In comparison to other countries, the United States has had a slow start to the development of health insurance. From the late 1800’s, the United States attempted to develop a universal government-funded insurance for nearly a century. During this time, other developed countries had developed some form of a social insurance, that later developed into national insurance. In the United States, however, the government was not taking any action regarding provisions with health insurance; instead, the government was leaving laws regarding health insurance up to the individual states. During this time, there were o legislative or public programs to provide funding for healthcare.
The first group to really push for health insurance was the American Association of Labor Legislation (AALL). The AALL formed a committee in 1912 based on social welfare, and held their first national conference in 1913. Their first drafted bill was completed in 1915, and it proposed limiting coverage to the working class and those earning less than $1200 a year, including dependents. (http://www.pnhp.org/facts/a-brief-history-universal-health-care-efforts-in-the-us). The bill included the services of physicians, nurses, and hospitals as well as sick pay, maternity benefits, and a death benefit. This initial bill of the AALL captured the intrigue of the American Medical Association, who then assigned physicians in support of the bill to help secure legislation. By 1916, the AALL and AMA were working together on this bill to initiate health insurance. However, the following year, many state medical societies began to reject the proposed bill, causing the AMA to retract its involvement regarding the bill. At the same time, both the AFL (American Federation of Labor) and the private insurance industry opposed the AALL proposed bill. The AFL deemed it as an “unnecessary paternalistic reform that would create a system of state supervision over people’s health.” (http://www.pnhp.org/facts/a-brief-history-universal-health-care-efforts-in-the-us) This was thought to potentially lead to the disbanding of unions, which was the opposite of the AFL’s overall goal of maintaining union strength. The private insurance industry opposed the proposal because it would have hindered their multi-million dollar commercial life insurance industry. Plans for this bill, or any bill regarding health coverage, was forgotten due to opposition from doctors, labor, insurance companies, and businesses.
In the 1930’s, there began an increased need to focus on financing and expanding access to care, as the cost for workers was becoming a serious problem. This is in part due to rising health care costs, middle class people using hospital services more, and the rise of hospital charges. This need developed a new committee, the Committee on the Cost of Medical Care, or the CCMC. First meeting in 1926, the committee met to research the need for medical care. Over a five year period, they published 26 research volumes and 15 smaller reports that detailed the need for medical care coverage.
Franklin D. Roosevelt became the first President to attempt to pass a bill regarding medical care coverage. In 1935, Roosevelt was unsuccessful as passing the Social Security Act of 1935. It was thought that the passage of this bill would hinder the overall passage of the Social Security legislation and was therefore excluded. His next attempt would come in 1939 with the Wagner Bill and the National Health Act of 1939. This Act gave general support for a national health program to be funded by federal grants, then to be distributed by the states and localities.
The next bill to be proposed was the Wagner Bill, first introduced in 1943. It called for a compulsory national health insurance and payroll tax. It was highly opposed, and would never pass by congress. After Roosevelt died, Harry S. Truman took over the Presidency. During his time as President, the healthcare issue moved into the center of national politics. In his plan, Truman proposed a single universal comprehensive health insurance plan. He also dropped the funeral benefit previously proposed. Many had mixed feeling regarding the bill, though the AMA vehemently opposed the bill. While his initial attempt as passing the bill was denied, Truman would continue to push for health care coverage in his next Presidential campaign. During his next Presidential run, Truman attempt again, but would once again be denied by the congressional committee. However, compromises were made which enabled our current system of private insurance for those who could afford it, and public welfare for those who could not.
In 1958, a Rhode Island congressman by the name of Aime Forand made a proposal to cover hospital costs for the aged on social security. This proposal was the start of Medicare. Over the next 7 years, this proposal would be developed into the 3 part Medicare and Medicaid system we have today. Lyndon B. Johnson signed it into law as part of his Great Society Legislation.