By 1935, 23,000 people from over 400 different employee groups had enrolled (Andrews, 1995).
Following the Blue Cross system was the Blue Shield program, designed to cover the fees of surgeons and other specialists. At the same time, private insurance companies began to underwrite policies for companies to provide health coverage to their employees. These private insurance companies created custom-designed plans that allowed employers to determine what benefits their employees should receive. Health care coverage gradually became an important benefit for business employees, and the level of coverage a means employers could use to attract employees (Andrews, 1995).
The government's role in health care started to increase during World War II, with treatment of the vast number of individuals involved in the war effort. The government continued to play a role through the development of the Veteran's Hospitals, social security, and other agencies that were involved with the general health and welfare of its citizens.
There were sporadic efforts to create some sort of national health insurance system, including one led by Harry Truman. John F. Kennedy, too, attempted to create health care coverage, although limited to the aged. Finally, the Medicare and Medicaid programs were created in 1965, with these covering the elderly and the poor, although only to a limited extent (Mueller, 1993).
Both of those programs continued to expand, along with both private corporate insurance and hospital or physician based insurance programs. Costs increased rapidly, generally in tandem with increasing technological efforts to prolong life, including such things as organ transplants and heart bypasses. Expensive machinery became mandatory for major hospitals, and even some small hospitals in rural communities. Primary care, or family, physicians became a smaller percentage of the total health care workers, with less and less influence o...