Examining Social Trends: Health Care Coverage in the United States. A Contemporary Analysis Through an Historical Lens

Abstract

Understanding the historical road an important policy issue has taken is important not just as a theoretical exercise in public policy formation but also as a (hopefully) useful prescriptive tool to identify and anticipate obstacles moving forward to suggest realistic, concrete alternatives for progressive reform. This is especially true today in a country like the United States, where extreme political and ideological polarization often leads to dysfunctional governmental paralysis. The present article examines the health care debate adopting a historical narrative perspective, from the Progressive Era to the Affordable Care Act (Obamacare). The article argues that the history of health care in the U.S. can be usefully viewed as passing through various phases, which were not always linear from a reform perspective, characterized by the political, economic, and ideological context, as well as by certain societal factors such as the power of important stakeholders regarding health care, for example, unions, health care providers, and insurance companies. Underlying the entire discussion is the complex and often misunderstood nature of health care in the country, even among those inside the sector. An explanation of the various types of public and private insurance programs will also be presented as well as a brief look at some key health care statistics.