In 1946, just seven months into his administration, President Harry Truman proposed a sweeping national health insurance program. In terms of its design and scope, it was remarkably similar to the type of plan President Obama and congressional Democrats are considering today. The debate that followed and the circumstances that led to the plan’s demise should be a lesson to anyone with a similar idea in the 21st century.
While Truman was the first President to publicly propose a national health care plan, the idea didn’t start with him. Franklin Roosevelt, Truman’s predecessor, had considered adding a national healthcare insurance plan to the 1935 Social Security Bill.
Realizing that the pension program’s success in Congress was by no means guaranteed, Roosevelt decided to drop the controversial health care provision. The idea languished until Truman, shortly after the end of World War II, picked up the idea and made it one of the hallmarks of his presidential agenda.
The Truman health care plan, much like the plans being considered by Congress today, would have created a national health insurance program. Americans who chose to participate would pay subsidized premiums and would receive coverage similar to that provided by private plans.
The bill had trouble from the start. Liberal Democrats supported it, but Republicans and Southern Democrats, concerned about the price tag didn’t like the idea. Many were also skeptical about the government’s ability to administer such a large program.
The American Medical Association labeled it “socialized medicine” and assessed their members an extra $25 to organize a campaign against the initiative. The bill stalled.
Truman wasn’t deterred, and when he started his famous 1948 campaign against Thomas Dewey, he made national health insurance one of his campaign themes. He used it as a hammer and repeatedly accused the Republican 80th Congress of failing to act on his health care bill. It was good fodder for the campaign trail. After the election, even with the Democrats in control of Congress and Truman’s continuing support, the bill wasn’t able to muster enough support to make it out of committee.
But there was more going than just opposition in Congress. The healthcare marketplace in the late 1940’s was rapidly changing. Private insurance plans were becoming a standard part of employee compensation packages.
This had begun in World War II as an added inducement to keep and retain workers. By war’s end, 28 million American families had private health care plans. Eight years later, when Truman left office, another 50 million Americans had signed up for employer sponsored health care plans. This growth in private plans, with more and more Americans feeling they had adequate coverage through the market, dampened the public’s enthusiasm for a national healthcare plan.
Supporters of government-provided national health care consider Truman and his national health insurance program to be a martyr in their cause. But the lesson they and Truman missed wasn’t that it failed because of special interests or an intransigent Congress.
It failed because the American people became convinced that the private sector could better meet their health care needs than the government. Obama and his advisers pride themselves on being such careful students of history, but in this case, they might have learned the wrong lesson.
Examiner contributor David S. Kerr lives in Alexandria.
