Early 20th Century: Government Involvement and Regulation

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The Birth of Social Insurance: The 20th century saw the expansion of government involvement in insurance. Germany was the first to introduce social insurance programs in the 1880s under Chancellor Otto von Bismarck. These programs included health insurance, accident insurance, and old-age pensions to protect workers.
U.S. Social Security Act (1935): In the United States, the Social Security Act of 1935, introduced during the Great Depression, laid the foundation for public insurance programs, such as Social Security, unemployment insurance, and disability benefits. These programs were designed to provide a safety net for citizens in times of economic hardship.
Health Insurance in the U.S.: The 20th century also saw the introduction of employer-based health insurance in the United States during the 1940s as a response to wage controls during World War II. This system became entrenched in the U.S. healthcare system, despite attempts to introduce a national health plan like Medicare or universal healthcare.

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