when was the idea of national health care insurance first debated in the united states
History of health care reform in the United States In the first 10â€“15 years of the 20th century Progressivism was influencing both Europe and the United States.[5] Many European countries were passing the first social welfare acts and forming the basis for compulsory government-run or voluntary subsidized health care programs.[6] The United Kingdom passed the National Insurance Act of 1911 that provided medical care and replacement of some lost wages if a worker became ill. It did not, however, cover spouses or dependents. U.S. efforts to achieve universal coverage began with progressive health care reformers who supported Theodore Roosevelt for President in 1912, though he was defeated.[7] Progressives campaigned unsuccessfully for sickness insurance guaranteed by the states.[8] A unique American history of decentralization in government, limited government, and a tradition of classical liberalism are all possible explanations for the suspicion around the idea of compulsory government-run insurance.[6] The American Medical Association (AMA) was also deeply and vocally opposed to the idea,[8] which it labeled "socialized medicine". In addition, many urban US workers already had access to sickness insurance through employer-based sickness funds.
Patient Protection and Affordable Care Act The ACA includes provisions to take effect between 2010 and 2020, although most took effect on January 1, 2014. Few areas of the US health care system were left untouched, making it the most sweeping health care reform since the enactment of Medicare and Medicaid in 1965.[2][3][4][15][5] However, some areas were more affected than others. The individual insurance market was radically overhauled, and many of the law's regulations applied specifically to this market,[2] while the structure of Medicare, Medicaid, and the employer market were largely retained.[3] Most of the coverage gains were made through the expansion of Medicaid,[16] and the biggest cost savings were made in Medicare.[3] Some regulations applied to the employer market, and the law also made delivery system changes that affected most of the health care system.[3] Not all provisions took full effect. Some were made discretionary, some were deferred, and others were repealed before implementation.