http://www.associatedcontent.com/article/339640/a_brief_history_of_health_care_in_america.html?cat=5Managed Care as we know it today has its roots in a number of prepaid healthcare arrangements in the early 20th century. The earliest example of this dates back to 1910, when the Western Clinic in Tacoma, Washington provided a wide range of medical services to lumber mill owners and employees for a monthly premium of 50 cents.
In 1929, a managed care pioneer by the name of Dr. Michael Shadid began a cooperative health plan for rural farmers in Elk City, Oklahoma. The members who enrolled in his plan paid a predetermined fee and received medical care from Dr. Shadid. In the same year, the Ross-Loos Medical Group was established in Los Angeles, and it provided prepaid services to county employees and employees of the city's department of Water and power. Its members paid a premium of $1.50 a month. In 1982, the Ross-Loos Medical Group came to be known as CIGNA Healthcare.
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With the 2nd world war raging in the 1940's, labor was in short supply, and the government imposed wage controls. To deal with this situation, employers begun to offer health insurance as a fringe benefit to attract more workers. The government sought to encourage this new development, offering businesses income tax exemptions for health care related expenses. This begun the current trend of the employer as a health insurance supplier.
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The enactment of the Medicare and Medicaid legislation in 1965 was a landmark in the history of managed health care, by extending coverage to millions of additional Americans. It also hastened the end of segregation in hospitals, as segregated wards were ineligible for federal payments.
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