National Health Act

Introduced by Sen. Robert Wagner initially as S. 1050 to the 79th Congress (1945-1946) with financing, and introduced later without financing as S. 1606 to the same Congress, then by Sen. James Murray as S. 1320 to the 80th Congress (1947-1948). Companion legislation was filed by Rep. John Dingell initially as H.R. 3293 to the 79th Congress (1945-1946) with financing, and later without financing as H.R. 4730 to the same Congress.

Photo: President Harry Truman giving a radio address in 1946.

Index of Information on the National Health Act

• History of the National Health Act
• Details of the National Health Act
• Public Hearings on the National Health Act
• Contemporary Summaries and Analysis of the Health Security Act
• Information on the Senate Bills
• Bibliography of Historical Writings on the National Health Act

---

History of the National Health Act

After proposing an “economic bill of rights” during his State of the Union speech in January 1944, President Roosevelt at long last gives his administration the green light to push ahead with national health reform, convening a Health Program Conference in New York City.

In April 1945 Roosevelt dies and his VP Harry Truman becomes President just as WWII is coming to an end. Senators Wagner and Murray and Rep. Dingell file an early version of their National Health Act in May 1945 as S. 1050 and H.R. 3293, but as both bills contain financing proposals, they are sent to the Senate Committee on Finance and the House Ways & Means Committee, where they meet a cool reception and poor chances of a public hearing.

Far from shying away from FDR’s health program, in November 1945 President Truman proposes a national health program in a speech to Congress. Wagner, Murray, and Dingell decide to strip the National Health Act of financing details, and resubmit their bill as S. 1606 and H.R. 4730, allowing the Senate bill to be referred to the Committee on Education and Labor, which is chaired by Senator Murray, who launches extensive hearings in April through July of 1946.

Republicans, led by Senator Taft, walk out of the hearings when Sen. Murray asks that participants not inaccurately describe the proposal as socialist or communist. With significant opposition from the medical industry, no chance in the House, and some internal divisions within the Truman administration about how the program should work, Sen. Murray closes down the hearings and shelves the bill for the next session.

Republicans sweep the 1946 elections, gaining veto-proof majorities in both houses, and hold their own hearings in the Senate, where Murray’s re-filed National Health Act (S. 1320) is also discussed, but has no chance of passage.

---

Details of the National Health Act

The National Health Act would create a national health insurance plan, administered by the Surgeon General’s office, covering most benefits except for dental and home-nursing care initially. All U.S. residents who had been paid wages during 6 of their previous 12 quarters would be eligible for the program. All seniors eligible for Social Security benefits would also be covered, along with the dependents of eligible residents.

The Act gives the Surgeon General broad discretion over payment methods to providers, and is also empowered to impose cost-sharing if it is determined necessary, or even restriction of some benefits if necessary.

A separate program is created to cover “the needy” – low-income residents who may not have the wage-income history to qualify for the national program – by providing grants-in-aid to States (a precursor proposal to Medicaid).

During WWII, the U.S. Children’s Bureau had administered a massive medical insurance program for soldiers’ spouses and children under the Emergency Maternity and Infant Care Program, and the National Health Act protects this existing program by creating another separate expansion of grants-in-aid to states for maternal and child health services, which would be administered by the Children’s Bureau.

---

Public Hearings on the National Health Act

During the 79th Congress the Senate Committee on Education and Labor held 35 days of public hearings on S. 1606 from April to July of 1946.

The subsequent legislative session, the Subcommittee on Health of the Senate Committee on Labor and Public Welfare held an additional 19 days of public hearings on S. 1320 between May 1947 and January 1948.

---

Contemporary Summaries and Analysis of the National Health Act

Report of the Committee on Education and Labor on S. 1606, including Summary and Q&As, titled “National Health Act of 1945” (Senate Committee Print No. 1, November 26, 1945):

---

Report of the Committee on Education and Labor on S. 1606, views for and against the bill, titled “National Health Act of 1945” (Senate Committee Print No. 1, December 4, 1945):

---

Information on the Senate Bills, S. 1606 and S. 1320

Summary and Q&A on S. 1606 as submitted to the Congressional Record by Sen. Wagner on November 19, 1945:

---

The full text of S. 1606 (extracted from the first public hearing hosted by the Committee on Education and Labor, held on April 2, 1946):

---

Background and summary of S. 1320 as submitted to the Congressional Record by Sen. Murray on May 20, 1947:

---

The full text of S. 1320 (extracted from the first public hearing hosted by the Committee on Labor and Public Welfare, held on May 21, 1947):

---

Bibliography of Historical Writings on the National Health Act

• Anderson, Odin W. “Compulsory Medical Care Insurance, 1910-1950,” The Annals of the American Academy of Political and Social Science 273, Medical Care for Americans (Jan., 1951): 106-113.
• Derickson, Alan. “Health Security for All? Social Unionism and Universal Health Insurance, 1935-1958,” The Journal of American History 80, no. 4 (Mar., 1994): 1333-1356.
• Doherty, Kathleen, and Jenkins, Jeffery A. “Examining a failed moment: national health care, the AMA, and the US Congress, 1948-50.” Paper prepared for presentation at the 2009 Annual Meeting of the Southern Political Science Association (January 2009), New Orleans, LA.
• Falk, I. S. “Medical Care in the USA: 1932-1972. Problems, Proposals and Programs from the Committee on the Costs of Medical Care to the Committee for National Health Insurance,” The Milbank Memorial Fund Quarterly. Health and Society 51, no. 1 (Winter, 1973), 1-32.
• Poen, Monte M. Harry S. Truman versus the Medical Lobby: The Genesis of Medicare. Columbia, MO: University of Missouri, 1996.
• Starr, Paul. “Transformation of defeat: the changing objectives of national health insurance, 1915-1980,” American Journal of Public Health 72, no. 1 (January 1, 1982): 78-88.