The Long Road to Universal Healthcare: Lessons from History

Ben H.

Hatched by Ben H.

Sep 20, 2023

4 min read


The Long Road to Universal Healthcare: Lessons from History


The pursuit of universal healthcare in the United States has been a long and arduous journey spanning over a century. Despite numerous attempts, the goal of achieving comprehensive, government-funded healthcare for all citizens has remained elusive. In this article, we will explore the historical background of universal healthcare efforts in the U.S., drawing insights from international examples, and discussing the recent agreement between Humana Inc. and Interwell Health that expands care for individuals living with chronic kidney disease.

A Brief History of Universal Healthcare Efforts in the U.S.:

The campaign for universal healthcare in the United States has faced repeated setbacks and obstacles. It traces back to the late 19th century when countries like Germany, Austria, Hungary, and Britain introduced systems for workers to counteract the growing influence of socialist and labor parties. Paradoxically, these systems were implemented by conservative governments as a means of consolidating power.

During the Progressive Era in the early 20th century, President Theodore Roosevelt supported health insurance, recognizing that a strong nation cannot exist if its people are sick and impoverished. However, the majority of reform initiatives took place outside of government. In 1914, reformers collaborated with physicians, and even the American Medical Association (AMA) backed a proposed bill. Simultaneously, labor unions expressed concerns that a government-based insurance system would undermine their role in providing social benefits, ultimately weakening their power.

Another significant development was the establishment of the Committee on the Cost of Medical Care (CCMC) in the 1920s. Comprised of philanthropic organizations, the committee aimed to address concerns about healthcare costs and distribution. However, the committee disbanded without substantial progress by 1932.

The New Deal era under Franklin D. Roosevelt saw the exclusion of health insurance from the Social Security Bill, as the CES feared it would impede the legislation's passage. It was not until 1958 that hospital costs for the elderly were proposed by Rhode Island congressman Aime Forand. The subsequent grassroots support from seniors marked a turning point in the national healthcare debate.

The AMA responded by introducing an "eldercare plan," prompting the government to expand its proposed legislation to include physician services. Ultimately, this led to the establishment of Medicare and Medicaid in 1965 as part of President Lyndon B. Johnson's Great Society Legislation.

Lessons from Canada's Journey to Universal Healthcare:

Drawing inspiration from international examples, Canada's path towards universal healthcare began in 1916 and took nearly five decades to achieve. The first province to implement comprehensive hospital and doctor care was followed by the rest of the country, culminating in the passage of nationwide healthcare. This example highlights the lengthy and complex nature of implementing universal healthcare systems.

Humana and Interwell Health's Agreement for Chronic Kidney Disease Care:

In a significant development, Humana Inc. and Interwell Health recently announced a value-based care agreement to expand comprehensive care for members living with chronic kidney disease (CKD) and end-stage kidney disease (ESKD). This partnership will benefit most Humana Medicare Advantage HMO and PPO members in 13 states, as well as members across the country with ESKD.

Actionable Advice:

  • 1. Advocate for Grassroots Support: The success of the movement towards universal healthcare in the U.S. has often been driven by grassroots support. Engage in community organizing, awareness campaigns, and lobbying efforts to build momentum for change.
  • 2. Collaborate with Medical Professionals: Involving physicians and medical organizations in the formulation of healthcare reform proposals is crucial. By addressing their concerns and soliciting their active support, the chances of enacting meaningful change increase significantly.
  • 3. Embrace Incremental Progress: The journey towards universal healthcare may not occur overnight. It often requires incremental steps and compromises. While comprehensive reform is the ultimate goal, celebrating and supporting smaller victories along the way can sustain momentum and build public trust.


The United States has a long and complex history of pursuing universal healthcare. Examining the lessons from past efforts and drawing inspiration from successful examples, such as Canada, can inform future endeavors. The recent agreement between Humana and Interwell Health represents a step forward in expanding comprehensive care for individuals with chronic kidney disease. By embracing grassroots support, collaborating with medical professionals, and recognizing the value of incremental progress, we can continue to strive towards a more equitable and inclusive healthcare system for all.

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