Contributed by Wendy R. Leibowitz

“I have had some bitter disappointments as president, but the one that has troubled me most, in a personal way, has been the failure to defeat organized opposition to a national compulsory health insurance program.”

-Letter, cited in Poen, Monte M.: Strictly Personal and Confidential: The Letters Harry Truman Never Mailed, Boston: Little Brown, ed. 1982. See also:  http://www.thealliancefordemocracy.org/pdf/AfDJR3314.pdf

Following the health care reform debate of 2009 was difficult enough, but one thing made it harder for some Truman Scholars: the failure of many media outlets to mention Harry S. Truman as the first president to champion national obligatory health insurance coverage. Many publications and electronic services mentioned Clinton’s failed attempt, but the references to “HillaryCare” far outnumbered references to “HarryCare.”  (OK, that term did not exist when Truman held office. But shouldn’t it have been invoked in 2009?) Truman’s efforts, over many years, to obtain national compulsory health insurance were strikingly more similar to the current administration’s efforts than more modern efforts had been.

Within a year of taking office, Truman called for compulsory health insurance for all, funded by payroll deductions. All citizens would receive medical and hospital services regardless of ability to pay. The plan went nowhere. Actually, it went nowhere twice—reform efforts failed in both his first term (1945-1949) and his second term (1949-1953).

The first time he proposed it, Truman simply did not have the stature or the personal influence over Congress to bring such a change about.  He had been vice president for only 82 days when President Franklin Roosevelt died. Truman’s image was of someone who had become president by a “wild accident,” in the words of a newspaper columnist of the day, Max Lerner. David McCullough, in his best-selling biography, Truman, explains that Truman’s plain-speaking style—a stark contrast to FDR’s more elegant speech—did not help polish Truman’s image as a powerful statesman who could steer the ship of state well, let alone into the unknown waters of universal health insurance. Truman himself stated to the press corps, shortly after taking the oath of office: "Boys, if you ever pray, pray for me now. I don't know if you fellas ever had a load of hay fall on you, but when they told me what happened yesterday, I felt like the moon, the stars, and all the planets had fallen on me." After Truman left office, his honesty came to be admired, but at the outset of his presidency, the “I’m just a man from Missouri” talk did not increase people’s confidence in his abilities.

Truman’s relations with Congress were rocky, and his poll numbers low. Still, in November 1945, Truman called for the creation of a national health insurance fund to be run by the federal government. The fund would be optional and open to all. Participants would pay monthly fees into the plan, which would cover the cost of any and all medical expenses. The government would pay for the cost of services rendered by any doctor who chose to join the program. Truman argued that the federal government should play a role in health care, saying that, “The health of American children, like their education, should be recognized as a definite public responsibility.”

For the first time in our country’s history, Congress had before it an official administration proposal for a general program of national health insurance: the Wagner-Murray-Dingell bill. Truman called national health insurance a cornerstone of “The Fair Deal.” The idea in general was popular: a poll published in Forbes magazine showed 74 percent of the public favoring such a plan, and a Gallup poll showed 59 percent favored some kind of broad national program of health insurance.

But the plan couldn’t even get a hearing before the House Ways and Means Committee. The hearings in the Senate were bitter and divisive in ways that might sound familiar today. The acrimony did not help further a civil discussion of the issues. In the 1946 congressional elections, the New Deal-Fair Deal programs were a major campaign focus. The Republicans won their first majority in Congress since 1932 using the slogan, “Had Enough?”

Subsequent years solidified the opposition to government health insurance. Organized labor turned to employers to provide health care for their employees. The American Medical Association asserted some of the same arguments that helped kill “HillaryCare”: the United States already had the highest standards of medical care in the world. While there were some problems, great progress was being made at addressing them within the free enterprise system. Second, government control of medical care would undermine the existing system (which was the best system in the world, etc.)  Additionally, universal health insurance would be so expensive that it might bankrupt a country that needed to rebuild Europe after the war, fight Communism abroad and at home, and strengthen the free enterprise system. Finally, the AMA felt it was unnecessary: private insurance was capable of doing the job. The doctors’ organization distributed millions of pamphlets and won endorsements from almost 2,000 organizations, from the American Bar Association and the American Dental Association through the Catholic Church and the General Federation of Women’s Clubs. Support for national health insurance evaporated.
Even after Truman won a stunning electoral victory in 1948, with national health care as a new plank in the Democratic platform, the plan could not make it out of committee. His “Whistle Stop Tour” of the country—9,505 miles, through 18 states, delivering 73 speeches—helped to restore a (small) Democratic majority in Congress. But other concerns, from ant-Communism to the newly shaky economy to the Korean War, took precedence. By the election of 1950, a conservative postwar Congress married health insurance to patriotism. Opposition to the private insurance system was portrayed as un-American and "revolutionary," particularly by the American Medical Association.

On July 30, 1965, President Lyndon Johnson traveled to Independence, Missouri, to sign the new Medicare bill at the Truman Library so a frail Truman could be in attendance. According to McCullough’s biography, Truman sat with a cane in his lap as Johnson signed the law for health insurance for the elderly that Truman had championed (for all) two decades ago.  McCullough writes that Truman said, “You have made me a very, very happy man.”

Wendy R. Leibowitz (DC ’80) is a lawyer and writer in Washington, DC.

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