Persuaded, American Physicians and Compulsory Health Insurance, 1912-1920
by Ronald L. Numbers. The Johns Hopkins University press, Baltimore & London. 1978.
Review by Del Meyer, MD
Numbers points out in his preface: “In 1911 the British parliament passed a National Insurance Act making health insurance mandatory for most employees between the ages of 16 and 70. The following year the American Association of Labor Legislation created a Committee on Social Insurance to prepare a model health-insurance bill for the United States, and by 1916 several state legislatures were actively considering bills that would have covered virtually all manual laborers earning $100 or less a month. No such law ever passed, but between 1916 and 1920 compulsory health insurance was a real possibility in a number of industrial states.”
In this study of America’s first debate over compulsory health insurance, Numbers focuses on the changing attitudes of the medical profession. The initial response of physicians to compulsory health insurance was surprisingly positive. From the AMA to various state and sectarian medical societies, the feel prevailed that this method of paying medical bills was both inevitable and desirable. By 1917, however, medical opinion was beginning to shift, and, before long, scarcely a physician could be found willing to endorse such a “socialistic” proposal.
In an era prior to opinion polls, Numbers relies on medical society minutes, unpublished correspondence, and the numerous national, state, and local publications to present what he feels is a reasonably accurate reading of the prevailing view of the medical profession. As the public debate continues, it behooves as many of us as possible to become conversant with how health care evolved to our present dilemma.