Talk:History of health care reform in the United States

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This article was the subject of a Wiki Education Foundation-supported course assignment, between 27 August 2019 and 12 December 2019. Further details are available on the course page. Student editor(s): William Khandkar.

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Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Peer reviewers: BernieJerome.

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Sections and Related articles on Current Debate in desperate need of overhaul
I have added this note to all major articles related to the current healthcare reform debate. The related sections in this article and all related articles on the current healthcare debate desperately need to be overhauled and expanded. There is practically nothing in this article about the ongoing major events around the current debate, a subject area that is absolutely required.

The main discussion around generating an overhaul effort is on the talk page on the main article: Health care reform debate in the United States

For now, for this overhaul effort, please discuss anything not pertaining specifically to this article on that talk page.

NittyG (talk) 05:06, 27 October 2009 (UTC)

Monopoly exclusion of health insurance industry?
I am amazed this is not in the article. I will have to add it.Ikip (talk) 07:29, 28 October 2009 (UTC)

missing 1970s content
I believe there was considerable debate under Nixon about health care reform, with proposals and counterproposals between Kennedy and Nixon, though I don't know enough about them to write a section myself. --Delirium (talk) 11:51, 21 January 2010 (UTC)

The article does not mention "The Health Maintenance Organization Act of 1973 (P.L. 93-222), signed by President Nixon on’ December 29, 1973, is the first major health legislation enacted by the 93d Congress. The new measure “commits’ the Federal Government to a limited, trial-period support of the development of health maintenance organizations (HMO’s)." which is often cited as the end of US healthcare being not for profit 71.86.197.182 (talk) 05:59, 8 May 2017 (UTC)LK

Adding here text from Health care reform in the United States
Here is text which has been taken from the article mentioned and is to be checked for content in this article and integrated where appropriate. This article seems more suited to this article and the other article now has a summary of the main national reform efforts.--Hauskalainen (talk) 16:18, 1 September 2010 (UTC)

History of reform efforts (taken from Health care reform in the United States)
Health reform became a coordinated movement during the unsuccessful 1912 campaign of progressive candidate Theodore Roosevelt. Franklin D. Roosevelt attempted to make a national health insurance program part of Social Security, but deferred action until 1944, when he endorsed the Wagner–Murray–Dingell Bill. After Roosevelt's death in 1945, Harry S. Truman continued support of an expanded bill, but was defeated by a powerful American Medical Association lobby, conservative opposition to labor unions, and refocused concern at the outbreak of the Korean War. Harry Truman called for legislation establishing a national health insurance plan for all though later this was focused on efforts to get national health insurance for seniors. However, in October 1949, Congress adjourned without acting on the bills.

In 1961, Robert M. Ball, the then Deputy Director of the Bureau of Old-Age and Survivors Insurance in the Social Security Administration defined the major obstacle to financing health insurance for the elderly. The high cost of care for the aged combined with the generally low incomes of retired people. Because retired older people use much more medical care than younger employed people, an insurance premium related to the risk for older people needed to be high, but if the high premium had to be paid after retirement, when incomes are low, it was an almost impossible burden for the average person. The only feasible approach, he said, was to finance health insurance in the same way as cash benefits for retirement, by contributions paid while at work, when the payments are least burdensome, with the protection furnished in retirement without further payment. But it was not until 1965 before President Lyndon Johnson enacted legislation which introduced Medicare, covering both hospital and general medical insurance for senior citizens paid for by a Federal employment tax over the working life of the retiree. A companion program called Medicaid permitted the Federal government to part fund a program for the poor, with the program managed and co-financed by the individual states. The Military Health System, TRICARE, and the Veterans Health Administration cover more than 9.2 million active military personnel and veterans and their families. The federal-state Medicaid program provides coverage to the poor while the State Children's Health Insurance Program (SCHIP) provide health insurance to children in families at or below 200 percent of the federal poverty line. Native Americans are covered on the reservation (by tribal hospital). Additionally, members of many American Indian tribes or Alaskan Native communities are covered by the Indian Health Service pursuant to treaties, laws, or executive orders. However, this coverage is rarely equivalent to private insurance, with one-third less funding than the average American per capita and one-half that of American prisoners. Merchant marines were eligible for publicly funded care through the Marine Hospital Service (later renamed Public Health Service from 1798 until the program was canceled in 1981.

In subsequent years, debate continued along party lines. Republicans favored a voluntary choice of government or private insurance for those over 65, and Democrats sought to create a national healthcare benefit. By 1964, one-half of those over 65 lacked health insurance. The Medicare program was established by legislation signed into law on July 30, 1965, by President Lyndon B. Johnson, as a part of his "Great Society".

In his 1974 State of the Union address, Republican President Richard M. Nixon called for comprehensive health insurance. On February 6, 1974, he introduced the Comprehensive Health Insurance Act. Nixon's plan would have mandated employers to purchase health insurance for their employees, and provided a federal health plan—similar to Medicaid—open to any American on an income-based sliding scale basis. The New York Daily News wrote that Ted Kennedy rejected the universal health coverage plan offered by Nixon because it wasn't everything he wanted it to be. Kennedy later realized it was a missed opportunity to make major progress toward his goal.

Former President Jimmy Carter wrote in 1982 that Kennedy’s disagreements with Carter's proposed approach thwarted Carter’s efforts to provide a comprehensive health-care system for the country.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) amended the Employee Retirement Income Security Act of 1974 (ERISA) to give some employees the ability to continue health insurance coverage after leaving employment.

Health care reform was a major concern of the Clinton administration; however, the 1993 Clinton health care plan, developed by a group headed by First Lady Hillary Clinton, was not enacted into law. However, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) made it easier for workers to keep health insurance coverage when they change jobs or lose a job, and also made use of national data standards for tracking, reporting and protecting personal health information.

During the 2004 presidential election, both the George W. Bush and John Kerry campaigns offered health care proposals. As president, Bush signed into law the Medicare Prescription Drug, Improvement, and Modernization Act, which included a prescription drug plan for elderly and disabled Americans.

In February 2009, Barack Obama signed a re-authorization of the State Children's Health Insurance Program, which extended coverage to millions of additional children, and the American Recovery and Reinvestment Act which included funding for computerized medical records and preventive services.

On March 21, 2010, the U.S. House of Representatives passed the Senate version of its health care reform bill. On March 23, President Obama signed it into law.

State-level reform efforts
A few states have taken steps toward universal health care coverage—most notably Minnesota, Massachusetts, and Connecticut. A recent example of enacted legislation is the Massachusetts 2006 Health Reform Statute, that mandated residents to purchase health insurance by July 1, 2007. The bill led to an influx of new patients and at first and pressure on services including wait times, though by 2009 89% of those needing urgent care reported getting an immediate appointment always or nearly always when they called and a further 10% reported that they could usually get an appointment within an appropriate time. In July 2009, Connecticut passed into law a plan called SustiNet, with the goal of achieving health care coverage of 98% of its residents by 2014. California, Maine and Vermont are also considering or seeking to implement universal or near-universal systems.

Other states, while not attempting to insure all of their residents, cover large numbers of people by reimbursing hospitals and other health care providers using what is generally characterized as a charity care scheme; New Jersey is perhaps the best example of a state that employs the latter strategy. Since 1974, Hawaii has required employers to provide a comprehensive health insurance plan to employees working more than 20 hours per week.

Several single payer referendums have been proposed at the state level, but so far all have failed to pass: California in 1994, Massachusetts in 2000, and Oregon in 2002. The state legislature of California has twice passed SB 840, The Health Care for All Californians Act, a single-payer health care system. Both times, Governor Arnold Schwarzenegger (R) vetoed the bill, once in 2006 and again in 2008.

At the municipal level, the City of San Francisco is undertaking a universal health care program for uninsured residents, Healthy San Francisco.

Adding here text from Health care reform in the United States
Here is text which has been taken from the article mentioned and is to be checked for content in this article and integrated where appropriate. This article seems more suited to this article and the other article now has a summary of the main national reform efforts.--Hauskalainen (talk) 16:18, 1 September 2010 (UTC)

History of reform efforts (taken from Health care reform in the United States)
Health reform became a coordinated movement during the unsuccessful 1912 campaign of progressive candidate Theodore Roosevelt. Franklin D. Roosevelt attempted to make a national health insurance program part of Social Security, but deferred action until 1944, when he endorsed the Wagner–Murray–Dingell Bill. After Roosevelt's death in 1945, Harry S. Truman continued support of an expanded bill, but was defeated by a powerful American Medical Association lobby, conservative opposition to labor unions, and refocused concern at the outbreak of the Korean War. Harry Truman called for legislation establishing a national health insurance plan for all though later this was focused on efforts to get national health insurance for seniors. However, in October 1949, Congress adjourned without acting on the bills.

In 1961, Robert M. Ball, the then Deputy Director of the Bureau of Old-Age and Survivors Insurance in the Social Security Administration defined the major obstacle to financing health insurance for the elderly. The high cost of care for the aged combined with the generally low incomes of retired people. Because retired older people use much more medical care than younger employed people, an insurance premium related to the risk for older people needed to be high, but if the high premium had to be paid after retirement, when incomes are low, it was an almost impossible burden for the average person. The only feasible approach, he said, was to finance health insurance in the same way as cash benefits for retirement, by contributions paid while at work, when the payments are least burdensome, with the protection furnished in retirement without further payment. But it was not until 1965 before President Lyndon Johnson enacted legislation which introduced Medicare, covering both hospital and general medical insurance for senior citizens paid for by a Federal employment tax over the working life of the retiree. A companion program called Medicaid permitted the Federal government to part fund a program for the poor, with the program managed and co-financed by the individual states. The Military Health System, TRICARE, and the Veterans Health Administration cover more than 9.2 million active military personnel and veterans and their families. The federal-state Medicaid program provides coverage to the poor while the State Children's Health Insurance Program (SCHIP) provide health insurance to children in families at or below 200 percent of the federal poverty line. Native Americans are covered on the reservation (by tribal hospital). Additionally, members of many American Indian tribes or Alaskan Native communities are covered by the Indian Health Service pursuant to treaties, laws, or executive orders. However, this coverage is rarely equivalent to private insurance, with one-third less funding than the average American per capita and one-half that of American prisoners. Merchant marines were eligible for publicly funded care through the Marine Hospital Service (later renamed Public Health Service from 1798 until the program was canceled in 1981.

In subsequent years, debate continued along party lines. Republicans favored a voluntary choice of government or private insurance for those over 65, and Democrats sought to create a national healthcare benefit. By 1964, one-half of those over 65 lacked health insurance. The Medicare program was established by legislation signed into law on July 30, 1965, by President Lyndon B. Johnson, as a part of his "Great Society".

In his 1974 State of the Union address, Republican President Richard M. Nixon called for comprehensive health insurance. On February 6, 1974, he introduced the Comprehensive Health Insurance Act. Nixon's plan would have mandated employers to purchase health insurance for their employees, and provided a federal health plan—similar to Medicaid—open to any American on an income-based sliding scale basis. The New York Daily News wrote that Ted Kennedy rejected the universal health coverage plan offered by Nixon because it wasn't everything he wanted it to be. Kennedy later realized it was a missed opportunity to make major progress toward his goal.

Former President Jimmy Carter wrote in 1982 that Kennedy’s disagreements with Carter's proposed approach thwarted Carter’s efforts to provide a comprehensive health-care system for the country.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) amended the Employee Retirement Income Security Act of 1974 (ERISA) to give some employees the ability to continue health insurance coverage after leaving employment.

Health care reform was a major concern of the Clinton administration; however, the 1993 Clinton health care plan, developed by a group headed by First Lady Hillary Clinton, was not enacted into law. However, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) made it easier for workers to keep health insurance coverage when they change jobs or lose a job, and also made use of national data standards for tracking, reporting and protecting personal health information.

During the 2004 presidential election, both the George W. Bush and John Kerry campaigns offered health care proposals. As president, Bush signed into law the Medicare Prescription Drug, Improvement, and Modernization Act, which included a prescription drug plan for elderly and disabled Americans.

In February 2009, Barack Obama signed a re-authorization of the State Children's Health Insurance Program, which extended coverage to millions of additional children, and the American Recovery and Reinvestment Act which included funding for computerized medical records and preventive services.

On March 21, 2010, the U.S. House of Representatives passed the Senate version of its health care reform bill. On March 23, President Obama signed it into law.

State-level reform efforts
A few states have taken steps toward universal health care coverage—most notably Minnesota, Massachusetts, and Connecticut. A recent example of enacted legislation is the Massachusetts 2006 Health Reform Statute, that mandated residents to purchase health insurance by July 1, 2007. The bill led to an influx of new patients and at first and pressure on services including wait times, though by 2009 89% of those needing urgent care reported getting an immediate appointment always or nearly always when they called and a further 10% reported that they could usually get an appointment within an appropriate time. In July 2009, Connecticut passed into law a plan called SustiNet, with the goal of achieving health care coverage of 98% of its residents by 2014. California, Maine and Vermont are also considering or seeking to implement universal or near-universal systems.

Other states, while not attempting to insure all of their residents, cover large numbers of people by reimbursing hospitals and other health care providers using what is generally characterized as a charity care scheme; New Jersey is perhaps the best example of a state that employs the latter strategy. Since 1974, Hawaii has required employers to provide a comprehensive health insurance plan to employees working more than 20 hours per week.

Several single payer referendums have been proposed at the state level, but so far all have failed to pass: California in 1994, Massachusetts in 2000, and Oregon in 2002. The state legislature of California has twice passed SB 840, The Health Care for All Californians Act, a single-payer health care system. Both times, Governor Arnold Schwarzenegger (R) vetoed the bill, once in 2006 and again in 2008.

At the municipal level, the City of San Francisco is undertaking a universal health care program for uninsured residents, Healthy San Francisco.

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1928 - 1932, the Committee on the Cost of Medical Care and Secretary of the Interior Dr. Ray Lyman Wilbur
LeeTilson (talk) 21:11, 16 June 2017 (UTC) --LeeTilson (talk) 21:11, 16 June 2017 (UTC)

Note: I am a newbie to posting items in Wikipedia Talk sections. You can reach me by email to

PeopleMatters@gmx.com

I am also submitting this information to the Wikipedia page on Dr. Ray Lyman Wilbur

I do not expect this to be posted as is. I am just trying to provide additional information to others who might be working on the page.

President Herbert Hoover's Secretary of the Interior, Dr. Ray Lyman Wilbur, was one of the leading advocates for universal healthcare. Prior to serving as Secretary of the Interior, he had been President of Stanford University since 1915 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1641977/pdf/calstatejmed00110-0004d.pdf which is a link to CALIFORNIA STATE JOURNAL OF MEDICINE, DEC., 1915, p. 457) as well as president of the AMA in 1922 (See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1517283/pdf/calstatejmed00021-0027a.pdf    which is a link to CALIFORNIA STATE JOURNAL OF MEDICINE, July, 1922, p. 241)

Dr. Wilbur was asked to convene a meeting of the Committee of Five in connection with an AMA convention to address some healthcare issues raised by President Coolidge. That committee grew into the Committee on the Cost of Medical Care which issued 28 detailed reports during Wilbur's tenure as Secretary of the Interior.

When the Committee on the Cost of Medical Care issued its final report, the Committee and Wilbur were publicly attacked.

______________________________

See: 2002 article     http://www.einstein.yu.edu/uploadedFiles/EJBM/19Ross129.pdf “The Committee on the Costs of Medical Care and the History of Health Insurance in the United States” The Einstein Quarterly Journal of Biology and Medicine, (2002) 19:129-134. By, Joseph S. Ross Montefiore Medical Center Department of Medicine Bronx, New York 10467

Also see: 1998 article  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508565/pdf/amjph00023-0127.pdf 2013 article  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603728/pdf/bumc0026-0142.pdf

Here are some additional items by Wilbur

1932 December - Final Report of the Committee on the Cost of Medical Care    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1658442/pdf/calwestmed00442-0036b.pdf\ 1932 by Wilbur  “Organized Medical Care: Its relation to persons of low income https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1658215/pdf/calwestmed00446-0018.pdf 1932 speech by Wilbur: "The Economics of Public Health and Medical Care"    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690268/pdf/milq0083-0390.pdf 1929 article by Wilbur "Science in the Government"  http://science.sciencemag.org/content/69/1790/409 1928 article by Wilbur "The Cost of Medical Care"  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1655770/pdf/calwestmed00187-0009.pdf

______________________________

Articles by others about the work of the Committee on the Cost of Medical Care Editorial: "THE WORK OF THE AMERICAN COMMITTEE ON THE COST OF MEDICAL CARE" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC381566/pdf/canmedaj00086-0067.pdf 1933  Journal of the National Medical Association: "Committee on the Cost of Medical Care: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2623705/pdf/jnma00769-0022.pdf 1933   Canadian Medical Association:  "The Report of the Committee on the Cost of Medical Care” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC402728/pdf/canmedaj00128-0076.pdf ______________________________

Articles by Wilbur after 1932 that continue to show a commitment to the cause: 1933 article by Wilbur    "Medicine at the Crossroads" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1658611/ 1937 speech by Wilbur  "The March of Medicine"  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1658611/ 1939 Wilbur “California Physicians’ Service” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1660096/pdf/calwestmed00351-0063b.pdf 1942 Wilbur:“THE CALIFORNIA PHYSICIANS' SERVICE AND THE LOW-INCOME PATIENT” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1634391/pdf/calwestmed00285-0010.pdf

LeeTilson (talk) 21:11, 16 June 2017 (UTC) --LeeTilson (talk) 21:11, 16 June 2017 (UTC) posted by   PeopleMatters@gmx.com

External links modified
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 * Added archive https://web.archive.org/web/20100321004550/http://www.lewin.com/content/publications/2983.pdf to http://www.lewin.com/content/publications/2983.pdf
 * Added archive https://web.archive.org/web/20081221180907/http://institute.ourfuture.org/audio-media/2008125117/news-conference-case-public-plan-choice-national-health-reform to http://institute.ourfuture.org/audio-media/2008125117/news-conference-case-public-plan-choice-national-health-reform
 * Added archive https://web.archive.org/web/20090320044417/http://institute.ourfuture.org/files/Jacob_Hacker_Public_Plan_Choice.pdf to http://institute.ourfuture.org/files/Jacob_Hacker_Public_Plan_Choice.pdf
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 * Added archive https://web.archive.org/web/20100308000433/http://www.whitehouse.gov/the-press-office/remarks-president-a-joint-session-congress-health-care to http://www.whitehouse.gov/the-press-office/remarks-president-a-joint-session-congress-health-care
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Section on recent "Medicare for All" bills/Sanders, Warren campaigns?
It seems reasonable given how the healthcare conversation has shifted recently. We've gotten to the point where options like single-payer are being seriously considered in the high echelons of American politics, for the first time since the 1970s and the public-option now has supermajority support in polls.

Full disclosure that I supported Bernie in his campaign. Brikumw02 (talk) 01:48, 18 October 2020 (UTC)Brikumw02

Request writer to elaborate "It would have required parents to cover their children, but did not require adults to buy insurance."
As shown in lines 14 and 15 in the part of ===Debate in the 2008 presidential election===, I'm now editing my translation into traditional Chinese (done in 2020), but having hard time to understand the wordings. Thank you in advance for your kind attention. ThomasYehYeh (talk) 08:32, 4 February 2021 (UTC)

Regarding citations needed in this section
2009 reform debate === ==


 * In the paragraph "There is one bill currently before Congress but others are expected to be presented soon. A merged single bill is the likely outcome.............A proposed but not yet enacted short bill with the same effect is the Republican sponsored Patients Act 2009." there are about 6 [citation needed] posted by editor(s), I'm wondering if there's any writer who can help fill up? I'm also interested to know them. I did the translation into traditional Chinese last year, and started editing this translation 2 days ago. I love this article. Thank you for your attention.ThomasYehYeh (talk) 00:58, 5 February 2021 (UTC)