The forerunner of our modern health insurance system began in the 1920s, when hospitals began offering prepaid services. What is widely considered to be the first employer-sponsored plan began with a group of teachers in Dallas. Texas hospitals came together in 1929 to create a means to help patients pay for care. This first health insurance, Blue Cross, helped cover the costs of a hospital stay.
Dallas-area teachers were among the first to benefit from hospital coverage in exchange for a monthly premium of 50 cents. We created Oscar to create a health insurance company that behaved like a family doctor. However, the creation of a wide range of social security programs took an uneven pace between countries and was piecemeal in its formulation within nations (Anderson, 1968, 1972; Glaser, 199). Bismarck is cited as the creator of compulsory health insurance, which was one of the social insurance programs that began in Germany in the 1880s.
One of the main objectives was to calm workers' unrest. Like many subsequent programs, this system was the product of commitments that, in this case, left the national government with much less administrative power than Bismarck had proposed. Existing health insurances retained the administrative responsibilities that persist to this day. As with many other social security programs, Germany's became universal in anger.
White-collar workers weren't initially covered, and farmers weren't included until after World War II. In 1907, only 21 percent of the German population was covered by health insurance (Starr, 198). However, at the end of World War II, most European countries had social health insurance or other government health programs for major segments of their population. It was called the Children's Health Insurance Program (CHIP) and it extended Medicaid assistance to “uninsured children up to 19 years old” from families with incomes too high to qualify for Medicaid.
However, the financial implications of a comprehensive public health insurance program provided another reason for inaction in 1935.Using health care and other additional benefits to attract the best employees, private-sector and white-collar employers across the country expanded the U. The next four chapters of this report describe the current state of employment-based health benefits and analyze developments over the past two decades. The EBRI interviewed employers for the study and found that others could do the same if a major employer suspended health benefits. Workers and some other liberal groups were still in favor of a completely public program, but organized medicine and traditional opponents of government action seemed to have accepted that the time had come to develop a national comprehensive health program.
States may indirectly reach out to some employers by regulating insured health plans, including insured HMO plans, but the pool of insured employers has shrunk each year as more employers, including fairly small employers, have seen the advantages of self-insurance to avoid such regulation. The 1950s also seem to have witnessed the first attempt by health plans to encourage or demand a second opinion on the need for proposed surgery. Providing insurance to people 65 years of age or older successfully countered several criticisms that those who opposed government-sponsored health insurance had directed at previous bills. In an effort not to alienate at-risk citizens, some government officials considered it important to continue pushing for a national health system.
With the exception of the 1973 HMO Act, which required most employers to offer their employees a federally qualified HMO if one was available, these initiatives did not directly affect employment-based health benefits. While commercial insurance companies did not offer health insurance during this period, a large portion of their businesses offered burial insurance to pay for funeral costs. If health insurance had been included, it is estimated that it would have doubled the amount of the payroll deduction required to fund the new programs (Anderson, 1968, p. However, Congress never passed a mandatory national health insurance bill, and several less extensive proposals11 failed to achieve any results in the face of the AMA's strong public relations campaign against socialized medicine.
The Blue Cross plans also benefited from special legislation at the state level that allowed them to act as non-profit corporations, enjoy tax exemption and be free from the usual insurance rules. The importance of these advances, namely the defeat of national health insurance, government decisions in favor of employer-based insurance, the success of the Blue Cross concept, and the shift of opposition unions to support employer-based insurance, led to a greater and rapid growth of employment-based health benefits in the 1950s. . .