Background: For over a century, health care reform advocates have attempted to change health care reform laws in the United States . After a few close misses and little or no change, the battles for health care reform and the explanations for their failures provide an interesting lesson in American history, philosophy, and politics. From the late 1800s to 1912, the federal government left issues to the states and the states left them to private and charitable programs. America had voluntary funds to support its members in the event of illness or death, but there was no government or public assistance in the late 19th and early 20th centuries. The starting point of our health system is at the beginning of the twentieth century. Medical technology was advancing rapidly and opportunities were growing with it. Training, performance and skills have all improved significantly. Hospitals have become centers of specialized medicine, surgery and research. With all of this, the cost of medical care has begun to rise and will continue to exceed the cost of living for the rest of the century. By the late 1920s, the middle class and poor found themselves facing increasing medical costs. In what was called the Progressive Era, reformers worked to improve the social conditions of the working class. However, there was no strong working-class support for social insurance in the United States, and support from the labor and socialist parties for health insurance reform was incomplete and disorganized. Consequently, early health insurance proposals in the United States were not the subject of political debate. President Theodore was in power during the Progressive era and he defended the Nationa...... middle of paper ...... ombberg better (and worse) (nd). At Bloomberg. Retrieved April 17, 2014 from http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-countries Davidson, KA (August 29, 2013). The most efficient health systems in the world. In Le Monde Post. Accessed April 14, 2014, from http://www.huffingtonpost.com/2013/08/29/most-efficient-healthcare_n_3825477.htmlHealth Care Facts: Why We Need Health Care Reform (2013) . In Obama Care Facts. Retrieved April 18, 2014, from http://obamacarefacts.com/healthcare-facts.phpHNN's History of Healthcare Reform (2013). In History Information Network. Retrieved April 14, 2014 from http://hnn.us/article/146911The history of the US health care reform effort (June 28, 2012). In Fox News. Retrieved April 14, 2014 from http://www.foxnews.com/us/2012/06/27/us-health-care-reform-efforts-through-history/