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's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20â€“24 million additional people covered during 2016.[6][7] The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and to major changes to individual insurance markets. Both involved new spending, funded through a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office reports said that overall these provisions reduced the budget deficit, and that repealing the ACA would increase the deficit.[8][9] The law also enacted a host of delivery system reforms intended to constrain healthcare costs and improve quality. After the law went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.[10]