[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-416524-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-416524-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","the-governments-role-health-care-industry","The Government's Role - Health Care Industry","","The Government's Role by Charles T. Carlstrom analyzes how market forces and federal policy shaped U.S. health care from the early 1900s to the mid-1960s and beyond. It explains the rising economic share of medical spending, the expansion of Medicare and Medicaid, and criticisms such as job lock caused by employer-based insurance. It also traces the evolution of insurance from early prepaid hospital plans to Blue Cross growth, highlighting how premium rating systems influenced access, costs, and coverage gaps.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/the-governments-role-health-care-industry/416524/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/the-governments-role-health-care-industry/416524.png","ImageObject",300,407,{"name":42,"@type":43},"Genevieve","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What were the key reasons driving calls for health care reform?","Question",{"text":63,"@type":64},"The text cites the fast-growing share of the economy devoted to health care, the persistence of uncovered individuals despite federal spending, and the job-lock effect created by employer handling most private insurance.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How did Medicare and Medicaid change health care coverage in 1965?",{"text":68,"@type":64},"The document states that Congress enacted Medicare and Medicaid to ensure poor and elderly Americans would not be denied access to health care.",{"name":70,"@type":61,"acceptedAnswer":71},"How did insurance rating systems affect who could buy coverage?",{"text":72,"@type":64},"It explains that shifting from community-rated premiums to experience-rated premiums related to adverse selection, causing insurers to assess risk classes and potentially price some people out of the market.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},416524,1791038099,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":55,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},1374391974585,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","# The Government's Role\n\nby Charles T.Carlstrom  \nI  \n1965,Congress enacted Medicareand Medicaid to ensure that poor andelderly Americans would not be deniedaccess to health care.In that year,5.9percent of the nation's total output wasspent on medical services.By 1992,thisshare had soared to approximately 14percent,and by the year 2000,it is pro-jected to reach almost 19 percent.'Thegrowing fraction of the economy de-voted to health care is one reason whymany advocate a major overhaul of thecurrent system.  \nA second is that although federal andstate govenments are projected tospend $365 billion this year providingmedical care for the poor and aged,15percent of the population still lackshealth coverage—a situation manyfind deplorable.²A third criticismstems from the fact that 91 percent ofprivate health insurance is handledthrough employers.³This has createdwhat is known as \"job lock,\"or the re-luctance of workers to change jobs orindustries because they fear losingtheir medical benefits.Although it ishard to quantify the impact ofjob lockon the economy,publicopinion pollssuggest that between 10 and 30 percentof workers feel tied to their currentcompanies for this reason.  \nThese problems have led to increasingpressure on the federal govemment topass some type of health care reformpackage.Congress,the administration,and the American public are currently  \n# in the Health Care Industry:Past,Present,and Future\n\ndebating what form this legislationshould take.Before adopting any newsystem,however,we need to under-stand the forces—both market andgovemment—that have shaped andare currently shaping our approach tohealth care.This Economic Commen-tary examines these forces by looking atthe history of medical care in the UnitedStates since the early part of the century.  \n■ Health Care:1913 to 1966  \nMany claim that the market for healthcare is unlike that for most goods andservices.While this may be true,priorto the Depression,the health care mar-ket in the United States operated muchlike any other,with customers payingdoctors and hospitals directly out oftheir own pockets.The major differ-ence between health care and othergoods and services today is insurance:Third-party payers now contribute 78cents of every medical dollar spent.  \nThe U.S.health insurance industry cantrace its roots to 1929,when BaylorHospital began offering prepaid hospi-tal coverage to 1,200 teachers.Thiswas the beginning of what later be-came known as Blue Cross.⁵The dra-matic growth in health insurance didnot occur until World War II,however.By 1943,43 Blue Cross plans were ineffect nationwide.  \nBlue Cross originally based its premi-ums on the cost of insuring specificgeographic areas,with each resident  \nJune 1,1994  \nWhen Medicare and Medicaid werepassed in 1965,less than 6 percent ofthe nation's output was devoted tohealth care.Today,that figure ex-ceeds 14 percent and is rising rapidly.This article looks at some of the rea-sons behind the relentless ascent inmedical costs over the last several dec-ades and examines how governmentpolicy has both contributed to andtried to rein in these costs.  \na.Includes philanthropy and industrial in-plant spending for health care.  \ncharged the same amount.This prac-tice,known as the community ratingssystem,was gradually superseded byexperience-rated premiums,whichwere based on the expected cost of in-suring an individual or subgroup.Thus,payments began to depend on a per-son's age,sex,and health status.  \nThe advent of experience ratings wasinevitable in light of adverse selection.Adverse selection refers to the greaterincentive under community-rated plansfor those with generally poor health orchronic illnesses to purchase medicalinsurance.Because ofthis selectionbias,insurers could not charge actuari-ally fair premiums to normal healthy in-dividuals,who were thus driven evenfurther out of the market.To bringthem back in,it became necessary tomove toward an experience-rated sys-tem.Insurance companies hence startedspend","cbCaimhFOEBXPTQo","https://ap.wps.com/l/cbCaimhFOEBXPTQo","pdf",1752054,"English","# The Government's Role\n## Health Care: 1913 to 1966\n## The Continued Growth","[{\"question\":\"What were the key reasons driving calls for health care reform?\",\"answer\":\"The text cites the fast-growing share of the economy devoted to health care, the persistence of uncovered individuals despite federal spending, and the job-lock effect created by employer handling most private insurance.\"},{\"question\":\"How did Medicare and Medicaid change health care coverage in 1965?\",\"answer\":\"The document states that Congress enacted Medicare and Medicaid to ensure poor and elderly Americans would not be denied access to health care.\"},{\"question\":\"How did insurance rating systems affect who could buy coverage?\",\"answer\":\"It explains that shifting from community-rated premiums to experience-rated premiums related to adverse selection, causing insurers to assess risk classes and potentially price some people out of the market.\"}]","The Government's Role - Health Care Industry | PDF",1790605735,18]