The Struggle for Universal Health Care and the Crisis of Mentally Ill Inmates in the US

Ben H.

Hatched by Ben H.

Jul 12, 2023

4 min read


The Struggle for Universal Health Care and the Crisis of Mentally Ill Inmates in the US


The pursuit of universal government-funded health care in the United States has been a long and arduous journey. Over the course of nearly a century, advocates have faced numerous setbacks and defeats. Meanwhile, the issue of mentally ill inmates languishing in jails without proper treatment has reached crisis levels. This article examines the historical efforts for universal health care in the US and explores the current challenges faced by mentally ill inmates.

The Historical Quest for Universal Health Care:

The movement for universal health care began in the late 19th century, with Germany being the first country to implement a system for workers in 1883. Other European countries, including Austria, Hungary, Norway, Britain, Russia, and the Netherlands, followed suit. Interestingly, the British and German systems were established by conservative governments as a means to counter the socialist and labor parties. This raises the question of whether a similar tactic could be employed in the US.

During the Progressive Era, President Theodore Roosevelt expressed support for health insurance, but most of the reform efforts took place outside of government. In 1914, reformers sought the involvement of physicians in formulating a health insurance bill, and the American Medical Association (AMA) actually supported the proposal. However, concerns were raised by the American Federation of Labor, who feared that a government-based insurance system would undermine the role of unions in providing social benefits.

One of the major challenges faced by the reformers was opposition from the multi-million dollar commercial life insurance industry. They argued that covering death benefits would help finance the costs of health insurance, but this proposal was vehemently opposed by the industry. Furthermore, during World War I, anti-German sentiment in the US led to the denouncement of "German socialist insurance," which further hindered progress.

Franklin D. Roosevelt and the New Deal:

The tenure of President Franklin D. Roosevelt was marked by significant challenges, including World War II and the Great Depression. While the conditions created by the Great Depression seemed ideal for the passage of compulsory health insurance, other priorities took precedence. Unemployment insurance and old age benefits were prioritized, leading to the exclusion of health insurance from the Social Security legislation.

In 1958, Congressman Aime Forand introduced a proposal to cover hospital costs for the aged on social security. This marked a turning point in the national health insurance campaign, as grassroots support from seniors forced the issue onto the national agenda. The AMA responded by introducing an "eldercare plan," which sparked further debate. Ultimately, this led to the creation of Medicare and Medicaid, which addressed the healthcare needs of the elderly and low-income individuals.

The Crisis of Mentally Ill Inmates:

In recent years, there has been a significant increase in the number of mentally ill inmates in jails across the US. The Wall Street Journal's analysis of state data reveals that this growing crisis is overwhelming space in psychiatric hospitals. Many inmates who require court-ordered treatment remain in jail, unable to stand trial and without access to appropriate care.

The system for addressing the mental health needs of inmates is flawed. Unlike psychiatric hospitals, jails cannot force inmates to take medication, and the availability of prescriptions is often limited. Additionally, the scarcity of behavioral-health services and workers has become dire, exacerbating the problem. The lack of monitoring and proper treatment in jails can contribute to the worsening of mental health conditions.

Actionable Advice:

  • 1. Increase funding for mental health services: Addressing the crisis of mentally ill inmates requires adequate funding for mental health services and facilities. This includes expanding the capacity of psychiatric hospitals and ensuring access to appropriate treatment for inmates.
  • 2. Improve collaboration between healthcare and criminal justice systems: Closer collaboration between healthcare providers and the criminal justice system can help ensure that mentally ill individuals receive the necessary care and support. This includes implementing diversion programs to redirect individuals away from incarceration and towards treatment.
  • 3. Raise awareness and reduce stigma: Educating the public about mental health issues and reducing stigma can help create a more supportive environment for individuals with mental illness. This includes promoting understanding and empathy and advocating for policy changes that prioritize mental health care.


The long and complex history of efforts for universal health care in the US reveals the challenges and obstacles faced by reformers. Similarly, the crisis of mentally ill inmates in jails highlights the urgent need for comprehensive mental health care reform. By learning from history, taking action to address the current issues, and prioritizing the well-being of all individuals, progress can be made towards achieving universal health care and ensuring proper treatment for the mentally ill.

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