Health Insurance 1883 – Protection Against Medical Costs

Health insurance is a system that helps protect against high medical expenses and can be provided by governments or private insurance companies. In 1883, Prussian-German statesman Otto von Bismarck introduced one of the earliest forms of national health insurance, providing healthcare to a large section of industrial workers. National health plans were later established in England (1911), Sweden (1914) and France (1930).

In the United States, health insurance is a relatively recent concept, because until 1920 most people were treated at home at low cost. The state of medical technology could do little for many patients. Even operations were performed in private homes until the 1920s. 

• The first individual insurance plans in the United States began during the Civil War (1861-1865). However, they provided protection only against accidents associated with steamboat or railway travel. 
• Massachusetts Health Insurance of Boston began offering relatively comprehensive group policies in 1847. 
• In 1929, teachers in Dallas, Texas, established the first modern group health insurance plan with Baylor Hospital, providing medical services for a fixed monthly fee. This is considered a precursor of Blue Cross Hospital Insurance in the United States. 
• In 1939, the California Medical Association launched Blue Shield to pay doctors' fees. During World War II, the US government prohibited employers from raising wages. Employers therefore tried to retain staff by offering health insurance.
• Established in 1965, Medicare is a public programme for older people and certain people with disabilities. Medicaid also covers certain very-low-income children and their families.

Government control of healthcare has often been debated in the United States. In 1935, Morris Fishbein, editor of the Journal of the American Medical Association, said that publicly funded medical services would "communise" America and turn Americans into "automatons who move, breathe, live, suffer and die at the will of politicians".

Description of the article image: Trains could be very dangerous in the late 19th century. The first individual insurance plans in the United States provided coverage against accidents associated with steamboat or railway travel. The image shows an accident involving the Granville-Paris Express in October 1895.

Historical figures mentioned in the article: Otto Eduard Leopold von Bismarck (1815–1898)

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