Health Care Reform
- LAST REVIEWED: 06 May 2015
- LAST MODIFIED: 23 May 2012
- DOI: 10.1093/obo/9780195389678-0022
- LAST REVIEWED: 06 May 2015
- LAST MODIFIED: 23 May 2012
- DOI: 10.1093/obo/9780195389678-0022
Efforts to expand access to health care in the United States date back to at least 1798, when Congress enacted legislation for “the relief of sick and disabled Seamen.” Modern reform efforts began during the first two decades of the 20th century, largely through the efforts of the American Association for Labor Legislation, an organization of academics and other professionals, political figures, and business and labor officials. In 1912 Theodore Roosevelt’s Progressive Party called for “adoption of a system of social insurance,” including the “protection of home life against the hazards of sickness.” Despite this, national health insurance (NHI) failed to achieve broad public support. During World War I opponents of NHI succeeded in linking it with Germany and later the Soviet Union. These developments put reform advocates on the defensive, and by 1920, efforts for NHI had waned. The issue reemerged during the 1930s, when FDR’s Committee on Economic Security debated adding NHI to the Social Security Act. Strong opposition from the American Medical Association and others convinced Roosevelt not to include it. After Roosevelt’s death, Harry S Truman advocated NHI, but this effort was also unsuccessful. During the 1950s many advocates of NHI began advocating government coverage for older adults, who were then the most vulnerable segment of the population. In 1965 this effort culminated in the enactment of Medicare and, to the surprise of many, Medicaid. During the 1970s the escalation of health-care inflation forced reformers to begin addressing the issue of health-care costs. Employers and government officials increasingly turned to managed care as an alternative to the traditional fee-for-service system. The spread of managed care, in turn, raised questions and concerns about the quality of care. With the failure of President Clinton’s Health Security Act, which tried to combine competition, managed care, and government regulation, reform efforts again largely waned. The battle between Hillary Clinton and Barack Obama for the Democratic presidential nomination in 2008 again brought reform to the fore. Without support from Republicans, Congress in 2010 enacted the Affordable Care Act (ACA). This entry focuses on the history, background, and current status of three aspects of health care reform—coverage, cost, and quality. It also addresses the contentious debate over the future of the ACA, Medicaid, and Medicare.
Discussion of the history of health-care reform can be found in a wide range of sources, including work by social workers, sociologists, economists, political scientists, physicians, and others. Corning 1969 provides a detailed examination of the background and development of Medicare. Starr 1982, a Pulitzer Prize–winning analysis of the development of the medical profession, includes valuable material on reform efforts through the 1970s, and Mizrahi and Gorin 2008 presents an overview of reform efforts since the early 1900s, with emphasis on the role of social workers in formulating, developing, and advocating for social policies. Quadagno 2006 provides a historical and theoretical discussion of why the United States lacks national health insurance: the author particularly focuses on how powerful interest groups have mobilized to undermine public support for reform. Birn, et al. 2003; Hoffman 2003; and Hoffman 2009 offer three unique perspectives on the history of reform efforts. Moniz and Gorin 2010 presents an overview of development and current status of health and mental health policy in the United States.
Birn, A. E., T. M. Brown, E. Fee, and W. J. Lear. 2003. Struggles for national health reform in the United States. American Journal of Public Health 93.1: 86–91.
Overview of popular efforts to achieve health-care reform.
Corning, P. A. 1969. The evolution of Medicare. . . from idea to law. Woodlawn, MD: Social Security Administration.
Insightful discussion of the origins and development of Medicare, commissioned by the Social Security Administration. Available online.
Hoffman, B. 2003. Health care reform and social movements in the United States. American Journal of Public Health 93.1: 75–85.
History of the role of social movements in broadening struggles for health-care reform; concludes with a valuable discussion of recent organizational reform efforts.
Hoffman, C. 2009. National health insurance—a brief history of reform efforts in the U.S. Menlo Park, CA: Henry J. Kaiser Family Foundation.
Succinct overview of reform efforts from 1934 to 2011, including discussion of economic and political factors, supporters and opponents of reform efforts, and reasons for the success and failure of each effort.
Mizrahi, T., and S. H. Gorin. 2008. Health care reform. In Encyclopedia of social work. Edited by T. Mizrahi and L. E. Davis, 340–348. New York: Oxford Univ. Press .
Discussion of reform efforts through 2008, with a particular emphasis on the role played by social workers.
Moniz, C., and S. Gorin. 2010. Health and mental health care policy. Boston: Allyn and Bacon.
Broad overview of health- and mental health–care policy and reform; includes content on role of social work in health- and mental health–care policy practice.
Quadagno, J. S. 2006. One nation, uninsured: Why the U.S. has no national health insurance. New York: Oxford Univ. Press.
A detailed analysis by a leading theorist of the long effort to enact national health insurance in the United States. The author stresses the role of “shareholder mobilization” and organizational structure.
Starr, Paul. 1982. The social transformation of American medicine: The rise of a sovereign profession and the making of a vast industry. New York: Basic Books.
Pulitzer Prize–winning account of the development of the medical profession in the United States. Book Two of this work examines modern efforts to expand coverage and address the growing problem of costs.
Users without a subscription are not able to see the full content on this page. Please subscribe or login.
How to Subscribe
Oxford Bibliographies Online is available by subscription and perpetual access to institutions. For more information or to contact an Oxford Sales Representative click here.
Purchase an Ebook Version of This Article
Ebooks of the Oxford Bibliographies Online subject articles are available in North America via a number of retailers including Amazon, vitalsource, and more. Simply search on their sites for Oxford Bibliographies Online Research Guides and your desired subject article.
If you would like to purchase an eBook article and live outside North America please email email@example.com to express your interest.
- Adolescent Depression
- Adolescent Pregnancy
- Adoption Home Study Assessments
- Adult Protective Services in the United States
- African Americans
- Aging, Physical Health and
- Alcohol and Drug Abuse Problems
- Alcohol and Drug Problems, Prevention of Adolescent and Yo...
- Alcohol Problems: Practice Interventions
- Alcohol Use Disorder
- Alzheimer's Disease and Other Dementias
- Anti-Oppressive Practice
- Asian Americans
- Asian-American Youth
- Autism Spectrum Disorders
- Baccalaureate Social Workers
- Behavioral Health
- Behavioral Social Work Practice
- Bereavement Practice
- Brief Therapies in Social Work: Task-Centered Model and So...
- Bullying and Social Work Intervention
- Canadian Social Welfare, History of
- Case Management in Mental Health in the United States
- Child Poverty
- Child Welfare
- Child Welfare and Child Protection in Europe, History of
- Children of Incarcerated Parents
- Chronic Illness
- Clinical Social Work Practice with Adult Lesbians
- Cognitive Behavior Therapies with Diverse and Stressed Pop...
- Cognitive-Behavioral Therapy
- Community Development
- Community Policing
- Community-Based Participatory Research
- Community-Needs Assessment
- Comparative Social Work
- Conflict Resolution
- Council on Social Work Education
- Counseling Female Offenders
- Criminal Justice
- Crisis Interventions
- Cultural Competence and Ethnic Sensitive Practice
- Culture, Ethnicity, Substance Use, and Substance Use Disor...
- Dementia Care, Ethical Aspects of
- Depression and Cancer
- Development and Infancy (Birth to Age Three)
- Direct Practice in Social Work
- Domestic Violence Among Immigrants
- Eating Disorders
- Ecological Framework
- Economic Evaluation
- Elder Mistreatment
- End-of-Life Decisions
- Epigenetics for Social Workers
- Ethics and Values in Social Work
- Evidence-based Social Work Practice
- Evidence-based Social Work Practice: Finding Evidence
- Evidence-based Social Work Practice: Issues, Controversies...
- Experimental and Quasi-Experimental Designs
- Families with Gay, Lesbian, or Bisexual Parents
- Family Caregiving
- Family Group Conferencing
- Family Policy
- Family Services
- Family Therapy
- Family Violence
- Fathering Among Families Served By Child Welfare
- Field Education
- Financing Health-Care Delivery in the United States
- Forensic Social Work
- Foster Care
- Gay Men
- Generalist Practice and Advanced Generalist Practice
- Group Work
- Group Work across Populations, Challenges, and Settings
- Group Work, Research, Best Practices, and Evidence-based
- Harm Reduction
- Health Care Reform
- Health Disparities
- Health Social Work
- History of Social Work and Social Welfare, 1950-1980
- History of Social Work and Social Welfare, pre-1900
- History of Social Work from 1980-2014
- History of Social Work in China
- History of Social Work in Northern Ireland
- History of Social Work in the Republic of Ireland
- History of Social Work in the United Kingdom
- HIV/AIDS Prevention with Adolescents
- Homelessness Outside the United States
- Human Needs
- Human Trafficking, Victims of
- Immigrant Policy in the United States
- Immigrants and Refugees
- Immigrants and Refugees: Evidence-based Social Work Practi...
- Impaired Professionals
- Implementation Science and Practice
- Indigenous Peoples
- Individual Placement and Support (IPS) Supported Employmen...
- International Social Welfare
- International Social Work
- International Social Work and Education
- International Social Work and Social Welfare in Southern A...
- Internet and Video Game Addiction
- Interpersonal Psychotherapy
- Intervention with Traumatized Populations
- Intimate Partner Violence
- Juvenile Justice
- Korean Americans
- Latinos and Latinas
- Law, Social Work and the
- Life Span
- Major Depressive Disorder
- Management and Administration in Social Work
- Maternal Mental Health
- Measurement, Scales, and Indices
- Medical Illness
- Men: Health and Mental Health Care
- Mental Health
- Mental Health Diagnosis and the Addictive Substance Disord...
- Mental Health Needs of Older People, Assessing the
- Mental Illness: Children
- Mental Illness: Elders
- Middle East and North Africa, International Social Work an...
- Military Social Work
- Mixed Methods Research
- Motivational Interviewing
- Native Americans
- Native Hawaiians and Pacific Islanders
- Neighborhood Social Cohesion
- Neuroscience and Social Work
- Nicotine Dependence
- Occupational Social Work
- Organizational Development and Change
- Pain Management
- Palliative Care
- Palliative Care: Evolution and Scope of Practice
- Parent Training
- Philosophy of Science and Social Work
- Physical Disabilities
- Police Social Work
- Positive Youth Development
- Postmodernism and Social Work
- Post-Traumatic Stress Disorder (PTSD)
- Practice Interventions and Aging
- Practice Interventions with Adolescents
- Practice Research
- Primary Prevention in the 21st Century
- Productive Engagement of Older Adults
- Profession, Social Work
- Psychiatric Rehabilitation
- Psychoanalysis and Psychodynamic Theory
- Psychopathology and Social Work Practice
- Psychopharmacology and Social Work Practice
- Psychosocial Framework
- Psychosocial Intervention with Women
- Qualitative Research
- Race and Racism
- Religiously Affiliated Agencies
- Reproductive Health
- Research Ethics
- Restorative Justice
- Risk Assessment in Child Protection Services
- Risk Management in Social Work
- Rural Social Work Practice
- School Social Work
- School Violence
- School-Based Delinquency Prevention
- Services and Programs for Pregnant and Parenting Youth
- Severe and Persistent Mental Illness: Adults
- Sexual Assault
- Single-System Research Designs
- Social Development
- Social Insurance and Social Justice
- Social Intervention Research
- Social Justice and Social Work
- Social Movements
- Social Planning
- Social Policy
- Social Security in the United States (OASDHI)
- Social Work Education and Research
- Social Work Regulation
- Social Work Research Methods
- Solution-Focused Therapy
- Strategic Planning
- Strengths Perspective
- Strengths-Based Models in Social Work
- Supplemental Security Income
- Survey Research
- Systematic Review Methods
- Task-Centered Practice
- Technology, Human Relationships, and Human Interaction
- Technology in Social Work
- Terminal Illness
- Transdisciplinary Science
- Translational Science and Social Work
- United States, History of Social Welfare in the
- Veteran Services
- Victim Services
- Welfare State Reform in France
- Welfare State Theory
- Women and Macro Social Work Practice
- Women's Health Care
- Work and Family in the German Welfare State
- Working with Non-Voluntary and Mandated Clients
- Young and Adolescent Lesbians
- Youth at Risk
- Youth Services