History repeats itself, at least when it comes to America’s attempts to bring affordable healthcare to its people. In order to understand today's healthcare environment, you must first take a look back at American healthcare history.
In 2010, President Barack Obama passed the Patient Protection and Affordable Care Act (PPACA). But did you know there were similar attempts dating all the way back to the 1940s? President Harry S. Truman proposed a “universal” health insurance program in 1945, declaring, “Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health. Millions do not now have protection or security against the economic effects of sickness. The time has arrived for action to help them attain that opportunity and that protection. These words are very similar to remarks made by President Obama some 70 years later.
Traditional and domestic healing measures are the norm, mainly administered by women of the family. Doctors make house calls in times of extreme need. The late 1700s bring medical colleges to the U.S., providing standardization of healthcare practices and licensing for physicians. Doctors become trusted authorities. As cities grow more crowded, close conditions and poor sanitation contribute to the spread of disease.
1846 - 1899
The American Medical Association organizes and begins regulating prescription medications. The railroad industry paves the way with employee medical programs in response to high rates of injury among railroad workers.Some physicians and surgeons begin specializing in railway surgery and form professional societies to share information. Most healthcare is provided “fee-for-service,” with payment due at the time of each visit. Some individuals use private health insurance pools, and employers occasionally offer healthcare benefits to their workers.
1900 - 1920
Beginning in the early 1900s, the American Medical Association grows its membership to include half the physicians in the country. Surgery is becoming routine for removing tumors and infected tonsils.
In 1912, the Progressive party introduces the idea of a National Health Service and public healthcare for elderly, jobless, and disabled individuals. The American Medical Association and other organizations oppose this plan, and by 1916, the Progressive party dissolves. However, the idea of social insurance would be influential in years to come. By the 1920s, hospitals are modern, clean institutions, and General Motors agrees to insure 180,000 of its workers.
In 1929, Dallas-based Baylor Hospital works with local schools to provide healthcare to teachers for a monthly fee. The popular plan spreads to schools across the nation, expanding into Blue Cross/Blue Shield. The nonprofit Blue plans insured organizations such as the Elks. The success of these plans would inspire commercial health insurance companies to enter the market.
1930 - 1950
The Great Depression increases the focus on the need for health insurance as well as old age and unemployment benefits. Henry Kaiser arranges a fixed rate of care for his 5,000 aqueduct workers with a nearby hospital. This became the Kaiser Permanente Health Plan, which would evolve into the managed care system, the basis of modern HMOs and PPOs.
In 1935, President Franklin D. Roosevelt passes the Social Security Act. He initially considered including health insurance in Social Security, but it was cut from the final bill due to political pressure. Nevertheless, the Social Security Act is the first significant plan to provide public support for retired people.
Companies increasingly offer assistance with healthcare in the 1940s as a way to cope with wartime wage controls giving way to the employer-based system now in use in America. More private health insurance companies begin offering services to meet the increased demand. Penicillin is now being used.
Truman’s national healthcare proposal is denounced and called a communist plot in 1945 .
1960 - 1990
It’s 1960. At this point in American healthcare history, the cost of hospital care has doubled. America has private insurance for those who can afford it, and welfare programs for the poor have expanded since the Great Depression. The elderly can’t afford health insurance, prompting President Lyndon Johnson to approve Medicare and Medicaid so they can be put to use.
Nixon renames group health plans HMOs in the seventies. The number of women choosing careers in medicine increases from 9 percent to over 25 percent, and smallpox is eradicated. Jump forward to the 1990s. Healthcare costs have risen at twice the average inflation rate of other goods and services. Federal efforts to reform healthcare fail again, and more than 16 percent of the nation is left uninsured. Healthcare costs continue to rise during the millennium, and many see Medicare as unsustainable.
President Obama passes the Affordable Care Act, which brings big changes to American healthcare. ACA-approved plans must provide 10 essential health benefits and cannot deny coverage based on pre-existing conditions. Obamacare’s individual mandate encourages citizens to maintain health insurance coverage with tax penalties for those who let insurance lapse. Along with Obamacare comes the Health Insurance Marketplace, allowing people to compare prices on ACA-approved plans.
American Healthcare History: Modern Times
That brings us to today. Thanks to the Affordable Care Act, we’ve seen uninsured rates drop dramatically. This big step forward means more than 16 million Americans have gained health insurance. HealthMarkets is proud to be a part of that success.
If American healthcare history has taught us anything, it’s that we’ve seen lots of ups and downs over the years. HealthMarkets is here to help you navigate the ever-changing landscape of U.S. healthcare. Whether you need to choose a health insurance plan or want to make sure the one you have is best for you, a HealthMarkets agent can help. Our service is free, so don’t hesitate—contact us online or by phone at (800) 803-9094.
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