http://open.salon.com/blog/paul_j_orourke/2010/03/24/news_pres_signs_h-care_insurance_mandate-212_years_ago

CHAP. LXXVII – An Act for the Relief of Sick and
Disabled Seamen

Section 1.  Be
it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled -

That from and after the first day of September next, the master or
owner of every ship

or vessel of the United States, arriving
from a foreign port into any

port of the United States, shall,
before such ship or vessel shall be

admitted to an entry, render
to the collector a true account of the

number of seamen, that
shall have been employed on board such vessel

since she was last
entered at any port in the United States,-and shall

pay to
the said collector, at the rate of twenty cents per month for every

seaman so employed; which sum he is hereby authorized to retain out

of the wages of such seamen.

SEC2.
. And be it further
enacted, That from and after the first day

of September next,
no collector shall grant to any ship or vessel whose

enrolment
or license for carrying on the coasting trade has expired, a

new
enrolment or license before the master of such ship or vessel shall

first render a true account to the collector, of the number of
seamen,

and the time they have severally been employed on board
such ship or

vessel, during the continuance of the license which
has so expired, and

pay to such collector twenty cents per
month for every month such

seamen have been severally employed,
as aforesaid; which sum the said

master is hereby authorized to
retain out of the wages of such seamen.

And if any such master
shall render a false account of the number of  men, and
the length of time they have severally been employed, as is

herein
required, he shall forfeit and pay one hundred dollars.

SEC3. . And be it further
enacted, That it shall be the duty of the

several collectors to
make a quarterly return of the sums collected by

them,
respectively, by virtue of this act, to the Secretary of the Treasury;

and the President of the United States is hereby authorized, out of
the same, to provide for the temporary relief and
maintenance of sick or

disabled seamen, in the hospitals or
other proper institutions now established

in the several ports
of the United States, or, in ports where no

such institutions
exist, then in such other manner as he shall direct:

Provided,
that the monies collected in any one district, shall be expended

within
the same.

SEC. 4. .And
be it further enacted, That if
any surplus shall remain

of the monies to be collected by virtue
of this act, after defraying the

expense of such temporary
relief and support, that the same, together ,

with such private
donations as may be made for that purpose (which the

President
is hereby authorized to receive) shall be invested in the stock

of
the United States, under the direction of the President; and when,

in his opinion, a sufficient fund shall be accumulated, he is hereby

authorized to purchase or receive cessions or donations of ground
or

provision for buildings, in the name of the
United States, and to cause buildings,

when necessary, to be
erected as hospitals for the accommodation of sick and disabled seamen.

SEC5. . And
be it further enacted, That the
President of the United

States be, and he is hereby authorized
to nominate and appoint, in

such ports of the United States, as
he may think proper, one or more

persons, to be called directors
of the marine hospital of the United

States, whose duty it
shall be to direct the expenditure of the fund

assigned for
their respective ports, according to the third section of this

act;
to provide for the accommodation of sick and disabled seamen,

under
such general instructions as shall be given by, the President of

the
United States, for that purpose, and also subject to the like general

instructions, to direct and govern such hospitals as the President
may

direct to be built in the respective ports: and that the
said directors

shall hold their offices during the pleasure of
the President, who is

authorized to fill up all vacancies that
may be occasioned by the death

or removal of any of the persons
so to be appointed. And the said

directors shall render an
account of the monies received and expended

by them, once in
every quarter of a year, to the Secretary of the Treasury,

or
such other person as the President shall direct; but no other

allowance
or compensation shall be made to the said directors, except

the
payment of such expenses as they may incur in the actual discharge

of the duties required by this act.

APPROVED
July 16, 1798.

In July, 1798, Congress passed, and President John Adams signed into
law “An Act for the Relief of Sick and Disabled Seamen,” authorizing the
creation of a marine hospital service, and mandating privately
employed sailors to purchase healthcare insurance.

This
legislation also created America’s first payroll tax, as a ship’s owner
was required to deduct 20 cents from each sailor’s monthly pay and
forward those receipts to the service, which in turn provided injured
sailors hospital care. Failure to pay or account properly was
discouraged by requiring a law violating owner or ship's captain to pay a
100 dollar fine.

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