Part IV. The Need for Reform: “Necessitous men are not free men.”

Mike Magee

The need for reform, especially following the Great Depression, was obvious to all. And no one understood the power of words better than the new president, Franklin Delano Roosevelt. Brimming with optimism, he channeled Emily Dickinson who wrote, “A word is dead when it is said some say. I say it just begins to live that day.”

She certainly was on the mark when it came to this President’s signature legislation. FDR’s “New Deal,” extending from 1933 to 1939, ultimately came down to just three words – the 3R’s – Relief , Recovery, and Reform.

He promised “Action, and action now!” This included a series of programs, public work projects, financial reforms, a national health care program and regulations… to provide support for farmers, the unemployed, youth and the elderly” And he wasn’t afraid to make enemies. Of Big Business, he said in a 1936 speech in Madison Square Garden, “They are unanimous in their hate for me – and I welcome their hatred.”

But he was also a political realist. And by his second term of office Justice Hughes and his Conservative dominated Supreme Court had begun to undermine his legislative successes and were threatening his signature bill- the Social Security Act.

In response, FDR found Hughes’s Achille’s heel. There were no Constitutional restrictions on the number of Supreme Court Justices. So FDR floated the idea of adding a Supreme Court justice for every member (all Conservative) over the age of 70. Known as “Court Packing”, just the threat was enough to dampen the enthusiasm of the Hughes “activist” court. But FDR also compromised – and one of those give-backs, in the face of withering criticism from the AMA, was abandoning further movement on national health care.

A decade later, now into his Fourth term, with massive public support, on June 11, 1944, he gave voice to a “Second Bill of Rights”, declaring that the Original Bill of Rights was “inadequate to assure us equality in the pursuit of happiness.”

It was clear from the speech’s beginning that he saw opportunity in this moment. He said:

“We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence.

‘Necessitous men are not free men.’ People who are hungry and out of a job are the stuff of which dictatorships are made.

In our day these economic truths have become accepted as self-evident. We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all—regardless of station, race, or creed.”

In FDR’s words: “This Republic had its beginning, and grew to its present strength, under the protection of certain inalienable political rights…As our nation has grown in size and stature, however—as our industrial economy expanded—these political rights proved inadequate to assure us equality in the pursuit of happiness.”

What was required, he believed was economic security and that entailed a progressive approach to employment, housing, medical care, social security, and education.

What FDR was suggesting was nothing less that a radical cultural shift. Among his itemized list of new “rights” were included:

The right to adequate medical care and the opportunity to achieve and enjoy good health;
The right to adequate protection from the economic fears of old age, sickness, accident, and unemployment;
The right to a good education.

He assigned his Military head of his wartime Organization of Science and Research development, Vannevar Bush, whose successes had led TIME magazine to invite the public in 1942 to “Meet the man who may win or lose the war”, the task of designing a peacetime health delivery system.

But on the eve of its delivery President Roosevelt died.

President Truman was quick to pick up the mantel, meeting with Vannevar Bush, and just six months later stating, “Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health… The time has arrived for action to help them attain that opportunity and that protection…as a definite public responsibility.”

But the moment was lost. By then the Pharmaceutical Manufacturers Association and the American Medical Association had joined hands, accusing the new President of advancing Socialized Medicine and “following the Moscow party line.”

If President Truman had been placed in check, Eleanor Roosevelt never missed a beat. During FDR’s final two terms as President, she had continued to write and travel building a worldwide portfolio marked by shared beliefs and a focus on poverty alleviation, access to education and civil rights.

Her anchor was Human Rights. As she stated at the Sorbonne in Paris in September, 1948, “People who have glimpsed freedom will never be content until they have secured it for themselves… People who continue to be denied the respect to which they are entitled as human beings will not acquiesce forever in such denial.”

Under the auspices of the newly formed United Nations, two months later on December 10, 1948, the U.N. adopted the Universal Declaration of Human Rights.

Of the rights defined and enumerated and endorsed that day was included Article 25: Right to An Adequate Standard of Living. It read:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family…”, and “Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”

One important contribution made that day had a lasting effect. It was a universal definition of health: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

And these were not merely empty words, even as our citizens rejected the Truman health care plan, their tax dollars supported the creation of comprehensive national health plans under The Marshall Plan – for our two vanquished enemies – Germany and Japan.

As the Rand Corporation stated, “Nation-building efforts cannot be successful unless adequate attention is paid to the health of the population.” But what was good enough for them apparently was not good enough for us.

Part V (continued).