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July 11—17, 1938

President Franklin Roosevelt Fights for a National Health Plan

On July 15, 1938, President Franklin Roosevelt wrote a letter of greeting to the representatives of the public and of the medical professions who would be attending the National Health Conference in Washington, D.C. Roosevelt told them that there was a pressing need for a coordinated national action program on health. "Such a program," wrote the President, "necessarily must take account of the fact that millions of citizens lack the individual means to pay for adequate medical care."

Franklin Roosevelt's campaign for better health care for Americans had begun at Warm Springs, Georgia, where he focussed not only on his own rehabilitation from polio, but became an expert on physical therapy for the disabled. Literally summoned from Warm Springs by his nomination for Governor of New York, Roosevelt won the office, and then embarked on a campaign to provide better health for all New Yorkers. He began his famous radio "fireside chats" were while he was New York's Governor, and used them to report to his constituents on future plans, and to what extent the legislature had or had not acted upon them.

On February 18, 1931, Roosevelt devoted the whole of a radio message to the problems of the crippled, appealing to people to stop hiding their crippled children in back rooms or the attic and to bring them to doctors or public health officers so that their problems could be diagnosed and they could then be treated with modern medicine. In that address, Roosevelt stated, "People know well that restoring one of us cripples—because as some of you know, I walk around with a cane and with the aid of somebody's arm myself—to useful occupations costs money." But he stated that the cost was justified, even if merely from a monetary standpoint, because crippled people could then become part of society and earn a living.

Governor Roosevelt appointed a Special Health Commission and then sent its report to the Legislature in February of 1931. The outstanding feature of the report was its proposal to institute county boards of health, rather than relying on the smaller town and city boards which did not have the population or wealth to support vital medical infrastructure. The legislature, which was controlled by Republicans allied to President Herbert Hoover, ignored the proposal on county boards of health, but it did vote to fund a smaller proposal for building three state tuberculosis sanitariums.

In June of 1931, Roosevelt attended the annual Governors' Conference at French Lick, Indiana. There, he outlined a program for dealing with the deepening Depression, including measures instituting a progressive, rather than regressive, tax system; dealing with unemployment by providing jobs; and working out a system of health insurance for people who could not afford medical care.

By the summer of 1932, Roosevelt was the Democratic candidate for President, and he was furious when the Hoover Administration made attempts to cut appropriations for child-welfare work. A member of Hoover's Cabinet had suggested that the Depression wasn't altogether a bad thing for the nation's children, and Roosevelt responded that unemployment of parents led to malnutrition for the children, something which would affect them for the rest of their lives.

Governor Roosevelt stated that the Federal Government had no continuing policy for dealing with the problems of public health and social welfare. "I propose," he said, "to inaugurate a definite long-range plan for dealing with all phases of public health and welfare, which are a proper concern of the Federal government. May I add that, in the State of New York, during the past four years, we have accomplished definite and practical results by coordinating and planning the work of the state? I cite as a simple example the public-health program, which is a part of my administration. It has been referred to in other states as the most important contribution to practical public-health work during this generation."

In the notes to his public papers, Roosevelt reviewed his actions as President to develop a comprehensive health plan for all Americans, as he had promised during his campaign. "In 1934," wrote Roosevelt, "I appointed the Committee on Economic Security whose research and recommendations formed the basis of the Social Security Act. In an address to the Advisory Council of the Committee on Economic Security a few months after its appointment, I called attention to the need for study of plans which would minimize the economic loss due to sickness.

"The Social Security Act of 1935 authorized an annual appropriation of $8,000,000 to enable the Public Health Service to assist states and their local subdivisions in training personnel and maintaining public health services. Under the 1939 amendments to the Act, this authorization was increased to $11,000,000.

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