Health Care as a Crisis: 40-plus Years in the Making

Way-back Wednesday, if you will: in the mid-1970's I did research on the topic of healthcare. Senator Ted Kennedy, along with Senator James Corman, had just reintroduced their Health Security Act. Originally proposed in 1971, they again put forward the universal health insurance policy in 1975.

Insurance premiums were rising at 12.6% per annum in the 1970's, a figure familiar to many in this decade. They had increased over 300% in the eleven years leading up to 1976.

More than a hundred years ago, in 1912, many doctors called for national health insurance but the idea had been killed by the insurance companies. During World War II and up to 1950, there were 10 proposals for national health insurance. Capitalizing on the socialism scare, the American Medical Association killed any discussion of national health insurance. However, overcoming the AMA's objections, Medicare and Medicaid were established in the 1960's. In the 1970's, the AMA and the American Hospital Association put forward their own proposal. See if this sounds familiar?

The proposal by the American Medical Association is lacking in several important areas. Participation is voluntary and not universal, thus leaving unprotected many of those who need health insurance the most. The proposed plan suffers from high premium costs, high coinsurance costs, and limited coverage. The AMA's plan requires that the consumer pay all expenses out of the pocket, an obvious problem for the medically indigent.

Absent in this plan are cost controls and quality controls which hold down overutilization, reduce inefficiencies, and increase the quality of care.

(National Health Insurance, field hearings before the Subcomittee on Health, Committee on Ways and Means, House of Representatives, 94th Congress, 2nd session, Government Printing Office, 1976)