2.22.05

Whose Security?

A Voice from the Past

By Betsey Culp

The federal government these days is riffing on the word “security.” There’s the Department of Homeland Security, the National Security Council and its National Security Advisor, the National Security Agency — and yes, Social Security.

But it wasn’t so long ago that President Franklin Delano Roosevelt was offering his own riff on the word. In the 1944 State of the Union speech, FDR outlined a new, economic Bill of Rights for the United States, adding, “All of these rights spell security. And after this war is won we must be prepared to move forward, in the implementation of these rights, to new goals of human happiness and well-being.”

The idea of social security played a major role from the very beginning of the New Deal, and in 1935 FDR made it an official part of his administration by signing the Social Security Act, which created the Social Security Board. A grand game of musical chairs ensued:

In 1939, the Board became part of the newly created Federal Security Administration, along with Public Health Service, the Office of Education, the Civilian Conservation Corp., and the U.S. Employment Service.

In 1946, the Social Security Board became the Social Security Administration, still part of the FSA.

In 1950 President Harry S. Truman proposed a new cabinet-level department, to be called the Department of Health, Education, and Security, which was quickly shot down by Congress.

Eventually, in 1953, President Dwight David Eisenhower accomplished what Truman had been unable to do, although — perhaps because of Cold War concerns about national security — the new department was called Health, Education, and Welfare.

The new department later divided up & given other new names.

Now we are engaged in a new debate over Social Security — and social security, lowercased — testing whether its promise can long endure. To understand the roots of the present controversy, it may be useful to look at an interview recorded in 1969 with Oscar R. Ewing, head of FSA. Ewing recalls the furor surrounding Roosevelt’s and Truman’s original plans and the organized opposition to it. The entire interview can be found at http://www.trumanlibrary.org/oralhist/ewing3.htm; the interviewer is J. R. Fuchs. (Ewing later achieved additional notoriety as a proponent of socialism for his campaign to add fluoride to the nation’s drinking water.)

FUCHS: What are the chief reasons that you felt FSA did not achieve Cabinet status, I believe it was to be called the Department of Health, Education, and Security during Mr. Truman's time?

EWING: Oh, it was the opposition of the American Medical Association unquestionably. Both times the reorganization plans were sent up to Congress the AMA staged campaigns to prevent the agency being made a department. Their main argument was that they did not want me given a higher platform from which to argue for national health insurance.

FUCHS: Did they base their attacks on you solely or largely on principles or personality?

EWING: No. You see, national health insurance had been proposed by President Roosevelt in the very first social security bill introduced in Congress back in 1934. Later President Roosevelt dropped his support of national health insurance. I think he did this largely because he thought that including national health insurance in the bill might make it more difficult to get the social security program through Congress and that it would be better to take a step at a time, get what he could, and later try to get the more controversial parts of his program, such as national health insurance, adopted.

FUCHS: How did Mrs. Roosevelt, who we know was greatly interested in welfare type projects, feel about this earlier approach to health insurance?

EWING: I can say something about that that I learned from Arthur Altmeyer, who was a member of the first Social Security Board, and later when the Board was abolished, he became Social Security Administrator. I think Arthur knew what he was talking about when he told me this. He said that at the time the social security legislation was first introduced including the provision for national health insurance, some doctor friend of Mrs. Roosevelt had a talk with her and convinced her that it was very unwise to push for national health insurance; and that she convinced the President that it was unwise and accordingly he withdrew his support for the proposal. Later Mrs. Roosevelt changed her mind, apparently, because she became an active member of the Committee for the Nation's Health which was very strongly in favor of national health insurance. You see, even at that time, the United States was the only civilized nation that didn't have a national health insurance program in operation. National health insurance was started by Bismarck in Germany back in the 1880s and similar programs had been gradually adopted by other countries one after another. There had been ample experience so that we who were pushing it could say that it was a workable program that would fill a very great need.

FUCHS: Do you have any knowledge of how it worked in Germany, and was it continued under the Hitler regime and is it still in?

EWING: Oh, yes. It's worked very well there. And the interesting part of it is that, say from the 1880s on up until the American technology caught up, it was out of Germany that came all of the great medical advances. I wouldn't say that today nor would I say it of the time since World War II, but German medical research from the 1880s on was outstanding.

FUCHS: Was theirs linked with the social security type system?

EWING: I think it was. It is all part of a social insurance program.

….

FUCHS: Do you know when they first tagged it "socialized medicine" and how that came about?

EWING: I'm not sure but I think that what I will now say is correct. In California, Governor Warren back in the early 1940s had proposed a program of health insurance for the residents of California and he had legislation for it introduced into the California legislature. The California Medical Association staged a campaign in opposition. They spent a great deal of money for billboards, newspaper advertising, radios, etc. Their opposition was directed by a public relations firm in San Francisco known as Whitaker Baxter.  That was a husband and wife team. Clem Whitaker was the head of it and his wife, whose maiden name was Baxter, was the other partner. That fight took place before I was Federal Security Administrator, before I even got interested in national health insurance. Until I became Administrator the problem was one that I had had no reason to consider. After I became Administrator, I realized that President Truman was strongly in favor of national health insurance. It was, of course, my job to push any program that he wanted pushed. Then I soon came to realize that health insurance was an important subject and that I should know more about it and the country should know more about it. Accordingly, at the request of the President, I called a conference to consider the health problems of the country, not merely national health insurance but every phase of health problems that faced this country.

FUCHS: What year was that?

EWING: The conference was held in May of 1948 and covered the whole spectrum of medical problems.

FUCHS: Whose idea was it to call this conference?

EWING: Well, it originated in my office. I think it was Don Kingsley, my assistant administrator, who first suggested it. It's very hard to remember just who suggested an idea to you, but I know Don was very much interested.

The question you asked me is how the term socialized medicine came to be used and I was trying to give you a little background about that. It was sometime in early 1948 that I began publicly advocating national health insurance and it was becoming a controversial issue all over the country. This story that I am now telling you was told me much later. It was about this time that a friend of mine, Mike Gorman, was working on a paper in Oklahoma City, and he wrote an article for his paper that was quite favorable to the idea of national health insurance. The next morning he was called in by his publisher and fired. Mike's family lived in Los Angeles, so he returned there. He had been there only a few days when he received a telephone call from Clem Whitaker in San Francisco. Clem told him that the firm of Whitaker & Baxter had just been employed by the American Medical Association to conduct a hard-hitting fight against national health insurance and he would like Mike to join his staff and help in the fight. Mike replied, "Clem, I'm not sure. I don't think you can beat it. I'm convinced that it's the right thing to do and such a program will eventually be adopted and you can't stop it."

"Oh," Whitaker said, "that's easy. We've been through this fight with Governor Warren's proposal for a state health insurance program and it's a cinch to beat it. In order to do so, there are only two things that you have to have. First you have to give the program a bad name and we're going to call it 'socialized medicine' because the idea of socialism is very unpopular in the United States. We'll give it this bad name. No one wants to be, or at least very few want to have the tag socialist attached to them. Then the second thing you have to have is a devil. You have to have a devil in the picture to paint him in all his horns and we've got that man chosen. We first thought we would center the attack on President Truman, but we've decided he is too popular; but we've got a perfect devil in this man Ewing and we're going to give him the works."

So, apparently that is where the large scale use of the term "socialized medicine" all started.

FUCHS: Why did they feel that they had a perfect devil in you? Have you any idea?

EWING: Well, I think they had to center their attack on someone who was close to the program and was prominent in promoting it and since they had decided not to attack the President, my being second in the line, caught the fire.

….

FUCHS: Why were the pharmaceutical manufacturers so against national health insurance?

EWING: The reason for that is quite simple. In the original draft of the bill, which has been prepared in the Federal Security Agency, largely under the immediate direction of Dr. Isadore Falk, there had been included a provision to the effect that if the price of drugs became excessive the Government could step in and fix prices. That was a perfect anathema to the Pharmaceutical manufacturers, and I think it was unfortunate that it was put in. I say this because it instantly created a solid opposition from the pharmaceutical manufacturers and it wasn't necessary at that time. What should have been done was to make no mention of price control, get the program adopted and then if the manufacturers began charging excessive prices, that would be the time to consider legislation to control the situation. Later, I remember making a talk to the Pharmaceutical Manufacturers Association and I told them I thought they were very foolish to oppose the bill because it would mean a great deal more widespread distribution of health services and that would necessarily mean a much greater market for their products; that they would have dollars instead of dimes running through their cash registers. Actually I think that argument proved quite effective because shortly afterwards the pharmaceutical manufacturers, who had been the chief financial supporters of a so-called "National Physicians Committee for the Extension of Medical Service," withdrew their support. The National Physicians Committee was really the propaganda arm of the American Medical Association. You see, under the tax laws, contributions to an organization that uses its money for the purpose of influencing legislation cannot be considered a charitable deduction. The Physicians Committee had been set up because the American Medical Association didn't want to impair a ruling it had obtained to the effect that gifts to it were charitable gifts and therefore tax deductible. Actually, I think the AMA would have lost its tax-free gift status had they kept operating the Physicians Committee, because it was doing nothing but carrying on propaganda to influence legislation. Dr. Fishbein, the Executive Director of the AMA., was on the board of directors of the National Physicians Committee and there were other interlocking officers and directors.

FUCHS: Was he the principal man in the National Physicians Committee?

EWING: No. Dr. Morris Fishbein had been for many years the AMA's principal mouthpiece. He was a very vocal man and really brilliant.

….

FUCHS: I would like you to comment upon the positions of these people or any conversation you may have had with them upon national health insurance. David Dubinsky.

EWING: Oh, he was all for it.

FUCHS: What about Sidney Hillman?

EWING: I think Sidney Hillman died a couple of years or so before I became Administrator.

FUCHS: How about Phil Murray?

EWING: He was strong for the program.

FUCHS: And George Meany?

EWING: Oh, I had many contacts with George Meany. Well, that isn't quite an accurate statement. I saw him in my dealings with labor groups. I don't think I ever worked with him closely on anything.

FUCHS: Did you have private conferences with members of the AMA when you were going into this health insurance program? Also, what was their position towards voluntary insurance? Anything you might point up about this?

EWING: I did not have many talks with members of the AMA or with any of their representatives. My position was made clear in public statements so that they didn't try to persuade me one way or another. They showed their opposition in the literature that Whitaker & Baxter prepared for them and also by their active lobbying against the proposed legislation. They brought a lot of pressure on individual Senators and Congressmen. They particularly tried, I think in most cases successfully, to have a Congressman's individual doctor contact that Congressman and convince him what a terrible thing national health insurance would be. That was their technique. Whitaker & Baxter would prepare resolutions for various organizations to adopt. The local doctor would get — well, say the Daughters of the American Revolution to pass one of these prepared resolutions.

FUCHS: Did they work through any voluntary insurance companies such as Blue Cross or any other companies that you know of, to put on a campaign?

EWING: I'm sure that they did everything they could to defeat the bill. If any organization anywhere was susceptible to their wiles, why they would take advantage of it.

FUCHS: Doctor Robins, whom you mentioned before, in April 1950 was a Democratic National Committeeman from Arkansas, wrote the House Appropriations Committee and also the Department of Justice saying that your activities, "in promoting public meetings, traveling around the country, disseminating propaganda...diverting the agency's appropriations improperly...to stampede Congress into...the Socialistic compulsory health insurance program were improper and should be probed." Do you remember that?

EWING: Oh, vaguely. Those things were coming so fast that I don't remember Robins particularly. It was just one of many.

FUCHS: One of many.

EWING: As a matter of fact, we didn't spend a penny in public money propagandizing this program.

....

FUCHS: I believe that you participated in a "Town Meeting of the Air" debate with Nelson Cruikshank, Morris Fishbein and Senator Alexander Smith. Do you recall anything about that of interest?

EWING: Oh, yes. I'm not just sure when that took place but it was fairly early in my administration. "Town Meeting of the Air," was a radio program. Mr. Cruikshank and I had a number of sessions getting ready what we would say. As a result we came fairly well prepared. We knew that Dr. Fishbein wrote a syndicated column called "Dr. Fishbein's Diary," something after the manner of Dr. Pepy's Diary. Mr. Cruikshank had found one of Dr. Fishbein's so-called diaries in which he described a recent visit he had made to England. In the course of our debate Dr. Fishbein had described the horrible confusion that existed in the British Health Service that had recently been established in Britain. He told of the utter confusion that he found existed when he was in England a few weeks previously; that there were long queues in every doctor's office, that doctors were overburdened with paper work; that a mother who wanted an extra allowance of milk for her sick child had to get a doctor's prescription for it and then go to the Health Department for permission to buy the milk. Dr. Fishbein painted a picture of complete confusion. He described all these details as a result of a question Mr. Cruikshank had had planted in the audience which was: "Do you know how the British Health Service is operating now?" After Dr. Fishbein had described all these horrible details he found existing when in England a few weeks earlier Mr. Cruikshank pulled out this particular diary of Dr. Fishbein in which he described his last visit to London. He had arrived in London Friday morning and that afternoon had gone out to spend the weekend with Lord and Lady so-and-so at their country place; that he'd come back to London Monday morning, had stopped by the Health Department to pick up some papers, and had gone on to catch the noon plane for Paris. So the questioner then asked, "Well, is your appraisal of the British Health Service based on those few hours in London?" The question was a stinger and pretty much discredited Dr. Fishbein.

FUCHS: Did the press comment upon this "Town Meeting of the Air?"

EWING: I think it did but I don't recall. The press usually commented on all of their programs.

FUCHS: You don't recall how they felt that the opponents came out?

EWING: No, I don't know. But it wasn't too long after that that Dr. Fishbein resigned from his position with the American Medical Association.

FUCHS: Mr. Ewing, we can go ahead now. Do you have any other comments about Dr. Fishbein?

EWING: No. My personal relations with Dr. Fishbein were always very cordial.

FUCHS: Did you feel at any time the public had become somewhat apathetic about national health insurance either as a result of other matters or because of AMA's campaign?

EWING: Yes. But the latter part of 1950 I had become convinced that the public was not in a mood to support it. The AMA propaganda against it had been pretty effective and I had come to believe that we could not get our program enacted. Actually, the only way Medicare got enacted in 1966 was because an organized group, the Senior Citizen's Council, really got in the fight and showed some real political power.