Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #105753

Suzanne Rotwein, PhD, Centers for Medicare & Medicaid Services, 7500 Security Blvd, Baltimore, MD 21244, 410-786-6621, srotwein@cms.hhs.gov

Since the turn of the last century, hospitals, physicians and their patients have grappled with the problem of health care costs and how to pay for them. As the century progressed, associations formed to pool risk and offer patients health care insurance; first “sickness” insurance, akin to disability or payment for lost wages, then “health” insurance to pay for the actual charges for services that were “usual, customary and reasonable”. As more people moved from rural America into the cities, large employers began offering health care benefits to unionized workers. Pre-paid plans became popular and Blue Cross/Blue Shield offered hospital and physician services insurance to patients beginning in the 1930s and 1940s. The federal government became interested in universal insurance in the 1950s, but was defeated in its efforts until the passage of Medicare in 1965. Government intervention in employer-based health insurance was helped by the fact that employers did not pay a payroll tax on their contributions to employee health plans. During the last 40 years, Medicare has increasingly covered ever larger numbers of elderly patients. In December, 2003, the Medicare Modernization Act was passed which added a Prescription Drug Benefit. Over the past 5 years, health coverage has declined because of escalating costs. This presentation looks at the historical record of providing health insurance and the effects this latest legislation has on employer-sponsored health plans. (This presentation is part of a panel: abstracts: 104227, 105927,105857,110977 and 105843). YES, I WOULD LIKE TO HAVE ABSTRACTS CONSIDERED SEPARATELY.

Learning Objectives:

• Understand and discuss the historical influences of health insurance on the elderly workforce.
• Describe the various attempts to insure elderly working Americans and the subsequent successes and failures to provide retirement health benefits.
• Describe the role of Medicare in the campaign for universal health insurance.
• Analyze and discuss trends effecting the elderly workforce and events that led to the Medicare Prescription Drug legislation.

Keywords: Employer-Provided Health Insurance, Medicare

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.