Why the U.S. never got universal health care

One big thing you should know about the U.S. health care system: it’s barely a system at all. It’s a patchwork. A bunch of different systems crammed together. That’s why it’s so expensive and why it can be such a pain to use. We’ve never really decided what we want to prioritize, and that’s part of the reason we don’t have universal health care, like so many other countries do. So why doesn’t the U.S. have universal health care? There have been lots of calls for it, dating back to Theodore Roosevelt, who proposed national health insurance in 1912. But a national system of government-run health insurance never happened. Instead, employers started offering health insurance in World War II as a benefit to attract workers, since everyone’s wages were frozen. That’s how we got the employer-based health insurance system we have today. Instead of creating one program to cover everyone else, the U.S. decided to add onto it piece by piece: * Medicare for seniors. * Medicaid for low-income people. * CHIP for kids. * And each one of those programs is a patchwork within itself. Then there’s the Affordable Care Act, another complex marketplace for people who don’t

have another source of health coverage. The catch is - that still leaves about 28 million people uninsured, including low-income adults and non-citizens. Many of those who haven’t signed up say it’s because they can’t afford the coverage. By contrast: * Canada has had national health care since 1968. * Britain has had it since 1948. * Germany requires everyone to be insured by a “sickness fund” — a system that started in 1883. * Switzerland has required everyone to buy health insurance since 1996. The bottom line: Unlike other countries, the U.S. has never reached a consensus on whether health care is a right, or whether universal health care should be a goal. Unless that happens, the U.S. isn’t going to have the kind of health care safety net that other countries have.