ABSTRACT
Since early in the twentieth century, health insurance coverage has been an important issue in the United States. The first coordinated efforts to establish government health insurance were initiated at the state level between 1915 and 1920. From the late 1930s on, most people desired some form of health insurance to provide protection against unpredictable and potentially catastrophic medical costs. The main issue was whether health insurance should be privately or publicly financed. Private health insurance coverage grew rapidly during World War II, as employee fringe benefits were expanded because the government limited direct wage increases. Responsibility for administering the Medicare and Medicaid programs was entrusted to the Department of Health, Education, and Welfare—the forerunner of the Department of Health and Human Services. Until 1977, the Social Security Administration managed the Medicare program, and the Social and Rehabilitation Service managed the Medicaid program.
