The U.S. Healthcare Debate: Still Catching Up to Bismarck

Ruling the German Empire from 1871 to 1890, Otto von Bismarck's appetite for military assets (hard and soft) — and a strong national economy supporting that machine — was legendary.

The most important people to him were the steel barons and financiers who provided the empire with the tools of ascendancy and materiel-based strategic advantage for global conquest.

Lest we forget the implicit challenge to U.S. conservatives today emanating from his dealings a century and a quarter ago, Otto von Bismarck was also quite an enlightened man. As far back as 1883 and 1889, he laid the groundwork for Germany's national health insurance and pension/retirement system, respectively.

His legislative accomplishments in that arena were so solidly conceptualized that they last to this day.

Bismarck's reckoning was simple. In providing a network of health and pension security, he laid the basis for a strong nation. Bismarck realized that only people who know they will be cared for in times of need and weakness are a strong people.

That is why it is all the more astounding to see that his insight, legislated in the 1880s, is still fought vehemently today as a socialist revolution in the halls of the U.S. Congress.

The grand bargain struck back then was straightforward enough — and it applies with amazing acuity to today's United States: Bismarck wanted to get the support of Germany's working class for his nation-building agenda.

But their political representatives, the Social Democrats, were only willing to accede to his designs if they got something significant in exchange — and hence those crucial healthcare and social security reforms were born.

Which leaves one to wonder what keeps the United States, a society that has long been an acknowledged leader of modernity, from striking the same bargain. And yet, as things stand, President Obama essentially acceded to the Republicans' wishes on troop deployments to Afghanistan, while limping forward to an iffy outcome of his health reform initiative.

And yet, in this very same context, it is worthwhile to recall that the seeds for such social security have been sown in the United States as well. The U.S. military remains rather exemplary for the breadth and cost effectiveness of the health and pension security it provides to its current and former members.

In effect, it has lived under the wise laws of Otto von Bismarck for decades. All that is left to be done is to extend similar privileges to the rest of the nation, in that unique form of Bismarckian compassionate — and strategic — conservatism, one rooted not in blind ideology, but in a profound sense of social realism.

It is indeed high time for the United States not just to have a strong military, but also a strong nation — in Bismarck's view of things.

U.S. business leaders, in particular, should hope for such a development to materialize. After all, the consensus supporting U.S. openness in the age of globalization is getting ever more frayed. Polls make it plain that support for trade and global integration is waning, even among the U.S. middle class and mainstream U.S. Republicans.

Health security is a key insurance mechanism to counter this worrisome trend, which would only add to the nation's current woes.

Bismarck eradicated any notion of people in Germany going bankrupt over health care 127 years ago. It is high time for the Republicans in the U.S. Congress to be prepared, at long last, to live up to that standard set by one of Europe's most conservative 19th century leaders.

Whatever the faults of Obama's healthcare plan, Bismarck defined the essence of compassionate conservatism clearly enough.

Doing so now, at an uncertain time, would give the American people the confidence that they, too, can cope with the changes in the world economy that are upon all of us.