The American system of health care has changed considerably over the past 200 years. At one time, workers voluntarily paid into a fund that would pay for sickness and death benefits. The federal and state governments didn't provide any regulation or mandate any provisions for early workers. Voluntary programs were developed and structured by the paid members. It wasn’t until the Progressive Era, according to Karen Palmer’s speech transcribed by Physicians for a National Health Plan--or PHNP--that emphasis started being placed on improving the health of the working class.
National Health Act
During the 1930s, economic hardships forced the U.S. government to provide employment security, health benefits and retirement provisions. President Franklin D. Roosevelt appointed a committee to deal with social security. The Social Security Act passed, but omitted national health insurance when priorities started to shift in the government.
The National Health Act was proposed by New York Senator Robert F. Wagner, suggesting that federal funding for states provide medical services. The "Wagner Act" didn't receive the president's full support, because it was overshadowed by World War II and his New Deal programs.
Blue Shield
The National Health Act proposed by Senator Wagner failed to become law in 1939. As stated by the Kaiser Family Foundation, physicians start offering health insurance to cover the cost of the medical services they provided, which led to the formation of today’s Blue Cross and Blue Shield medical insurance.
Social Security
The Social Security Act in 1943 called for medical benefits as part of the Social Security System, according to the Kaiser Family Foundation. After Harry Truman’s presidential win, political opponents used fear of socialism and racial desegregation as a tactic to stall efforts for his push of national health care coverage.
Medicare and Medicaid
Medical coverage is being provided by private companies, while the aging and disabled are being treated unfairly with higher premium costs to cover their care, alleges the PNHP.
In 1958, Rhode Island Congressman Aime Forand proposed providing care for the aging population. Physicians sited there would be jeopardy to the doctor-patient relationship under this new medical program.
Senior citizens banded together to fight for Medicare coverage and this grassroots effort forced physicians to counter with a voluntary medical program. This grassroots effort led to development of Medicare Part A, B and the Medicaid system used today. In 1965, President Lyndon Johnson signed all three parts into law.
Health Care Today
Cost containment is the chief concern with medical care. During the 1970s, President Richard Nixon renamed health maintenance organizations HMOs, which try to contain rising medical costs.
Medical services often use diagnostic codes for payment of services. This changes how physicians are able to do business, because payment is based on medical care protocols for illness, versus time or services provided. This leads to payment caps for physicians and changes how physicians provide care.
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