TAILIEUCHUNG - National Health insurance—a Brief History of reform efforts in the u.s.

The need to train those who will be responsible for the O&M is an important institutional issue. Sometimes those responsible may be in the community, sometimes they may be a private contractor, or sometimes they may be in the ministry. User training is needed, par- ticularly in water supply and sanitation. Sanitation education has not always been provided and is very important. If the operator is going to be the sectoral agency, sometimes basic budgetary reforms need to be addressed. It is not always helpful to rely on sectoral agencies if they are embroiled in a dysfunctional budgeting system or do not have the necessary resources | FOCUS THE HENRY J. on Health Reform KAISER FAMILY FOUNDATION MARCH 2009 NATIONAL HEALTH INSURANCE A Brief History of Reform Efforts in the . Introduction Many believe the United States is on the brink of national health reform. Health care costs seem uncontrollable while 46 million Americans remain uninsured. Millions more are under-insured and even more worry that they are under-insured. The quality of health care is in question as more come to realize that the . does not lead the world in the health of its people. These problems resonated during the 2008 presidential campaign where health reform held its own among the top issues even after the economic crisis began to overshadow the election. Health care and its costs were seen as a large part of Americans pocketbook concerns. And now a White House Office on Health Reform is being newly established while seasoned Members of Congress are readying proposals of their own. The country has been on the verge of national health reform many times before however. In the early 1900s smaller proposals began to pave the way. In 1912 Theodore Roosevelt s Bull Moose party campaigned on a platform calling for health insurance for industry and as early as 1915 Progressive reformers ineffectively campaigned in eight states for a state-based system of compulsory health insurance. The prominent reformers of the 1920s the Committee on the Costs of Medical Care proposed group medicine and voluntary insurance modest ideas but enough to raise opposition and the term socialized medicine was born. Over the years the American public as measured in opinion polls as far back as the 1930s has generally been supportive of the goals of guaranteed access to health care and health insurance for all as well as a government role in health financing. However support typically tapered off when reforms were conditioned on individuals needing to contribute more to the costs. While the general public may largely support reforming the health .

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