She applied the “Page 99 Test” to her book, Burdens of War: Creating the United States Veterans Health System, and reported the following:Burdens of War is about the beginnings of the United States veterans’ health system. The excerpt on Page 99 describes congressional hearings that took place in December 1919, approximately one year after the Armistice of World War I. It features testimony of Rupert Blue, the Surgeon General of the Public Health Service. Blue was deeply concerned that his agency’s facilities were “overflowing” with recently discharged service members, whose care was funded by another federal entity, the Bureau of War Risk Insurance:Learn more about Burdens of War at the Johns Hopkins University Press website.As he reported that the Public Health Service and Bureau of War Risk Insurance were lacking in resources, the surgeon general also argued for legislation supporting “care for all discharged soldiers and sailors”… Blue offered an economic rationale as justification for providing care to all veterans. Expanding access, he said, will “operate to save the government millions of dollars in preventing or deferring the payment of compensation and insurance claims.” It would also, he maintained, foster industrial productivity; it made good business sense to provide “medical supervision for such a large portion of the population at the greatest productive age period.”Throughout Burdens of War, I connect policy debates and decisions with real life experiences of military veterans. Page 99 is heavy on the policy debate angle. That said, Blue’s statements hint at a central point of the book: the veterans’ health system was established, not simply because there was a consensus that former service members deserved publicly sponsored care, but because advocates made strategic, practical, and historically contingent arguments about why it was necessary.
Like many Progressive Era public health advocates, Blue believed that the government should play a role in enhancing citizens’ well-being. The proposal that publicly sponsored facilities provide care to “all” honorably discharged veterans – many of them unable to afford treatment otherwise – was, to him, perfectly logical.
But plenty of legislators disagreed. It was fiscally reckless and dangerously socialistic, they maintained, to provide federally funded health services to millions of veterans, including a great number who had never seen battle.
Blue’s pragmatic justifications for expanding access were intended to undercut the arguments of skeptics. Echoed throughout the interwar years by veterans’ advocates, they helped form a sturdy ideological foundation for the establishment of a vast, federally sponsored health care system tailored to the needs of former service members.
--Marshal Zeringue
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