Health policy and the underserved

Abstract

Historically, the provision of health benefits and health services has been wedded to the needs of an industrial society to maintain a productive labor force. The casual observer will note that since the late 19th century the role of government as a participant either in the provision for health services or the delivery of health services has been strongly tied to the labor movement in Western Europe. Overtime benefits, initially procured for the worker, were expanded to include the dependents of the worker and, finally, to include the former worker who was no longer able to work due to age or infirmity. The provision of health care to the poor was considered an act of charity and was never liberal enough to reward poverty nor was it essentially humane, for poverty was a condition to be punished. The rise of "alms houses" and public hospitals for the poor provided constant physical reassurance to the worker that he was, indeed, successful. Such institutions were also warnings to the worker lest he slip into the numbers of the poor.