From a global perspective, there are four main models of health care, each of which takes a different approach both legislatively and in practical terms of how it affects a populace’s ability to obtain health care coverage and services. In 1929, Blue Cross established the first employer-sponsored health coverage in Dallas as a partnership between the Baylor University hospital and its patients. One of the largest health care acts in American history, commonly referred to as the Medicare and Medicaid Act, was approved by President Lyndon B. Johnson in July 1965. After intense debate, lawmakers passed the Patient Protection and Affordable Care Act (PPACA) or Obamacare, which was signed into law on Mar. 23, 2010.