Barack Obama’s defence of his health care reforms may prove the most important speech of his presidency. Constantly reminded that defeat on the same issue crippled Bill Clinton’s first term, he knows how a hostile Congress could savage his plan and crush his authority.

He should also worry that the arguments being deployed against his proposals are remarkably similar to those that vanquished perhaps the best chance to introduce national health insurance just after the war.

In 1946 only a quarter of Americans had even basic health care insurance and as late as 1952 the Commission on the Health Needs of the Nation revealed that the country was annually spending more on tombstones than medical research. There was considerable interest in British proposals for universal welfare provision, and their principal author, William Beveridge, was feted when he toured the US in 1943. According to Gallup, 59 per cent of Americans wanted a publicly funded health scheme.

President Truman’s support was not enough to get the measures through a Republican-majority Congress. But in 1948 Truman resurrected his health care plan on the campaign trail. He duly won re-election to the White House, and the Democrats returned to power on the Hill.

However, physicians were alarmed and in December 1948 the American Medical Association launched its nationwide crusade against “the enslavement of the medical profession” to “politically controlled medicine”. A host of other professional organisations joined the assault on “socialised medicine”.

A Kansas doctor, Sam E. Roberts, appealed directly to Truman, stating that he had spent a summer in Britain and could thus attest to how governments destroy incentives when they “guarantee everything from birth to grave”. Truman replied, “When we find 34 per cent of our young men and women unfit for military service because of physical and mental defects, there is something wrong with the health of the country and I am trying to find a remedy for it.”

In reality, what Truman proposed was less like the British “publicly provided” NHS and closer to the “publicly organised” scheme that might have emerged if the Conservatives had won the 1945 general election. But he did not cost the plan. Bogged down in Congressional detail, the measure was lost and in the meantime the proportion of Americans taking out basic private health insurance soared, becoming a majority during the 1950s. In his memoirs Truman reflected, “I have had some bitter disappointments as President, but the one that has troubled me most, in a personal way, has been the failure to defeat the organised opposition to a national compulsory health insurance programme.”

Will these sentiments one day reappear in Obama: My Story?

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