Jill Lepore: Health care hopes ... from the 1910s





“At present the United States has the unenviable distinction of being the only great industrial nation without compulsory health insurance,” the Yale economist Irving Fisher said in a speech in December. December of 1916, that is. More than nine decades ago, Fisher thought that universal health coverage was just around the corner. “Within another six months, it will be a burning question,” he predicted. Oh, well. What’s a century, give or take?

Health care has been on the docket longer than most Americans can expect to live, with or without it. “Let’s take a quick trip back in time,” Sheldon Whitehouse, a Democrat from Rhode Island, said on the Senate floor this past July, whereupon he proceeded to page through back issues of the Times, quoting headlines about the astronomical cost of health care in 1992, 1988, and 1979, all the way to 1955 (the year he was born), to read this timeless line: “As it does each year without fail, the government declared again this week that it is time to do something about the rising cost of medical care.” Health-care reform isn’t premature, Whitehouse insisted. It’s “55 years late.” (Or ninety-three. But who’s counting?) Last month, Congresswoman Sheila Jackson-Lee, a Texas Democrat, echoed the point that it was funny to call health-care reform “rushed”: “America has been working on providing access to health care for all Americans since the nineteen-thirties, the nineteen-forties, the nineteen-fifties, the nineteen-sixties, nineteen-seventies, nineteen-eighties, and the nineteen-nineties.”

True enough, but don’t forget the nineteen-tens. In 1912, the year after Parliament passed a National Insurance Act, the American Association for Labor Legislation (which Glenn Beck would surely call Bolshevik but was, in fact, a group of economists whose officers included Louis Brandeis, Jane Addams, and Woodrow Wilson) formed the Committee on Social Insurance, the brainchild of Isaac M. Rubinow, a Russian-born doctor turned policy wonk and the author of the landmark study “Social Insurance.” Rubinow hoped that “sickness insurance” would help eradicate poverty. It was also the next logical step after workers’ compensation, which the association had got passed in more than a dozen states. By 1915, Rubinow’s committee had drafted a bill providing for universal medical coverage. “No other social movement in modern economic development is so pregnant with benefit to the public,” the editor of the Journal of the American Medical Association wrote. The next year, Congress began debating Rubinow’s bill, which was also put forward in sixteen states. That’s why Irving Fisher was so optimistic. It looked like this thing was good to go.



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