Health care issues in the United States, 1875–1900

Health Care 1875-1900

The history of health care in the United States is one that often brings to mind traditional and folk medicine subverted and them overtaken by the greatest scientific medical care in the world. The United States played an integral role in the development of modern medicine and at the root of such change is a small group of years. The changes that occurred between the years 1875 and 1900 almost exclusively revolves around legal issues as forces of change in the medical world. The legitimating of medicine as a vocation, rather than as an avocation began during these years. The seeds of health care consumer protection began to weed out what it considered unfounded forms of medical care and bean in stead to replace such care with trained medical care, that was taught in schools rather than in the best since through oral history or experience ad n in the worst sense as a sham to make money.

Health care is the largest single industry in the country. Health policymaking in the United States involves a complex web of decisions made by various institutions and political actors across a broad spectrum of the public and private sectors. These institutions and actors include federal, state, and local governments in the public sector. In the private sector they include health care providers such as hospitals and nursing homes, health care professionals, and health care purchasers such as insurance companies, industries and consumers. In addition, a wide variety of interest groups influence and shape health care politics and policymaking. (Patel & Rushefsky, 1995, p. 1)

The difference between the preceding players in the health care industry and that which began to evolve during this period is based on the ideals of a scientific and centralized source for the good of many as apposed to the profit and false hope of a few,

Though there are many who would say that the beginning of the legalization and exclusionary actions of a small group of men in a small area of the country did more harm than good to the evolution of health care, the reality is that the intentions were largely associated with protecting the public from scam artists who made a great deal of money selling "snake oil" cure alls and other things with unproven and impossible claims of restorative powers. Claiming that many combinations of inert ingredients had amazing restorative powers in what would be called by many an entertainment venue, could at best rob the aggrieved of a few hard earned pennies and at worst actually harm a person who might have really needed available medical care.

The entire history of modern medicine, it has plausibly been argued, has been a war against nature, that nature which sickens, cripples, and kills us. Yet of late there has been a powerful movement toward alternative medicine, and particularly the notion of holistic health based on a supposedly richer understanding of nature; and a no less strong emphasis, in conventional medicine, on the development of good health habits, based on the ancient Greek notion of hygeia, that a proper heeding of the needs of the body will allow the body to take care of itself with minimal medical intervention. (Callahan, 1999, p. 7)

Though there is some evidence that the harm done to traditional folk healers and especially the midwifery avocation is irreparable the intentions where to more safely provide medical care to all people. The issue is still hotly debated with some level of contempt by both natural healers and medical doctors today practicing what some call heroic medicine. (Haller, 1994, p. 41) Yet there is at least limited evidence that from the beginning there was at least a marginal attempt to compromise the modern with the traditional as some forms of folk medicine or alternative medicine began to reappear as options for education and practice in the early years.

An early sign of compromise came in Michigan, where the state legislature required the incorporation of homeopathy into the University of Michigan Medical School. The regulars were aghast but finally yielded. Once the school added a homeopathic division in 1875,professors of the two camps taught there together. (Starr, 1982, p. 100)

During these years a few substantial events occurred within the legislation of health care.

The American Public Health Association (APHA) is founded. This organization is concerned with the social and economic aspects of health problems.

The National Quarantine Act is signed into law. This legislation is designed to prevent entry into the country of persons with communicable diseases.

1899 the National Hospital Superintendent's Association is created. It later becomes the American Hospital Association.

Patel & Rushefsky, 1995, p. xvii)

The seeds of health care legislation and centralization began before 1875 but began to take hold as the most accepted manner in which to ensure safe and scientifically founded health care for many and to begin to ensure that diseases that commonly plagued a newly urbanized and highly stressful environment of mass immigration could be dealt with, in a more centralized and practical manner. Founded earlier in 1847, the American Medical Association began to have a concrete and centralized role in the health care decisions of the nation. Without such intervention by this group the foundations of modern health care may have been stunted by the continued emphasis on profit driven false hope.

Another beginning during the short period was the establishment of insurance consortiums as a source for centralized health care reform and management. These organizations began to offer people assurance that if their needs for health care outweighed their ability to pay for it out of pocket they would care for them and their families One of the first such companies was the Prudential Insurance Company of America, whose roots are detailed in a wonderful work that encompasses it history during the very years here in question. (Morone & Belkin, 1994, p. 55)