A "Solemn Obligation": Soldiers, Veterans, and Health Policy in the United States, 1917–24

From 1917 through 1924, policy makers, soldiers, and veterans laid the groundwork for the extension of government-sponsored medical care to thousands of former service members in the United States. In the process, they helped define the American welfare state. World War One-era policies shaped military and veterans' health care for the greater part of the twentieth century, and underpinned the 1921 creation of the Veterans’ Bureau (VB), one of the nation’s first and most enduring direct assistance government agencies. In 1924, all ex-soldiers – not just those harmed in the line of duty – gained legal access to the veterans’ hospitals overseen by the VB. The guarantee of medical care for veterans provided allowances for some of those who made extreme personal sacrifices. But it also helped set the precedent that, in the U.S., state-sponsored privileges could be earned by virtue of membership in a definable group, not birthright or citizenship.

The guiding question of this project is: How and why did one group of U.S. citizens earn the status of a political interest group worthy of access to publicly-funded medical services? I use personal and professional correspondence, organizational minutes, diaries, newspapers, and government documents from a variety of archives to show that, in spite of the lofty political rhetoric often employed to explain why certain benefits have historically been extended to soldiers and veterans, it is imprecise to view state-funded medical care as a “right” that was naturally and willingly granted to those who served. Long after President Woodrow Wilson declared, in December 1918, “this nation has no more solemn obligation than healing the hurts of our wounded…” the government struggled to figure out how best to fulfill its self-declared responsibility. A crisis situation resulting from pre-war planning oversights, and vigorous political lobbying – both arising as anti-radicalism and expectations of professional medicine grew – led to the creation of a federally-sponsored hospital system for veterans. By tracking how medical care came to be granted as a political right to certain Americans, this poster addresses general questions regarding the tensions surrounding citizens’ and states’ expectations of each other.