From Bismarck to Woodcock: The "Irrational" Pursuit of National Health Insurance

AbstractAlmost a century ago Prince Otto Eduard Leopold von Bismarck, the principal creator and first chancellor of the new German nation-state, introduced compulsory national health insurance to the Western world. Since then, nation after nation has followed his lead until today almost every developed country has a full-blown national health insurance plan. Some significant benchmarks along the way are the Russian system (introduced by Lenin after the Bolshevik Revolution), the British National Health Service (Beveridge and Bevan, 1945), and the Canadian federal-provincial plans (hospital care in the late 1950s, physicians’ services in the late 1960s). In nearly all cases these plans built on previous systems of medical organization and finance that reflected particular national traditions, values, and circumstances.1…