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Today the Supreme Court upheld the 2010 health care law in a dramatic victory for President Barack Obama.
US Health Care: How It Began: Photos
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?
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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
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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.
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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.
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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
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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.
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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
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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.
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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
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Actor Charlie Sheen's announcement this morning that he is HIV positive may seem like bleak news, but like others infected with the virus, he could have a relatively normal life, doctors say.
Researchers have found encouraging results in tests on monkeys of a new gene therapy strategy that leaves HIV unable to replicate.
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"I am, in fact, HIV positive," Sheen, 50, told Matt Lauer on the NBC show "Today," adding that when he learned of his status about four years ago, it was "a hard three letters to absorb." "It's a turning point in one's life," he said.
According to the Centers for Disease Control and Prevention (CDC), 1.2 million people in the U.S. are living with HIV. Though the human immunodeficiency virus ( HIV) is a serious infection, the levels of the virus in a person's body can be controlled with a handful of drugs, and many people living with the virus have a normal life span, said Dr. David Rosenthal, medical director at the Center for Young Adult, Adolescent and Pediatric HIV at the North Shore-LIJ Health System, in Great Neck, New York. [ 10 Celebrities with Chronic Illnesses]
"It's much more like a chronic illness," said Rosenthal, who is not involved in treating Sheen.
HIV destroys the so-called T-cells of the immune system, making it difficult for people infected with the virus to fight off infections.
It is spread through certain bodily fluids, including blood, semen, rectal fluids, vaginal fluids and breast milk, according to the CDC. The virus is most commonly transmitted through sharing needles or having unprotected sex with an infected person. However, Sheen said he is not sure how he got HIV.
In the 1980s, an infection with the virus was a sure death sentence. Back then, HIV infection inevitably progressed to the disease AIDS (acquired immune deficiency syndrome). A person is considered to have AIDS when HIV has wiped out many of his or her disease-fighting T-cells — typically, when there are fewer than 200 T-cells per cubic millimeter of blood. At that level, the person is even more prone to infections.
Back in the '80s, people typically lived just three years after an AIDS diagnosis, according to aids.gov.
However, with the introduction of the HIV-suppressing drug AZT in 1987, and then the introduction of a much more powerful drug mixture that combined three antiretroviral medications in 1995, the prognosis changed dramatically.
"Patients who got on the treatment early were able to suppress the virus, were able to keep their immune system strong and were able to maintain health as a result," Rosenthal said.
Sheen started taking antiviral drugs immediately after his diagnosis, and now, the levels of the virus in his blood are so low that the virus is undetectable, his physician, Dr. Robert Huizenga, an assistant professor of clinical medicine at UCLA, said on the show.
In fact, Sheen's other health problems are bigger concerns than his HIV infection, Huizenga said. "My biggest concern with Charlie as a patient is substance abuse and depression from the disease — more than what the HIV virus could do in terms of shortening his life, because it's not going to," Huizenga said on the show.