In February 1933, Franklin Roosevelt and Frances Perkins met in Roosevelt’s New York City home. The president-elect wanted his colleague in the New York state government to become the nation’s secretary of labor. Perkins would not accept this position unless she could pursue the goals important to her. These goals were breathtaking. The list included a minimum wage, maximum-hour laws, workers’ compensation, unemployment compensation, a public employment service, public works, a child labor ban, health insurance, and old age pensions.
Over the course of the Roosevelt presidency, Frances Perkins achieved substantial success. She met all but one of these goals, health insurance. She and Roosevelt fundamentally reordered American society. However, efforts at establishing health insurance met with defeat. Opposition mobilized by the American Medical Association was so intense that it threatened the passage of the 1935 Social Security Act.
This was not the first battle the AMA had won against the U.S. Labor Department. Shortly before, the children’s bureau of the department had lost funding for a successful initiative to reduce maternal and infant deaths. The AMA opposed the initiative as an intrusion into private medical practice.
A generation later, on July 30, 1965, President Lyndon Johnson signed the Medicare and Medicaid Act, which amended the Social Security Act. This new legislation initially provided health insurance for the elderly and the poor. It was, however, the result of a complex, torturous legislative history. Frances Perkins died two months before the bill was signed.
In his remarks at the signing, Johnson recognized numerous public officials who had contributed to the bill’s passage. There was no mention of Frances Perkins. However, Johnson quoted Roosevelt, who described the 1935 Social Security Act as “a cornerstone in a structure which is being built but it is by no means complete.” Johnson went on to say that “perhaps no single act in the entire administration of the beloved Franklin D. Roosevelt really did more to win him the illustrious place in history that he has as did the laying of that cornerstone.”
Additional efforts to build on that cornerstone have continued, especially during the presidential administrations of Bill Clinton and Barack Obama. Concepts such as “universal health care” and a “single payer system” provoke debate. Opponents of expanded health care include pharmaceutical and health insurance companies, fearing loss of profits or even their place in the national economy. Still, the battle rages to realize the final goal on the list that Frances Perkins presented to Franklin Roosevelt back in 1933.
The American people are increasingly aware that our country stands out as a scandalous exception in a world where numerous nations provide their people with a single payer health care system. The American people feel this scandal in a deeply personal way when they and their family members experience unnecessary suffering and die prematurely due to a lack of affordable medical care. While American medical technology is unsurpassed in the world, American health care delivery falls drastically short of a decent standard. People are often more concerned about paying for health care than they are about recovery from illness.
Frances Perkins was a devout Christian who lived her faith through public service for the common good. What America needs now more than ever is a health care system that serves the common good rather than corporate profit.
(Charles Hoffacker serves on the board of the Frances Perkins Center in Newcastle. An Episcopal priest since 1982, he is rector of St. Paul’s Parish, Baden, Md.
The Frances Perkins Center preserves and continues the legacy of Frances Perkins – the first female U.S. cabinet secretary, a principal architect of the New Deal, a key adviser to Franklin Delano Roosevelt, and a lifelong advocate for social justice and economic security. Through the center’s educational programs and advocacy, Perkins’ pursuit of social justice and economic security persists.)
