THE CONTROVERSY AND BACKGROUND
In an age where technology, medication, and services are constantly being created and used to combat sickness and disease, access to and quality of health care often depends upon the availability of finances. Thus, health insurance was created for the public in order to alleviate the anxiety of a possible medical emergency in which a patient would have to pay an exorbitant amount of money for testing and treatment. When a patient receives health insurance, he/she is basically paying an organization for a membership which guarantees compensation for certain medical bills as dictated by the organization. "Essentially, individuals make regular payments to the plan rather than having to pay especially large sums at any one time in the event of sudden illness or injury. in this way, the group as a whole funds expensive treatments for those few who need them."
However, not everyone can afford the insurance itself. Thus, many countries adopted nationally financed insurance plans. But there is currently a debate in the United States over whether or not, and to what degree, to have universal health coverage.
A BIT OF HISTORY
In 1883, Prince Otto von Bismark (Chancellor of Germany) passed a "compulsory sickness-insurance law . . . which was financed by a state subsidy" Many European countries later developed a variation of national health insurance (Austria-Hungary in the late 19th century, 1909-Norway, 1910-Sweden, 1911-Britain and Russia .), which was later expanded after World War II. In 1915, the U.S. began to coordinate efforts for a government-run health insurance at the state level, however nothing came of it. In the 1930s, the most the US was able to pass at a federal level was a part of the "Social Security Act that supported state activities relating to public health and health care services for mothers and children." The most of people in the United States at the time wanted some form of medical insurance and the majority chose a privately financed insurance. In order to attract workers (and avoid the government's limitation as to wage increases), many employers offered insurance as fringe benefits. Thus, private insurance companies expanded during and after WWII. Meanwhile, many proposals of a national health insurance were brought to Congress, yet none were actually voted on. In 1965, Medicare and Medicaid were developed as titles XVIII and XIX of the Social Security Act, providing financial support for the aged and needy. Title II covers the benefits for those retired, disabled, and who are considered "survivors." The Health Care Financing Administration currently manages Medicare and Medicade.
NOW AND THEN
Encarta describes the contrast well:
"Earlier in the 20th century, most physicians were solo practitioners working in their own offices or in partnership with another doctor. Patients visited the office, received an examination or other service, and paid a fee. this traditional solo, fee-for-service medicine has been declining. Many physicians now practice in groups where they share the same offices and equipment with other doctors. Group practices may combine primary care physicians, several kinds of specialists, laboratories, and equipment for diagnosing disease. Physicians who practice in a group reduce their own expenses and provide patients with an wider range of services. Many doctors are joining with hospitals, insurance companies, and industrial employers to provide managed care for groups of patients. Physicians may work as employees of Health Maintenance Organizations or other health care alliances. These plans oversee, or manage, care for patients, costs. Rather than taking a fee from each patient, managed care physicians may receive an annual summary form the HMO or affixed sum for each patient."
