The idea that governments had a responsibility to provide some form of health care is an old one. Although the idea did not begin to gain traction in Europe until the eighteen-fifties changes in Germany, the debate goes back to the Muslim physicians. An early contributor to the debate in the West was Daniel Defoe (1660-1731), better known as the author of Gulliver’s Travels.
In 1697 Defoe published “An Essay Upon Projects.” In this he proposed a number of practical, well-thought-out measures to improve public health. His ideas for societies of people each contributing money to pay for health care became the basis for the Friendly Societies, which were the premier health care organizations until the Lloyd George reforms of 1912. After describing the use of insurance in the shipping business and in the fire prevention business, Defoe goes on to say, “Another branch of insurance is by contribution, or (to borrow another term from that before mentioned friendly societies), in short, a number of people entering into a mutual compact to help one another in case any disaster or illness befall them.”
He then describes how these contributions could be used to help people deal with health calamities and old age, based on people contributing to a common fund. Although he worked out funding schemes in some detail, he seems to have stopped a little short of advocating government compulsion or government funding.