Compulsory Health Insurance, the Continuing American Debate  by Ronald L. Numbers, Editor. Greenwood Press, Westport, CT & London.  1982.

Review by Del Meyer, MD

This volume, which appears to be a continuation of Numbers’ prior volume, is also the 11th in a series titled “Contributions in Medical History,” with John Burnham as the series editor.  Numbers gives an historical overview in his preface on compulsory health insurance beginning with Germany in 1883, spreading to Austria in 1888, Hungary in 1891, Luxembourg in 1901, Norway in 1909, Serbia in 1910, Great Britain in 1911, Russia in 1912, Romania also in 1912, and the Netherlands in 1913.  In this country, Dr. Rupert Blue, president of the AMA, announced that compulsory health insurance would “constitute the next great step in social legislation.”  Time proved him wrong, but others made the same prediction:  In the middle 1930s (Roosevelt gave up on it only to save Social Security); the late 1940s (Truman made a 5-year effort for compulsory health insurance); the early 1960s (Congress passed an AMA-approved amendment to the Social Security Act providing federal taxpayers funds to meet the medical needs of the poor, the Kerr-Mills Bill.  In 1965, health insurance advocates finally won their first major victory: the passage of Medicare, a form of compulsory health insurance for the elderly on social security.)  Although voluntary health insurance had been available since the 19th century, it did not become popular until the Depression, when hospitals, led by the Baylor University Hospital in 1929, began experimenting with what came to be known as Blue Cross.

This volume is a series of essays that explores the historical context for understanding the 60-year-old debate over compulsory health insurance in America.  The details in chapter three are typical:  Proponents of compulsory health insurance judge the British experiment to be a great success, while opponents, viewing the same evidence, declared it to be a dismal failure.  The same pattern of interpretation has been repeated in recent years with our neighbor Canada.  The eighth and final chapter is by Wilbur Cohen who has devoted five decades of his life to the field of social legislation.  He concluded that after we came out of the problems of the 1980s, the issue of national health insurance would reappear.  We haven’t.  The issue has.