American Hospital Association

A brief history of the government's role in practicing medicine

From the beginning, American citizens have wrestled with how much government should regulate and control medical care. Before the revolution, various colonies unsuccessfully tried to determine physician fees. In 1798, President John Adams promoted the first federal government sponsored medical insurance plan for merchant seaman. This initial attempt failed.

While Congress did not try to regulate doctors before or after the Civil War, many states attempted to manage physicians through licensure legislation. These laws were ineffective and eventually repealed because of the American spirit of individualism and adherence to the laissez faire philosophy

As the nation expanded in...