Insurance is critical to our economy and our lives and, taken as a whole, surprisingly big. Americans spend nearly as much each year on insurance coverage as on food. But insurance rests on a promise that, if the worst happens, you will be protected. Why should we believe that promise? Because for nearly 200 years, state governments have audited insurance companies’ books and watched their payment records to be sure they keep their word.
State governments began licensing doctors, lawyers, engineers, and other professionals in the late 1800s. They did it because colleges were turning out highly trained people who found themselves surrounded by con artists and quacks. The professionals turned to the states for help. In the century and a half since, licensing has raised professional standards and given us some assurance that those we depend on for expert advice are trained and acting in our best interests. For this, we can thank government.
A scientific breakthrough occurred in 2003. It was the mapping of the human genome, which is creating medical advances that will touch every human on earth. The indispensable partner in this great discovery was the federal government. What did the government ask in return? You may be surprised to learn. And delighted.
Medicare is the second-most popular federal government program, behind only Social Security. Retirees love Medicare, and workers don’t mind paying taxes to support it. So how was this popular, effective, efficient health insurance program enacted? After a bitter, partisan political battle accompanied by warnings that government health care would bankrupt the country, ruin doctors, and bring about an end to freedom. If you enjoy Medicare coverage today—or hope to have it one day—you can thank government leaders for ignoring the hysteria and enacting Medicare 55 years ago.
Cities created public hospitals in the early 1800s as places the poor went to die. In the late 1800s, their roles changed dramatically as the practice of medicine changed. Since then, other kinds of hospitals have emerged, but large public hospitals still play essential roles as caregivers for the poor, centers for advanced trauma care, and providers of public services like poison-control centers. Let’s hope you never need the care these hospitals provide. But if you do, you can thank government for making them available.