June 28, 2012 --
Today the Supreme Court upheld the 2010 health care law in a dramatic victory for President Barack Obama. The lead up to today's decision has prompted debate between opponents and supporters of the Patient Protection and Affordable Care Act two years ago. Take a look at how we got to the health care system we have in place today.
Do Mexicans Have Better Health Care Than You?
Prior to the 20th century, nothing even close to what could be called a health care system existed in the United States. Although the Civil War had led to some medical breakthroughs in terms of surgical techniques and pain management, medical knowledge, techniques and treatment availability at the time left little hope that patients would actually recover from severe ailments. As NPR's Alex Blumberg and Adam Davidson point out, medical treatments may have been downright medieval at the time, consisting of potions. But at least it was cheap. "In 1900, the average American spent $5 a year on health care ($100 in today's money)," they note in their report.
How the Civil War Changed Modern Medicine
In 1912, Theodore Roosevelt was the first presidential candidate to get behind the idea of a national health insurance plan. Roosevelt ultimately didn't win election that year. Proponents of government-provided health care tried to press the issue through state initiatives, only to see their efforts fail in 16 states. Roosevelt's plan may have certainly been ahead of its time, particularly since there weren't that many services that doctors could actually provide patients during that era.
At the same time, however, developments within the medical community changed the face of the industry. The horrors of World War I led to advances in the areas of wound care, sanitation, pain management and more, according to an article published in the Journal of the Royal Society of Medicine. Hospitals in the United States began to widely adopt the practice of using antiseptics to sanitize their facilities, preventing the possibility of medical personnel or patients becoming exposed to infection. That decade also saw the introduction of the first employer group insurance contracts (though not specifically for health insurance) as well as the first physician service and industrial health plans.
In 1928, Alexander Fleming made one of the most important discoveries in the history of medicine: penicillin, a life-saving drug used to treat countless millions. It would be decades, however, before penicillin would be mass-produced. Fleming's discovery was the signature achievement in an era that saw medical treatment become more effective, and, as a result, expensive. The Great Depression also fueled concerns about affordability of medical treatment as millions of Americans suddenly found themselves out of work. In 1929, Baylor Hospital provided the first group health insurance plan in the United States through an agreement with Dallas-area teachers. The plan was the forerunner of Blue Cross. The effort wasn't just meant to be in the best interests of patients, but also the hospitals. Patient facilities saw more empty beds as fewer patients during the Great Depression could afford treatment without participating in these collective prepaid health insurance plans.
Ancient Nubians Drank Antibiotic-Laced Beer
As part of his push to create a social safety net for Americans during the Great Depression, President Franklin D. Roosevelt advocated the passage of national health insurance. Roosevelt pushed ahead with efforts to pass Social Security first, a bill which intentionally omitted any mention of medical care to ensure its passage. Harry Truman attempted to carry on Roosevelt's legacy in 1945 by calling on Congress to create such a program. His efforts failed, partly due to criticism by the American Medical Association (AMA), who called the plan "socialized medicine." In this photo taken in 1937, First Lady Eleanor Roosevelt examines a chart of enrollment of health care insurance plans.
Like its predecessor, World War II would lead to new medical advancements, including the widespread adoption of antibiotics and the use of ultrasound. The war would also have a similar effect in terms of the spread of employer-sponsored health plans. Because the nation was in a state of emergency and had a legally mandated wage freeze as a result, employers had to attract workers to assist the war effort by providing them with benefits, including health insurance. Tax laws passed between 1943 and 1945 also gave breaks to employers who provided insurance to their employees, which gave businesses all the more incentive to offer coverage. Following the war, employer-sponsored health insurance became common. In 1951, around 77 million Americans had some kind of coverage, according to an insurance industry trade group. That era also saw one of the most celebrated medical achievements in history: Jonas Salk's polio vaccine.
NEWS: World War II
Although health insurance was widely available to employed Americans in the mid-20th century, the unemployed and the elderly were often excluded from these plans. President John F. Kennedy campaigned on the issue of insuring these groups. President Lyndon B. Johnson succeeded where Kennedy left off, securing the passage of a bill through Congress creating Medicare and Medicaid. At the bill-signing ceremony, shown here, Johnson presented former president Truman with the nation's first Medicare card. Within the medical industry itself, an increasing number of doctors began specializing in certain fields of medicine rather than acting as general physicians. By 1960, more than two-thirds of doctors reported themselves as full-time specialists, rather than general practitioners.
Starting with Richard Nixon in 1970, presidents have offered successive plans for covering the nation's uninsured, but they have have stalled for different reasons. In 1974, Nixon put forward a plan to cover all Americans through private insurance, only to have the Watergate scandal force him out of office. An economic crisis prevented Jimmy Carter from pushing forward with a national health plan. Congress late in Reagan's second term attempted to expand Medicare, only to have the law repealed the following year. Bill Clinton had a 1,300-page health care reform bill that was never even taken up for a vote in Congress. Since Nixon's presidency, health care costs have continued to rise, often outpacing inflation. This increase is due to a number of factors, including the increased use of new medical technologies for diagnosis and treatment. The Patient Protection and Affordable Care Act signed by President Barack Obama was intended to cover the 30 million Americans who live without health insurance, according to the bill's authors. It has been the most far-reaching piece of health care legislation since Johnson's signed the legislation creating the Medicare and Medicaid health care programs.
NEWS:Think You'll Live Long? Think Again
Like pollens that can spread quickly through the air, myths about seasonal allergies also seem to circulate widely.
"I hear allergy myths all the time," said Dr. John Costa, medical director of the Brigham and Women's Hospital Allergy and Clinical Immunology Practice in Boston.
To clear the air of these common misconceptions, here are nine allergy myths that may be making the rounds.
Myth: Everybody has allergies. Only one in five Americans has allergic rhinitis, which in spring is also known as "rose fever" and in fall is called "hay fever," Costa said. While there has been a rise in the incidence of seasonal and food allergies in the United States over the last 20 to 30 years, people who don't have any allergies don't really worry about getting them, he said. And they often have no clue how miserable people with seasonal allergies feel, Costa said.
Myth: If you didn't have seasonal allergies as a child, you won't develop them as an adult. The body comes in contact with new things all the time, and can become highly allergic to them at any time. There is nothing innately harmful about tree pollen, for example, but some people's immune systems look at tree pollens and say, 'I'm going to have a reaction to this,' Costa said. "If you didn't have allergies as a kid, it can happen to you as an adult," he said. "If you had them as a kid, allergies can gradually and unpredictably go away."
Myth: Eating local honey helps relieve seasonal allergy symptoms. It's true that bees collect pollen from plants, Costa said, and honey has pollens in it from the local area. But, he said, the wind-carried pollens from trees, grasses and weeds that cause seasonal allergies are very light and stay airborne for a long time. The pollen in bee honey comes from flowers, and is very heavy and falls to the ground. "They are the wrong kind of pollens for causing seasonal allergies," Costa said.
Myth: Scientists can accurately predict a bad pollen season. "Predictions about pollen seasons are disingenuous," Costa said, and he refrains from making them. For example, only when forecasters can predict a great number of dry days in a row without any rain (such as a severe drought), can pollen predictions be made. During that time, nothing is growing, so pollen can be ruled out, he explained. "Short of severe climactic change, it's hard to say anything meaningful about pollen season," Costa said.
Myth: Moving to a different geographic area could ease seasonal allergies. "Moving is of little benefit to the seasonal allergy sufferer," Costa said, because pollens are actually shared over large areas. Ragweed in New England is the same as ragweed in Texas, and people who are allergic to grass pollen may just be miserable everywhere, because this type of pollen is incredibly cross-reactive, he said. [8 Strange Signs You're Having an Allergic Reaction]
Myth: Flowers are a common trigger for seasonal allergies. "It's rare for flower pollen to contribute to seasonal allergies," Costa said. Flower pollens are relatively heavy and fall to the ground rather than lingering in the air. In contrast, pollens from trees (such as birch, oak, elm, maple and cottonwood), grasses and weeds are very light and stay airborne for a long time, he explained. "Unlike tree and grass pollens, you can control your exposure to flowers," Costa said.
Myth: All nasal sprays are bad. Patients need to use some nasal sprays selectively and judiciously, Costa told Live Science. Topical nasal steroids are usually best for people with seasonal allergies, he said. They work by reducing inflammation in the lining of the nose. Most are available by prescription and can be used safely for years without worry, Costa said. One brand, Nasacort AQ, is now available over the counter.
However, the sprays can have a downside. People sometimes call over-the-counter nasal decongestant sprays addictive, Costa said, and it's true that when people use decongestant sprays for more than five days in a row, the blood vessels lining the nose can become dependent on the drugs, and rebound congestion is a common problem. To relieve the stuffiness, some may use even more nasal spray, and get caught in a vicious cycle of overuse.
Myth: You only need to take allergy medication when you start feeling terrible. Allergies are an inflammatory response, and their effects can last for weeks. "It makes more sense to use allergy medications on a consistent basis to maintain control over moderate to severe allergies," Costa explained. People should know their allergic triggers and their seasons, and then use medications regularly when those pollens are in the air, he suggested.
Myth: Allergy shots are not worthwhile. Over the last 20 years, allergy shots have become more sophisticated and fine-tuned, Costa said. The shots are typically given to people with the most severe symptoms. "In 2014, we have a much better chance of using the right dosages of allergens than we did with your grandfather's allergy shots," he said. The FDA has recently approved daily tablets that dissolve under the tongue as an alternative to allergy shots, but they are only available for ragweed or grass pollens.
More From LiveScience:
Chikungunya Virus Spreads in Caribbean Islands
Could Cannabis Prevent Childhood Seizures?
7 Devastating Infectious Diseases
This story originally appeared on LiveScience.com.
Copyright 2014 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.