HealthcareintheUnitedStates

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American Sentinel University *

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520

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History

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Apr 3, 2024

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Running head: HEALTHCARE IN THE UNITED STATES 1 Healthcare in the United States American Sentinel University HCA520

HEALTHCARE IN THE UNITED STATES 2 Healthcare in the United States Americans began receiving healthcare provided by the government in the very early 19 th century. Care was provided in what is referred to as almshouses or poorhouses, these houses served the indigent and provided shelter as they recovered. The government also created what is known as pesthouses for indigent patients that required segregation due to the infectious nature of the patient (McLaughlin, Johnson, & Sollectio, 2012, p. 5). During this time period, the wealthy did not seek out care in these facilities due to the unskilled nature of the physicians and nurses and the deplorable conditions. The wealthy paid for healthcare from their own pockets and sought out private care as needed. Most Americans at this time could not afford basic medical care. Leaving most without basic medical care. The establishment of increased medical training and the cleanliness of the facility in the early 20 th century, made seeking out care in hospitals widely accepted by all Americans. This included stringent requirements in education and training as well as on going credentialing by the American Medical Association (AMA). At this time most Americans could not afford modern healthcare due to the rising cost. The AMA national convention of 1926 had issues with the price of healthcare, at this time 15 delegates decided to investigate, and attempt to solve, the organizational problems leading to the rising costs of medical care. In 1927, a committee of the AMA produced the first estimate of national health care spending, about 4% of national income or $3.66 billion in 1929 (Gorman, 2006, p. 5). During the Great Depression 1929-1939, healthcare continued to be a source of great discussion and debate and the talk of socialized medicine was introduced. President Franklin D. Roosevelt charged committees with creating proposals for health care to add to the Social Security Act (the Committee on Economic Security and the Technical Committee on Medical Care). These committees worked in secret to create healthcare reform. The committees

HEALTHCARE IN THE UNITED STATES 3 recommended federal subsidies to states rather than a national system. However, these recommendations did not lead to any changes. The president was met with opposition form the AMA and dropped healthcare reform form his agenda. This left the American public with the burden of paying for their healthcare (Hoffman, 2003). Fee for service was introduced just prior to World War II, and what we know as managed care came soon after. Limitations were set on what network you may use. During World War II (WWII) 1941-1945 wage control was implemented and employers began offering insurance benefits to attract employees, a trend which continues to this day. Indeed, several key trends in health care emerged after WWII, medical and scientific technology advanced dramatically, and more people enrolled in health insurance coverage. At the end of WWII, Americans continued to seek out healthcare in greater numbers, largely due to many jobs being available that offered insurance plans. Healthcare in general continued to be the subject of debate through the 1950’s and 1960’s with little changes being made. President Lyndon Johnson signed Titles XVIII and XIX of the Social Security Act into law on July 30, 1965. Title XVIII established Medicare , which provided public health coverage to seniors over the age of 65. ("History of healthcare policy in the United States," n.d., para,8). The enactment of this law saw great numbers of Americans enrolling in Medicare, in 1966, 19 million people enrolled and by 2015, 55 million people were enrolled in Medicare ("History of healthcare policy in the United States," n.d., para, 9). The availability of these programs opened the door for more affordable care to all seniors and in 1972 title XVIII of the Social Security Act was signed into law. This law expanded Medicare coverage to disabled people who had been receiving Social Security benefits for at least two years, and to people with serious kidney disease. ("History of healthcare policy in the United States," n.d., para. 8)

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