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A Lee Enterprises, Incorporated newspaper. Majority shareholder: David Hoffmann, Hoffmann Media Group.

Stories: Health Matters in the Heartland

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August Health Matters: Nebraska patients opted for telehealth visits during the pandemic

Health-Matters-Heartland-Logo-Horizontal-V2.jpg

Kayla Northup's family is pretty healthy, but when her kids do get sick, it's often at an inconvenient time, such as on a vacation.

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Watch now: Health care sector in Nebraska works to rebuild, bolster workforce

Internship program connects Latino students with careers in health care

OMAHA — As high school students, Camila Delgado Garcia and Joerdy Flores-Garcia both were interested in health care careers. 

So the Omaha youths signed up for a health and wellness internship offered by the Latino Center of the Midlands and CHI Health. Their internships helped them decide what they wanted to do.

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Incoming UNO freshman Camila Delgado Garcia's opportunity for a health career started with an internship program offered by Latino Center of the Midlands in Omaha. Already a certified nursing assistant, she wants to become a dental hygienist. 

LILY SMITH, WORLD-HERALD

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Selene Espinoza, a surgical assistant with CHI Health, said she wanted to make sure Latino students could see people like themselves in health care settings, so she got involved in a Latino Center/CHI Health program last year.

LILY SMITH, WORLD-HERALD

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Sue Nuss

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Selene Espinoza (left), a surgical assistant with CHI Health, instructs students in a hands-on surgery workshop. They are taking part in a health internship that CHI Health offers with the Latino Center of the Midlands. 

LATINO CENTER OF THE MIDLANDS, Courtesy photo

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Russ Gronewold

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Jalene Carpenter

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Joerdy Flores-Garcia (left) tries his hand at maneuvering a surgical camera. He is participating in a health internship offered by CHI Health and the Latino Center of the Midlands.

LATINO CENTER OF THE MIDLANDS, Courtesy photo

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Bo Dunlay

COLIN CONCES PHOTOGRAPHY

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Dr. Jana Broadhurst and her team developed a modified PCR saliva test at Emerging Pathogens Laboratory at the University of Nebraska Medical Center. Photographed in Omaha on Tuesday, June 7, 2022.

Just before the COVID-19 pandemic broke out, the University of Nebraska Medical Center's Global Center for Health Security received a grant from the federal Centers for Disease Control and Prevention to strengthen infection-control training, education and tools.

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Researchers at the University of Nebraska Medical Center helped develop isolation tents called Carecubes, which have clear, flexible plastic walls so care providers can interact with patients without protective gear.

CARECUBES

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Pandemic forced Nebraskans to innovate
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Pandemic forced Nebraskans to innovate

Dr. Jana Broadhurst and her team developed a modified PCR saliva test at Emerging Pathogens Laboratory at the University of Nebraska Medical Center. Photographed in Omaha on Tuesday, June 7, 2022.

In the early months of the COVID-19 pandemic, researchers, clinicians, businesspeople and everyday men and women spun out new ways to deal with the coronavirus.

The result was a host of innovations, including new designs for masks and face shields, intubation shields for COVID-19 patients, ultraviolet disinfection methods for protective gear and 3D-printed nasal swabs. Along with those came a flurry of new tests for the virus, some treatments and highly effective vaccines brought to market in record time.

While protective gear was hard to find early in the pandemic, Nebraska Medicine used ultraviolet light towers such as this one to decontaminate masks so they could be used multiple times instead of just once. 

NEBRASKA MEDICINE

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Michael Dixon

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Joe Runge

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Early in the pandemic, a team of UNMC physicians worked with a local plastic fabricator to design a box to protect health care providers from contagion during intubation, a procedure used to help people breathe, and to conserve protective gear. 

UNEMED/UNMC

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Staff at the University of Nebraska Medical Center's emerging pathogens laboratory developed this modified PCR saliva test to get around supply shortages that plagued the nasal swab and PCR-based testing early in the pandemic and meet the demand for screening programs in the community.

ANNA REED, Omaha WORLD-HERALD

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Andrew Goldsweig

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Tyler Martin

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Staffing shortages, COVID-19 spread plagued Nebraska providers in past year, survey finds
Lancaster County reports COVID-19 death
COVID-19 cases continue to rise in Lincoln

How the availability of COVID-19 treatments has changed throughout the pandemic

How the availability of COVID-19 treatments has changed throughout the pandemic

At the beginning of the COVID-19 pandemic in March 2020, doctors had limited knowledge of how to respond to this new disease. Physicians in hard-hit regions across the world had to learn as they treated the first wave of patients, relying on ventilators and high-flow oxygen treatments, as well as early drugs such as hydroxychloroquine and remdesivir to reduce patients’ risk of dying.

Years later, we have since seen several vaccines prove highly effective in preventing severe disease. The Pfizer/BioNTech, Moderna, and Johnson & Johnson vaccines were all developed in record time, building upon past research into coronavirus vaccines and genetic technology. In December 2021, unvaccinated adults in the U.S. were 2.4 times more likely to test positive for COVID-19 than fully vaccinated adults and were 14 times as likely to die of the disease, according to the Centers for Disease Control and Prevention. The likelihood of unvaccinated infection rose to 2.6 times as recently as January 2022.

At the same time, pharmaceutical companies have developed a variety of drugs that may alleviate COVID-19 symptoms in those who test positive. Monoclonal antibody treatments provide a boost to the immune system, as patients receive infusions of lab-made proteins designed to fight off the coronavirus. In December 2021, the U.S. Food and Drug Administration provided emergency authorization to an antiviral pill treatment that reduces the risk of COVID-19 hospitalization and death. Both the monoclonal antibodies and pills are most effective when patients receive treatment soon after their COVID-19 symptoms begin.

Relative to the fact that this is a novel disease never before known to medical science, progress in treatment development has been remarkably swift and agile. Stacker compiled a list of milestones in the availability of COVID-19 treatments and vaccines throughout the first two years of the pandemic, using information from the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, and media reports.

faboi // Shutterstock

January 2020: SARS-CoV-2 sequence is made public

The world first learned about the coronavirus in late 2019, as the disease spread through Wuhan, China. Within weeks of the first documented COVID-19 cases, a group of scientists—including those in China and international collaborators—published the virus’ sequence on an open-access site. Virologist Edward Holmes shared a link to the sequence on Twitter, enabling researchers around the world to begin studying the virus.

That early research included vaccine development at Moderna and BioNTech, a German biotechnology company that would soon partner with Pfizer on clinical trials. As both of these companies had previously been working to produce vaccines based on genetic sequences, they were able to quickly adapt their work to the coronavirus. Moderna’s first clinical trial for its vaccine started in March 2020, just two months later.

Smith Collection/Gado // Getty Images

March 2020: Emergency authorization for hydroxychloroquine

In the early months of the pandemic, doctors treating severely ill COVID-19 patients had very little information about what drugs or treatment methods might be most effective. This knowledge gap led some doctors to try out drugs that had not undergone clinical trials for COVID-19, while regulators attempted to provide guidance as quickly as possible.

One drug that became popular during this period was hydroxychloroquine, a drug primarily used to treat malaria and some forms of arthritis and lupus. After some early data suggested hydroxychloroquine might also work against COVID-19, the FDA provided this drug with an Emergency Use Authorization in late March; it was also touted as a potential miracle drug by then-President Donald Trump. Further clinical trials showed that hydroxychloroquine did not actually help alleviate COVID-19 symptoms, however, and the FDA revoked its authorization in June 2020.

Laurent Viteur // Getty Images

May 2020: Emergency authorization for antiviral drug remdesivir

Remdesivir was another early drug that received Emergency Use Authorization in spring 2020. This antiviral drug, made by the biopharmaceutical company Gilead Sciences, was shown to shorten COVID-19 patients’ recovery time in a trial run by the National Institutes of Health. After its emergency authorization, the federal government purchased about 500,000 treatment courses of remdesivir to distribute to U.S. hospitals between June and September 2020.

Later, in 2020, hospitals started working directly with Gilead to purchase the drug. It has remained one of the most widely used antiviral drugs for hospitalized COVID-19 patients and was fully approved by the FDA—a more rigorous process than emergency authorization—in October 2020.

ULRICH PERREY/POOL/AFP // Getty Images

November 2020: First monoclonal antibody treatment receives authorization

Pharmaceutical company Eli Lilly was the first to begin testing a monoclonal antibody treatment for COVID-19. In these treatments, patients receive infusions of lab-made immune system proteins that are designed to fight off the coronavirus. The treatments effectively give a boost to the immune systems of patients who are particularly vulnerable to severe symptoms.

Bamlanivimab, Eli Lilly’s monoclonal antibody treatment, received Emergency Use Authorization from the FDA in November 2020. A similar treatment made by Regeneron received Emergency Authorization later that month. Both treatments were initially only available for high-risk patients in hospitals but became more widely distributed in 2021.

Irfan Khan / Los Angeles Times // Getty Images

December 2020: Pfizer, Moderna vaccines receive authorization

Less than a year after Chinese scientists publicly shared the coronavirus’ genetic sequence, two mRNA vaccines designed from this sequence received emergency authorization from the FDA. Many scientists and health experts considered this quick timeline a “miracle,” as no vaccine had ever been produced so fast in human history.

The Pfizer/BioNTech and Moderna vaccines were able to progress so quickly because both BioNTech and Moderna, along with the National Institutes of Health, had been working on coronaviruses and genetic sequence-based technology for years before COVID-19 hit. In addition, the Trump administration poured billions into vaccine development and production through “Operation Warp Speed,” allowing the COVID-19 vaccines to move through bureaucratic hurdles more efficiently.

The U.S. vaccine rollout started on Dec. 14, 2020, with a New York City critical care nurse receiving the nation’s first dose. Healthcare workers and nursing home residents were first in line for doses, followed by seniors and other immunocompromised and otherwise vulnerable Americans.

SAJJAD HUSSAIN/AFP // Getty Images

Summer 2021: Politicization of monoclonal antibody treatments

As the COVID-19 vaccine rollout progressed in 2021, vaccination became increasingly polarized: As of January 2022, 91% of people who identify as Democrat have received at least one dose of vaccine compared to 63% of people who identify as Republican, according to polling by the Kaiser Family Foundation.

Republican politicians who are hesitant to alienate their bases by encouraging vaccination have instead turned to monoclonal antibody treatments as an alternative option for reducing COVID-19 deaths. During the summer 2021 Delta surge—which primarily hit Southern, Republican-led states where mask mandates also served as a political tipping point—governors in Florida, Texas, and other nearby states set up monoclonal antibody clinics where residents could receive these treatments for free.

By mid-September, just seven states were accounting for 70% of monoclonal antibody orders from the federal government, according to the Department of Health and Human Services. The HHS responded by taking control of monoclonal antibody distribution, making it similar to the distribution system for remdesivir in 2020.

Paul Hennessy/SOPA Images/LightRocket // Getty Images

August 2021: Pfizer vaccine receives full FDA approval

Eight months after Americans started receiving the Pfizer/BioNTech vaccine under Emergency Use Authorization, the FDA fully approved this vaccine. “The public can be very confident that this vaccine meets the high standards for safety, effectiveness, and manufacturing quality the FDA requires of an approved product,” Acting FDA Commissioner Janet Woodcock said in a statement at the time.

Some public health experts hoped that the full FDA approval would help to convince vaccine-hesitant Americans—concerned about the rapid timeline for COVID-19 vaccine development—that Pfizer’s vaccine was entirely safe and effective. However, polling and data analysis afterward found that the full approval had a limited impact on vaccine uptake. Vaccination rates went up slightly in late August 2021 but fell again in September.

Michael Nagle/Xinhua // Getty Images

November 2021: Children ages 5-11 become eligible for vaccination

Millions of parents rejoiced in early November 2021 when the FDA and CDC authorized a version of the Pfizer/BioNTech vaccine for children ages 5 to 11. Enthusiastic parents got their children vaccinated in time for the 2021 holiday season. But overall, uptake in this age group has been low so far, with just over 28% of children in this age group having received at least one vaccine dose as of January 2022.

Meanwhile, parents of the youngest Americans (those under 5 years old) are still waiting on vaccine authorization. In December 2021, Pfizer found that two doses of a low-dose version of its vaccine did not provide a strong immune response in children ages 2 to 4; after initially applying for FDA authorization with two doses while continuing to test a third dose, the company postponed its application in February 2022 to wait for more data.

JEFF KOWALSKY/AFP // Getty Images

December 2021: Two anti-COVID pills receive authorization

As of December 2021, Americans who get infected with the coronavirus now have two options for treatment that do not require infusion in a health care center. The FDA provided emergency authorization to two antiviral treatments in pill form: one produced by Pfizer, the other by Merck.

Both pills work by stalling the coronavirus’ replication in the body, leading to a lower risk of severe symptoms. The Pfizer pill, called Paxlovid, has been much more successful in clinical trials: It reduces the risk of hospitalization and death by 88%, compared to 30% for Merck’s pill. For both treatments, patients must get a prescription and begin taking the pills within five days of onset of COVID-19 symptoms—which can be challenging, as supplies of the drugs are limited in the U.S., as of early 2022.

Jakub Porzycki/NurPhoto // Getty Images

February 2022: Eli Lilly develops new monoclonal antibody treatment for Omicron

The Omicron variant caused a major shift in COVID-19 treatment availability, as scientists at Eli Lilly and Regeneron quickly discovered that their monoclonal antibody drugs no longer worked well against this version of the virus. Consequently, the FDA limited its emergency authorization for their use. Nonetheless, some of the same Southern states that popularized these drugs in summer 2021 continued to provide them during the Omicron surge despite their ineffectiveness.

Eli Lilly responded to the situation by developing a new monoclonal antibody treatment, called bebtelovimab, that is effective against Omicron. According to the company, this new drug also works against BA.2, a sister lineage of Omicron that has garnered some concern as it is even more contagious than Omicron itself. The U.S. government has purchased 600,000 courses of bebtelovimab, to be distributed in February and March 2022.

Jonathan Weiss // Shutterstock

April Health Matters: Series intended to help Omaha World-Herald readers learn about health care changes

Health care is an important part of our lives, in big and small ways.

Sometimes, it’s as basic as taking our kids to a routine checkup. At the other extreme, it may involve the need for lifesaving treatment.

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Our best Omaha staff photos & videos of April 2022

A squirrel nibbles on flowers outside of Andrews Hall on the campus of the University of Nebraska at Lincoln on Saturday.

CHRIS MACHIAN, THE WORLD-HERALD

The Union For Contemporary Art announced that they are going to turn the F.J. Carey Block building into the Shirley Tyree Theater. The project also plans to preserve the historic architecture of the building.

CHRIS MACHIAN, THE WORLD-HERALD

Nebraska's Trent Hixson talks to the media on Wednesday.

CHRIS MACHIAN, THE WORLD-HERALD

UNO's Eduardo Rosario tags out Nebraska's Max Anderson at home at Tal Anderson Field in Omaha on Wednesday.

LILY SMITH/THE WORLD-HERALD

Chris Jambor, left, and his son Dexter Jambor, 8, enjoy the Nebraska's 2022 spring game from the sound end of the Memorial Stadium on Saturday.

CHRIS MACHIAN, THE WORLD-HERALD

Nebraska takes the field for the start of the Nebraska football spring game in Lincoln in April.

ANNA REED, Omaha World-Herald file photo

Millard West's Drew Borner (4) celebrates his run in the fourth inning with his teammates in the dugout during the Millard West vs. Elkhorn South baseball game at Elkhorn South High School on Friday. Millard West won the game 16-0 in five innings.

ANNA REED/THE WORLD-HERALD

Storms approach Blair, Nebraska, looking west on State Highway 91 as the sun starts to set on Tuesday.

CHRIS MACHIAN, THE WORLD-HERALD

Storms approach Blair, Nebraska, looking north on County Road 25, just north of State Highway 91 on Tuesday.

CHRIS MACHIAN, THE WORLD-HERALD

Creighton's Tommy Lamb pitches against Arizona at Charles Schwab Field in Omaha on Monday.

LILY SMITH/THE WORLD-HERALD

A pedestrian finds a moment in the sun while walking underneath Interstate 480 in downtown Omaha this week.

CHRIS MACHIAN, THE WORLD-HERALD

A four-alarm fire burns at a senior living center under construction on Applied Parkway near 144th and Pacific Streets on Sunday. The four-alarm was the first in Omaha since the Butternut Coffee building fire in 2004. 

CHRIS MACHIAN, THE WORLD-HERALD

A four-alarm fire burns at a senior living center under construction on Applied Parkway near 144th and Pacific Streets on Sunday.

CHRIS MACHIAN, THE WORLD-HERALD

Nebraska health care providers adapted during pandemic

Over 1,100 registered dietitians took part in a survey to reveal the top food and nutrition trends of 2022. 

OMAHA -- Freddie Warner Jr. couldn’t take it anymore.

His hip hurt, which caused him to put more pressure on his knee. That made his back hurt. He couldn’t sit or stand for long periods. The 51-year-old Omaha man gave up his job in lawn care, his occupation since high school.

Freddie Warner Jr.

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Cory Shaw

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Cary Ward

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Allen Gaspers, a technician with Control Services, consults with Kenny Walters, Methodist Health System's facilities director, and Morgan Hankins, Methodist construction project manager, during the installation of additional negative airflow systems at Methodist Women's Hospital in April 2020. Hospitals quickly converted entire floors to negative air pressure during the pandemic to house infected patients.

METHODIST HEALTH SYSTEMS, COURTESY PHOTO

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Dr. Clayton Thor, an orthopedic surgeon with CHI Health, Dr. Clayton Thor, an orthopedic surgeon with CHI Health, said most of his hip and knee replacement patients before the pandemic spent at least one night in the hospital. Now, roughly 80% to 85% go home the same day.

ANNA REED, WORLD-HERALD

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Freddie Warner Jr. tidies up a neighborhood while working for a landscaping company in Omaha earlier this month. Warner had his left hip replaced in December and his right knee replaced in February. He was released from the hospital on the same day after both surgeries. The practice became more common during the pandemic.

ANNA REED, WORLD-HERALD

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A brief look at American health care’s long, complicated history

A brief look at American health care’s long, complicated history

America’s health care system has existed, in one form or another, since the time when the country’s founding fathers were still fighting for their freedom from Great Britain. Over the intervening 200-plus years, medical care in the U.S. has had a long history of ups and downs, from the difficulty of addressing racism toward the formerly enslaved to the historic enactment of the Affordable Care Act.

Health care in the U.S. may be best described as a hodgepodge of systems. From a global perspective, there are four main models of health care, each of which takes a different approach both legislatively and in practical terms of how it affects a populace’s ability to obtain health care coverage and services. The U.S. model is unique among nations in that it incorporates aspects of each of the four health care models into its own. Most Americans receive coverage under what is known as the Bismarck model, which is to say they are covered through their employer. But the U.S. Veterans Health Administration more closely resembles the Beveridge model, as it leans toward a more socialized coverage system. And then there is Medicare, whereby the U.S. government acts as a single-payer service for older Americans. This is in stark contrast to our neighbor to the north—Canada offers a national health insurance model, where the government essentially runs health care on behalf of its citizenry. In China, an out-of-pocket model is in place, meaning people are on the hook to pay their medical expenses as needed, while in Europe, various countries offer more socialized renditions of the Beveridge and Bismarck models.

The 2020 U.S. Census indicated that as many as 8.6% of Americans do not have health insurance. Universal health care has proven to be an especially tricky topic for Americans to navigate, as lobbyists and politicians alike have waged ferocious campaigns to try bringing it to life—or burying it from ever being signed into law. To this day, the Affordable Care Act, which in recent years brought the country closer to the universal health care model, remains under scrutiny.

With political battles over the health care system ongoing—the most recent controversies centering on health care for transgender youth and the COVID-19 vaccine—Sidecar Health identified 10 major milestones in U.S. health care policy from the colonial era to recent history, charting our nation’s fraught relationship with how it cares for its citizens.

Bettmann // Getty Images

1781: First medical society established

The Massachusetts Medical Society is the oldest medical society in the U.S. that is still in operation. It was incorporated in 1781 to “promote medical and surgical knowledge, inquiries into the animal economy & the promotion & effects of medicine.” Several of the nation’s founding fathers, including revolutionary leaders Samuel Adams and John Hancock, were among the Society’s 31 founding members. “It was born in troublous times; and its founders were still engaged more or less actively in a political struggle which even today, by reflex action, is exerting a powerful influence on the events of the world,” Samuel Abbott Green, a physician and historian, said in a speech in 1881. The “political struggle” Green referred to was the Revolutionary War and, in fact, the society was established just days after the Battle of Yorktown. A medical society had been previously established in 1735 in Boston, but it was short-lived and its records were lost. Since it was established, the Massachusetts Medical Society has grown from its original number of 70 members to its current roster of 23,000 members.

Fine Art Images/Heritage Images/Getty Images

1865: Medical division of Freedmen's Bureau is established

The medical division of the Freedmen’s Bureau was an institution dedicated to serving the formerly enslaved, or freedmen, in the South after the Civil War. The Freedmen’s Bureau was established on March 3, 1865, by Congress and played a vital role during the Reconstruction era as a means to “direct such issues of provisions, clothing, and fuel.” The organization, which was run by the U.S. War Department and General Oliver O. Howard, was meant to help bring unity in the South between Black and white Americans. The medical division addressed the health needs of the formerly enslaved, and despite poor conditions, it was often the only access to medical care many freedmen had. Demand for medical attention became so overwhelming, it was difficult for these hospitals to keep up and provide resources. The Freedmen’s Bureau came to an end in 1872 due to an overall lack of support in Congress.

CORBIS/Corbis via Getty Images

1929: First employer-sponsored health care plan in the US is made available to teachers

In 1929, Blue Cross Blue Shield established the first employer-sponsored health coverage in Dallas as a partnership between the Baylor University hospital and its patients. The patients, many of whom were school teachers, were struggling to cover their medical bills. To counteract this, Justin Ford Kimball, an administrator at the university, offered a plan in which teachers were provided 21 days of hospital care for just $6 annually. Many employees began to sign up for the plan, and it didn’t take long for this plan to gain popularity across the U.S. Today, BCBS serves more than 106 million members across the U.S.

Dick Whittington Studio/Corbis via Getty Images

1943: IRS makes employer-sponsored health insurance tax-free

President Franklin D. Roosevelt’s Executive Order 9250 established the Office of Economic Stabilization, one of the direct effects thereof was a nationwide wage freeze. The executive order, issued in 1942, was in response to the labor shortage the country was facing due to its participation in World War II. As a result, businesses began to use employer-sponsored health care benefits as a way to attract employees. A year later, the Internal Revenue Service made health insurance provided by employers tax-free. As a result, this made it far cheaper for Americans to get health insurance through an employer than other providers. As the economy improved after World War II, employer-sponsored health insurance became even more popular among businesses.

[Pictured: Mrs. Franklin D. Roosevelt stands with Dr. Claude Munger, president of the American Hospital Association, during her visit to the American Hospital Association Convention.]

Bettmann // Getty Images

1945: Harry Truman’s proposal for a national health insurance fails

Despite it being a failed attempt, President Harry Truman’s proposal in 1954 for national health care was still a crucial moment in American history. After pointing out that millions of Americans were without health care, President Truman told Congress, “The time has arrived for action to help them attain that opportunity and that protection.” Truman wanted to introduce universal health insurance to address the shortage of health care available to workers in rural areas, improve the quality of hospitals, and slow rising health care costs. His bill, however, didn’t gain enough support. But it was a significant ask during a time when the country was mired in the early decades of the Cold War and any governmental system perceived to be “socialist” in nature was construed as anti-American.

Bettmann // Getty Images

1950-1960s: American Medical Association lobbies against single-payer systems

The American Medical Association has long been in opposition to single-payer systems, stretching as far back as the 1950s. During that time period, the AMA lobbied harshly against socialized health care, supporting employer-sponsored health care plans instead. Later, in the 1960s, the organization created Operation Coffee Cup in retaliation against President John F. Kennedy’s proposal to introduce federally supported health care for the elderly. The plan called for the Woman’s Auxiliary, which had partnered with the AMA, to rally support through morning coffee meetings. The campaign even featured a speech by Ronald Reagan who stated, “One of the traditional ways of imposing statism or socialism on a people has been by way of medicine.”

[Pictured: President Kennedy speaks at Madison Square Garden in New York to a crowd of 17,000 people, many of them elderly. In his address, Kennedy urged the nation's doctors to get the facts on his proposed legislation to offer medical care for seniors.]

Bettmann // Getty Images

1965: Medicare and Medicaid programs established

One of the largest health care acts in American history, commonly referred to as the Medicare and Medicaid Act, was approved by President Lyndon B. Johnson in July 1965. Both Medicare and Medicaid are actually subtitles to the overall Social Security Amendments of 1965. In addition to providing health insurance to the elderly and to those with low incomes, they also established programs for retirement, disability benefits, and survivors’ benefits. During the first six months of its enactment, Medicare covered the health care of more than 2.5 million Americans. When the bill was first passed, it allowed users over age 65 to pay a monthly fee of just $3 for health insurance, which covered 80% of their health care services. Early forms of the Medicare and Medicaid Act also required that users promise that they were not members of the Communist Party. Former President Harry Truman, who originally proposed the legislation almost two decades before, and his wife, Bess, were the first people to register for Medicare at the act’s signing ceremony.

[Pictured: President Lyndon Johnson flips through the pages of the Medicare bill while former President Harry Truman holds the pens that Johnson used to sign the bill. Behind Johnson and Truman are Mrs. Johnson (L), Mrs. Truman, and Vice President Hubert Humphrey.]

Bettmann // Getty Images

1970s: First bills for single-payer system are proposed in Congress

In 1971, Senator Ted Kennedy introduced the Health Security Act, which called for health care coverage for all U.S. citizens and documented permanent residents. It competed with a similar bill, the National Health Insurance and Health Services Improvement Act, backed by Senator Jacob Javits. The legislation was offered up as a solution to skyrocketing inflation that was impacting the health care system. Eventually, in 1974, Kennedy presented a compromise, though it not only lost approval from unions, but also was dropped entirely due to President Nixon’s Watergate scandal and subsequent resignation from office. After Gerald Ford became president, Representative Grey Mills attempted to reintroduce the bill, but it lost traction after it received lukewarm support from both political parties.

[Pictured: Senator Edward Kennedy lectures in front of a chart on health care spending in June 1971.]

CORBIS/Corbis via Getty Images

1996: Health Insurance Portability and Accountability Act passes

To protect the privacy of medical patients, in 1996 the Health Insurance Portability and Accountability Act was signed into federal law by President Bill Clinton. HIPAA prohibits the sharing of private medical information without a patient’s consent. This law can even extend to sharing medical information with an individual’s relatives, which has led to issues in some missing persons cases, such as in the case of the 2013 Asiana Airlines crash. According to the Centers for Disease Control and Prevention, “A major goal of the Privacy Rule is to ensure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high-quality health care and to protect the public’s health and well-being.” If a health care provider breaks HIPAA laws, they may face criminal charges as well as the loss of their medical license.

Vitalii Vodolazskyi // Shutterstock

2010: Affordable Care Act passes

The Affordable Care Act, popularized in the media as “Obamacare,” was a sweeping health care reform law that expanded health care coverage for Americans and was the most dramatic overhaul of the U.S. health care system since the ratification of the Medicare and Medicaid Act in 1960s. The ACA expanded health care services and required that all American legal residents obtain and hold health insurance. The act also created a health insurance marketplace where people could search, compare, and sign up for health care plans. Of the reform legislation, President Barack Obama said, “In the wealthiest nation on Earth, no one should go broke just because they get sick.”

While the act remains in place and certain evidence shows that it has reduced health care disparity for minorities, there has been no shortage of challenges to its retention. On April 5, 2022, President Joe Biden signed an executive order directing federal agencies to expand quality, affordable health care coverage. The Biden  Administration has also proposed eliminating “family glitch,” which is when employer-sponsored health care insurance is affordable only for the employee. Purchasing family coverage is often costly, so the proposal would give an employee's family members premium tax credits to purchase more affordable insurance in the marketplace. 

 

 

This story originally appeared on Sidecar Health and was produced and distributed in partnership with Stacker Studio.

KAREN BLEIER/AFP via Getty Images

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IrelandUruguay, Eastern Republic ofUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet Nam, Socialist Republic ofWallis and Futuna IslandsWestern SaharaYemenZambia, Republic ofZimbabwe

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