Health Care Reform in America: The Good, The Bad and The Ugly

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Health care providers, the insurance industry, and all of us as health care consumer continue to experience the difficult birth pangs of the Patient Protection and Affordable Care Act ("ACA" or the "Act"). Political battles rage in many states over whether to adopt the Medicaid expansion option called for by the Act, numerous congressional attempts to repeal parts or all of it have been mounted and not doubt will continue, and two lawsuits challenging important provisions of the Act have reached the United States Supreme Court. The natural inclination is to view the ACA as unique in its scope, impact and political implications. But such a view is myopic, for the road to health care reform in America is well traveled. Every American presidential administration following the end of World War II has, to some extent, proposed or supported changes to the health care system in this country. And many of those previous reform proposals hold similarities to some provisions in the ACA.

This is not the first time the nation has debated controversial health care reform proposals. This is not the first time bitter partisan politics have complicated, and sometimes obfuscated, attempts at reform. Some attempts at health care reform have succeeded and some have failed, and the political process has often been ugly and divisive. Here is a look at some past attempts at health care reform in the post war era: the good, the bad, and the ugly.

The Truman Administration (1945-1953)
The first attempt at health care reform in the post-war era occurred during the administration of President Harry S. Truman. His predecessor Franklin D. Roosevelt did little to advance the cause, and health care accessibility was one of the few societal needs not addressed in the New Deal programs. There is evidence President Roosevelt intended to pursue some form of health care reform after the end of World War II, but he died before then, in April 1945. President Truman recommended to Congress a proposal known as the Wagner-Murray-Dingell bill consisting of nine goals to be achieved over a ten-year period. Universal health insurance coverage, administered and paid for by a National Health Insurance Board, was third down the list of priorities. The first two priorities were increasing the number of medical practitioners-primarily doctors and nurses-and increasing hospital expansion and construction. Opponents of the proposal, including the American Medical Association (AMA), decried it as "socialized medicine" and the bill died in Congress. Truman made a second effort at health care reform in 1948, following his re-election, but the outbreak of the Korean War proved to be the death knell of the proposal.


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