As commercial insurance gained foothold, many Americans remain uninsured due to bias regarding medical services that are being covered. Majority of population still suffered due to high unemployment ratio and the criteria of experience rating based on healthy ratio differed with common insurance needs of general population. Blue Cross and Blue Shield plans continued to provide quality reimbursement in hospital and health institutions. There arose a great need to understand this emerging pattern of the insured because the hospitals and other health care also started to introduce medical facilities and services and due to proper diagnosis more diseases became curable. Though physicians were compensated for their fees but in tough competition the treatment remained evasive and limited to use of generic techniques. Otherwise, special case scenarios such as unemployment, old-age benefits, chronic medical illnesses, disability and those suffering from complex medical conditions also got marginalized services and with no coverage, these sections suffered. This start affecting the American government and also due to stringent policies of AMA, conclusive public insurance plans were considered before the committee.
Late 1950s, only few signed up for health insurance in different categories. In 1945, Harry S. Truman raised the idea of national health insurance fund with the support of the federal government for all communities irrespective of their type and income. Participants under a nominal fee structure would have been covered for lifetime. This bill was in the form of a Social Security expansion bill and was popularly known as W-M-D bill. However, due to remarks by AMA terming it as socialized medicine and in due course outbreak of the Korean War, this bill was never introduced.
Incorporation of Medicare and MedicaidIn 1961, it became priority of President Kennedy to involve more people under national health insurance plan. The cases were discussed and a complete insurance plan targeting masses of all ratios became important. Finally, Medicaid under the Social Security Amendments of 1965 was developed by the United States government as a social welfare program targeting families and individuals of all ages with low income and people with disabilities. Still the states were not required to endorse the insurance plan and it was worked out inefficiently leading to poor insurance enrolment by people. Due to experience rating which favoured the young people, only 65% of people above 65 ages had insurance coverage. President Johnson introduced the Medicare bill in the Congress in 1965 which provides health insurance to people age 65 and above, irrespective of their finances and health condition. Commercial insurers were attracting the businesses but due to massive scale down and large number of enrolment in the national insurance plans and suitable funding for the participating organizations, the physicians responded positively towards the concept and helped in strengthening the movement.
Kerr-Mills Eldercare as a proposed expansion of the health care insurance bill in the U.S. was opposed by AMA which under the leadership of Dr. Norman A. Welch who led a national drive against it. The primarily reason was that the elder patients can choose any facility which was not part of the original healthcare insurance.