1940s and 1950s Health Care

Roosevelt: Pre-1940

• New Deal: 1933– Ended Great Depression in 1941

• Social Security Act: 1935• The Technical Committee on Medical Care: 1937• Wagner National Health Bill: 1939– Increased aid and services

• Germany starts WWII: 1939• Soviet Union drawn into WWII

Roosevelt: 1940-1945• Democratic Congress• Emergency Maternity and Infant Care Program: early 1940s

– Provided maternity care of wives of army and navy enlisted men• U.S. enters WWII: 1941• Emergency Stabilization Act: 1942

– Encouraged employers to offer benefits, such as health insurance• IRS Employer Tax Incentive: 1942• War Labor Board: 1943

– Ruled health insurance exclusion from period’s wage and price controls• Wagner-Murray-Dingell Bill: 1943

– National health insurance funded through employee taxes• Public Health Service Act: 1944

– Increase in grant money for medical services and care– Grounds for public health insurance

Truman: 1945-1946Fair Deal

• Health Reform in the Fair Deal– Proposed single insurance system to cover all Americans

• McCarran-Ferguson Act: 1945• National Health Insurance Proposal: 1945– Re-proposed: 1947 & 1949– Cover all citizens

• Hill-Burton Act: 1946 – Enacted The Hospital Survey and Construction Act – Recognized those not able to pay for medical services

Truman: 1946-1953• Full Employment Act: 1946

– Use government resources to promote maximum employment, production, and purchasing power

• Termination of Fair Employment Practices Committee: 1946– Terminated despite Truman’s support

• Marshall Plan: 1948• Berlin Blockade: 1948-1949• Inland Steel Co. vs. United Steelworkers Union: 1949• Post-war Economic Boom!!!!!!• Social Security Act Amendment: 1950

– Permanently disabled eligible• Korean War: 1950-1953

Eisenhower: 1953-1959• Department of Health, Education, & Welfare: 1953• Medical Facilities Survey and Construction Act: 1954

– Amendment to Hill-Burton Act• Transfer Act: 1954

– Indian health care responsibility from BIA to PHS• Health Amendments Act: 1956

– Amends Public Health Service Act: 1944• Dependents Medical Care Act: 1956

– Health care for the family members of military personnel • Civil Rights Act: 1957• Federal Employees Health Benefit Act: 1959• Vietnam/Cuba

– Continued expansion of Communism

Social Leaders and Organizations

• Unions• AMA– Opposed national health insurance

• Blue Cross and Blue Shield• Southern Democrats– Wanted to maintain segregation in health care

• Majority in Congress– 1946: Republicans in control– 1948: Democrats in control

Racism and “Health Care”

• The Tuskegee Syphilis Experiment: 1932-1972– 400 African-American males purposely banned from

treatment over the course of 40 years to enable study of pathology via autopsy

– Made possible by leaders and staff of United States Public Health Service, incl. African-American nurse Eunice Rivers

– University of Virginia medical school eugenics curriculum consistent with beliefs of the time which still influence health care policy today!

– One lasting ramification: Modern lack of trust in gov‘t public health programs by minorities

Public vs. Private Health Insurance

• What’s the difference?– Administration Bill and AMA Plan

• Proposals– Private: AMA; Taft Bills– Public: Roosevelt’s plan; Wagner-Murray-Dingell Bills; Truman’s plan

• Key Players: Nationalized Health Care– For: Committee for the Nation’s Health, Organized Labor, Liberal

Farmers, Liberal Physicians, Henry Sigerist, Rep. Nixon(CA)– Against: AMA, American Hospital Association, American Bar

Association , southern Democrats, Chamber of Commerce • Debates

Implications of our Findings:Relating Then to Now

• Attitudes Towards Nationalized Health Care– AMA, Union, Southern Democrat: no longer opposition

• Socialism– Socialized medicine

• Private vs. Public Health Insurance

– Now know the outcomes of private health care– Internationally demonstrated outcomes of Nationalized Health Care

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