USA Healthcare history

After the war ended, in 1886, the United States Army established the Hospital Corps.

In 1901, AMA reorganizes as the national organization of state and local associations.

In 1906, the American Association of Labor Legislation (AALL) finally led the campaign for health insurance.

In 1912, President Theodore Roosevelt and his Progressive party endorsed social insurance and the National Convention of Insurance Commissioners introduced a prototype for states to follow for to regulate health insurance.

In 1914, reformers sought to involve physicians in formulating this bill and the American Medical Association (AMA) actually supported the AALL proposal.

Despite its broad mandate, the committee decided to concentrate on health insurance, drafting a model bill in 1915.

In 1917, the AMA House of Delegates favored compulsory health insurance as proposed by the AALL, but many state medical societies opposed it.

For a number of reasons, health care costs also began to rise during the 1920’s, mostly because the middle class began to use hospital services and hospital costs started to increase.

In 1923, Baylor Hospitals in Dallas created a unique program, in conjunction with local schools, to provide healthcare to teachers for a pre-paid monthly fee.

In 1929, Dallas-based Baylor University Hospital worked with local schools to provide healthcare to teachers for a monthly fee of $6, forming the start of Blue Cross health insurance plans.3 The plans covered $5 per day for a 21-day hospital visit.1

In the 1930’s, the focus shifted from stabilizing income to financing and expanding access to medical care.

The resulting Social Security Act of 1935 created the first real system of its kind to provide public support for the retired and elderly.

Though it never received FDR’s full support, the proposal grew out of his Tactical Committee on Medical Care, established in 1937.

FDR’s second attempt — Wagner Bill, National Health Act of 1939: But there was one more push for national health insurance during FDR’s administration: The Wagner National Health Act of 1939.

First introduced in 1943, it became the very famous Wagner-Murray- Dingell Bill.

In 1944, the Committee for the Nation’s Health, (which grew out of the earlier Social Security Charter Committee), was a group of representatives of organized labor, progressive farmers, and liberal physicians who were the foremost lobbying group for the Wagner-Murray-Dingell Bill.

They assessed their members an extra $25 each to resist national health insurance, and in 1945 they spent $1.5 million on lobbying efforts which at the time was the most expensive lobbying effort in American history.

In 1946, the Republicans took control of Congress and had no interest in enacting national health insurance.

Truman responded by focusing even more attention on a national health bill in the 1948 election.

In 1952, the Federal Security Agency proposed health insurance benefits for people on Social Security.

In 1954, President Dwight Eisenhower proposed a federal reinsurance fund for private insurance companies to help expand the availability of health coverage.

In 1956, the government enacted a program that provided health insurance for family members of those in the military.2.

Finally, Rhode Island congressman Aime Forand introduced a new proposal in 1958 to cover hospital costs for the aged on social security.

By 1960, the government started tracking National Health Expenditures (NHE) and calculated them as a percentage of Gross Domestic Product (GDP). At the start of the decade, NHE accounted for 5 percent of GDP.

In 1961, President Kennedy started the groundwork for health insurance for seniors and four years later, President Johnson signed the legislation that created the Medicare system.

The law represented the most significant overhaul and expansion of healthcare coverage since the passage of Medicare and Medicaid back in 1965.

By 1970, NHE accounted for 6.9 percent of GDP, due in part to “unexpectedly high” Medicare expenses.

In 1971, Senator Edward (Ted) Kennedy proposed a single-payer plan (a modern version of a universal, or compulsory system) that would be funded through taxes.

By 1980, NHE accounted for 8.9 percent of GDP, an even larger leap than the decade prior.

By 1990, NHE accounted for 12.1 percent of GDP — the largest increase thus far in the history of healthcare.

After a period of debate toward the end of 1993, Congress left for winter recess with no conclusions or decisions, leading to the bill’s quiet death.

In 1996, the Health Insurance Portability and Accountability Act (HIPAA) added some protections to people with pre-existing conditions and changed some rules for long-term care insurance.

The Balanced Budget Act in 1997 slowed the growth of Medicare spending and created a new insurance structure, Medicare Advantage.

By the year 2000, NHE accounted for 13.3 percent of GDP — just a 1.2 percent increase over the past decade.

The Medicare Drug, Improvement, and Modernization Act passed in 2003, which created Medicare Part D prescription drug benefits.

Massachusetts and Vermont enacted legislation in 2006 that provided health insurance access to residents, a precursor to the Affordable Care Act.

In 2007, the Healthy Americans Act was proposed in the Senate that would have required all Americans to have health insurance.

In 2010, President Barack Obama changed American healthcare history by signing the Affordable Care Act (ACA), which brought big changes to American healthcare, including protections for people with pre-existing conditions and children up to age 25 able to be covered by a parent’s plan.

KFF. Retrieved from https://www.kff.org/wp-content/uploads/2011/03/5-02-13-history-of-health-reform.pdf.

The first open enrollment season for the Marketplace started in October 2013, and it was rocky, to say the least.

Nevertheless, 8 million people signed up for insurance through the ACA Marketplace during the first open enrollment season, with enrollment peaking in 2016 at 12.2 million (with 10 million of those receiving subsidies to help pay for insurance).

Since Donald Trump was sworn in as the 45th President of the United States on January 20, 2017, many have questioned what would happen with our healthcare system — specifically, what would happen to the ACA, since Donald Trump ran on a platform of “repealing and replacing” the bill.

According to the Kaiser Family Foundation, the ACA has covered an average of 11.3 million annually since its inception, though 8.5% of the United States population (roughly 27.5 million Americans) remain uninsured, as reported by the KKF in 2018.

Hungry to notch a win on healthcare prior to the 2020 election, the Trump administration continues to push ahead on initiatives designed to reign-in healthcare costs.

KFF. Retrieved from https://www.kff.org/health-reform/state-indicator/marketplace-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. Accessed July 12, 2021.