5 most significant developments in the evolution of the health care in the United States: **Medical care was relatively inexpensive in the early part of the 20th century although there were attempts by progressive reformers to protect workers [ against both wage loss and medical costs beginning around 1915. At that time, people were more concerned about loss of pay when they were ill; so “sickness funds” were established to provide insurance against lost wages. **The Great Depression that ended the 20s brought multiple changes. An historic change was the Social Security Act, which was passed in 1935. However, a push within the Roosevelt administration to include health insurance was defeated by internal government conflicts over priorities. **In November 1945, President Truman, noting that 40 percent of the population still lacked access to adequate health facilities, addressed Congress and proposed a new national health care program, known as the Murray-Wagner- Dingell bill. It met opposition from labor as well as the American Medical Association, and, following the outbreak of the Korean War, Truman was forced to abandon it. **By 1958, almost 75 percent of U.S. citizens were covered by some form of private insurance, and the medical profession had been able to avoid the government intervention and nationalized insurance they had feared since early in the century. Doctors’ concerns from the beginning had been the preservation of their independence and ability to charge different fees to different patients for the same procedures – less to the poor, more to the wealthy. **In 1994, after the defeat of President Clinton’s health care reform effort, major changes in the private health care insurance system began to be implemented by health insurance companies. These changes and their effect on beneficiaries are described in “A Short History of Major Changes in the U.S.