FRANKLIN D. ROOSEVELT | President Franklin Roosevelt discusses an extension of Social Security benefits to include hospitalization—the germ of Medicare

FRANKLIN D. ROOSEVELT

TYPED LETTER SIGNED ("FRANKLIN D. ROOSEVELT") AS THIRTY-SECOND PRESIDENT, TO DR. S. S. GOLDWATER, RESPONDING TO HIS INQUIRY ABOUT THE EXTENSION OF SOCIAL SECURITY BENEFITS TO INCLUDE HOSPITALIZATION

One page (10 3/8 x 8 in.; 265 x 202 mm) on blue-embossed White House letterhead, Washington, 9 February 1942; staple holes and paperclip shadow in upper left corner. Accompanied by a copy of Dr. Goldwater's letter to Roosevelt, 23 January 1942.

Dr. Sigismund Schulz Goldwater, a world-renowned expert on hospital administration and a strong proponent of national health services, was working at New York City's Welfare Hospital for Chronic Disease (which he had been instrumental in founding and which would eventually be renamed for him), when he addressed a letter to the President on the topic of "Federal Hospitalization and the Voluntary Hospital System." 

In a recent budget message to Congress, Roosevelt had suggested Social Security benefits be extended to include hospitalization. Goldwater reminded the President that he had stated in that message, "I oppose the use of pay roll taxes as a measure of war finance unless the worker is given his full money's worth in in increased Social Security." But, Goldwater continued, he had lately been presented with the outline of a program by representatives of Roosevelt's administration, "which would not 'give the worker his money's worth,' [and] which would gravely affect the voluntary hospital system." Goldwater assures the President that he is writing "not in opposition, but rather because I am in full sympathy with your social aims, and would regret to see a faulty system established in haste. In such a matter, method is all-important." 

Sensing a potential important ally, Roosevelt sent a detailed response: "As you recognize, there is as yet no final plan to provide the hospitalization payments which I recommended be furnished as an integral part of the social insurance system. The study of plans is proceeding.

"I gather that the Chairman of the Social Security Board [Arthur J. Altmeyer] outlined a tentative plan for the informal discussion to which your refer. In view of the doubts you express that this particular plan would give the worker his full money's worth in increased social security for such additional taxes as may be levied for these purposes, I hope you will make available to Mr. Altmeyer the grounds for your opinion and will lend assistance in the studies which are under way.

"All of us have a deep concern that we should work out for submission to the Congress a program which will give the maximum possible return, in social security, for the contributions paid." Roosevelt assures Dr. Goldwater that Chairman Altmeyer "will carefully consider suggestions from all who like yourself have special interest and competence in this field."

A decade into the FDR presidency, the legislative appetite for his social programs had considerably slackened, and no such proposal for a national health insurance plan funded by payroll taxes ever came to a vote. In 1965, long after the deaths of Goldwater and Roosevelt, Congress passed Title XVIII of the Social Security Act, which established Medicare.