As America’s 250th birthday approaches, we look back and wonder – where did healthcare freedom go, and can we ever get it back?
Early American healthcare developed by necessity, individual experience, and apprenticeship. The first medical school at the College of Philadelphia predated our country’s Declaration of Independence by ten years.
The Civil War was a crucible that fiercely challenged healthcare innovation. Medicine, surgery, nursing, mental health – all advanced rapidly. After the war, innovators used their experience to found medical and nursing schools, hundreds of hospitals, and mental institutions.
But progressive ideas soon threatened that freedom with control. Our timeline centers on Michigan’s regulation of professions, their education, and practice. (If you’re in another state, most regulations will be similar, although dates may vary.)
I’ve added a few national milestones for context.
From red flannel to full control: a timeline
1861 US Sanitary Commission supplies red flannel shirts to soldiers
1873 first three US nursing schools
1873 MI Board of Public Health
1875 Michigan dental license law & first approved school
1876 First medical school accreditation
1891 UM Training School for Nurses
1899 Michigan medical license law
1900 more than 2000 nursing schools nationwide
1909 Michigan nurse license law
1910 MI license first nursing schools
1913 MI Board of Health members help pass forced sterilization act
1940 MI Ballot measure adds to Dental license & school law
1950 MI Constitution Amended: Bonds for Specialized Hospitals and Schools
1965 US Medicare and Medicaid Act
1965 MI licenses Doctors of Osteopathy and physical therapists
1970 MI nurse anesthetist license law
1972 MI Certificate of Need law
1973 MI requires continuing education units (CEUs) for doctors
Board of health calls for moratorium on new healthcare licenses
1980 MI Marriage and Family Therapy license law
1980 MI managed care (HMO) law
1998 MI requires pain management education (pro-opioid)
2016 MI nurse license fee doubles ($120)
2017 MI opioid reform
2017 MI midwife license law
2020 Implicit Bias Training CEU mandate for all health licenses
2023 Michigan registry of nurses aides
2023 MIRegistry tracks CEUs
2025 US down to 1500 nursing schools (23 in Michigan)
Obviously, the trajectory of this timeline is away from freedom. Opportunities for individuals to innovate are fewer and fewer outside today’s rigid healthcare structure.
For additional context, I recommend the recent timeline of US health insurance regulation.
Does momentum make totalitarian control of American healthcare inevitable?
In a word – No.
Like colonial and Civil War Americans, we have necessity, morality, and love of freedom and our fellow Americans on our side. And together, we are determined to win.
Read our progress this year in our year-end letter.
Join the cause! For your donation of any size before December 31, we’ll send you one of our MHF “Red Tape” bookmarks that debuted this year.
