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August 13, 2003

Small Steps or a Giant Leap for the Uninsured?

Author Affiliations

Author Affiliations: Primary Care Research Center, Division of General Internal Medicine, San Francisco General Hospital, and Department of Medicine, University of California, San Francisco.

JAMA. 2003;290(6):816-818. doi:10.1001/jama.290.6.816

Health insurance originated in the industrialized nations of Europe, emerged in the United States in the early 20th century, and spread through US employers who sought to attract workers with this benefit. Health insurance was designed to protect workers against the catastrophic costs of medical care and create an incentive for individuals to pursue cost-effective preventive services that would keep them healthy enough to remain on the job.1 In 1965, the government introduced Medicare and Medicaid to extend health insurance coverage to elderly and some poor persons. However, for a variety of reasons, the United States remains the only industrialized nation without universal health insurance coverage.