Statistics published by the U. S. Department of Commerce (1980) indicate
that in 1977 we spent 8. 1% of our gross national product (GNP) on life,
health, property-casualty, and other forms of insurance. An additional
5. 7% was used to pay the Social Security tax, which is another form of
insurance premium, for a total of 14. 8% of the GNP. \ Although
insurance had its historical origin in marine insurance, it has now
developed into one of the major industries of the American economy and
extends into many areas of economic activity. One area where growth has
been particularly strong is the medical sector. Health insurance is a
major institution in all industrialized countries. It became a
government responsibility in 1883 when Bismarck intro- duced a
compulsory program of health insurance for industrial workers in
Germany. Programs for workers in various industrial and income
categories soon followed in other European countries-Austria (1888),
Hungary (1891), Norway (1909), Servia (1910), Great Britain (1911), and
Russia and Romania (1912) (Rubinow, 1913:250). Programs in these
countries were extended in subsequent years, and other countries in
Europe followed with their own programs. Consequently, today most
industrial countries have universal or near-universal health insurance
coverage. In the United States the issue of national health insurance
has been seriously debated since just prior to World War I, and polling
data since the 1930s show that a substantial majority of the public has
been supportive of such a program (Erskine, 1975).