Good Health for America

Good Health for America - Title: Good Health for America?...

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Title: Good Health for America? By: Gorsky, Martin, History Today, 00182753, Feb2010, Vol. 60, Issue 2 Database: Academic Search Premier Today's History America has struggled to reform public healthcare for over 100 years and now has a byzantine, costly system controlled by powerful, money-hungry interest groups. Martin Gorsky wonders whether President Obama can deliver reform When Barack Obama swept to power in November 2008, he seemed to promise a new start for domestic politics in the United States. High on his agenda was reform of the healthcare system, widely considered to be expensive, underperforming and unfair. America was spending a huge proportion of its national wealth on medical care — 15 per cent in 2005, compared with eight per cent in Britain and 11 per cent in France. Vet unlike European countries with universal coverage, around 46 million US citizens lacked any health insurance. With Obama's thumping majority and a tide of goodwill towards him, expectations of change were high. Since then reform politics have been a rollercoaster ride. The presidents proposals had three basic goals: regulation of the private insurance market, a 'public option' of a state-run health insurance scheme and more compulsion on employers and individuals to purchase coverage. However, the plan quickly generated huge controversy with opponents saying it was tantamount to Soviet-style Communism. For European observers, long accustomed to tax-funded national health services or state-mandated social insurance, this is rather baffling. Why should so many Americans believe universal health coverage poses a fundamental threat to their liberty and why has it been so hard for Obama to deliver his legislation? History can help us understand the choices which led the US to such a different approach to that of Europe. A useful concept in thinking about this is 'path dependency', the idea that decisions taken early on can significantly constrain possibilities for change later in time. With this in mind, we can look at why national health insurance was rejected by Americans from the early 20th century onwards. Statutory sickness insurance originated in Germany in 1883, devised by civil servant Theodor Lohmann and implemented by the 'Iron Chancellor' Otto von Bismarck. The principle was that health coverage became obligatory for particular groups of waged workers, financed by employer contributions and employee payroll deductions. Bismarck's goals in delivering welfare benefits were partly to enhance the efficiency with which 'human capital' was managed in an era of dynamic industrial expansion and partly to head off the appeal of socialism. As the system proved broadly successful, other countries began to consider their own versions of it. In Britain it was adopted in 1911 as part of the Liberal welfare reforms, which also included unemployment insurance and old age pensions. In America, proposals for blue-collar health insurance were made in the 1910s by the American
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This note was uploaded on 02/11/2012 for the course BUSINESS 345 taught by Professor Roselli during the Spring '10 term at Berea.

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Good Health for America - Title: Good Health for America?...

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