Health insurance reform in the United States: old lessons on a renewed debate

In 2009, following the election of Barack Obama to the Presidency of the United States, the American public entered into a fierce debate on how to reform its health care system. The intense debate on health care reform, however, is not a new phenomenon in American political life. Debate over health care has cycled its way into the American political discourse every twenty-years or so. History suggests that forceful opposition has prevailed against most major efforts to alter the health system in the United States. Yet, once again the Democratically-controlled Congress and Presidency in the United States aspire to break this cycle of history. With both houses in Congress passing a bill with significant reforms, it seems that this time may be different. While it is very likely some reforms will pass in 2010, no law has been signed yet56. In the end, only time will dictate the outcome of this round of health reform debates. Through a thorough literature review, this article provides the Polish reader a sense of health care reform efforts in the U.S. from the historical perspective and discusses the current proposed reforms. Particular attention is paid to the evolution of the American health insurance system, failed efforts of past health reform initiatives, their contrast with today’s efforts, and current health and economic indicators that could lead to reform in 2010