Now that the shock and awe factor has subsided and Americans have quit threatening to move to Canada in regards to Justice John Roberts’s delivery of the majority opinion on National Federation of Independent Business v. Sebelius, it is important that everyone understands how we got to where we are today. I am, of course, referring to the United States’ healthcare reform. As the Supreme Court upheld most of the provisions on the Patient Protection and Affordable Care Act (Obamacare), there will be several changes that occur over the next several years. As the future is uncertain—especially as far as 2020, which is the last phase of the Act—we shall focus on the past.
Ah, yes….the past. It was a simpler time, a time where the elderly sat behind their white picket fences, sipping lemonade on their porch. (And apparently everyone took this time to force their children and grandchildren to reminisce with them about the times they walked uphill, both ways, in the snow, everyday, to and from school.
Sadly, the average American mentioned here would not enjoy a lengthy retirement. At the turn of the 20th century the average life expectancy was 50. While some debate the reasons for why the average American had a shorter life span, I am a firm believer that advances in medicine and changes in healthcare accessibility should receive the recognition for this accomplishment. Before the Civil War, hospitals had been establishments for the chronically ill and terminal. As the war continued, hospitals became specialized and medical procedures gradually become more progressive. As medicine became more of a science and less of a guessing game, hospitals possessed the ability to properly remedy and even take preventative steps to ensuring longevity in life. The following advances were just a few of many that would lead to the change in hospitals: development of the ABO system of blood typing for successful blood transfusion, invention of the endotrachael tubing, and the discovery of x-rays, penicillin, and radium.
But let’s get back to healthcare reform. Because if my opinions are true and if medical science is the reason for today’s life expectancy age to be 78, instead of 50, then I say, “Forward ho!” While I may or may not agree with Obamacare, I am certainly grateful that I personally have insurance and plan on using it, as needed, to reach (and hopefully surpass) the continually growing life expectancy rate.
The political debate for healthcare reform and universal healthcare is one that has been around since the 1800’s. It was Dorothea Dix, activist for the indigent insane, who first attempted to seek healthcare on the federal level. In 1854, Dix proposed a bill, the 1854 Bill for Benefit of the Indigent Insane, which would establish asylums for the insane, blind, deaf, and dumb. The bill was passed by both houses of congress, but was vetoed by President Franklin Pierce. President Pierce believed that the federal government should not get involved in social welfare, and that welfare should be an issue of the state. However, shortly after the Civil War, the federal government constructed the Freedmen’s Bureau, a chain of hospitals in the South, that were intended to treat any ill or dying former slaves. Even though an astonishing one-million plus received medical care, this was only a short-term project and only lasted for five years. This would be the extent of the federal government’s assistance in healthcare reform for at least another fifty years.
There were two main reasons for general opposition of universal healthcare: the American Medical Association and employer sickness insurance. Throughout our nation’s attempts to reform healthcare the American Medical Association (AMA) always seemed in disagreement of proposed legislation. The first form of insurance was employer sickness insurance. Before medical advances there was no need for insurance to cover procedures, just insurance that provided cash payments to employees unable to work due to illness or injury. Insurance was originally purchased through the company you worked for and it helped cover cost when you were sick and unable to work. During this era, an employee would actually spend decades working for a company so this was a possibility. In today’s world, one may jump from new job to new job every other year, making this unfeasible. As our country already associated insurance with employers, compounding that with the fact that the AMA was highly against any form of government insurance, early steps towards healthcare reform were slow to start.
Because of the earlier mentioned advances in medical science, hospitals became of value. There was now a purpose—a need—for hospitals! Hospitals were seen as “get well clinics” and not just a place to go simply to ease one’s pain until death. With this need, healthcare cost rapidly increased, quickly making the middle and lower classes unable to afford the medical attention they were seeking. By 1927, the average American was unable to afford healthcare, so the AMA formed a committee to select options to ensure everyone could afford to see a doctor. This AMA committee concluded that the greatest solution was private insurance.
This is just part one, make sure that you come back (hopefully tomorrow) and I will get into the legislation and government programs that have gotten America where it is today. It is ready….click here to read Part II.