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Health Care Reform and History

Class 2: Health Politics in the 1920s and the Great Depression


In 1920 Congress passed the Sheppard-Towner Act, the first federal program funding health services for mothers and infants. However, in the late 1920s and 1930s, health reformers lost ground as Congress ended Sheppard-Towner and President Franklin D. Roosevelt refused to include coverage for medical care in the Social Security Act.

Class Resources
Primary Sources
Secondary Sources
  • Lemons, J. Stanley. “The Sheppard-Towner Act: Progressivism in the 1920s.” The Journal of American History Vol. 55, No. 4 (March 1969): 776–786.
  • Blumenthal, David and James Morone. “Franklin Delano Roosevelt: The Enigmatic Angler.” In The Heart of Power: Health and Politics in the Oval Office. Berkeley: University of California Press, 2005, 21–56.
Discussion Questions:
  1. How do the letters to the Children’s Bureau help us understand women’s experiences of childbirth, motherhood, and medical care? Why do you think they wrote to a government agency about their problems?
  2. Why did Congress approve the Sheppard-Towner Act in 1920 but end the program in 1929?
  3. Why did Franklin D. Roosevelt refuse to include health coverage in the Social Security Act? What role did the medical profession play in his decision? Other factors?
  4. Watch and/or read Franklin D. Roosevelt’s Four Freedoms and Second Bill of Rights speeches. How did he define freedom and security? Do you agree with Blumenthal and Morone that FDR would have pushed for national health insurance had he lived? What evidence do Blumenthal and Morone use to make this argument?
  5. Analyze the impact of the Great Depression and World War II on health care politics in the U.S.
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