October 5, 2013
A fourth event shaping the government’s role in naming access to health and care as political priorities was the Great Depression, 1929-1941. Unemployed workers were unable to pay for their own health care. Because so many workers were unemployed, this led providers’ incomes to fall. Middle class citizens began to rely on public hospitals, and state and local health departments to receive health care. In turn, doctors began providing more services through these venues. Doctors charged the welfare departments. State welfare departments in turn charged the federal government. This cost-shifting system was supported by political priorities established in debates at the federal level and then by passage of such policy as the Social Security Act in 1935.
President Truman expanded Social Security and recommended national health insurance in 1949. He continued to work toward it unsuccessfully until 1953, a year before I was born. Nonetheless, an economic model based on commerce as the stimulus to support a government role in health care access made a transition to a government role in health care access for the needy or underserved with the initial stimulus being the unemployed.
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