Medicare: Past, Present, and Future
The History of Medical Insurance
The idea for a national health plan was not something considered to be a priority of American government prior to the 1940’s. President Harry S. Truman was the first president to push the issue to the United States Congress in 1945. Truman called for the creation of a national health insurance plan that would be aviailable to all Americans. He envisioned coverage for hospital visits, dental care, nursing care, and doctor’s visits. The plan would cover any medical expenses that were considered typical medical expenses. Although Truman envisioned this plan, he was unsuccessful in getting Congress to approve such a vast undertaking during his term (2). President John F. Kennedy also made an unsuccessful attempt at persuading Congress to enact a national health care coverage plan during his term in the 1960’s (2). The push for a national health care coverage plan, especially for the elderly, came from the economic problem that health care costs increase as a person ages, and income declines within this same period. Prior to medicare, only a little over half of those aged 65 or older had some type of health care coverage. Additionally, those who did have health care coverage were at risk for being terminated from that coverage once they reached a certain age limit. Older individuals were considered to be in a high risk category for health problems, therefore insurace companies did not want to insure them (3). Health care coverage was not a pressing issue in the 1920’s and the years prior. This was due to realtively low medical expenditures for individuals and families. In 1918, the Bureau of Labor Statistics conducted a survey of 211 families in the Columbus, Ohio area. They found that only 7.6% of a family’s medical expenditures were paid for hospital care. The families reported that the largest cost of medical care was that a sick person could not work. It was discovered that lost wages due to illness were four times larger than medical expenditures for hospital care. The lack of demand for hospital care during this time period reflected the rudimentarty state of medical technology and medicine as an exact science (4). The practice of medicine evolved tremendously during the 1920’s and 1930’s. The roaring 20’s were not just wine and jazz. This was decade that ushered in the medical use of insulin, vitamin E, immunizations, and pencillin. There was also an increase in the standard of practice for physicians. The American Medical Association brought about changes in the entrance requirements for medical schools and required medical schools to teach in the better medical facilities. Additionally, hospitals were being held at higher standards than they had been in the past. All of these changes in the medical field increased consumer confidence for those who otherwise might not have sought medical treatment. This caused an increase in the demand for medical treatment (4). The increase in demand for medical treatment and the increase in medical technology costs meant that health care became significantly more expensive. This made the need for a national health care plan all the more prominent. In the development stage of addressing the coverage problems, legislators had to be careful to set goals that were realistic and only made an impact where necessary. A national health care coverage plan had to improve health care coverage for individuals but not directly change the way health care was distributed by practioners. The plan would also have to make economic sense; meaning that it should not pay for unnecessary expenses or encourage the use of more expensive medical services when other less expensive alternatives are available. There was an 8 year span between the development of predecessor bills and the enactment of the Medicare bill. During this 8 year span many presentations and speeches were given regarding how the bill should be laid out and what...
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