Health care reform refers to the program undertaken by the government whose main aim is to bring significant changes to the health sector and encompass a positive influence on its citizen's wellbeing (Jacobs & Skocpol, 2015). The whole concept of health care is vast, and it entails many things. Basically, what health care attempts to do is reduce the costs incurred in when getting medical services. The health care act also wants to improve health care services and ensure that the majority of the citizens can get excellent services health wise by increasing the number of people who can obtain affordable insurance programs. The act also wants to ensure that access to healthcare providers is improved and also to set up a wide range of health providers from which the citizens can choose. In the United States of America, the healthcare report is one of the significant issues that the government wants to ensure it attains the required standards.
History of Health Care Reform
Healthcare reforms go back to as early as the 20th century during the administration of President Franklin D. Roosevelt. During this period, a lot of American citizens could not have access to affordable medical services. President Roosevelt drafted a proposal which included healthcare policies that were funded by the public. The American Medical Association together with the states and other local affiliates of the association came out guns blazing on seeing this proposal (Jama, 2016). These attacks from the American Medical Association prompted President Roosevelt to do away with the bill. Different hospitals began offering insurance programs.
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Two private hospitals; Blue Cross and Blue shield were the first offer insurance programs. Blue cross hospital was selling insurance programs to individuals while Blue shield was comprised of doctors and physicians and was selling policies to employees (Jacobs & Skocpol, 2015). Blue cross then developed various guidelines with the help of American Help Association that allowed people under the plan to visit any hospital they wished. The third-party insurers were fully supported later in 1945 when the Congress passed a law.
After world war two, President Harry S. Truman who was the predecessor to President Roosevelt also presented a health care reform proposal. Even though President Truman's proposal encountered many challenges including strong opposition from the American Medical Association and the outbreak of war in Korea his efforts were not in vain because he managed to increase and modernize the number of hospitals (Jacobs & Skocpol, 2015). The modernization happened because of the Hill-Burton Act that was passed by the Congress in 1946. The government equipped hospitals with grants and loans that enabled them to expand and also have modern equipment (Jama, 2016). The health care facilities again expanded rapidly until a regulatory act; the institution of Military Medicare. The ‘Military Medicare' was added under the Eisenhower administration to help military dependents get their health care services paid.
Then later came in President Kennedy's administration. President Kennedy presented a modest health care coverage that the one presented early by President Truman. President Kennedy under his new proposal, the healthcare benefits were limited to citizens who had 65 years of age and above (Jacobs & Skocpol, 2015). This proposed bill also had social security package as part of the profits. The president was feeling some opposition from some particular interest group, and he decided to take the case to the American citizens. He held a series of rallies over the country where he attended and addressed the public. The president also did a speech at Madison Square Garden that was nationally televised. He was confident and sure that the Congress would pass the bill since he believed that it was what the American citizens needed to reform the health care. Later that year, the law never went through the committee (Stevens, 2017). The bill was never successful due to strong opposition from American Medical Association with the help of Wilbur Mills a conservative Democrat who happened to be the chairman of the committee of house and ways. President Kennedy never lived to see a chance of the bill to succeed. He was assassinated later that year.
President Kennedy's successor Lyndon B. Johnson became president having won with a landslide victory and had a commanding majority in both houses. The Medicare and Medicaid policies went through the congress houses despite strong opposition from the American Medical Association a part of conservative Republican members (Zand, 2017). After the final approval by the Senate in July 1965, President Johnson signed the bill into law. The bill covered low-income families, people born with the disability, blind people and people of 65 years and above 's services in hospitals and various health care providers facilities. Later, various health care proposals cropped up from the people who felt they were left out in the Medicare program.
In 1971 the administration now in charge of President Nixon proposed another bill dubbed the ‘National Health Insurance Standard Act.' In the proposal, the administration wanted all the employees and employers to have an insurance coverage hence they were to make payments regarding premiums for the same. The proposed bill with the government help would give out subsidies regarding premiums to specific employees (Zand, 2017). The National Health Insurance Act Standard Act was meant to keep the rivalry among the private insurers and also enlarge the insurance exposure, but the policy never went through. After the unsuccessful National Health Insurance Act proposal act, President Nixon's Administration put down a managed care basis through the Health Maintenance Organization Act.
Senator Edward M. Kennedy from Massachusetts brought forward an opposing healthcare proposal. In his proposed health care act, Kennedy provided a comprehensive health coverage that was to help a majority of the American citizens (Constantinou, Farley, Grady & Miller, 2014). Kennedy suffered a significant blow when the bill was turned down in Congress, but the health care proposal turned out to be the start Kennedy's long career.
In the '80s the health care system inclined more to the private sector. Various private corporations and organizations involved themselves in the hospital structure. The health care cost inflated at a rapid rate. In the '90s the Congress tried multiple times to pass the health care reform bill but was in vain (Zand, 2017). In 2010 after the general election of President Barrack Obama, the Affordable Care Act known as ‘Obamacare' became law. Many people never expected President Obama to make health care reform a priority. Through his campaign he promised the American citizens a new health care reform that was cheaper and in the first six months after getting to the office, he sent a bill to Congress on the same. The Affordable Care Act drew a lot of different public opinion. During this period, a lot of divisive views and misleading information was getting to the public. After a long period, the bill dragged in Congress with a series of reforms, but later the act made its way to the house and was approved (Constantinou, Farley, Grady & Miller, 2014). The Obamacare bill became the law in the year 2010.
The Current State of Health Care Reform
The Affordable Care bill of 2010 has made significant changes in the health coverage for the American citizens. According to Jama (525-532), the act has made positive progress in addressing the various challenges in the united states health care structure. The uninsured rate has dropped significantly since the 2010 health reforms. Most American citizens have termed the Affordable Care Act as the most significant reform in the health system since the introduction of Medicare. But not all the American citizens are convinced that the Affordable Care Act it the best option for health reforms in America (Blumenthal, Melinda &Nuzum, 2015). Some citizens feel that the health act tends to hurt the small businesses and it has the potential of increasing the deficit.
The budget projected by the Congress early predicted that the gap would decrease and Medicare spending rate was to go down by introducing the Affordable Care Act which is not the case (White, 2015). Another section of citizens views the universal health care commodity like any other and are of the opinion that it should not be mandatory for citizens to be insured. President Trump recently a new law that will see the end of Individual Mandate that was under the Obamacare bill. Initially, the mandate required all American citizens to be covered under the Medicare program or face penalties (Rice et al., 2018). The new law signed by president Trump will eliminate the insurance penalty when it becomes effective in 2019.
Solutions To The Current State Of Health Care Reforms
Repealing of the misguiding laws in Obamacare; Let the American residents get to purchase health care coverage that they want not a plan decided and approved by the government for them. Also, the administration should work towards fixing the current health programs. By adjusting the Medicare program, the costs will be expected and sustainable for the citizens who pay taxes. The state and federal governments should work together to eliminate various healthcare challenges that both states are facing (Savel & Munro, 2018). By working together, both the federal and state government will be able to identify multiple problems with the health care reform act and come up with full new health care structure that will offer affordable health care options for the citizens.
Financial impact analysis on the health reforms solution
If the government will repeal the Affordable Care Act with no replacement, 19.7 million estimated American citizens will drop, a total of 33.1 billion dollars deficit will rise because of the scrapped of provisions for raising funds I Affordable Care Act. There will be an increase of 4200 dollars annually for personal enroll in the market (Obama, 2017). If the government will repeal the Affordable Care Act and replace it with a single payer plan would increase the total expenditure of the national government by 435 dollars and that of the federal government by 1 trillion dollars.
In conclusion, the health care reforms are a hotly contested topic among the American citizens. Most presidents have tried to find the perfect health care structure over the past years. The former President Barrack Obama's Affordable Care Act is the most recent. The federal and state governments should work together and address the few issues not discussed in the Affordable Care Act.
References
Andrews C, A Abraham, CM Grogan, HA Pollack, Clifford Bersamira, Keith Humpreys, Peter Friedmann (2015) Despite resources from the ACA, most states do little to help addiction treatment programs implement health care reform. https://doi.org/10.1377/hlthaff.2014.1330
Behrouz Zand, (2017) A history of health care reform. E-journal of Kevinmd.com. https://www.kevinmd.com/blog/2017/08/history-health-care-reform.html
Constantinou C , E Farley, F Grady, DF Miller, (2014) Who's dragging their feet? Obama care stalled in Congress
David Blumenthal, Melinda Abrahams, Rachael Nuzum, (2015) The Affordable Care Act at five years. Health Policy Report. Advance online publication. DOI: 10.1056/NEJMhpr150361
Jacobs L, T Skocpol, (2015) Health care reform and American politics: What everyone needs to know, Oxford University Press
Jama, (2016) the United States Health Care Reform Progress to Date and steps. Journal by US National Library of Medicine National Institute of Health. Advance online publication. doi: 10.1001/jama.2016.9797 pg 525-532
Jess White, (2015) Health reform: Current impact on hospitals.
Obama BH , (2017) Repealing the Affordable Care Act without a replacement. The risks to American health care.
RA Stevens, (2017) The Public-Private Health Care State: Essay on the History of American Health Care Policy
Richard H. Savel, Cindy L. Munro, (2018) Current State of Health Care Reform: DysfunctionalGovernment, Divided Country. American Journal of Critical Care.
T Rice, LY Unruh, E van Ginneken, Pauline Rosenau, Andrew J. Barnes (2018) Universal coverage reforms in the USA: From Obamacare through Trump volume 127, pages 698-702
