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
For children with autism, a dose of oxytocin -- the so-called "love hormone" -- seems to fine-tune the activity in brain areas linked to social interactions, according to a new study.
Although the hormone didn't change children's social skills in the study, its boosting effect on the brain's social areas suggests that using oxytocin nasal sprays immediately before behavioral therapies could boost the effects of those treatments, the researchers said.
"Oxytocin temporarily normalized brain regions responsible for the social deficits seen in children with autism," said study researcher Ilanit Gordon, a neuroscientist at Yale University in New Haven, Conn. [11 Interesting Effects of Oxytocin]
The study involved 17 children and teens with autism spectrum disorders who underwent two sessions of brain imaging as they performed a task related to social behavior. In each session, the participants received either oxytocin nasal spray or a placebo, and were asked to judge the mental states of people based on a picture of their eyes.
The results showed that, compared with placebo sessions, when children received oxytocin they showed greater activity in the "social brain," which includes regions that process social information and are linked to reward, social perception and emotional awareness.
In contrast, oxytocin seemed to decrease the activity of the brain's social regions when children were engaged in a task that was not related to social processing, such as labeling the category of vehicles shown in pictures of cars.
In other words, the hormone seemed to help attune the brain to the difference between social and nonsocial stimuli, according to the study, published today (Dec. 2) in the journal Proceedings of the National Academy of Sciences.
However, Gordon said the findings do not mean that one dose of the hormone would treat social deficits in people with autism. "It means that there's a change in the brain that we read as positive and exciting, but we need to learn how to utilize it to create a change in real-life behavior," she said.
Previous studies had found lower blood levels of the hormone in children with autism than in typically developing children, and it had been suggested that oxytocin treatments could help children with autism overcome their difficulties with social interactions.
However, studies that examined the behavioral effects of administrating oxytocin yielded negative or weak results. In those studies, researchers gave the hormone to adults and children with autism for days and weeks, and found only modest improvements, or no change at all, in participants' social behavior.
Similarly, in the new study, when children received oxytocin, they didn't perform any better in identifying mental states based on their assessment of a person's eyes. But the greater activity in the brain's social regions after they received the hormone suggests that it may improve the effectiveness of behavioral treatments.
"There's a window where the brain increases its efficiency in processing, and we can utilize that window to teach kids on the autism spectrum in behavioral treatment," Gordon told LiveScience.
It remains unclear how the hormone affects the brain and leads to better social processing. One possibility is that oxytocin makes social stimuli more rewarding to children with autism, the researchers said. It is also possible that the hormone makes the information pertaining to humans stand out from the background information consisting of objects and, in turn, helps social information to become salient to people with autism, the researchers said.
More from LiveScience:
11 New Warning Signs Help Spot Mental Illness in Children
Hypersex to Hoarding: 7 New Psychological Disorders
Psychiatry's New Guide: 6 Things You Should Know
Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
This story originally appeared on LiveScience.com.