Health insurance was developed to provide guaranteed coverage for sickness, injury and preventable health measures. Currently, the United States is facing a major challenge in controlling the cost of health care and providing coverage for everyone. This is why it is so important for the government to develop a new health care insurance plan. The purpose of this paper is to explore the history of health care, the major improvements made to coverage through the years. Discussing the healthcare reform and the plans to improve the quality, and cost of health care for everyone in the United States.
Birth of Health Insurance
Health insurance started in the early twentieth century when the working class of America faced the problem of sickness
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With the guarantee of payment the first provider health care program was born. It was called Blue Shield. Blue Shield’s role was to “negotiate with doctors and hospitals for reduced prices in exchange for a high volume of customers and guaranteed payment. To make up for the loss of revenue, doctors and hospitals raised their prices for patients who did not have group health insurance” (1). A lot companies during the 19040s and 50s were able to offer their employees health care benefits, but for some this was not an option. Many of Americans and small businesses during this time period could not afford group health insurance. This meant that the government had to come up with new programs to provide coverage for the uninsured people.
Improvements to Health Insurance
There was hope and a need for an insurance that would benefit the disabled, elderly and unemployed American people. The Medicare and Medicaid act of 1965 did just that and provided health insurance coverage to millions of Americans in need. There was a glimpse of light at the end of their dark tunnel “Medicare a uniform national health insurance program for the aged and certain disabled persons. [Along with] Medicaid which is administered by the states within broad federal guidelines and finances health services for certain low-income groups” (Lew “First
Prior to this shift, government involvement in health insurance services was minimal since it seemed to be under control by the non-profit sector. There didn’t seem to be an urgent need to control or universalize health care at the time. The government’s first interest in the health care industry sparked when employers began providing health care benefits as a competitive advantage for recruiting workers back into the workforce during World War II. To help cope with the rising unemployment rates, the government would offer tax incentives to employers providing these benefits. (add Quote)
However, when Private insurance companies soon joined the fray thereby creating stiff competition, costs were determined by a number of factors among them was the exclusion of the sick and the selective process of insuring only the healthy which meant more profit for the company because Blue Cross only provided coverage for hospital services. The Blue Shield plans were created in 1939 by employers in lumber and mining. This was done to ease the healthcare burden and bring satisfaction to both the physician and the patient. In 1982, The Blue Shield plan merged with The Blue Cross to form The Blue Cross and Blue Shield Association(4).
of the patient with controlling the costs of care, the issue of the uninsured began to grow. The concept of some sort of governmentally funded universal health care for all began over a century ago, however, never successfully implemented. From a historical viewpoint, individuals obtained health insurance by purchasing their own policy, as a benefit of employment, or through governmentally funded programs that required certain eligibility criteria be met in order to be eligible. If a person did not qualify for one of these types of health insurance, they generally were left without health insurance coverage.
A powerful force for change can be created by embracing transparency. According to the Department of Health and Human Services, “transparency is a broad-scale initiative enabling consumers to compare quality and the price of health care services so they can make their own informative choices among doctors and hospitals. This initiative is laying the foundation for pooling and analyzing information about procedures, hospitals and physicians services. In order to create value driven health care, there are four steps to turn raw data into
The depression in the 1930’s brought about the Social Security Act. This, however, omitted health insurance. Blue Cross also started offering people hospital care insurance in several states.
The latest health care reform has done what few policies manage to do – sicken both republicans and progressive democrats. While we can all agree that a reform of the health care system is sorely needed, we must also acknowledge that “Obamacare” is not the cure-all we so desperately require. Rather, President Obama, like a medieval barber, prescribed a health care reform that treated the symptoms of our flawed system rather than the actual disease. The subsidization of health insurance providers has proven ineffective at providing affordable coverage for all. Certainly one is likely to hear the various incendiary talking points of both the proponents and opponents. Whether it’s the republican candidates blaspheming Obamacare as socialism, or the administration praising the success of health care for all, it is difficult to actually find constructive dialogue. We are purview to many sound bites, but few actual solutions. We have witnessed heated debates, but rarely do we witness intelligent discourse. If beneficial reform is to be crafted and implemented, we must first acknowledge the issues and inconsistencies of the current system and begin to explore alternate methods of providing health care to the American people.
During the 1920s and 1930s, there was an increase in the cost of medical care and hospitalization. This was due to the middle class accessing health care services. The cost of medical care became a bigger portion of a family’s budget then loss wages due to sickness. The Wagner Bill, National Health Act of 1939 proposed for the creation of a national health program funded by federal grants to states. The Wagner Bill would provide health insurance for seniors but there were limitations to the bill.
The Great Depression in the 1930’s had been followed by a period of growing income inequality and a shrinking middle class. Due to the economic conditions, Income disparities in access to health care had grown much worse, medical costs were rising, and sickness became a leading cause of poverty. Since few people could afford to pay for medical care welfare agencies began to help pay for medical costs for the poor. By “1940, the population of the united states was 132 million with only 12 million – a little less than 10 percent covered by some form of health insurance”( Scofea, 1994). The growing concern of the increase in the number of people who are uninsured led to the enactment of the Stabilization act in 1942, which imposed wage and price controls but at the same time permitted the adoption of employee insurance plans. The federal government enacted this legislation to prevent employers from raising wages in order to compete for scarce labor in response to the inflation pressure of the wartime economy. Furthermore, the government provided private insurers with a new market for their products by permitting employers to offer health insurance to their employees. In the years that followed, the government passed several regulations that helped reinforced the institutionalization of the employment-based system of health insurance that
U.S. health care reform is currently one of the most heavily discussed topics in health discourse and politics. After former President Clinton’s failed attempt at health care reform in the mid-1990s, the Bush administration showed no serious efforts at achieving universal health coverage for the millions of uninsured Americans. With Barack Obama as the current U.S. President, health care reform is once again a top priority. President Obama has made a promise to “provide affordable, comprehensive, and portable health coverage for all Americans…” by the end of his first term (Barackobama.com). The heated debate between the two major political parties over health care reform revolves around how to pay for it and more importantly, whether it
Less than a hundred years ago, in the late 1920’s and 30’s, almost 90% of Americans did not have health insurance (Fall of HMO’s 4). They used a variety of home remedies and when medical assistance was truly needed, they paid for it out of pocket, even incurring vast amounts of debt. This had been the case throughout history, and it changed due to an important factor, medical equipment. The industrial revolution finally caught up with the medical industry and the country saw a vast change in the scientific instruments used by physicians. These instruments required a lot of money to make and care for which caused prices to rise. Due to this massive problem, a committee was formed of health care professionals and after a 5 year study, the Committee on the Cost of Medical Care suggested that health insurance co-operatives start. These corporate medical practices became known as Health Maintenance Organizations (HMO’s) and preferred provider organizations (PPO’s), and up until the 1970’s, were an experiment to regions across the U.S. Factors that hindered health care included bullying of “money politics” from both sides of the isle as well as Presidential views and tactics as well. President Nixon first
The main historical developments that have shaped the health care delivery system in the United States. Knowledge of the history of health care is essential for understanding the main characteristics of the system as it exists today. For example, the system’s historical foundations explain why health care delivery in the United States has been resistant to national health insurance, which has been adopted by Canada and most European nations. Traditionally held American cultural beliefs and values, technological advances, social changes, economic constraints, and political
Due to the upcoming presidential election, the two major political parties, and their candidates, have been focusing on the primary problems that the nation will face. Chief among those problems is the future of Medicare, the national health-insurance plan. Medicare was enacted in 1965, under the administration of Lyndon B. Johnson, in order to provide health insurance for retired citizens and the disabled (Ryan). The Medicare program covers most people aged 65 or older, as well as handicapped people who enroll in the program, and consists of two health plans: a hospital insurance plan (part A) and a medical insurance plan (part B) (Marmor 22). Before Medicare, many Americans didn't have health
Healthcare Reform has been and still is a highly debated controversial political issue in this country. It has been a hot topic of past presidential campaigns, with many proposed solutions, none of which were enacted upon by Congress. The Affordable Care Act (ACA) was passed in 2010. This law or Obamacare, as it is commonly called, was designed to cover the 48 million Americans, including about 1 million in New Jersey who did not have health insurance. It is envisioned to provide seamless, affordable, quality care that is accessible to all. Great emphasis will be placed on transforming our current “sick care” hospital system into a community “health care” system of prevention and health promotion. This paper discusses the evolving and future roles of nurses under the new system. It also examines the proposals of a joint committee made up of members of the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF), as an initiative to help nurses in their new leadership roles to a healthier nation.
Healthcare didn’t always exist in the United States. Before the 1920’s, most people didn’t have health coverage. Most people were treated at home and hardly anyone, except a few large employers offered healthcare. Everyone else paid out of pocket. As the population shifted from rural areas to urban centers, families lived in smaller homes with less room to care for sick family members (Faulkner 1960, p. 509). Increasing requirements for licensing and accreditation, in addition to a rising demand for medical care, eventually led to rising costs. By the end of 1920s, there was an increased demand for medical care and the costs of medical care increased.
Throughout the first part of the 20th century there was little effort to promote health insurance, but in the second half of the 20th century healthcare became a major concern. Once, Medicare and Medicaid were introduced in 1965 the government along with its citizens took a major step in the progression of healthcare. From then, there was a shift in the privatization of healthcare. This forced many of the lower class to be without health insurance. In 1993, President Clinton with the best of in intentions failed at establishing a universal healthcare system in the United States. Finally in 2006, Massachusetts passed a law that would provide healthcare coverage for all of its state residents. In 2010 the