History of healthcare systems and evolution

¶ … History of Healthcare

In The United States

It appears that the history of healthcare in the United States began sometime in the early 1900's during a time known as the Progressive Era, a reform movement which began in the states and by 1910 had spread through much of America. Basically, those linked to this era wished to make the federal government more responsive to the will of the people, to limit the power of great corporations, to protect the helpless and guarantee justice to poor and indigent Americans (Anderson, 2006, p. 56). Before this time, the federal government "took no actions to subsidize voluntary funds or make sick insurance compulsory" and generally "left matters to the states and to private and voluntary programs." However, there seems to have been a number of voluntary healthcare-related funds set up by companies and individuals in case employees became sick, but there were "no federal or state legislative public programs during the late 19th and early 20th centuries" ("A Brief History," 2009, Internet) aimed at providing healthcare coverage. In effect, all Americans were forced to make their own way when it came to healthcare.

Between 1901 and 1910, President Theodore Roosevelt made some rather weak efforts to create healthcare insurance for all Americans, but because of conservative policies in the federal government, the creation of healthcare insurance was left to reformers outside of the government. However, in 1906, the American Association of Labor Legislation (AALL) created a nationwide campaign for healthcare insurance and managed to draft a bill which "limited coverage to the working class and all others that earned less than $1,200 a year, including dependents" ("A Brief History," 2009, Internet). This bill also included the services of professional health practitioners, sick pay, maternity benefits and death benefits, but unfortunately, the bill did not move the federal government in the right direction. But in 1914, the American Medical Association (AMA) openly supported this bill and actively became involved with the AALL and in 1916, the AMA created "a united front on behalf of health insurance" ("A Brief History," 2009, Internet) and in 1917 proposed mandatory healthcare insurance for all Americans. Not surprisingly, many state-based medical organizations were strongly against this idea, due to realizing that "physicians would lose money if they were forced to provide healthcare to people who could not afford it" (McKenzie & McAuliffe, 2005, p. 213).

Things began to change rapidly during the 1920's, when the costs associated with healthcare rose dramatically as a result of the return of veterans from World War I and the construction of urban hospitals which Americans in the middle class began to use on a regular basis for their healthcare concerns. In 1926, a number of philanthropic organizations founded the Committee on the Cost of Medical Care (CCMC), a privately-funded group which determined via some reports that Americans were in desperate need of healthcare insurance. By 1935, during the Presidency of Franklin Roosevelt, the Social Security Act, "one of the great landmarks in the history of healthcare legislation in the United States" (Couchman, 2001, p. 245), prompted the government to accept some responsibility for the future security of the aged, the handicapped and the unemployed as it relates to healthcare needs. In 1939, the Roosevelt Administration also introduced the Wagner National Health Act which "gave general support for a national health program to be funded by federal grants to states and administered by states and localities" ("A

Brief History," 2009, Internet); however, due to a rapid decline in progressivism and the costs linked to World War I, this act failed to create a national healthcare agenda.

In 1943, the federal government finally came to acknowledge that healthcare was a major national priority which soon led to the Wagner-Murray-Dingell Bill which called for "compulsory national health insurance and a payroll tax" to help cover the expenses. One year later saw the creation of the Committee for the Nation's Health, group represented by "organized labor, progressive farmers and liberal physicians" ("A Brief History," 2009, Internet). By the time that Harry Truman became President after the death of FDR in 1945, healthcare concerns in the U.S. took on new initiatives with Truman's "Fair Deal, a comprehensive program of social legislation which expanded Social Security" (Schmidt, 2001, p. 267) and helped to launch a nationwide campaign for a healthcare system in the U.S. However, conservative Republicans saw this as socialized medicine, and because of anti-Communist sentiments in the late 1040's via the Cold War, "national health insurance became vanishingly improbable" ("A Brief History," 2009, Internet).