The earliest record of coverage for health services was back in 1798, but the beginning of employer insurance was in the pre-1900s when life expectancy in the U.S. was 47 years. So in 1850, comes the First insurance policy, from 1870 to 1889 we start to see employers beginning to provide healthcare to employees. From 1899 to 1908 we start to see private insurance companies coming into play. In 1910, we have the first group health insurance police when Montgomery Ward and Co. seeks to protect its employees from financial hardship, so they create a plan that pays for lost worktime, but not for medical treatment. In 1911 President Roosevelt makes the 1st attempt to make national health reform. In 1919, health care spending rises, also medical standards rise and people start seeing medicine as science therefore the demand for medical care grows. In 1929, in the year of the great depression, the growing national fiscal crisis worsens health care access and cost problems. (JUST AS AN ILLUSTRATION, URBAN FAMILIES HAD AN AVERAGE ANNUAL INCOME OF $2,000 - $3,000, AND A MEDICAL EXPENSE AVERAGE OF $108 TO $261 [PER FAMILY]). Also, in 1929 a clinic for Los Angeles’ Department of Water and Power created the first HMO (Health Maintenance Organization). So the Great Depression leads to public interest in unemployment insurance and senior benefits, so we have people wanting more health protection and income security between 1930 and 1939. From 1933 to 1938, there is the beginning of the Kaiser Foundation Medical Care Plan, where a physician at Kaiser Co.’s California dam construction site convinces the Kaiser owned construction workers’ insurance company to pay him in advance per employee for providing medical care on-the-job rather than send workers with serious injuries to medical facilities 200 miles away. This kind of prepaid care allows employers to better predict costs.