HISTORY This Week: When America Almost Had Universal Healthcare

Episode Release Date: February 10, 2025
Host: Sally Helm
Guest: Professor Marcela Alshon Angelopoulos, Harvard University

Introduction

In this compelling episode of HISTORY This Week, host Sally Helm delves into a pivotal moment in American history: the near-adoption of universal healthcare in the United States. Titled "When America Almost Had Universal Healthcare," the episode explores the intricate dynamics between the American Medical Association (AMA), political strategists, and the New Deal-era policies that could have dramatically reshaped the nation's healthcare landscape.

The AMA's Opposition to National Health Insurance

At the heart of this historical narrative is the AMA's vehement opposition to national health insurance. In 1935, amidst the Great Depression, the AMA recognized the limited scope of existing sickness insurance, which primarily consisted of prepayment hospital plans covering only room and board. The AMA feared that a comprehensive national health program would encroach upon doctors' autonomy and financial stability.

Marcela Alshon, a medical doctor and economist at Harvard University, provides insightful analysis on this period. She states, "Solution, that private health insurance was simply better, more efficient, more equitable. Somehow the outcome of a competitive process never did. I think it was the outcome of an interest group." (09:09)

Dr. Charles E. Hummiston of Illinois highlights the urgency within the medical community, calling the moment a "national emergency" (06:07). Dr. R.B. Anderson of Texas echoes this sentiment, remarking that the medical profession was facing "the most serious situation it has ever, ever faced in the history of this country" (06:07).

Campaigns, Inc.: The Architects of Anti-Healthcare Propaganda

To counter President Franklin D. Roosevelt's proposed national health insurance, the AMA enlisted the services of Campaigns, Inc., a pioneering political consulting firm founded by Clem Whitaker and Leon Baxter. Originally masterminding attack ads against political figures like Upton Sinclair, Whitaker and Baxter were adept at leveraging media to sway public opinion.

Alshon explains, "They moved their office from Sacramento to Chicago. That's where the AMA is headquartered and launched what they call the National Education Campaign" (26:12). However, this "education" campaign was anything but educational. Instead, it was a strategic dissemination of fear-mongering messages equating national health insurance with socialism.

Whitaker addressed medical professionals directly, stating, "Compulsory health insurance will mark the beginning of the end of free institutions in America" (27:33). The use of trusted voices—physicians—to propagate anti-government healthcare messages was a cornerstone of the campaign's effectiveness.

The Collapse of Truman's Health Plan

Following Roosevelt's death, President Harry Truman inherited the push for national health insurance. Despite initial optimism, Truman's plan faced overwhelming resistance fueled by the AMA's aggressive campaigning. In 1952, Truman's health initiative suffered a significant blow as the Republican Party, influenced by the AMA's rhetoric, adopted a staunchly anti-national health insurance stance.

Alshon notes, "People exposed to the campaign seemed to be more likely to sign up for private health insurance. Public opinion shifted too. When Truman first announced the plan, about 60% of people supported it, according to Gallup. By 1953, it's only 30%" (16:32; 30:07). This dramatic shift underscored the effectiveness of the AMA's strategies in eroding public support for government-backed healthcare.

Ultimately, Truman was defeated in the 1952 presidential election by Republican Dwight D. Eisenhower, marking the definitive end of his national health insurance efforts. The AMA's intensive three-year campaign had successfully neutralized the movement towards a universal healthcare system.

Long-Term Implications on American Healthcare

The thwarting of national health insurance in the mid-20th century set the stage for the complex and fragmented healthcare system that the United States grapples with today. Alshon reflects on this legacy, stating, "I don't think they ever could have imagined the juggernaut that would kind of be released and unfold does now the US Healthcare industry. And it's become, you know, an industry" (31:35).

The current system, characterized by high costs and varied coverage, stands in stark contrast to the more unified approach that was nearly realized. Alshon emphasizes the inefficiencies and disparities inherent in the American model, noting, "We spend so much more than any other country. And our outcomes are, I think, on many outcomes, lackluster" (31:49).

The AMA Today and Reflections on Progress

Despite representing a significant portion of American doctors, the AMA's influence has waned compared to its peak in the 1930s and 1940s. While today’s AMA supports a blend of private and government-backed insurance plans and advocates for improvements to the Affordable Care Act, the dream of a comprehensive national health system remains unfulfilled.

Alshon envisions a more rational and efficient system, stating, "Having a much more rational system that is more about delivering care and less about reducing costs and increasing revenues. I mean, that would be a game changer" (32:27). This suggests that overcoming the entrenched interests and systemic complexities introduced in the past is essential for meaningful healthcare reform.

Conclusion

When America Almost Had Universal Healthcare offers a nuanced exploration of a critical juncture in U.S. history. By intertwining firsthand accounts from the 1930s through expert analysis, the episode underscores how institutional resistance and strategic misinformation can profoundly influence public policy and societal welfare. As the United States continues to navigate its healthcare challenges, understanding this historical context provides valuable lessons for future advocacy and reform efforts.

Notable Quotes:

• Dr. Charles E. Hummiston, Illinois: "This is a national emergency." (06:07)
• Dr. R.B. Anderson, Texas: "The medical profession of the United States is facing the most serious situation it has ever, ever faced in the history of this country." (06:07)
• Clem Whitaker, Campaigns, Inc.: "Compulsory health insurance will mark the beginning of the end of free institutions in America." (27:33)
• Marcela Alshon, Harvard University: "Solution, that private health insurance was simply better, more efficient, more equitable. Somehow the outcome of a competitive process never did. I think it was the outcome of an interest group." (09:09)
• Professor Marcela Alshon Angelopoulos: "Knowing that they didn't have to fight so hard just to get the MRI covered or that medication prescribed. There's many different ways to do it, but having a much more rational system that is more about delivering care and less about reducing costs and increasing revenues. I mean, that would be a game changer." (32:27)

Credits:

• Guest: Marcela Alshon Angelopoulos, Professor of Public Policy at the Kennedy School of Government and Professor of Public Health at the Chan School of Public Health, Harvard University.
• Produced and Sound Designed by: Ben Dickstein
• Executive Producers: Eli Lehrer and Liv Fiddler, History Channel
• Production: Back Pocket Studios in partnership with the History Channel

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