Health Care Reform Analysis - Research Paper Example

?Running head: HEALTH CARE REFORM Health care reform 13th November The provision of health care is a paramount agenda that has been adopted by various US leaders during their campaigns and while in the leadership position. The major source of health care funding comes from Medicare, Medicaid, Tricare as well as Children's Health Insurance Program among other sources. One of the major causes of the failure of health plan under the leadership of Roosevelt, Truman and Clinton was political interferences. The ideological differences between congress and democrats largely lagged behind the efforts of the leaders to enhance health reforms. Being a focused leader, Obama realized the benefit of health care for all Americans. This was a major factor discussed in the paper that resulted to approval and enactment of Affordable Care Act (ACA). Introduction Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector. Health insurance is now primarily provided by the government in the public sector, with 60-65% of healthcare provision and spending coming from programs such as Medicare, Medicaid, Tricare, the Children's Health Insurance Program, and the Veterans Health Administration. The issue of health insurance reform in the United States has been the subject of political debate since the early part of the 20th century and recently reforms remains an active political issue. Active debate about health care reform in the United States concerns questions of a right to health care, access, fairness, efficiency, cost, choice, value, and quality. Some have argued that the system does not deliver equivalent value for the money spent. In the United States, ownership of the health care system is mainly in private hands, though federal, state, county, and city governments also own certain facilities. The USA pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy, though the relation between these statistics to the system itself is debated. Currently, the USA has a higher infant mortality rate than most of the world's industrialized nations. Life expectancy in the USA is 42nd in the world, below most developed nations and some developing countries. It is also below the average life expectancy in the European Union. The World Health Organization (WHO) in 2000, ranked the U.S. health care system as the highest in cost, first in responsiveness, 37th in overall performance, and 72nd by overall level of health (Bok, 1994). The Commonwealth Fund ranked the United States last in the quality of health care among similar countries, and notes U.S. care costs the most. Doctors and hospitals funded by payments from patients and insurance in return for services given. Around 84.7% of Americans have some form of health insurance; either through their employer or the employer of their spouse or parent (59.3%), purchased individually (8.9%), or provided by government programs (27.8%) (Brint & Karabel, 2009). This paper will discuss various reasons as to why health plans have failed under Roosevelt, Truman and Clinton regime and the reason as to why Obama's plan succeed in getting approved. Reasons as to why Roosevelt's plan failed In 1912, there was a proposal for a national health insurance when President Theodore Roosevelt's Progressive Party platform called for the fortification of home life against the problems of sickness, asymmetrical employment and old age through the espousal of a system of social insurance that was relevant to American use. (Christensen et al, 2008) Shortly thereafter, the American Association for Labor Legislation (AALL) formed a Committee on Social Insurance comprising prominent members of the American Medical Association (AMA) and others. The committee recommended a compulsory plan covering the majority of workers. In 1917, efforts to enact the AALL plan at the state level failed, largely due to opposition from organized medicine and other conservative elements that considered it a harbinger of radical social change. The AMA initially called the plan the "inauguration of a great social movement", but rapidly changed course and consistently opposed mandatory health insurance since that time (Brint & Karabel, 2009).. Reasons as to why Truman's plan failed Just like Roosevelt’s plan, Truman’s plans were met with opposition, from both the public and from special interest groups. Although polls confirmed that over 58% of Americans approved Truman’s proposal, his programs seemed too liberal and radical for the American public. Due to external forces like the "Red Scare" and the commencement of the Cold War, Truman's health reform plan never had a chance (Mitchell, 2002). Domestic policy like health care reform was not the priority at the time. Moreover, the American Medical Association (AMA) attacked Truman's ideals. Truman's opposition felt that increased government control on American health care would result in socialized medicine. They therefore portrayed Truman's reform as an increase in big government, which would result in lowered competition. This led to increased medical fees, inefficiency, and a result of "damaging the high quality of American health care" (Mayes 37). Their efforts of framing Truman's reform negatively largely resulted in the failure of Truman to make any progress. The framing of health reform by opposition effectively targeted the vulnerability of America to the expansion of big government and the increasing fear of the spread of communism. Reasons as to why Clinton's plan failed Just as in the case of Roosevelt’s and Truman’s plans, Clinton’s plan failed due to heavy opposition of the plan from conservatives, libertarians, and the health insurance industry. In 1993, President Bill Clinton's administration proposed a significant government-run health care reform package. Clinton had mentioned various socialized health care schemes in the 1992 election and despite prohibitions on nepotism set up a task force headed by First Lady Hillary Rodham Clinton, to come up with an ample plan to enforce universal socialized health care on all Americans (Estrich, 2005).  Democrats, instead of uniting behind the President's original proposal, offered a number of competing plans of their own. As the mid-term elections approached, the plan was defeated because it was overly bureaucratic and restrictive of patient choice. The effort to bring about rejection of the legislation included minimal advertising criticizing the plan, including the famous Harry and Louise ad, which depicted a middle-class couple despairing over the plan's bureaucratic nature.   The Clinton plan anticipated opposition from small-business owners and limited their obligations under an approach that the Chamber of Commerce had suggested, but it was to no avail. The press reported that employers would have to pay 80% of premiums; few small employers understood that this obligation was limited to a share of payroll, ranging from 3.2 to 7.9%, depending on the size and average wage of a firm. In fact, most small businesses that currently insure would have experienced a significant decline in cost under the Clinton plan (Longman, 2007).  As in other areas, the plan's complexity impeded the ability to communicate it, but the misunderstandings may have made little difference. The lack of trust in the president and the government undermined every attempt to adjust the proposal to make it acceptable. Clinton administration's greatest mistake was excessive ambition. The plan attempted simultaneously to secure universal coverage, regulate the private insurance market, change health care financing through an employer mandate, control costs to levels enforced by a national health board, and transform the delivery system through managed care. Any one of these goals alone would have been difficult to achieve, and although there is a substantive rationale for taking all of them on at once, it was a politically treacherous task. The Clinton administration underestimated the opposition and overestimated the support for reform. The administration failed to mobilize any organized constituency to counter the attacks, and groups they had counted on as allies, such as big business, disappointed them. Congressional Democrats were divided and rather than endorsing the Clinton plan, they pushed their own favored solutions. Why Obama's plan (ACA 2010) succeed in getting approved  Like Clinton, Obama came into office with reforming the nation's health care system as one of his top priorities. Affordable Care Act (ACA) is a United States federal statute signed into law by President Barrack Obama on March 23, 2010. Recognizing that an estimated 47 million Americans remain without health care coverage and that the continued rapidly rising cost of health care may cause millions of others to lose their existing health care benefits in the future, healthcare reform became a major objective of the 111th Congress and White House.  On March 23, 2010 President Obama signed H.R. 3590, the Affordable Care Act into law (Hamby and Alonzo, 1972). Although the ACA was signed by President Obama, majority of the states, and numerous organizations and individual persons, have filed actions in federal court challenging the constitutionality of ACA, making it difficult for the ACA 2011 to survive the legal and political challenges and remain law in 2014  (Sidak, 1993).  Several other challenges were dismissed on technical grounds such as jurisdiction and plaintiffs lacking standing. The Supreme Court may review the matter at the end of 2011. The only part of the law to that has been challenged within appeals courts with some success has been the individual mandate to purchase health insurance. Public opinion supported healthcare reform proposals in 2008, but turned negative when the plan changed in 2009, and remains opposed to the final version that was signed in 2010. Organizations and lawmakers who opposed the passage of the bill threatened to take legal action against it upon its passage and several court challenges are currently at various stages of development. The targets of the threatened lawsuits were several key provisions of the bill. Some claimed that fining individuals for failing to buy insurance is not within the scope of Congress taxing powers. Conclusion Based on the above discussion, it is clear that United States has debated the merits of universal health care since the 1912 election. Whenever the issue has been brought up, the politicians have been smacked down by public opinion. Even Franklin Roosevelt at the height of his power and political skill failed to pass a nationalized health care plan. Today, both factors are at work. Voters are stewing and the left seems to be on the verge of killing national health care. References Bok, D. (1994). Political Leadership in the Great Health Care Debate of 1993-1994. Oxford: Oxford University Press. Brint, S., & Karabel, J. (2009).The Diverted Dream: Community colleges and the promise of educational opportunity in America. Oxford: Oxford University Press. Christensen, H., Clayton, H., Jason, M., Grossman, M., Jerome. (2008). The Innovator's Prescription, New York: McGraw Hill. Estrich, S. (2005). The Case for Hillary Clinton. New York: HarperCollins. Hamby, Alonzo L. (1972). The Vital Center, the Fair Deal, and the Quest for a Liberal Political Economy. New York: Macmillan Publishers Longman, P. (2007). Best Care Anywhere: Why VA Health Care Is Better Than Yours. New York: PoliPointPress.  Mitchell, D. (2002) Impeding Earl Warren: California's Health Insurance Plan that Wasn't and What Might Have Been. Oxford: Oxford University Press.  Sidak, J (1993). Amicus Brief of J. Gregory Sidak in Association of American Physicians & Surgeons v. Hillary Rodham Clinton. A journal on. Social Science Research Network. New York: Macmillan Publishers. Read More