Focus on Health Care Reform

on

Health Reform

MARCH 2009

NatioNal HealtH iNsuraNce—a Brief History of reform efforts in the u.s.

introduction

Many believe the United States is on the brink of national health reform. Health care costs seem uncontrollable while 46 million Americans remain uninsured. Millions more are under-insured—and even more worry that they are under-insured. The quality of health care is in question as more come to realize that the U.S. does not lead the world in the health of its people. These problems resonated during the 2008 presidential campaign where health reform held its own among the top issues, even after the economic crisis began to overshadow the election. Health care and its costs were seen as a large part of Americans’ pocketbook concerns. And now a White House Office on Health Reform is being newly established, while seasoned Members of Congress are readying proposals of their own. The country has been on the verge of national health reform many times before however. In the early 1900s, smaller proposals began to pave the way. In 1912, Theodore Roosevelt’s Bull Moose party campaigned on a platform calling for health insurance for industry; and as early as 1915, Progressive reformers ineffectively campaigned in eight states for a state-based system of compulsory health insurance. The prominent reformers of the 1920s, the Committee on the Costs of Medical Care, proposed group medicine and voluntary insurance— modest ideas, but enough to raise opposition, and the term “socialized medicine” was born. Over the years the American public, as measured in opinion polls as far back as the 1930s, has generally been supportive of the goals of guaranteed access to health care and health insurance for all, as well as a government role in health financing. However, support typically tapered off when reforms were conditioned on individuals needing to contribute more to the costs. While the general public may largely support reforming the health system, no particular...