The Evolution of Universal Health Care Efforts in the US and the Role of Technology in Medicaid Redeterminations

Ben H.

Hatched by Ben H.

Jul 14, 2023

4 min read


The Evolution of Universal Health Care Efforts in the US and the Role of Technology in Medicaid Redeterminations


The pursuit of universal government-funded health care in the United States has been a long and arduous journey. Over the course of nearly a century, various reform efforts have emerged, faced defeat, and sometimes achieved success. In this article, we will explore the history of universal health care efforts in the US, drawing parallels between different countries' experiences and examining the role of technology in addressing challenges in Medicaid redeterminations.

Historical Context:

The idea of universal health care began to gain traction in the late 19th century, with Germany leading the way in 1883 by implementing a system for workers. Other European countries followed suit, including Austria, Hungary, Norway, Britain, Russia, and the Netherlands. Interestingly, the British and German systems were developed by conservative governments as a defensive measure against the socialist and labor parties. This raises the question of whether a similar tactic could be employed in the US, such as a Trump tactic to return in '24.

Early Initiatives and Opposition:

During the Progressive Era, President Theodore Roosevelt expressed support for health insurance, but most reform efforts took place outside of the government. In 1914, reformers sought the involvement of physicians in formulating a health insurance bill, receiving support from the American Medical Association (AMA). However, concerns were raised about potential government overreach and its impact on union strength.

Obstacles and Compromises:

Opposition to national health insurance came from the multi-million dollar commercial life insurance industry, which feared losing business if death benefits were covered. Furthermore, with the US entering World War I, anti-German sentiment fueled criticism of health insurance as a "Prussian menace." The Committee on the Cost of Medical Care (CCMC) was formed to address concerns about medical care costs and distribution, but it ceased meeting in 1932.

The New Deal and Medicare/Medicaid:

Franklin D. Roosevelt's presidency was marked by the Great Depression, WWII, and the New Deal. While the Great Depression seemed like a catalyst for compulsory health insurance, unemployment insurance and old age benefits took priority. It was not until 1958 that a proposal to cover hospital costs for the aged gained momentum, leading to Medicare and Medicaid. Political compromises, concessions to doctors and hospitals, and the inclusion of Republicans resulted in a three-part plan that was signed into law in 1965 by President Johnson.

The Canadian Lesson:

Canada's journey toward universal health care began in 1916 and took until 1962 for passage in a single province. It then took another decade for the rest of the country to follow suit. This highlights the lengthy process and challenges involved in achieving universal health care.

The Role of Technology in Medicaid Redeterminations:

As states face the daunting task of Medicaid redeterminations, technology is being leveraged to facilitate communications and outreach to affected enrollees. With an estimated 15 million people projected to lose Medicaid during this process, the need for efficient and effective systems is paramount. States are collaborating with technology vendors to streamline eligibility determinations and reduce the risk of disenrollments due to procedural reasons.


The pursuit of universal health care in the US has been a complex and multifaceted endeavor that spans decades. While progress has been made with the implementation of programs like Medicare and Medicaid, challenges persist. However, the integration of technology in Medicaid redeterminations offers opportunities for improved efficiency and better outcomes. As we continue to navigate the path towards universal health care, it is crucial to learn from historical experiences, embrace innovative solutions, and prioritize the well-being of all individuals.

Actionable Advice:

  • 1. Advocate for comprehensive health insurance: Support efforts to expand access to comprehensive health insurance that covers both hospital and physician services. Grassroots support can have a significant impact on shaping the national agenda.
  • 2. Embrace technology in health care: Encourage the adoption of technology in health care systems to enhance eligibility determinations, improve communication with enrollees, and reduce the risk of procedural disenrollments.
  • 3. Learn from international experiences: Study the successes and challenges faced by countries like Germany and Canada in their journey towards universal health care. Identify common points and insights that can inform future reform efforts in the US.

Note: The content has been paraphrased and organized to create a coherent article.

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