Revolution of the American Health Care Industry - Research Paper Example

Revolution of the American Health Care Industry al Affiliation Impact, Aspects, and Characteristics of 18th and 19th CenturyAmerican Health Care America has come a long way in terms of health care and medicine reforms. Medical services have undergone significant revolution from the preindustrial period, to the postindustrial period, and now to the managed care period. During the 18th and 19th centuries, which comprised of the pre-industrial periods, American medicine and healthcare was characterized by underdeveloped, deplorable, and primitive conditions. The rest of Europe was ahead of America in the pre-industrial era. However, America resolved to reform its healthcare system through the legislature and adoption of new technologies (Ehrenreich & English, 2010). This concerted initiative led to the era of managed care, beginning from the late 20th century. The managed care movement contributed significantly to the contemporary American health care industry. Presently, some characteristics of the managed care operations resemble the early years when managed care emerged and the later years of the second half of the 19th century. Besides, the probability of the Congress passing legislation reminiscent of the HMO Act of 1973 is high (Zinner & Loughlin, 2009)... Although the 18th and 19th century health care and medical systems of America were primitive and deplorable, such systems contributed significantly to today’s health care and medicine in the United States. American Health Care and Medicine of the 18th & 19th Centuries America has undergone six eras of healthcare reforms namely the charitable era, government era, consumerism era, educational era, insurance era, and the managed care era. The health care of the United States began evolving even before the America was founded, particularly the charitable era (Kongstvedt, 2009). During the charitable era, healthcare institutions such as hospitals and dispensaries were non-existent. Most of the patients depended on well-wishers and charity organizations to take care of their medical needs (Sultz, & Young, 2009). The physicians used primitive medical procedures in treating patients and they often offered free services. Then came the dictation era during which the United States introduced medical education as a way of equipping the health physicians with the requisite medical skills. America underwent major revolution during this era in terms of the institutionalization of the health care industry Ehrenreich, B., & English, D. (2010).  Once Abraham Flexner introduced of medical education in 1910, the subsequent period saw the introduction of various health care insurance schemes. However, organizations rather than the federal government managed such insurance schemes. The federal government had provided leeway for organizations and health care insurers to operate. In essence, such organizations operated without any plan and the dispensaries available faced many challenges along the way (Sultz, & Young, 2009). Afterwards, the government took control of the healthcare industry when it carried out a number of reforms in the sector, including the introduction of Medicaid and Medicare in 1965, and the enactment of the HMO Act of 1973. From the late 20the century onwards, the managed care movement advocated for the reduction of the cost of providing health care services in the United Sates. In addition, managed healthcare has seen the improvement of the quality of health care services in America (Smith & Moore, 2010).  Contributions of the Managed Care Movement in America Today Currently, the United States boasts as one of the few countries in the world with the highest attainable health care standards because of constant improvement of some features. Considering the accessibility and affordability of health care services in America, no one can doubt the long revolutionary history of America’s health care industry, dating back to the 18th century ((Kongstvedt, 2009). Managed care has made significant contributions to the American health care industry in terms of prepaid group plans, contract practice, and group practice. Compared to the previous eras where consumer and professional dominance were commonplace, managed care has ensured government dominance in the critical areas of the American health care industry (Stack, 2015). Contract Practice Managed care in the contemporary healthcare industry has ensured availability of physicians through contract practice. Contract practice is a scheme whereby the federal government the federal government ensures that all public health care professionals work under guaranteed terms and conditions. Managed care got rid of the ‘capitation,’ which was an unguaranteed contract jobs for health professionals. Managed care, through the American medical Association (AMA) has ensured fair or equivalent terms for health care professionals who practice in the remote areas. In addition, managed care has contributed immensely towards the harmonization of the remuneration of public health workers in regards to those of the private health practitioners (Barr, 2002).  Although medical practice in the preindustrial era was disorderly, subsequent reformations have had significant impact in the manner in which the profession is practiced today. One of the characteristics of the 18th and 19th century American health care system that has changed is the practice of the profession. In the pre-industrial age, people did not consider medicine as a profession because it was practiced on charitable basis. However, managed care has given the profession the reputation that it deserves. Americans doctors, nurses, and health physicians are qualified specialists operating under professional terms. Besides, the managing care movement led to the introduction of for-profit private health entities. Prepaid Group Plans This scheme of managed care involved advocating for people to register in certain prepaid group plan and receive the medical services at a capitated fee. At first, the American Medical Association (AMA) opposed the plan but with time, the reality dawned on many of the critics of the critics concerning the efficiency of the plan (Gray, Lowery, & Benz, 2013). Prepaid group plans were famous only at some urban settings but through managed care movement, the plan spread across the United States. Today, the United States citizen can attest to the fact that the plan has benefitted many people, especially the rural folks who cannot control the medical bills (Barr, 2002). Health Maintenance Organization (HMO) Act of 1973 The federal government’s expenditure on health care services rose rapidly after the introduction of Medicaid and Medicare in 1965. By the time, the government was cushioning over 35 million Americans from their medical bills. This unprecedented rise in health acre expenditure by the government necessitated radical reforms in the industry. Under President Abraham Nixon’s Watch, the Congress enacted the Health Maintenance Organization (HMO) Act in 1973. The primary objective of the legislation piece was to promote more Health Maintenance Organizations (HMOs) to play their respective roles in American health care industry. The contribution of the HMO Act was evident in that health care services became more affordable because of the prepaid schemes. The Act sought to eliminate the pay-for-services trend that had exploded government spending of health care services. Today, one can acknowledge that such managed care schemes as Affordable Care Act was derived from managed care organizations (MCO) like Health Maintenance Organizations (HMOs) (Sultz, & Young, 2009). Group practice The movement of managing care led to the division of labor in the health care institutions. Initially, only the physicians looked into the affairs of health care centers. However, the corporatization of the health care industry, of which managing care was a component, opened the way for other career areas to exist within health care institutions. Such professionals as managers, technicians, and accountants came to occupy various departments of hospitals and dispensaries only after the federal government allowed managing care to be effective. Although group practice faced significant resistance at it incipient stages, the cynics realized its cost sharing advantages and embraced it wholly (Burnham, 2015).  Tracing Contemporary Managed Care Operations to the Late 19th Century Although contemporary managed care characteristics in the United States have taken new dimensions in terms of the organizations involved and the impacts on American citizenry, some aspects of such managed care techniques are age-old. In fact, the Northern Pacific Railroad Beneficial Association initiated contract practice before the practice became popular. The association offered direct medical aid to its employees in 1882. No other company had offered any form of health care cover at the time because America was still undergoing major reforms in its health care sector. Such companies offered attracting remunerations to physicians willing to work in remote areas where their employees were. Today, most company provides their employees with medical cover, especially the companies whose employees work in hazardous conditions such as factories, airlines, and drivers. Besides, the federal and county governments offer medical insurance cover to such strategic employees as the police, military people, and its top diplomats (Yesalis, Politzer, & Holt, 2012).  Group practice is a form of managing care technique that can be traced back to the 19the century although it is commonplace today. The Mayo Clinic, which was established in 1887, was a classic example of how to implement group practice within a healthcare institution. The Minnesota-based clinic incorporated specialists from various fields to undertake various tasks in their corresponding areas of specialization. However, the practice faced a number of challenges at the time in that the solo practitioners deemed the practice as a threat and they opposed it. Furthermore, those involved in general practiced had the perception that group practice would soon dilute the relevance and quality of general practice. Despite several challenges along the way, group practice has been resilient and it is the hallmark of operation in all medical institutions in the United States (Burnham, 2015).  The late 19th century was the medical education period when America carried out a number of medical reforms including licensing medical institutions and practitioners. This was the period when organized medicine materialized. In the 1870s, the Congress enacted the Medical Practices Act that necessitated the training and licensing of all medical practitioners. The contemporary managed care organizations offer their aid only in recognized health care institutions in America (DeZee et al., 2012). Although the physicians practiced their craft in autonomy, the late 19th century health care institutions had some level of organizations comparable to the modern day prototype. Perhaps the formation of the American Medical Association (AMA) in 1847 was the motivating factor towards the transformation of the health care industry in terms of organization (Johnson, Chaudhry, & Federation of State Medical Boards of the United States, 2012).  Likelihood of Passing Legislation Similar to HMO Act (1973) The likelihood of the Congress passing legislation similar to the Health Maintenance Organization (HMO) of 1973 is significantly high. It is so considering the upheavals surrounding the Affordable Care Act. The primary objective of the HMO Act (1973) was to promote the Health Maintenance Organizations (HMOs) to take up active roles in the management of medical care (Ferguson, 2014). The federal government intended to replace the commonplace fee-for-service with the prepaid medical care. The effect of the implementation of the scheme was competition among the providers of health care plans, leading to efficiency in the entire health care industry in America. The law was good but it still faced opposition from some employers. However, the adoption of the law brought many benefits including further enactments that would sanitize the health care industry in the United States (Green & Rowell, 2015).  One of the health care legislations that were enacted in America recently was the Affordable Care Act (ObamaCare). The passing of the legislation was a depiction that new laws could still be passed to reform the health care sector. While President Abraham Nixon signed a law in 1973 that put the HMOs in charge, Obama signed a law in 2010 that put the consumers of health care services in charge. The political and economic climate of the United States has been more turbulent since Obama took over from Bush. Significant sections of Americans oppose the Affordable Care Act and the U.S. elections are on the eve. It implies that any of the presidential candidates who oppose ObamaCare will most likely bring in another health care legislation for enactment if elected (Green & Rowell, 2015).  In summary, America has undergone tremendous transformations in its health care industry over the past four centuries. The transformations have been in terms of the treatment plans, organization of health institutions, and quality of health care. Fundamentally, the 18th and 19th centuries were the major periods in which America commenced basic reforms in health care. However, some aspects of American healthcare system remained intact through preindustrial era, postindustrial era, to the modern era (Zinner & Loughlin, 2009). Indeed, some features of American medicine and health care of the 18th & 19th centuries had significant influence on modern day U.S. health care system. In essence, the managed care movement made critical contributions to the United States health care industry and some of those managed care techniques can be traced back to the late 19th century. Although the HMO Act of 1973 was a good law for Americans, its significant provisions could easily be amended or enacted today, given the hot political and economic climate in America (Green & Rowell, 2015; Jacobs & Skocpol, 2012). References Barr, D. A. (2002). Introduction to U.S. health policy: The organization, financing, and delivery of health care in America. San Francisco: Benjamin Cummings. Burnham, J. C. (2015). Health care in America: A history. Baltimore: Johns Hopkins University Press. DeZee, K. J., Artino, A. R., Elnicki, D. M., Hemmer, P. A., & Durning, S. J. (2012). Medical education in the United States of America. Medical Teacher, 34(7), 521-525. doi:10.3109/0142159X.2012.668248 Ehrenreich, B., & English, D. (2010). Witches, midwives, & nurses: A history of women healers. 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