Affordable Care Act - Essay Example

College: Affordable Care Act Attempts to restructure the health care system to necessitate accessibility and affordability of health care services through enactment of all inclusive policies in the United States date back to the early 20th century1. During president Theodore Rosevelt’s term, the progressive party tried to initiate a national health insurance program unsuccessfully. The Medicare and Medicaid programs were enacted under, president Johnsons administration, in 1965. Medicare provides health care services for people above the age of 65 years, those with disabilities and those suffering from terminal illness2. On the other hand, Medicaid is funded by the state government to necessitate the provision of medical services to low income earners. In the history of the United States, efforts to implement universal health care policy have been stalled by both political factors from 1912 until the achievement of an Affordable Security Act that is aimed at providing affordable care to low income earners. Medicare and Medicaid programs have their roots in medical programs introduced in Germany and Britain in 1883 and 1911 respectively3. In 1916, the American Association of Labor Legislation organized a movement in an effort to enact a compulsory health insurance policy for all workers. The objective of the program was to cover for medical bills for sick workers as well as take care of cash compensations4. Upon the defeat of Theodore Roosevelt who was in support of the health card reforms in 1912, the decentralized government and American Medical Association opposition pushed the rejection of the bill5. The bill was defeated in different states under the argument it had costly social consequences and that Americans had efficient medical cover from their own savings and private insurers. Following several publications on the high cost of health care between the 1920s and 1930, and seeing the need for a national insurance program, president Franklin Roosevelt incorporated a national health program in the Social Security law in 1935. The program was developed during the period of great depression because poverty levels among the citizens was more than 50%. The aim of the Act was to alleviate the difficulties faced by Americans namely: old age, unemployment, poverty and orphans6. President Harry Truman endorsed the enactment of a National Health Care program in 1946. However, the issue was discussed and failed because of opposition from private insurance companies and a strong opposition by the congress. In 1951, most people in the United States were enrolled in the private insurance companies and used the coverage for their health care needs7. To garner support for the federal health care bill, its policies were addressed to meet the needs of the elderly because they were the high risk population and in some way were derailing the profitability of the private sector8. The private insurers felt that insuring the elderly population was not as profitable as insuring the young generation. Moreover, the elderly felt that the government proposition was much better and beneficial to them. However, there were strong opposition from private insurers and the post war climate was not good enough to support social reforms in the country. The Kerr-Mills bill was adopted and enacted in different states in 1960 to enable the government to channel funds towards helping the elderly who were considered needy according to the state evaluations. However, the bill could not cater to all the health care needs of the elderly and as a result president Kennedy initiated the creation of the Medicare bill. The bill was meant to cover for the health care costs of the elderly but because of a lack of support by the congress and economic recession, enactment of the bill was postponed9. In 1964, president Johnson prioritized the need for health care reforms and following the increase in medical expenses and economic recession, the bill received overwhelming support from the public10. Congress came up with three options to address the national health care problem that included Medicare to provide a federally funded program to cover the health care needs of the elderly, the Elder Care Bill 1964, was an expansion of Kerr-Mills program aimed at covering drug expenses and an insurance program funded jointly by beneficiaries and the government to cover hospital costs. The final bill that was passed in 1965 contained Medicare and the insurance program and was signed into law under the Social Security Act11. In 1972, the Medicare bill was reevaluated to include people under the age of 65 living with permanent disabilities and those with terminal illness. In an effort to reduce health care costs, a payment system for diagnosis of infections was introduced in 1983. A certain amount was to be deposited with health institutions for the diagnosis of the specified infections irrespective of the actual cost of the medical process12. In this case, the hospital either made a loss or profit depending on the amounts deposited and the nature of the diagnosis patients sought for. Upon evaluation, since 1992, the Medicare program allows physicians to charge for their services depending on predetermined scales for specific procedures and interventions13. On February 6 1974, the united states president Nixon proposed the enactment of a legislation to finance national health care needs of the citizens. A Comprehensive Health Insurance Act (CHIP) was introduced to provide insurance coverage for more than 25 million uninsured Americans and counter for health care costs that had grown by 20% in the previous three decades14. The program's objective was to provide employee insurance and to provide medical coverage as well as improved health care for low income earners15. Health insurance was aimed at creating an employer-employee programs and enhancing provision of government subsidies to the self-employed policy holders. The program was aimed at providing equal benefits to all Americans as well as providing coverage for people with mental illnesses, addictions and those receiving health care from their homes. The bill was passed by Congress but could not go beyond the political wave of the Watergate scandal16. This was a political scandal whereby Democratic National Committee offices were broken into and accusations of Nixon’s administration involvement were raised. On august 9, 1974, Nixon resigned as this led to rejection of his proposed policies by the congress17. The COBRA legislation was enacted in 1993 during the Bill Clinton’s administration as a Health Care Security Act in 1993. The Act required adoption of a national health care program integrating both private and public stakeholders and required government regulation. The policy had three options, namely: a low cost sharing program, a higher cost sharing program and a combination of the aforementioned options. The plan was targeted at allowing all Americans to be given health insurance cards and have the opportunity to choose their insurance providers. The Health Care Security Act was proposed in 1993, to provide a universal insurance scheme and to counter private insurer competition. Contrary to COBRA, the scheme was aimed at providing government subsided services at low quality, improved quality and for the benefit of all. The national health board was expected to form regional alliances to ensure that Americans in different localities had access to medical services18. The Clinton’s proposal received strong opposition from libertarians, conservatives and the health industry. Competing plans were raised by the opposition and in 1994, rejection of the bill led to then diminishing of Clinton’s popularity. In 1998, the sustainable growth rate program was introduced in the medical program to control medical costs. According to the sustainable growth program, physicians annual expenditures are set according to the country's GDP and if their spending surpasses the set limit, cuts on their reimbursement are initiated. The program was part of Balanced Budget Act 1997, and its objective was to tie doctors charge rates to medical costs, geographic location, GDP and inflation. The program replaced the Medicare Volume Performance Standard (MVPS) that was initially used to control medical costs.19 Upon the failure of the Health Security Act, in 2008 presidential candidate Obama promised to initiate health care reforms upon the assumption of office20. In president Obama’s 2010 budget proposal, he requested initiation of changes in income tax deductions so that $600 billion could be allocated to health care reform legislation. In the same year, democrats in the congress house tabled a bill that required all businesses to provide insurance coverage to their employees and penalties for failure to comply21. In July 2009, a bill requiring businesses employing more than 25 workers to provide them with insurance coverage was enacted by the Health Committee22. In September 2009, president Obama increased his estimates in health care costs for the health reforms in the next decade to $900 billion23. In addition, the president expressed his devotion to reduce health care costs and stated that measures would be put in place to initiate reforms in the health care sector. The medical fraternity made pleas to the federal government to focus on medical liability in their health care legislation. The Baucus plan was proposed by Senator Max Baucus to reduce health care costs as well as reduce federal budget spending. Tax on Cadillac health plans would be increased and organizations with more than 50 employees were expected to compensate the government for the employees who bought private insurance policies. In October, the senate approved the Baucus plan that was aimed at reducing health care expenditures, hence reducing federal spending24 On November 2009, the bill was passed into law by the congress to provide coverage for the uninsured and eliminate insurance policies that excluded individuals with disabilities. In December, the bill was modified to allow individuals between 55 and 64 to access the Medicare program25. Moreover, the office of personnel management was given the mandate to negotiate with insurance service providers to provide health care services. However, the efforts to achieve health care reforms were stalled by national issues like unemployment and the economy. This was changed by a meeting held at the Blair house where president Obama urged the congress to consolidate their efforts and pass the health care legislation into law. The proposed bill was expected to cost $940 billion in the next decade in the process of implementing the projected reforms. The Patient Protection and Affordable Care Act were passed into law on March 23, and it was signed it into law. The Obama health care plan has been greatly influenced by other acts and historical political factors in the United States. The plan was aimed at providing insurance cover to millions who are were unable to afford the policies that were not universal. Despite its perceived public interest, the bill faced political opposition and president Obama had to talk to the congress to put their political differences aside and support the bill26. The projected health care spending is expected to rise over time and for sustainability, the Obama care bill requires reforms. If the bill is not amended in the near future, it might raise political temperatures because it is expensive and at the detriment of the other aspects of the economy27. In conclusion, from Roosevelts enactment of Medicare and Medicaid programs, the health care and medical bills have undergone numerous reforms with tremendous influences from the economic and political systems of the country. Since the start of the 20th century, leaders have had the drive to provide health care services to all citizens in the United States. The health care system has achieved reforms and the government is able to provide quality and accessible health care to citizens from different walk of life. Bibliography American Association of Labor Legislation, (1916). “Health insurance—tentative draft of an act,” American Labor Legislation Review, vol. 6, pp. 239–268, American Association of Labor Legislation, (1916). “Health insurance—tentative draft of an act,” American Labor Legislation Review, vol. 6, pp. 239–268 Berkowitz, Elizabeth, (2008), Medicare and Medicaid: The past as prologue. Health Care Financ Rev. 29(3):81-93 Bryan Spear, (2012), The Comprehensive Health Insurance Act, http://www.ehow.com/about_7269487_comprehensive-health-insurance-act.html, Retrieved on 10th May 2013. Buddetti, Peter, (2004), 10 years beyond the Health Security Act's failure: Subsequent developments and persistent problems. JAMA, 292 (16): 2000-2006 Corning Paul, (1969), The evolution of Medicare: From idea into law. Washington, DC: U.S. Social Security Administration, Office of Research and Statistics. Gale, Terry, (2012), Key milestones in Medicare and Medicaid history, selected years: 1965-2003. Health Care Financ Rev. 2005-2006;27(2):1-4. Kutler Simons, (1997), Abuse of Power, page 247. Simon & Schuster. Truman, Harry S. (April 12, 1949), (2011), "Letter from Harry S. Truman to Ben Turoff". College Park, Md.: National Archives and Records Administration. Retrieved December 2, Read More