The United States is something of an outlier in the modern world; it holds the dubious honor of being the only developed western nation to not offer a national healthcare service. In fact, many in the US still view any talk of a centralized, tax payer funded healthcare system as an attempt to introduce socialist policies via the back door. Any attempts at reforming the healthcare industry are met with stiff resistance and an entrenched pro-capitalist healthcare industry that has the financial and human resources to mount a determined challenge to any legislation it views as damaging to its interests.
Nevertheless, Bernie Sanders was able to gather a broad support base for his proposed single-payer healthcare reform that formed a central part of his progressive manifesto when running in the Democratic primaries. This shows that there is a growing appetite for a system which resembles the universal healthcare offered in Canada and across Europe. In order to understand the current situation, it is prudent to consider the steps that bought us here.
The oldest records of healthcare in the United States date from the end of the 19th century. When the industrial revolution reached America, it rapidly transformed the country, and steel mills began to spring up across the incorporated territories and states that comprised the US. With these new manufacturing jobs came new work-related hazards and there was no formal health and safety legislation in place to protect workers. The first forms of health insurance in the US came about in response to the rate of death and injury in the workplace, which also helped to spur the creation of unions to lobby for workers’ rights.
The formation of the American Medical Association (AMA), which registered some 62,000 physicians as members during its first decade, helped instigate a push towards organized healthcare. The American working class of the time wasn’t as sympathetic to the idea as their European counterparts who would push much harder for universal healthcare in the coming decades. Following the outbreak of World War One, the US government introduced a bill to cover the healthcare costs of any soldiers injured while fighting, the act was later expanded to provide support to any of the serviceman’s dependents. Ultimately the policy ended with the war.
Following the death of FDR, Harry Truman took over as president and introduced a single-payer healthcare bill to congress. The bill met heavy resistance and fell victim to the ‘Red Scare’ after being repeatedly derided for being ‘socialist’. Surprisingly even the AMA objected to the bill on these grounds.
The latter half of the 20th century saw the arrival of various technologies which would transform the healthcare industry in the United States. Pagers appeared in the 50’s and remain in use today as an effective way of summoning staff in an emergency. The 60’s and 70’s saw the first electronic records and subsequent decades saw these technologies refined and expanded. Healthcare IT’s relatively brief and exciting history demonstrates the rapid and dramatic increase in technological sophistication that followed the Second World War.
Under Donald Trump, healthcare reform is once again becoming a hot issue in US politics. A rapidly shifting political climate suggests that within the next decade we could see a major shift in position from a number of groups and politicians.