With the issue of healthcare dominating the debate within the ongoing Democratic Primary, it is perhaps worth remembering the history of attempted healthcare reform in the United States. Critics of Bernie Sanders’s proposed ‘Medicare for All’ system have presented it as a radical and new idea, but in reality, the fight for a universal health care system has been prominent in the Democratic Party, and U.S politics, for over 100 years.
The campaign for ‘socialised’ healthcare began in the U.S, as well as Europe, in the early 20th century, in what became known as the ‘progressive era’. Prior to the First World War and Russian Revolution, there was a push to improve the conditions for the working classes. However, the U.S working class movement was generally more fractured than its European counter parts, and was less successful in achieving reform.
The concept of single-payer healthcare was supported by Theodore Roosevelt, and much of his campaign for the 1912 election was centred around health reforms, but he was defeated by Democratic candidate Woodrow Wilson, who was seen as more moderate on the issue.
Whilst in Europe, socialised progress was being made (such as the 1911 National Insurance Act in the UK), it was not in the U.S, which had already begun to develop a growing private healthcare industry.
Many industrial workers began receiving private healthcare through their employers, and often disliked the idea of losing it to a government provided insurance. As well as this, the American Medical Association (AMA) held a staunch anti-socialised healthcare stance, and were quick to dismiss any proposals.
Such a narrative was also heavily spread during WWI, in which ‘socialised’ healthcare was heavily associated with Germany, the birthplace of national health insurance. The combinations of these factors saw the defeat of the socialised healthcare movement for multiple decades.
That changed, however, with the election of Franklin Delano Roosevelt in 1932. After the Great Depression, and it’s devastating impact on the U.S populous, many people began looking to the government for reform and financial assistance.
This came in the form of ‘the New Deal’, a comprehensive set of government agencies and reforms, that spend vast amounts of money in an attempt to create economic growth and provide assistance for the tens of millions of people who had become unemployed.
This included a form of national health insurance, which Roosevelt attempted to include in his expansive 1935 Social Security Bill. However, once again, the prominent opposition by the AMA threatened to defeat the entire bill, and so was omitted.
The mantle of socialised healthcare was then taken up by Roosevelt’s successor, Harry Truman, who was a much fiercer advocate on the issue. He proposed a single universal comprehensive health insurance plan, and this pledge is cited by many as the reason for his surprise win in 1948.
However, this victory was met with mass panic by both the Republican party and the AMA. When the bill was proposed in 1949, the AMA launched a $1.6 million attack campaign, which was the most expensive ever at the time, and suggested the bill would “make doctors slaves”.
Similarly, the bill was heavily opposed by Republicans, who claimed the bill was “communist and un-American”. This campaign was very effective, especially as the Cold War began to escalate and anti-Soviet sentiments ran high. Once again, the movement for socialised healthcare was defeated.
This was until the 1960s, and the election of Kennedy and Johnson. JFK was outwardly in favour of a universal healthcare system, which he outlined in one of his most famous speeches in 1962.
However, by this point, the debate of a fully comprehensive program had been reduced to just including the elderly, which led to the proposal of the Medicare Bill, which was passed in 1965. To this day, it remains one of the U.S governments most popular programs, regularly reaching approval ratings of over 70%.
This momentum looked to continue through to the 1970s, with many bills for further expansion of Medicare being proposed. A prominent proponent of this was Ted Kennedy, who claimed that his life goal was to ensure that “Every American should be able to get the same treatment that U.S. senators are entitled to”.
Numerous bills were debated with then President Richard Nixon, but no compromise was ever reached, something that Kennedy has later expressed regret over. Similarly, Democratic President Jimmy Carter won election in 1976 on a program of national health insurance, but concerns over the economy meant the plan was side-tracked.
This continues the consistent theme of socialised healthcare being used as a tool for becoming elected, but then being inevitably discarded. By this point, the private healthcare industry had also become incredibly rich, and from 1970 onwards has been second only to the retail industry in terms of profitability.
The growth in political power for private healthcare companies coincided with the election of Ronald Reagan, and the ‘end of big government’. This was the beginning of a big shift away from socialised programs in mainstream U.S politics, and was only furthered by Bill Clinton, who deliberately moved his proposed healthcare reforms away from the term ‘socialised’.
Similarly, Barack Obama’s attempts at a moderate ‘public option’, was watered down even further into the Affordable Care Act, a world away from the bills of FDR, Truman and JFK.
For supporters of a socialised health system however, there is still hope. Whilst the private health industry is still incredibly powerful, and gives huge donations to most Democratic and Republican politicians, there has been a big shift in public opinion towards a ‘Medicare for All’ system in recent years.
What was seen as a fringe policy when proposed by Sanders in 2016, is now at the forefront of the national debate. Supporting it may be dismissed as ‘radical’ by some within the party, but with the Democratic party having such a long history of fighting for it, perhaps it is more radical not to support it.