As the pendulum swings — America’s history of health insurance expansions – Orange County Register




Here’s a question keeping many people in our country up at night these days: Just why is our health insurance system so hard to fix?

Shana Alex Charles Photo courtesy Cal State Fullerton

To answer, we have look back at the 20th century. Our system is complicated because, as a nation, we have a very hard time agreeing on the final goal of the system itself. It’s indisputable that study after study has clearly shown the importance of health insurance — it is the key factor in deciding whether individuals gets the health care they need in the United States. But we just can’t agree on what the system should look like.

Republicans believe, in general, that health insurance is a private product, and buying it should be like buying a new television. If your employer happens to help you buy it through your job, that’s like providing good coffee in the break room — it’s a perk, but not a necessary one. This saves money, but doesn’t necessarily expand health insurance coverage.

Democrats believe, in general, that health insurance is a public good, and if everyone has coverage then everyone benefits from good health. The closer that a public policy gets to universal coverage, the better a policy is, even if it costs more money at the outset.

The argument between these two perspectives has kept health care reform swinging like a pendulum, depending on who is in power. And just when we think we have widespread agreement, the argument starts all over again with a new swing, as the other party takes control of the debate.

Historically, private health insurance has not served all sectors of American society well. The elderly and the poor already became priced out of the market for private coverage by the 1950s and early 1960s. In 1958, only 43 percent of those aged 65 and over had insurance for hospital care, compared to at least two-thirds of the nonelderly population.

When the 1964 election gave Democrats a landslide…

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