Today, the average American visits the doctor four times a year; that may sound like a lot, but this statistic takes into consideration babies, who are seen by doctors an average of nine times a year. Many adults will only visit a doctor when they have a health crisis, and studies have found that uninsured people often go for extended periods without receiving the healthcare they need. Unfortunately, without a universal healthcare system in place, access to health services remains a persistent social justice issue in the United States.
Healthcare has long been a central concern in America, for obvious reasons, but it hasn’t always looked like it does today. America’s healthcare history, due to lacking a national healthcare system like many other first world countries have, is more closely tied to the nation’s economic history and its belief in capitalism. In general, the history of healthcare could be summarized as becoming more advanced and efficient over the years, but less personal- a necessary, albeit unfortunate, tradeoff. Here is a brief timeline of healthcare in America that will hopefully shed some light on how it has changed over the years.
The earliest records of healthcare in America date back to the late 1800s. Before that, healthcare was a more private affair, with doctors making personal house calls. The need for an organized health system emerged with the industrial revolution, with factory jobs contributing to more workplace injuries. Unions started to offer sickness and injury protection to shield their members from financial losses.
Early 20th century
It wasn’t until the turn of the century that healthcare in America started to take on a more organized form. Many non-governmental organizations, including the American Medical Association (AMA), started to push for stronger healthcare at this time. World War I spurred Congress to pass the War Risk Insurance Act, which offered financial coverage to active servicemen and their families in the event of injury or death.
In the 1920s, healthcare started gaining attention as a national issue and when the Great Depression hit in 1929, it became a heated debate. The AMA opposed plans for any kind of national health system, but in 1935, Congress passed the Social Security Act of 1935, creating old age, unemployment, and disability benefits. Then, with World War II followed by the Korean War, focus on healthcare was largely tabled, despite major medical advancements such as the creation of an effective polio vaccine and the first organ transplant.
The government started to take a more invested approach in national healthcare in the 1960s by tracking National Health Expenditures (NHE) and calculating them as a percentage of gross domestic product (GDP). In 1965, President Lyndon B. Johnson signed an amended version of the Social Security Act, which served as the precursor to Medicare and Medicaid. The 1970s saw an even greater push for a universal healthcare plan, since it was only people who could afford health insurance who were buying it. Surprisingly, Republican president Richard Nixon proposed a healthcare plan that would provide all Americans basic coverage through their employers, but his plans fell through following the Watergate scandal. Jump forward to the Clinton Administration in the 1990s and many health policies were put through, including HMOs designed to cost the insurer and the enrollee less money, but still no universal coverage. President George W. Bush passed the Medicare Prescription Drug, Improvement and Modernization Act of 2003, but the healthcare debate was largely abandoned when the nation turned its attention to terrorism threats.
In more recent history, President Barack Obama made healthcare reform one of his top objectives as president. On March 23, 2010, Obama signed the Patient Protection and Affordable Care Act (PPACA) in an effort to make health insurance accessible to everyone. While the act was met with a lot of contention, 8 million people signed up for insurance in the first enrollment season.
It is difficult to predict what the future of healthcare in America looks like and if the country will ever offer total universal coverage like other first world nations, but for the time being, the Trump Administration plans to repeal or replace the ACA. If there’s one thing that’s for sure, healthcare will continue to evolve and be a hotly debated issue, and only time will tell what future changes will be made.