This timeline summarizes the major developments in the history of health care and health insurance in the United States from 1900 to 2010. It shows that organized medicine began taking shape in the early 1900s while the concept of health insurance was first promoted in 1912. The first modern health insurance plan was created in 1929 in Dallas, Texas. Major developments include the establishment of Medicare and Medicaid in 1965, the passage of the Affordable Care Act in 2010, and various attempts at health care reform throughout the 20th century.

1. Health Care TIMELINE
Organized Medicine Concept of Health
Takes Shape Insurance Promoted A Model for Health Insurance
1900s 1912 1929
This period marks the beginning of organized medi- Social insurance, includ- Baylor Hospital in Dallas, Texas, starts a prepaid hos-
cine. The American Medical Association gains pow- ing health insurance, gains pital insurance program with a local teachers union and
erful influence as the national organization of state public attention when Teddy creates what is thought to be the nation’s first example
and local associations. Unlike European countries, Roosevelt and his Progres- of modern health insurance.
U.S. policy-makers find little value in health insur- sive Party campaign on the
ance. issue. The American Asso- Theodore
ciation for Labor Legislation Roosevelt
also publishes and promotes
Photo: Library of
a draft bill for compulsory Congress
health insurance, but the ef-
fort is derailed when the U.S.
enters World War I.
N.Y. Health Board supervising care of babies
in hot weather, c. 1900-1908.
Photo: Wikimedia Commons
New Focus With FDR Proposes ‘Economic National Health
Hard Economic Times Bill of Rights’ Insurance Condemned
1934 1944 1945
The Depression shifts attention to unemployment In his State of the Union Shortly after becoming president, Harry Truman pro-
insurance and “old age” benefits. President Frank- address, President Franklin poses a broad health care restructuring that includes
lin Roosevelt creates the Committee on Economic Roosevelt outlines an “eco- mandatory coverage, more hospitals, and double
Security to address these issues as well as medical nomic bill of rights” that the number of nurses and doctors. Denounced by
care and insurance. includes the right to ade- the American Medical Association and other critics
But when the So- quate medical care and the as “socialized medicine,” his plan goes nowhere in
cial Security Act is opportunity to achieve and Congress.
passed, health insur- enjoy good health. During
ance is omitted. The World War II, U.S. busi- Harry Truman
American Medical nesses begin to offer health
Photo: Wikimedia
Association strong- benefits as they compete Commons
ly opposes a nation- for workers, giving rise to
al health insurance the employer-based system
program, saying in place today.
it would increase
bureaucracy, limit
doctors’ freedom
and interfere with
A family affected by the
the doctor-patient Depression, 1936.
relationship. Photo: Wikimedia Commons

2. Health Care TIMELINE
Discrimination Barred Medicare and Medicaid
in Hospital Care Become Law Health Care in Crisis
1946 1965 1970s
The Hill-Burton Act (Hospital Survey and Con- President Lyndon Johnson signs into Medical costs rapidly escalate now that millions
struction Act) pays for the construction of hospi- law the most significant health reform more are insured after the passage of Medicare and
tals, especially in rural areas, to close the gap in of the century: Medicare, which pro- Medicaid. In 1972, President Richard Nixon signs
access to medical care. It also prohibits discrimi- vides comprehensive health care cover- the Health Maintenance Organization Act as part of
nation on the basis of race, religion, or national age for people 65 and older, and Medic- his national health strategy to reduce costs. HMOs
origin in the provision of hospital services, but al- aid, which helps states cover long-term are prepaid, managed-care group plans. But further
lows for “separate but equal” facilities. Hospitals care for the poor and disabled. action is stymied by the Watergate scandal. For the
are required to provide a “reasonable volume” of next several decades, presidents and lawmakers try,
charitable care. and fail, to overhaul the health care system.
President Lyndon B. Johnson signs Medicare Bill
Photo: Wikimedia Commons
Corporations Take States Enact Major Health Care
Greater Control Reform Laws Reform Signed
1980s 2006 2010
There is a shift toward privati- Massachusetts implements laws President Barack Obama signs landmark health care legislation. The Pa-
zation of health care as corpo- to provide health care coverage tient Protection and Affordable Care Act requires that all individuals have
rations begin to integrate the to nearly all state residents and health insurance beginning in 2014. Those with low and middle incomes
hospital system (previously a calls for shared responsibility who do not have access to affordable coverage through their jobs will be
decentralized structure) and en- among individuals, employers able to buy coverage with federal subsidies. Health plans cannot deny
ter many other health-care-re- and the government in financing coverage for any reason, including a person’s health status, nor can they
lated businesses and consolidate the expanded coverage. Within charge more because of a person’s health or sex.
control. In 1987, the Census Bu- two years, the state’s uninsured
reau’s annual estimate of health rate is cut in half. Vermont also President
insurance coverage in the United passes comprehensive health Obama reacts
States finds 31 million uninsured care reform aiming for near-uni- to the passage
of the health-
(13 percent of the population). versal coverage. The law creates care bill.
a health plan for uninsured resi-
Photo:
dents and focuses on improving Wikimedia
overall quality of care. Commons