Harry Truman and Health Care Reform: The Debate Started Here

Abstract

The signing of the Patient Protection and Affordable Care Act in March 2010 has not quelled the bitter debate over the issue of health care reform. National health insurance (NHI) plans have been considered by many presidential administrations since the beginning of the 20th century. Harry Truman (Fig 1) was the first US president to propose a system of NHI, however, when he addressed Congress on November 19, 1945.1 He had already included “the right to adequate medical care and the opportunity to achieve and enjoy good health” in his proposed Economic Bill of Rights. For Truman, the words did not go far enough. As a Jackson County, Missouri, judge, he had seen firsthand the disastrous effects that illness could have on a working family through his responsibility for the county poorhouse.2 He later learned that one-third of Selective Service registrants were rejected during World War II. In addition, many soldiers were discharged for health problems unrelated to combat, and still more were treated for conditions that predated their military induction. In his speech, Truman enumerated basic problems with health care delivery, including high costs and loss of earnings during illness. In response, he proposed compulsory NHI for all Americans and expanded social insurance systems to include replacement of lost earnings. FIGURE 1 President Harry S. Truman with March of Dimes children, 1950. Copyright unknown, courtesy of the Truman Library. NHI was not a new concept. Otto von Bismark initiated a compulsory health insurance program in Germany in 1883; its success led to the expansion of the concept of social insurance across Europe and the … Address correspondence to Robert D. Schremmer, MD, Division of Emergency Medical Services, Children's Mercy Hospitals and Clinics, 2401 Gillham Rd, Kansas City, MO 64108. E-mail: rschremmer{at}cmh.edu