Christy Chapin explains the evolution of the U.S. healthcare system

Published: Oct 7, 2016

In a new article in The Conversation, Christy Chapin analyzes the history of healthcare in the United States and traces the steps that lead to the insurance company model and the adoption of the Affordable Care Act.

Chapin, an assistant professor of history, is author of Ensuring America’s Health: The Public Creation of the Corporate Health Care System (Cambridge University Press 2015), which explains how private and public interests merged to place insurance companies at the center of the U.S. healthcare system. In her article “Why your insurance companies control your medical care,” Chapin draws on research in her book to illustrate how we arrived at the current healthcare debate heading into the 2016 election next month.

Before insurance companies, Chapin explains that prepaid physician groups, comprised of doctors from different specialties, were the dominant model for healthcare between the 1900s and 1940s.

“Many health care reformers, including those behind President Truman’s failed 1948 universal care proposal, hoped to develop the medical economy around prepaid groups. Progressives believed that by federally funding prepaid groups, they could efficiently supply the entire population with comprehensive care,” she writes in the article.

But Chapin explains that the American Medical Association opposed these measures because it feared it might lead to a “corporate medicine” culture and mode of healthcare, which led the to insurance company model.

“AMA leaders decided that rather than allowing doctors to insure patients, only insurance companies would be permitted to offer medical coverage,” explains Chapin.

When Medicare adopted the insurance company model in the 1960s, Chapin writes that health costs skyrocketed which led to the implementation of cost control measures.

“While the flaws of the insurance company model have become more evident, reforming the system has proven extremely difficult. Just look at the Affordable Care Act.”

Read the full article and additional coverage below.

Why insurance companies control your medical care (The Conversation)
How did health insurance get to be such a mess? (Houston Chronicle) 
Why insurance companies control your medical care (SF Gate)
Christy Chapin on the centrality of insurance companies to American health care (Who Makes Cents Podcast)  

Image: Christy Chapin presents a talk on her book at UMBC. Photo by Marlayna Demond ’11 for UMBC. 

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