The Changing Role Of National Health Insurance In The 19th Century

In 1928, a national health insurance scheme was proposed but not implemented because it would have required businesses to provide contributions to health insurance for their employees (Evolution of Government Involvement in Health Care, n.d). Another national health insurance scheme was proposed in 1938 but it was also rejected (Evolution of Government Involvement in Health Care, n.d; Hilless & Healy, 2001). The next proposal was the 1945 Pharmaceuticals Benefits Act. This Act was not implemented because the Australian Medical Association challenged it in the High Court of Australia and it was decided that parliament had “exceeded its constitutional power” (Hilless & Healy, 2001). In 1946, under the Hospital Benefits Act, the Commonwealth began to subsidise public hospitals under the condition that patients would not be charged (Evolution of Government Involvement in Health Care, n.d; Hilless & Healy, 2001). This act is similar to the current Medicare system.

Prior to this shift, government involvement in health insurance services was minimal since it seemed to be under control by the non-profit sector. There didn’t seem to be an urgent need to control or universalize health care at the time. The government’s first interest in the health care industry sparked when employers began providing health care benefits as a competitive advantage for recruiting workers back into the workforce during World War II. To help cope with the rising unemployment rates, the government would offer tax incentives to employers providing these benefits. (add Quote)

rehend the PPACA, one must understand the history of the United States’ health care system. The most successful and known reform would be the passage of Medicare and Medicaid. President Johnson’s main objective with his program was to provide health insurance to those over 65 years old, who otherwise wouldn’t be able to receive coverage due to retirement or being financially unfit to purchase health insurance. It has since been expanded to cover those with disabilities, and lower income families (“Overview,” 2015). Brady (2015) examines President Clinton’s attempt to massively overhaul health care in the United States. His plan, the Health Security Act (HSA), required employers to offer health insurance to their employees, and mandated that every US citizen purchase health insurance. This plan would have most likely expand health insurance to many more Americans; however, many feared the large tax increases, restricted options for patients, and with the lack of general support for the bill, it failed in Congress and was never implemented (p. 628). President Clinton’s failed attempt at health care reform opened up the door to future reforms, and it even shared multiple similarities to the PPACA. Smith (2015) updates the history of the health care system in America stating that “In the mid-2000s, America’s uninsured population swelled to nearly 47 million, representing about 16 percent of the population” and how “16 million Americans […] were underinsured” (p. 2). People

In 1943, Senator Murray, Edward Wagner and Congress man Dingell introduced the United States National Health Insurance bill, the acting president at the time, Roosevelt, did not endorse the bill but was supportive(5). The National Health Insurance wasn’t a new concept. In 1883, Otto von Bismark introduced an obligatory health insurance program(6). Its’ success expanded the concept of social insurance in Europe and America. Without official endorsement by the president and with the war still going on, the Wagner-Murray-Dingell bill died in committee.

The advancement of APN has been previously linked to health care reform in the United States (Aiken et al., 2009). Health care reform first became a national topic in 1912 when Theodore Roosevelt pushed for national health insurance in his reelection bid for the United States presidency (Cass, 2012).

The healthcare system prior to 1950 has gone through several major changes to make it better. For example surgery now is better than surgery in the 1800s because people have made discoveries to make surgeries easier, faster and more safe to have a better chance of success.

There are four evolutionary phases in healthcare. The first phase was the preindustrial era, which started in the middle 18th century to the beginning of the 19th century. At this time, American medicine was not developing as fast as other countries; in Britain, France, and Germany, medical science and research was much more advanced than America. The postindustrial era began in the late 19th century, physicians in America were becoming more successful than others in the world. The third phase was the corporate era, which was marked by the growth of managed care, organizational integration, the information revolution and globalization. Finally, the fourth phase is the one in which we are in today, it is still fairly new and is characterized by the health care reform, which was brought about by the Affordable Care Act.

In the beginning of the late nineteenth and early twentieth century, the “healthcare system” was left in the hands of the states, which the states handed off to private and voluntary programs to deal with. In the presidential term of Teddy Roosevelt, 1901-1909, he felt that “no country could be strong whose people were sick and poor.” (Palmer 1999) He did however back health insurance as a whole. Roosevelt was not the one fighting for the health care though, there were outside forces that impacted health care. The American Association of Labor Legislation (AALL) led the campaign for health insurance. They drafted their first bill by 1915. This bill wanted to limit the coverage toward the working class and anyone who earned less than $1,200 a year including dependents. The American Medical Association (AMA) backed this bill because they felt the same way about coverage. The AMA did not speak for all doctors and those who opposed this backing spoke up. The American Federation of Labor (AFL) opposed the bill because they felt that it would weaken the unions and they wanted to maintain their strength. The private insurance

President Harry Truman was the first president to call for a national health insurance program. His first attempt failed in 1945. He would try again in 1947 and 1949 but failed to make it through Congress. It would be another 20 years before the idea of a national health insurance would come to fruition. On July 30th 1965, President Lyndon Baines Johnson signed Medicare into law. Immediately upon signing the law into effect, President Johnson issued 81 year old former President Harry Truman the very first Medicare card. In its first year of enactment, the Medicare program received 19 million enrollees. Medicare is a national health insurance program provided for Americans who are 65 years of age and older and who have worked/paid into the

Health care reform and access to insurance have been staples of the American political agenda ever since the end of World War II. From President Truman’s call for universal coverage in the late 1940’s to the creation of Medicaid and Medicare to the Affordable Care Act, both parties have debated how to lower the rate of uninsured Americans. After nearly 70 years of debate in Washington and beyond, the number of Americans with health insurance has certainly grown (Miller, 2014). However, the number of people in the United States without coverage is still unacceptably high and a problem that should be addressed with a great deal of urgency and care.

What aspects and characteristics of American health care of the 18th and 19th centuries have had a major impact on shaping today’s U.S. health care system?”

During the beginning of this era, reformers had the support of President Theodore Roosevelt who thoroughly believed “that no country could be strong whose people were sick and poor”. In 1915, a bill was proposed by the American Association of Labor Legislation (AALL) that limited coverage to working class individuals whose annual income was less than $1200 a year and included hospital services, sick pay, maternity benefits, and funeral expenses (Palmer, 1999). This system was believed to “relieve poverty caused by sickness” and would “yield a net savings for society” that would benefit not only citizens but businesses as well (Toland, 2014). Opinions on the AALL bill were mixed. The American Medical Association (AMA) was included in the formulation of the bill, leading them to create a committee whose entire aim was to assist the AALL but a disagreement over physician payment led the AMA to redact their support (Palmer, 1999). The American Federation of Labor continuously spoke against universal health care, fearing that it would result in complete state supervision over citizen’s health and would undermine current worker unions and the benefits they provided. Within all of this was also the strong opposition of the private insurance industry which, oddly enough, rested on the inclusion of death benefits in the AALL bill which had

Healthcare didn’t always exist in the United States. Before the 1920’s, most people didn’t have health coverage. Most people were treated at home and hardly anyone, except a few large employers offered healthcare. Everyone else paid out of pocket. As the population shifted from rural areas to urban centers, families lived in smaller homes with less room to care for sick family members (Faulkner 1960, p. 509). Increasing requirements for licensing and accreditation, in addition to a rising demand for medical care, eventually led to rising costs. By the end of 1920s, there was an increased demand for medical care and the costs of medical care increased.

In this paper I will provide my understanding on why I feel Clinton’s Health Plan was unsuccessful. I will discuss the features of Clinton’s health care reform plan and provide my reasons I feel it failed. I will also discuss the influences of the various interests groups and governmental entities that were present during this process. Lastly I will discuss the policy process and policy environment key players that were involved and the other circumstances that shaped this policy-making effort.

Throughout the first part of the 20th century there was little effort to promote health insurance, but in the second half of the 20th century healthcare became a major concern. Once, Medicare and Medicaid were introduced in 1965 the government along with its citizens took a major step in the progression of healthcare. From then, there was a shift in the privatization of healthcare. This forced many of the lower class to be without health insurance. In 1993, President Clinton with the best of in intentions failed at establishing a universal healthcare system in the United States. Finally in 2006, Massachusetts passed a law that would provide healthcare coverage for all of its state residents. In 2010 the