2
Not Quite Catching the Wave: Health Care
and the Early-Twentieth-Century
Social Insurance Movement

The period from 1910 to the late 1930s saw the flowering of America’s welfare state in a variety of respects. States adopted workers’ compensation and mothers’ pension programs, Congress legislated a federal framework for state unemployment programs, and with the passage of the Social Security Act of 1935, Congress created old-age pensions, a federal cash welfare program for the children of single parents, and under later amendments to that landmark act, disability insurance payments for those unable to work. Governmentcoordinated health insurance, despite strenuous and prolonged efforts by progressive-minded advocates, was not included in this wave of social programming. Some social welfare historians have asserted that the early part of this period, particularly between 1915 and 1917, marked a moment when national health insurance stood a realistic chance of enactment. Although it is true that for a short time the leadership of the nation’s most politically active medical society, the AMA, did not actively oppose the idea, that posture did not endure, and throughout this period several other forces took a clearly negative view toward government-mandated health insurance. Organized labor divided on the question, with the influential American Federation of Labor opposed well into the 1920s. Southern members of Congress disapproved of how national health insurance might unsettle race relations, and even erstwhile allies of the reformers were skeptical of the administrative apparatus proposed to implement such a program. Complicating matters, Woodrow Wilson took little interest in health insurance during his administration, World War I blocked any grand plans for domestic

-23-

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