United States Healthcare Reform Bill of 2001 - Literature review Example

Healthcare Policy Analysis – US Healthcare Reform Bill, 2001 Introduction The history of healthcare policies and reforms in United States could be traced back to several decades. The issue of healthcare reform remained the central point of heated debates and subject of political and social discussions almost since the beginning of the 20th century (Igel, 2008). From time to time different policies, plans and reforms have been introduced into the US healthcare system with the intention of providing adequate and efficient healthcare facilities and services to the American citizens. Delineation and Overview of the Policy under Analysis An important landmark in the US healthcare policy and reform history has been achieved with the passage of the Patient Protection and Affordable Care Act (PPACA) that was signed on March 2010. It was amended by the Health Care Education Reconciliation Act of 2001 that became a law on 30th of March, 2010. The bill was propositioned by the President Obama during the US presidential elections in 2008. He stressed upon the need of making some major reforms into the American healthcare system so that every citizen could get due healthcare facilities (Trumbull, 2010). The House of Representative and Senate of United States passed the health care reform bill in 2010. The core purpose of the bill is to provide policy lines to the private healthcare companies and to find out the ways through which it would be possible to provide all the residents of America with quality healthcare services in exchange for affordable expenses (Grier, 2010). The passage of this law has been widely regarded as an importance victory of Obama government that is expected to make healthcare facilities affordable for all the Americans as it expands the health coverage (http://whitehouse.gov). The essay aims to concisely describe the history of healthcare policy making in United Stated by identifying major bills and acts implemented so far and discuss in detail the Healthcare reform bill 2010 to explain the major issues and areas associated with the bill. Historical Analysis The early steps in the area of healthcare reforms include the passage of Bill for the Benefit of the Indigent Insane in 1854 at federal level. The bill established asylum for the indigent insane and for the disable people like blinds, deaf and dumb with the help of the federal land grants given to the states. Dorothea Dix, a social activist proposed this bill that was passed by both the Houses of Congress but the President Franklin Pierce vetoed the bill and argues that state is responsible for social welfare and not the federal government has the responsibility to provide fund for this purpose. His step paved the way for federal non participation in the social welfare that remained in practice for over seventy years. After that, there were several important policies and plans implemented during different time period that induced different healthcare guidelines in to American healthcare system. In 1933, Franklin Roosevelt initiated the task for drafting propositions for socials security legislations in which the publically funded healthcare programs could also be included. American medical Association, state and the local affiliates of AMA opposed the propositions after which these were removed from the bill. After Second World War U.S President Harry Truman also attempted to foster universal healthcare as part of his Fair Deal but he also had to stop his plan due to the strong waves of opposition against his propositions (Blendon et al, 2008). In 1946, some important healthcare policies were passed including the National Mental Health Act, Hospital Survey and construction act or Hill Burton Act. Another important development took place in 1965 when the President Lyndon Johnson enacted the legislation and for the first time introduced Medicare. It was supposed to cover both the hospital as well as general medical insurance for the senior citizens funded by the Federal employment tax. It provided the services throughout the working life of the retirees. Medicare health programs also pave the way for the government to partially fund healthcare programs for the people living at and below the poverty levels. Another important development in the US healthcare system occurred in 1985 with the passage of the Consolidation Omnibus Budget Reconciliation Act of 1985 (COBRA). It proposed some amendments to the Employment Retirement Income Security Act (ERISA) passed in 1974. COBRA enables some employees that they could continue their health insurance coverage even after leaving their employment. It was an important act that worked for providing secure healthcare insurance to the people retired or going to be retiring in coming years. In 1997, the United State Children Health Insurance Program SCHIP was introduced by the federal government. The program was basically aims at providing health insurance services to the children below belonging to the families that were living at or below the poverty line. It was an important development because it showed the care and concern of the government to provide better healthcare services to the people and children who could not afford medical insurance and other heavy medical expenses (Igel, 2008). The year 2010 possesses great importance in the history of healthcare policy making in United States because in this year a very important healthcare policy bill was presented and implemented by the US government. The bill intends to bring improvement in the healthcare system of the country by enacting certain reforms and new rules. The bill sets the minimum ratio of direct healthcare spending upon the premium income. The bill was also criticized on the grounds that it raised the burden of taxes upon the common people. At the same time, the issue of illegal immigrants and abortion funds also became focal points of debates among the critics and general public (McDonough, 2011). Healthcare Reform Bill – Social Analysis Soon after its introduction and passage the law became centre of debates across the country. The passage of the law was also opposed by the attorney generals of eleven states. The matters like death panel, abortion and illegal immigrant healthcare facilities were specifically debated by the experts and people (Smith, 2010). The enacting of abortion coverage tax is widely criticised because people think that it will support the federal funded abortions and in this way abortions would be encouraged in the country (Malhotra, 2010). The inclusion of the illegal immigrant in the receivers of the healthcare facilities is also an important area of concern for the people. The bill expanded the healthcare coverage and despite the explanation of President it has been widely believed that the law allows illegal immigrant an access to healthcare facilities at the expense of other citizens of the country. The tax payer funded healthcare intends to cover the non-taxpaying groups that ultimately evolved as major area of concern for the people (Galewitz, 2010). Economic Analysis The bill consists of $940 to be spent upon healthcare over ten years. The bill proposed that the healthcare would be expanded to 32 million American who were not insured before the bill. According to the bill, the uninsured and self-employed Americans would also be able to purchase insurance with the help of state based exchanges where subsidies are available to the individuals and families having income level between 133 to 400 per cent of poverty level. The bill also proposed the establishment of separate exchanges for the small businesses for coverage purchase (Malhotra, 2010). There are several important reforms induced through the healthcare bill. The bill expanded the Medicaid by including 133 percent of the federal poverty level and clarifies that the illegal immigrants would not be eligible for Medicaid neither they could but insurance plan from the exchanges even if they are able to make complete payments. It was also decided that the individuals have to pay for the abortion coverage and they have to make two separate payments. The insurance companies were directed that after six month from enactment they could not deny children coverage based on pre-existing conditions. The rich people of the country have been obliged with high tax rates and it is also said that the law outcomes would help the government in reducing the budget deficit within next ten years. Under the law, the private insurance premium funds have been separated from tax payer funds. In this way people are no more required to pay in account for abortion coverage. The law invited heated debates and controversies because there were several aspects of the bill that were found controversial by the experts and general public. Political Analysis There are several important provision introduced by the healthcare reform bill PPACA. The law calls for the accountability of health care insurers that ultimately would support the economy, federal and family budgets of the country. The law also proposed largest middle class tax cut with the intention of reducing the premium healthcare cost of millions families that were not included in the healthcare coverage before this bill. The law assures that 32 million Americans would be able to afford healthcare services that they were not able to access before due to high cost of healthcare. The bill was passed after prolong heated debate in Washington and all over the country. The provisions of the bill are surrounded by the criticism and controversies on several grounds. The Republicans and attorneys general in 11 states have expressed their dissatisfactions regarding the bill that shows the bill has failed to meet the expectations of people and experts of different political thoughts and social groups. There are certain important controversial issues that have become the central point of debate among the supporters and opponents of the bill like issue of death panel, abortion and illegal immigrants’ healthcare facilities (Smith, 2010). Policy/Program Evaluation The bill is widely criticized on the grounds that it rations and denies the elderly and disabled by a bureaucratic panel that has been given the authority to decide about the health of the patient. This panel is given the name of death panel and people view it a serious threat to the public health and safety (Smith, 2010). However, the supporting side claims that the panel is not intended to make the healthcare intricate but it actually aims to promote the healthcare planning consultation so that the doctors and patients could be motivated to discuss and choose from the available treatment options (http://whitehouse.gov). Another controversial issue is the enacting of taxes for abortion coverage. It is widely argued that the bill actually leads towards the federally funded abortions and ultimately it encourages abortions. Though President Obama has clearly stated in his debates that the bill is not intended to fund abortion but the experts widely view the bill a supportive instrument that allows abortion at federal expenses. The bill expands the insurance coverage to 32 million Americans that were not illegible to receive healthcare services earlier and in this way, the illegal immigrants also likely to be covered by the bill. The opponents of the bill are very much concerned about the fact that the non-tax payers should not be provided with the opportunity to avail the facilities provided under the taxpayer-funded health care plan (McDonough, 2011). Though the President spoke about the issue and inform that illegal immigrants are not going to receive these facilities but in the bill, it is not stated that the illegal immigrants are not covered by the new provisions of the bill (Galewitz, 2010). Proposal, Need to Change – Conclusion The healthcare sector in United States has witnessed several phases of reforms and policies from time to time in form of different plans, acts and laws. The history of healthcare reforms is very old in the country and the laws and plans to manage the healthcare services have also received the criticism and controversies on different issues. Likewise, the healthcare reform bill 2010 also came along with strong wave of criticism and controversies that has considerably damaged the image of bill and gives the impression that the bill in not in real interest of the Americans. There are some critical issues that have invited critical debates against the bill and opponents have expressed their reservations against certain areas of the bill. Hence, it is unveiled from the above discussion that the healthcare reform bill 2010 possesses great importance for the healthcare sector of United States however, it is also important that the government should adequately address the issues and concerns of the people related with the bill. References Blendon, Robert J.; Altman, Drew E.; Benson, John M. (2008). "Voters and health reform in the 2008 presidential election". New England Journal of Medicine, 359 (19): 2050–2061 Igel, L. (2008). "The history of health care as a campaign issue", Physician Executive 34 (3): 12–15 Grier, P. (2010), Health care reform bill 101: How long will reform take? Christian Science Monitor; 3/20/2010, pN.PAG, 1p Galewitz, P. (2010), Health reform and you: A new guide, Kaiser Health News, Today at MSNBC.com, Retrieved online from: http://today.msnbc.msn.com/id/34609984/ns/health-health_care/ on December, 1st, 2010 McDonough, J.E. (2011). Inside National Health Reform, US: University of California Press Malhotra, U. (2010). Solving the American Healthcare Crisis, New York: iUniverse Smith, D. (2010). Health reform faces big test with implementation, Reuters, Mar 29, 2010, Retrieved online from: http://www.reuters.com/article/idUSTRE62S3L620100329 on December, 1st, 2010 Trumbull, Mark (March 23, 2010). "Obama signs health care bill: Who wont be covered?” Christian Science Monitor. White House (2009), Health Reforms. Retrieved online from: http://www.whitehouse.gov/Issues/health-Care on December, 1st, 2010 Read More