History of Healthcare Policy Development in the USA
The American healthcare system can be traced back a long way and back in the 1930’s the public were all access to healthcare for all. What made people wary then still makes people wary today – who pays for it?
Healthcare policy is an in-depth subject, one that cannot possibly be covered in one article. That’s how it is for the governments who are tasked with the responsibility of bringing about reforms to the public healthcare system and, for as long as we can go back in history, no matter what reforms the governments bring about, there is always backlash from somewhere.
The Post-Depression era saw the elderly, veterans and workers group pushing for national health insurance. Unfortunately they were up against strong opposition from the American Medical Association. Insurance companies also lobbied against the NHI and the Act did not get passed at that time.
The end of World War II saw America miss out on a chance to bring about changes to their healthcare system. European reform was far easier because they did not have the network of private healthcare providers that existed in the US and many European countries took the opportunity to bring out a National Healthcare system for their citizens. The US went in an alternative direction.
The War Labor Board ruled in 1943 that controls over wages and process should exclude benefits such as health insurance and, as such, employers began to offer the insurance as an incentive for people to work. That made it extremely difficult for the issue of the NHO to be raised again. In 1949, the AMA put a stop to the lobby for NHI by driving fear into the hearts of the people that socialized medicine would destroy the country.
Ten years later, the private insurance sector was a thriving business and insurers began to pick and choose who they would insure. Those who would attract higher medical costs were refused insurance.
1960 saw the Kerr-Mills Act passed which gave States a certain amount of money to spend on care of the elderly. However, the Act was adopted by only 28 States, resulting in a push for more coverage for the vulnerable.
When the Medicare/Medicaid Act was passed, it pushed healthcare costs out of the realm of many people. Support was split between an NHI and universal cover with employer participation, with Medicare being pushed out. However, Watergate and the oil shock pushed all thoughts of this from everyone’s minds.
Late 1970 saw another push for the NHI by President Carter and Senator Kennedy but this time the recession beat them. Cost containment became the name of the game and in 1983 the Medicare Prospective Payment system was passed.
Between then and 1992 no more was said about healthcare reform until the Clinton Administration tried to bring it up again. Unfortunately, due to lack of public promotion and too much fear and misgiving from the public, the NHI died another death. However, when he served a second term, President Clinton managed to pick up enough support for the Children’s Health Insurance Program – at least a good start to reforming the healthcare policies of the United States.
Reforming healthcare in the US is a battle that has been going on for centuries. As the 20th century arrived, a push began for health insurance to be compulsory however attempts at reform were constantly crushed by the AMA. The only successful attempts at healthcare reform have been the Medicare/Medicaid program and the latest policy, the Affordable Care Act, otherwise known as Obamacare.
The only reason these were successfully passed was because of the way they could adjust and adapt to the current healthcare structure in the United States. While Medicare and Medicaid may have had some degree of success, only time will tell for Obamacare.