When William J. Casey was a young attorney during the Great Depression, he learned an important lesson.
Jobs were hard to find, so Casey was glad to be hired by the Tax Research Institute of America in New York.
His task: Study New Deal legislation and write reports explaining it to corporate CEOs.
At first, he thought they wanted detailed legal commentary on the meaning of the new legislation.
But the he quickly learned a blunt truth: Businessmen neither understood nor welcomed President Franklin D. Roosevelt’s efforts at reforming American capitalism. And they didn’t want legal commentary.
Instead, they wanted to know: “What is the bare minimum we have to do to achieve compliance with the law?”
In short: How do we get by FDR’s new programs?
Fifty years later, Casey would bring the same mindset to his duties as director of the Central Intelligence Agency (CIA) for President Ronald Reagan.
William J. Casey
He was presiding over the CIA when it deliberately violated Congress’ ban on funding the “Contras,” the Right-wing death squads of Nicaragua.
Casey gave lip service to the demands of Congress. But privately, with the help of Marine Lieutenant Colonel Oliver North, he set up an “off-the-shelf” operation to provide arms to overthrow the leftist government of Daniel Ortega.
It was what President Ronald Reagan wanted. So Casey felt he had a duty to get it done, and Congress be damned.
When news of Casey’s—and Reagan’s—illegal behavior leaked, in November, 1986, it almost destroyed the Reagan administration.
Especially damning: Much of the funding directed to the “Contras” had come from Iran, America’s mortal enemy.
To ransom a handful of American hostages who had been kidnapped in Lebanon, Reagan sold them America’s most sophisticated missiles in a weak-kneed exchange for American hostages.
Then he went on television and brazenly denied that any such “arms for hostages” trade had ever happened.
Ronald Reagan
But the “Casey Doctrine” of minimum compliance with the law didn’t die with Casey (who expired of a brain tumor in 1987).
It was very much alive within the American business community as President Barack Obama sought to bring medical coverage to all Americans, and not simply the ultra-wealthy.
The single most important provision of the Affordable Care Act (ACA)—better-known as Obamacare—requires large businesses to provide insurance to fulltime employees who work more than 30 hours a week.
For part-time employees, who work fewer than 30 hours, a company isn’t penalized for failing to provide health insurance coverage.
Obama’s enemies slandered him as a ruthless practitioner of “Chicago politics.” So it’s easy to assume that he took “the Casey Doctrine” into account when he shepherded the ACA through Congress.
Barack Obama
But he didn’t.
The result was predictable. And its consequences quickly became clear.
Employers feel motivated to move fulltime workers into part-time positions, and thus avoid
- Providing their employees with medical insurance; and
- A fine for non-compliance with the law.
Some employers openly showed their contempt for President Obama—and the idea that employers had any obligation to those who make their profits a reality.
John Schnatter, CEO of Papa John’s Pizza, said:
- The price of his pizzas would go up—by 11 to 14 cents per pizza, or 15 to 20 cents per order; and
- He would pass along these costs to his customers.
“If Obamacare is in fact not repealed,” Schnatter told Politico, “we will find tactics to shallow out any Obamacare costs and core strategies to pass that cost onto consumers in order to protect our shareholders’ best interests.”
After all, why should a multibillion dollar company show any concern for those who make its profits a reality?
Consider:
- Papa John’s is the world’s third-largest pizza delivery chain, operating in 49 countries and territories with over 5,500 locations globally
- As of late August 2025, it had a net worth of approximately $1.56 to $1.59 billion.
In May, 2012, Schnatter hosted a fundraising event for Republican Presidential candidate Mitt Romney at his own Louisville, Kentucky, mansion.
“What a home this is,” gushed Romney. “What grounds these are, the pool, the golf course.
“You know, if a Democrat were here he’d look around and say no one should live like this. Republicans come here and say everyone should live like this.”
Of course, Romney conveniently ignored an ugly fact:
For Papa John’s minimum-wage-earning employees—many of them working only part-time—the odds of their owning a comparable estate are non-existent.
Had Obama been the serious student of Realpolitick that his enemies claimed, he would have predicted that most businesses would seek to avoid compliance with his law.
To counter that, he should have required employers to provide insurance coverage for all of their employees—regardless of their fulltime or part-time status.
This, in turn, would have produced two substantial benefits:
- All employees would have been able to obtain medical coverage; and
- Employers would have been encouraged to provide fulltime positions rather than part-time ones, since they would feel, “I’m paying for fulltime insurance coverage, so I should be getting fulltime work in return.”
The “Casey Doctrine” of minimum compliance should always be remembered when reformers try to protect Americans from predatory employers.
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REPUBLICANS’ LATEST TARGET–DOCTORS: PART ONE (OF SEVEN)
In Bureaucracy, History, Law, Medical, Politics, Social commentary on September 25, 2025 at 12:11 amThere was a time when most Americans considered doctors heroes, as men (mostly) and women who dedicated their lives to improving—and often saving—the lives of others.
Television played a major role in shaping this image—not through documentaries but medical dramas.
In 1961, two such drama emerged as popular entertainment: Dr. Kildare (1961 – 1966) and Ben Casey (1961 – 1966).
As played by then-unknown actor Richard Chamberlain, young intern Dr. James Kildare tries to learn his profession and deal with patients’ problems.
Early on, his superior, Dr. Leonard Gillespie (Raymond Massey), warns him: “Our work is to keep people alive. We can’t tell them how to live any more than how to die.” Kildare ignores the advice, and this forms the basis for stories, many with soap-opera themes.
Richard Chamberlain and Raymond Massey in “Dr. Kildare.”
In Cult TV: A Viewers Guide to the Shows America Can’t Live Without, John Javna describes his character:
“Dr. James Kildare, the first bona fide TV hero of the 60s, symbolized the best hopes of this new era. Young, intelligent, committed, the evil he fought was disease. His weapons were a good education and a willingness to care about people….
“Americans were turning to science for salvation, and doctors were often the new gods.”
Ben Casey, on the other hand, brought other weapons to the medical drama: As a no-nonsense neurosurgeon (Vince Edwards), he was intense, aggressive, and never failed to display a hairy chest. He refused to go “by-the-book” when he thought he was right, often risking dismissal to save his patients.
The portrayal of doctors as heroes was promoted heavily by the American Medical Association (AMA). The organization created a committee in 1955 to ensure that these shows presented a positive image of physicians and accurate medical information.
Logo of the American Medical Association
Ben Casey and Dr. Kildare were soon followed by other popular medical dramas, including:
Medical dramas evolved over time, moving from shows that presented idealized images of doctors to shows that delve into the complex realities of modern medicine. Current trends include:
But for millions of Right-wing Americans, the medical profession generally—and doctors in particular—have become hated and feared targets.
Republicans’ animosity toward the healthcare system can be traced to 1964, with the passage of Medicare. This has proven the most durable achievement of Lyndon B. Johnson’s one-term Presidency.
And even while it was under debate, Republicans—such as Ronald Reagan at the start of his political career—furiously attacked it as the initial step toward socialism.
But it was President Barack Obama’s signature plan to give every American access to healthcare, the Affordable Care Act (ACA)—universally known as “Obamacare”—that pushed the Republican party into overdrive.
The reform effort became a lightning rod for Right-wing groups like the Koch-brothers-financed Tea Party. In 2010, a massive Rightist turnout cost the Democrats the House of Representatives, and threatened Democratic control of the Senate.
Niccolo Machiavelli (1469-1527), the Florentine statesman and father of modern politics, could have warned him of the consequences of this—through the pages of The Prince, his infamous treatise on the realities of politics:
…There is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle than to initiate a new order of things.
For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who would profit by the new order, this lukewarmness arising partly from fear of their adversaries, who have the laws in their favor, and partly from the incredulity of mankind, who do not truly believe in anything new until they have had actual experience of it.
Niccolo Machiavelli
This proved exactly the case with the proposed Affordable Care Act.
Its supporters have always shown far less fervor than its opponents—with House Republicans voting more than 70 times to repeal, delay or revise the law.
Critics like Alaska Governor Sarah Palin lied outright that the Act would implement “death panels.” In an August 7, 2009, social media post, she wrote:
“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society.”
Right-wingers pundits and their followers quickly agreed. On his syndicated national radio program, Rush Limbaugh said of Palin, “She’s dead right.”
Despite Republicans’ lies and threats, the Affordable Care Act was signed into law on March 23, 2010.
The rift between the Republican party and the medical establishment grew wider between 2020 and the present. This has been fueled by Republicans’ relentless opposition to abortion, birth control and transgender healthcare.
And, increasingly, Republicans—and their voters—attacked the very foundations of science itself.
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