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Views & Reviews Past Caring

Uninsured in America? Blame the first world war

BMJ 2009; 339 doi: (Published 12 August 2009) Cite this as: BMJ 2009;339:b3269
  1. Wendy Moore, freelance writer and author, London
  1. wendymoore{at}

    In healthcare reform, timing is everything. The enthusiasts who first tried to bring compulsory health insurance to the United States were convinced that conditions were perfect for success at the beginning of the 20th century. There was widespread consensus about the problem. Rising medical costs had put basic health care beyond the means of many American families, so that millions were uninsured and those who could afford insurance often found that it did not cover their needs. There was general agreement about the solution. Beginning in Germany in 1883, countries across Europe had introduced national insurance schemes guaranteeing medical care for all, which provided a sensible template for the US to copy. And there was heartfelt support for change. …

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