Insurance Act of 1946 put more unemployment, sickness, maternity and widow’s benefits and better state pensions, which were funded by compulsory contributions by employers and employees.17 A government spokesman during a debate in the House of Lords said that the bill “is not the product of any single party of any single Government. It is in fact the result of a concerted effort, extended over a long period of years involving doctors, laymen and Government, to improve the efficiently of our medical service and to make them more easily accessible to the public.”6 Truly the program was as such: it may have been enacted and created into concrete legislation by the socialists. However it was not entirely their idea for the ideas behind it like the Beveridge report and the White Paper which came out before 1945 when the Labour party had just come to power. Various actors played a vital role in drawing opposition of the program to support it. Perhaps the actor with the most important role was Bevan, the Minister of Health. He drew the BMA towards the program, ending some of the largest organized opposition to an NHS in Great Britain. Without this opposition, it was much easier to secure passage. The end of WWII provided a perfect window of opportunity for legislation to be passed. It was passed a year after the end of the war. There was government interest in creating health care legislation. However at the end of the war, with the country in economic and financial distress, more citizens looked to the government to become more involved. With this perfect window of opportunity, government officials of the party like Bevan were confidently able to forge ahead with legislation. With this almost “social mandate” from the English public, even opposition to like the BMA slowly wore away. In England, there were few veto points that could prevent the passage of the bill. Perhaps the most obvious possibility of a juncture would have been continued opposition by the BMA to the point that it would eventually destroy a healthcare bill. However by making concessions, Bevan avoided further problems and instead got very strong support from the organization. Another reason for the success of the NHS is because of government structure in Great Britain. The English Parliamentary system contains few veto points, or places where the bill could have been killed off. The Labour party was in the majority in Parliament and hence was the party of choice to fill the positions of prime minister and cabinet. Thus, there was already a support network built in between the legislative and executive branches of the English political system. This unity allowed for easier passage of laws. Also, the prime minister and his cabinet were able to directly introduce their bills into Parliament for approval, making the legislative process much easier.
Conclusion:
By examining the histories of these two countries we can determine the different factors that led to the passage of two very different pieces of legislation under the general umbrella of government sponsored health care programs. The United Sates and Great Britain both had many things in common, but they took place at different times and under different circumstances. The political character and climate surrounding each piece of legislation was also different leading to differences in its implementation. Both had once particular actor who really took the reins and almost single-handedly created
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legislation, or at least attempted to thrust it into the spotlight and got it passed. In the UK and US, the main actors were not the prime minister or the president, although both Atlee and LBJ supported their respective bills. The men in charge were Bevan, Minister of Health and Wilbur Mills, chairman, of the Ways and Means committee--not even of the same party as the president. The time periods of passage were different, but all occurred after WWII. For Britain, it was directly afterwards. In the US after the war, there seemed to be an increased perception amongst the public for the national government to take a more active role in the daily lives of its citizens. However, in the US, despite the passage of Social Security, there were many conservatives, including the conservative coalition who didn’t agree that the government should interfere too much with citizens’ lives. Yet with the Social Security program already set up for the elderly, it was much easier for passage to take place. History is important to analyze each of these three countries because it can let one know of the particular path each piece of legislation took on the road to passage into law. It can let us know of the critical junctures that took place, the path dependence and the actors involved to give the current system of healthcare. References: 1� American Medical Association. The British Health Care System. Chicago: American Medical Association Press, 1976 (Study). 2� “Aneurin Bevan.” Online. Available: http://www.sparactus.schoolnet.co.uk/TUbevan.htm. December 2, 2004. 3� Anthony McGrath, “The National Helath Service.” Online. Available: http://pegasus.cc.ucf. edu/~gropper/NHSOverview.html. December 2, 2004. 4� Ball, Robert. 1995. “Perspectivies on Medicare, What Medicare’s Architects had in Mind. Health Affairs 14, no.4:62-72. 5� David, Paul A. “Clio and the Economics of Qwerty.” Online. Available: http://www.pub. utdallas.edu/~liebowit/knowledge_goods/david1985aer.htm#_ftnl. December 2, 2004. 6� Eckstein, Harry. English Health Service. Cambridge: Harvard University Press, 1958. 7� Feingold, Eugene. Medicare: Policy and Politics: A Case Study and Policy Analysis. San Francisco: Chandler, 1966. 8� Gottschalk, M. 1999. The Elusive Goal of Universal Health Care in the US.: Organized Labor and the Institutional Straightjacket of the Private Welfare State. Journal of Policy History. 11 (4): 367-98. 9� Graig, Laurene A. Health of Nations: An International Perspective on U.S. Health Care Reform. Washington, D.C.: Congressional Quarterly, 1993. 10� Grey, Gwendolyn. Federalism and Health Policy: The Development of Health Systems in Canada and Australia. Toronto: University of Toronto Press, 1991. 11� Hacker, Jacob. The Divided Welfare State. Cambridge: Cambridge University Press, 2002. 12� Harris, Richard. A Sacred Trust. New York: New American Library, 1966. 13� Iglehart, John. 2000. “Revisiting the Canadian Health Care System.” The New England Journal of Medicine. 342(26): 2007-2012. 14� Immergut, Ellen. Health Politics: Interests and Institutions in Western Europe. New York: Cambridge University Press, 1992. 15� Lindsey, Almont. Socialized Medicine in England and Wales. Chapel Hill: the University of North Carolina Press, 1962. 16� Marmor, Theodor R. The Politics of Medicare. New York: Aldine De Gruyter, 2000. 17� NHS. “History of the NHS.” Online. Available: http://www.nhs.uk/england/ aboutTheNHS/history/default.cmx. December 2, 2004. 18� Oberlander, Jonathon. The Political Life of Medicare. Chicago: University of Chicago Press, 2003. 19� Wilson, Donna. The Canadian Health Care System. Printed in Canada, 1995 (Booklet put out by Health Canada).