, and has the argument for universal health care coverage made any significant advance so that one day we might see universal health care coverage?

[Jill Lepore]

I think that Republicans in Congress are obviously floundering. They don't know what they're doing. They have a hard time talking about anything but rhetorically. The Democrats in Congress are the ones who would need to step up for us to achieve universal health care, and they would need to reclaim an argument about the common good. They would need to be able to speak with the kind of universalism, of liberalism that animated Johnson and Johnson's more soaring speeches on this subject. And until they do, they cannot defeat even a weakened argument against health care.

[Interviewer/Host]

Jill, thank you very much.

[Jill Lepore]

Thanks, Dave.

[David Remnick]

My colleague, Jill Lepore. You can find her piece on the history of universal health coverage and everything else she's written for the new [e-mail] Ah.

[Jill Lepore]

How you doing?

[David Remnick]

How are you?

[Edgar Keret]

Great.

[Jill Lepore]

Good to see you.

[Edgar Keret]

You look younger. I wouldn't have figured out I'm getting.

[Interviewer/Host]

Younger all the time.

[David Remnick]

The Israeli writer Edgar Kerritt was in town recently, and I wouldn't miss a chance to catch up with him in the New Yorker. We've published some of his terrific short stories, but his most recent book, in English, the Seven Good Years, is more of a memoir. Edgar talks about life and death, fatherhood, terrorism, politics, Angry Birds, prenatal yoga. It's as funny and as dark and somehow as sweet as his stories.

[Interviewer/Host]

As a writer of fiction in Israel, I'd love to know, and I bet you other people would want to know what's going on in the world of Israeli fiction. We usually hear, to be honest, the same four or five names for a long period of time. You're considered a young, young writer. And you're how old?

[Edgar Keret]

I'll be 50 this year.

[David Remnick]

Yeah.

[Interviewer/Host]

So what's happening in the fictional realm.

[David Remnick]

In Israel that we don't know about.

[Interviewer/Host]

And we should and might soon?

[Edgar Keret]

I think that the biggest new name is who had written a novel that was very well accepted in Israel, and I think that it just came out or about to come out in the States.

[David Remnick]

What's it called?

[Edgar Keret]

I don't remember the title. I remember the story. I think it's better. It's about a doctor who by mistake hit and kills an illegal African worker and basically runs away. And the wife of this or the widow of this man kind of extorts him to open some kind of a. A hospital, an illegal hospital in which he'll take care of illegal foreign workers. And it's about how basically this kind of encounter changes his perception and challenges his world view.

[Interviewer/Host]

You know, you've got a book coming.

[Edgar Keret]

Well, I'm supposed to finish it by the end of the year.

[Interviewer/Host]

And do you have time to read or watch, see movies or do anything.

[David Remnick]

On your own lately?

[Interviewer/Host]

You've been writing a lot.

[Edgar Keret]

Well, actually, when I came here to New York, I came with my son. So I've seen the kind of stuff that would interest him, too.

[Interviewer/Host]

How old is he?

[Edgar Keret]

Eleven.

[Interviewer/Host]

What's his name?

[Edgar Keret]

Lev.

[Interviewer/Host]

And what interests him?

[Edgar Keret]

So his English isn't that great. So we went to a musical. We saw Groundhog Day.

[Dr. Ezekiel Emanuel]

How was it?

[Edgar Keret]

Very good. Yeah, very good. It's actually. It's the second.

[Interviewer/Host]

Has he seen the movie?

[Edgar Keret]

I've seen the movie and really liked it. The musical is kind of. Is different in a good way because the idea of making a musical based, you know, on a film sounds like a bad idea, or it sounds like a bad idea, a very capitalistic one, you know, but it actually is different and makes sense. And it's the second musical I see in my life.

[David Remnick]

You're kidding.

[Edgar Keret]

The first one was Starlight Express.

[Interviewer/Host]

Oh, my God.

[Edgar Keret]

And I didn't like it.

[David Remnick]

Wasn't that on roller skates or something?

[Edgar Keret]

On roller skates? I was 10 years old.

[Interviewer/Host]

Oh, my God.

[Edgar Keret]

I really didn't like it. And I said to my parents, please don't ever take me to the music again. And this was my second one. And it's kind of. I've seen the light. I've danced, tap danced all the way.

[Interviewer/Host]

Back home, you know, and no roller skates.

[Edgar Keret]

No roller skates.

[Interviewer/Host]

I should tell you, just as a matter of information, the majority of musicals do not have roller skates.

[Edgar Keret]

The majority, no, it wasn't the roller skates that killed me. I think that there is something about it, about musicals that usually, like, people there are amazing. You know, they know how to sing, they know how to dance. And so usually, like, they're so busy showing you they're amazing that you don't get any Time to do anything else. It's like those people in American Idols that, you know, have amazing voice and they can sing very well, but they're so busy singing very well that they don't really think what they're thinking about, you know. So this was my impression of musicals, like, you know, that, you see, it's like kind of a circus, you know. But this one was really nice. Like, they, you know, they acted well. And it was even philosophical in a sense, because the premise is very philosophical.

[Interviewer/Host]

It's the nature of time.

[Edgar Keret]

Yeah. And the idea of this kind of eternal repetition, you know, it's very niche.

[Interviewer/Host]

Nature.

[Edgar Keret]

Yeah, in nature, really. Because this idea of, like, if you revisit something, what would you think about it? You know? And the thing about me, I'm the kind of person who usually, when I live so much in the present, you know, that I usually don't kind of take into account anything that I've done. So when I see this, I suddenly say, wow. Like, you know, if I would have gone through that, maybe I too, would have became a better person and knew better how to sing and dance.

[Interviewer/Host]

And your son enjoyed it.

[Edgar Keret]

He enjoyed it a lot. You know, when we said that even.

[Interviewer/Host]

Though his English is not so great, even.

[Edgar Keret]

Yeah. I think that the story or the premise is very simple. And before he said. He said, father, I just want to say to you straight, I prefer films. And I said to him, you know what? As a rule of thumb, I also prefer films because when it's not good, it's really embarrassing because the people are there in front of you and. But when it's good, it's better than films. And when the show was over, he said, you know, dad, you were right. This was better than a film.

[Jill Lepore]

Sometimes it's like I'm stumbling forward, hustled forward, jostled from behind by time. And sometimes it's like I'm being dragged, yet always lagging, trying to keep in time with time.

[David Remnick]

That's Edgar Carrot. The novel he mentioned by Ayelet Grunder Goshen is called Waking Lions, and it was published in English this year. This is the New Yorker Radio Hour.

[Jill Lepore]

If I could freeze a moment for a moment, rest before the.

[David Remnick]

I'm David Remnick and that's the New Yorker Radio Hour for today. Thanks so much for listening. See you next time.

[Narrator/Announcer]

The New Yorker Radio Hour is a co production of WNYC Studios and the New Yorker. Our theme music was composed and performed by Meryl Garbus of Tune Yards, with additional music by Alexis Cuadrado this episode was produced by Alex Barron, Emily Bottin, Ave Carrillo, Brianna Corby, Jill Duboff, Karen Frillman, David Krasnow, Sarah Nix, Michael Rayfiel, Maithili Rao and Stephen Valentino, with help from Susan Morrison, Emma Allen and Jessica Henderson. The New Yorker Radio Hour is supported in part by the Churina Endowment Fund, RA.