I was recently asked to speak about healthcare at an event about the Affordable Care Act and President Obama’s reference to Teddy Roosevelt as the creator of the concept. The research to get the answer of how that comment came to be meant many hours of in-depth reading and even more on health in the United States during the Roosevelt Presidency.
There were two major events that were part of Roosevelt’s Presidency that speak to the health of the nation. During his time, professionally trained physicians were just coming into their own. Because of this, Patent medicines, that promised “miracle cures” and that could be delivered by mail were the accepted way that many treated their healthcare concerns. Add to that “electric belts” and a variety of inventions, and the population was looking for anyway they could to overcome their infirmities. The money that was being made by these “snake oil” salesman made many very wealthy. So much wealth was being made that one enterprising entrepreneur even offered to pay the entire bill for the Statue of Liberty if he could make the base an advertisement for his patent medicine.
Roosevelt knew that people were being harmed by these claims and risking their lives by taking them. He enacted the Pure Food and Drug Act, requiring that accurate ingredients be listed to warn the consumer of the what they were taking. Certain ingredients were included on the Government list of harmful, including cocaine, opium and cannabis. It also allowed for penalty to medicines that in name made impression that certain ingredients were inside, but that in actuality did not exist in the products.
On the same day, he also passed the Meat Inspection Act, allowing the government to control the inspection of beef and purity of meat goods sold, thus protecting the public from poorly preserved or dangerous meat that injured or killed. (badly canned beef was responsible for many deaths during the Spanish-American War, in which Colonel Roosevelt participated as a Rough Rider).
These two Acts had significant impact on the health of Americans and continue to exist today in modified forms of government oversight and regulation. Healthcare as we know it today was delivered by a fee for service model, with costs being affordable for many.
After he left the Presidency, Physician skills and medical technology had come a long way, and citizens were interested in accessing the new technology in an affordable way. Because most medical expenses were paid for out-of-pocket, the new technologies had become treatments for those who could afford them. A few larger companies offered access, but the general labor population and rural areas did not have easy access to the new innovations.
It wasn’t until he ran for President again in 1912 as a Progressive that his platform would include the idea of a more nationalized healthcare idea. Roosevelt’s concept was labor based, with burden for costs shared between workers, employers and the government. It was indeed progressive, and was not embraced by those who saw it as competition to making money with medicine.
If he would have been elected, we might have seen a large amount of the populace covered by a healthcare plan. Wilson was elected, crushing the idea until 100 years later.
I believe this quote from 1910 reinforces that if Roosevelt would have taken the Presidency, Healthcare would have been a high priority:
“Of all the questions which can come before this nation, short of the actual preservation of its existence in a great war, there is none which compares in importance with the great central task of leaving this land even a better land for our descendants than it is for us. Let me add that the health and vitality of our people are at least as well worth conserving as their forests, waters, lands, and minerals, and in this great work the national government must bear a most important part.”
Roosevelt believed that hard work paid rewards, and giving hard-working Americans access to maintain their health to accomplish mighty things would have been high on his list.