The History and Future of Universal Health Care Efforts in the US

Ben H.

Hatched by Ben H.

Apr 18, 2024

4 min read


The History and Future of Universal Health Care Efforts in the US


The campaign for universal government-funded health care in the United States has been ongoing for nearly a century. Advocates have faced numerous setbacks and defeats, but the desire for accessible and affordable health care for all remains strong. This article will explore the history of universal health care efforts in the US and discuss the potential for future progress.

Early Efforts and European Influence:

The concept of universal health care first emerged in Germany in 1883 with the implementation of a system for workers. Other European countries, including Austria, Hungary, Norway, Britain, Russia, and the Netherlands, followed suit in the years leading up to 1912. Interestingly, the British and German systems were developed by conservative governments as a defense against the socialist and labor parties. This raises the question of whether a similar tactic could be employed in the US today, such as a Trump tactic in the 2024 election.

Progressive Era and the Role of Physicians:

During the Progressive Era, President Theodore Roosevelt expressed support for health insurance, recognizing the importance of a healthy and financially stable population. However, most of the reform efforts during this time occurred outside of government. In 1914, reformers sought to involve physicians in the formulation of a health insurance bill. Surprisingly, the American Medical Association (AMA) actually supported the proposal, with prominent physicians actively participating in securing legislation.

Union Concerns and Commercial Insurance Opposition:

Union strength was a central concern for labor organizations during the push for national health insurance. They feared that a government-based insurance system would weaken unions by assuming their role in providing social benefits. Additionally, opposition from the multi-million dollar commercial life insurance industry, which relied on the sale of insurance policies, posed a significant obstacle to the national health insurance proposal.

WWI and Anti-German Sentiment:

In 1917, the United States entered World War I, and anti-German sentiment began to rise. Government-commissioned articles denounced "German socialist insurance," linking it to a perceived threat to American values. This further complicated the universal health care efforts and hindered progress.

Committee on the Cost of Medical Care:

Concerns over the cost and distribution of medical care led to the formation of the Committee on the Cost of Medical Care (CCMC). This privately funded group, supported by philanthropic organizations, met from 1926 to 1932. While their meetings did not result in immediate progress, they laid the groundwork for future discussions and reforms.

Franklin D. Roosevelt and the New Deal:

Franklin D. Roosevelt's presidency, characterized by World War II, the Great Depression, and the New Deal, presented an opportunity for health care reform. However, the Great Depression shifted the focus to unemployment insurance and old age benefits. Fears that including health insurance in the Social Security legislation would jeopardize its passage led to its exclusion.

Aime Forand and Grassroots Support:

In 1958, Rhode Island congressman Aime Forand introduced a proposal to cover hospital costs for the aged on social security. The AMA launched a massive campaign against government insurance, but for the first time in the history of the national health insurance campaign, grassroots support from seniors forced the issue onto the national agenda. In response, the government expanded its proposed legislation to cover physician services, leading to the establishment of Medicare and Medicaid.

The Canadian Lesson:

Canada's journey toward universal health care provides insight into the potential timeline for progress in the US. The movement in Canada started in 1916 and took until 1962 for the passage of both hospital and doctor care in a single province. It then took another decade for the rest of the country to adopt universal health care. This history highlights the complexity and time required for significant health care reform.

Amazon's Contribution to Documentation Software:

In recent news, Amazon Web Services announced the launch of a generative artificial intelligence tool called AWS HealthScribe. This tool focuses on clinical documentation and aims to streamline the process of creating transcripts and summaries of doctor-patient discussions for entry into electronic health records. By leveraging speech recognition and generative AI, software vendors can simplify the documentation process and alleviate the burden on clinicians.


Universal health care efforts in the US have a long and complex history, with various obstacles and setbacks along the way. However, the desire for accessible and affordable health care for all remains strong. As we look to the future, it is essential to learn from past experiences and continue advocating for meaningful reforms. Three actionable pieces of advice for advancing universal health care are: 1) Foster grassroots support and mobilize communities to pressure lawmakers, 2) Engage with physicians and medical professionals to build consensus and support within the healthcare industry, and 3) Embrace technological advancements, such as Amazon's AWS HealthScribe, to streamline processes and improve efficiency in healthcare documentation. By combining historical knowledge, grassroots activism, and innovative solutions, the goal of universal health care in the US can become a reality.

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