Introduction
The history of health care in the USA has been closely tied to the political sphere for many years. In 1935, a massive government-led program was formed into the Social Security Act which included some major changes for American society (Altman & Kingson, 2015). In the first drafts of this major document, a health care reform was proposed as a way to change the insurance policies and provide people with more opportunities to get access to healthcare.
However, the Roosevelt administration, in hopes to approve the Act quickly, removed this part of the document. It can be assumed that this decision was based on various facts; no strong support was voiced to include health insurance policies, and some opposition arose to the government’s intrusion into people’s private matters. If revised health insurance policies were included in the Social Security Act, Americans’ economic situation would have changed drastically, since the cost of mediation and procedures would not be dictated by the industry.
Health Insurance Provision
The impact of the choice made by the administration during the enactment of the Social Security Act is most visible in disadvantaged populations. According to Dickman, Himmelstein, and Woolhandler (2017), a significant part of a low- and middle-income households have to give away a major share of their income to have health insurance, thus losing any opportunities to save money or plan for the future.
To balance their spendings, many Americans are neglecting their health, choosing to stop purchasing medications, or agreeing to procedures due to their high costs (Dickman et al., 2017). Moreover, one may also see that life expectancy, wage growth, living quality, and other similar indicators have been showing that the gap between the rich and the poor is growing. This problem is also strongly related to racial inequality, with many African-American communities having high rates of uninsured persons (Dickman et al., 2017). Thus, the effect of exclusion is apparent – the lack of help has been increasing the divide between the incomes of different socioeconomic groups, taking away people’s change to purchase insurance, or afford health care.
As Sommers, Kenney, and Epstein (2014) find, the later introduced Affordable Healthcare Act (ACA) has produced an impact that could be made in 1935, expanding people’s opportunities to receive care. The authors note that enrollment into the program raised an overall number of people with health insurance and argue that more people could be eligible for this program with time. Dickman et al. (2017) state that private insurance does not work for many Americans, raising prices without giving more access to care.
Thus, one may suggest that a structure such as single-payer healthcare may help the populations to balance their needs and opportunities and gain access to health care that they currently cannot afford. In this system, the taxes would include payment for some essential healthcare practices, hospital visits, and emergency care. These services would be similar to the active Medicare or the Veterans Health Administration but would include all residents, and not people older than 65 or persons with specific conditions.
Arguably, this system would allow every person to fund themselves and receive care that would positively affect their life quality, further contributing to the overall health of the population. Moreover, it would simplify the current structure, eliminating the complexities of working with many private insurance companies.
Conclusion
The 1935 Social Security Act did not assess the health needs of US citizens. The main effect of this exclusion can be seen to this day – health insurance is treated as a market, and many people encounter problems with accessing healthcare. If the Act contained some propositions for health insurance provision, the US residents would have more opportunities to access treatment. A single-payer system can address the concerns of the disadvantaged populations and allow people from all socioeconomic groups to gain access to basic healthcare without giving away a large portion of their earnings.
References
Altman, N., & Kingson, E. (2015). Social security works! Why social security isn’t going broke and how expanding it will help us all. New York, NY: The New Press.
Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet, 389(10077), 1431-1441.
Sommers, B. D., Kenney, G. M., & Epstein, A. M. (2014). New evidence on the Affordable Care Act: Coverage impacts of early Medicaid expansions. Health Affairs, 33(1), 78-87.