The US Health Care System and Policies - Research Paper Example

?Health Care System and Policies Like the rest of the global community, health care is indispensable for American nation. Its importance is evident in the political discourse of its constituents as people would make it as major social services agenda during national election and in deciding whom to vote. This paper will detail the health services policies of United States of America in the last 50 years. Gill (2012) defines healthcare system as a mix of public and private programs that deals with health care insurance that is currently advocated by the present administration to reduce fees and expand its services to include those who have less income. Below are significant highlights of healthcare policies in America that are sequenced in a timeline: a. 1798 – Legislatures passed the act for the establishment of federal network of hospitals to serve the sick and disabled seaman or merchant seaman. This is considered as the foundation of the current US Public Health Service (US National Library of Medicine, 2012); b. 1862 – Former President Abraham Lincoln appointed Charles M. Wetherill, a chemist, to head the Department of Agriculture and established the Bureau of Chemistry which became the foundation of Food and Drug Administration (FDA) (US National Library of Medicine, 2012); c. 1871 - US government created the office of Surgeon General (formerly known as Supervising Surgeon) for the Marine Hospital Service (US National Library of Medicine, 2012); d. 1878 – Legislator passed the National Quarantine Act to focus on quarantine functions (US National Library of Medicine, 2012); e. 1887- The federal government established and opened a one-room laboratory at Staten Island tasked to conduct extensive study on diseases and inspired the creation of National Institute of Health (US National Library of Medicine, 2012); f. 1891 - A health-sensitive policy was legislated to medically examine immigrants on their health conditions and status. This task was originally designated to Marine Hospital Service (US National Library of Medicine, 2012); g. 1902 - The Marine Hospital Service was transformed into Public Health and Marine Hospital Service due to the expanding services of public health. The hospital’s name was changed in 1912 as Public Health Service (US National Library of Medicine, 2012); h. 1906 – The Pure Food and Drugs Act was legislated to regulate the safety of medicines made and sold by pharmaceutical industry (US National Library of Medicine, 2012); i. 1912 – Former President Theodore Roosevelt wanted the establishment of Children’s Bureau to deal with issues on child exploitation (US National Library of Medicine, 2012); j. 1921 – The federal government created the Bureau of India Affairs Health Division which became the foundation in the creation of Indian Health Service (US National Library of Medicine, 2012); k. 1930 - The government institutionalized the National Institutes of Health as an independent office from Public Health Service’s Hygienic Laboratory (US National Library of Medicine, 2012); l. 1935 – Legislators passed the Social Security Act (US National Library of Medicine, 2012); m. 1938 – The Federal Food Drug and Cosmetic law was legislated (US National Library of Medicine, 2012); n. 1939 - Federal program and activities on health, education and health insurance were consolidated when Federal Security Agency was established (US National Library of Medicine, 2012); o. 1946 - The government institutionalized the Communicable Disease Center which became responsible on the Centres for Disease Control and Prevention (US National Library of Medicine, 2012); p. 1953 – Under the administration of former President Eisenshower, the Department of Health, Education and Welfare was established in 1953. Anent to its operational specialization, the Department of Education Organization Act was legislated to make the office totally independent. DHEW was renamed as Department of Health and Human Services officially in May 4, 1980 (US National Library of Medicine, 2012); q. 1955 – The Indian Health Services was transferred to HHS from the Department of Interior. On the same year, the government licensed the Salk polio vaccine (US National Library of Medicine, 2012); r. 1961 – This was the year when White House had its serious concern for geriatric welfare and thus, hosted a conference on aging (US National Library of Medicine, 2012); s. 1962 – The Migrant Health Act was legislated that accord services and supports for clinics serving the populace of farm workers (US National Library of Medicine, 2012); t. 1964 – This was the year when the Surgeon General has his first report on the effects or correlation of smoking and health (US National Library of Medicine, 2012); u. 1965 - The government established the Medicare and Medicaid programs for comprehensive health care. The Older American Act was also legislated to take care on the nutritional and social programs administration under HHS for the aging or under geriatric concerns (US National Library of Medicine, 2012); v. 1966 – The government created the International Smallpox Eradication program and the Community Health Center and Migrant Health Center programs were adopted as part of the integrated health care system (US National Library of Medicine, 2012); w. 1970 – American government established the National Health Service Corpse (US National Library of Medicine, 2012); x. 1971 – Legislators passed the National Cancer Act. y. 1975 – The government established the Child Support Enforcement Program (US National Library of Medicine, 2012); z. 1977 – The government established the Health Care Financing Administration was institutionalized to manage the Medicare and Medicaid independently from the Social Security Administration. The Public Health Service worked for the eradication of smallpox (US National Library of Medicine, 2012); aa. 1979 – The Department of Education Organization Act was legislated to make the DepEd an independent department. HEW became the Department of Health and Human Services (US National Library of Medicine, 2012); bb. 1980 – Funds were allocated for foster care and adoption services (US National Library of Medicine, 2012); cc. 1981 – The health experts started identification of AIDs and HIVs. IN 1985, blood test, as method of detecting HIV, was licensed (US National Library of Medicine, 2012); dd. 1984 – The National Organ Transplantation Act was signed into law (US National Library of Medicine, 2012); ee. 1988 - The JOBS program and federal support for child care was established. McKinney Act was legislated to ensure that the homeless are accorded with healthcare services (US National Library of Medicine, 2012); ff. 1989 - The Agency for Health Care Policy and Research (now named as Agency for Healthcare Research and Quality) was institutionalized. The office is assuming the extensive research works and policy advocacy on critical issues affecting health services and healthcare management (US National Library of Medicine, 2012); gg. 1990 - The Human Genome Project was created. Lawmakers passed Nutrition Labeling and Education Act which authorized food label. Meanwhile, on the same year, the Ryan White Comprehensive AIDS Resource Emergency (CARE) Act commenced delivering support for people infected with AIDS (US National Library of Medicine, 2012); hh. 1993 - The government made the Vaccines for Children Program aimed at immunizing children especially those from poor families. This 1993 Health Security Act also became a law (US National Library of Medicine, 2012); ii. 1995 - The Social Security Administration started operating independently (US National Library of Medicine, 2012); jj. 1996 - Welfare reform under the Personal Responsibility and Work Opportunity Reconciliation Act was legislated. The Health Insurance Portability and Accountability Act (HIPAA), likewise, became a law (US National Library of Medicine, 2012); kk. 1997 - The State Children's Health Insurance Program (SCHIP) was established and allowed federal states to provide health coverage for uninsured children (US National Library of Medicine, 2012); ll. 1999 - The policy on Ticket to Work and Work Incentives Improvement Act of 1999 was passed into law and enabled Americans with disabilities to work without losing their Medicaid and Medicare healthcare services. In the same year, the government’s initiative to fight bioterrorism was launched (US National Library of Medicine, 2012); mm. 2000 – This was the year when health experts publicized the human genome sequencing (US National Library of Medicine, 2012); nn. 2001 - The Centers for Medicare & Medicaid was created, replacing the Health Care Financing Administration. HHS responds to the nation’s first bioterrorism attack -- delivery of anthrax through the mail (US National Library of Medicine, 2012); oo. 2002 - Office of Public Health Emergency Preparedness was created to coordinate efforts against bioterrorism and other emergency health threats (US National Library of Medicine, 2012); pp. 2003 - The Medicare Prescription Drug Improvement and Modernization Act of 2003 were enacted; the most significant expansion of Medicare since its enactment, including a prescription drug benefit (US National Library of Medicine, 2012); qq. 2010 - The 2010 Patient Protection and Affordable Care Act (PPACA), was signed into law and putting in place the comprehensive U.S. health insurance reforms (US National Library of Medicine, 2012). The United States Centers for Medicare and Medicaid Services (CMS) revealed that in 2008 alone, the healthcare expenditures of the government reached an estimated cost of $2.34 trillion or about 16.2% of the national gross domestic products (Anderson & Squires, 2010). This is translated as $7, 681 per person. This increases posed a threat to the system because subscribers argued that they are paying insurance cost that does comprehensively cover other health plans (Anderson & Squires, 2010). The expenses also reduced the healthcare services and quality of care. It is for these causes that health care reform agenda has been continually pushed to review the 1993 Health Security Act and the 2010 Patient Protection and Affordable Care Act (PPACA) (Anderson & Squires, 2010). When President Barrack Obama assumed into office, Health Care Reform agenda was prioritized by establishing the Center for Medicare & Medicaid Innovation - (formerly known as Centers for Medicare & Medicaid Services (CMS)) to sustain the Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) by adopting payment models that could accommodate those low income families (US National Library of Medicine, 2012; Garson, 2012). The Health Affairs also reevaluated the “Chronic Conditions Account for Rise in Medicare Spending From 1987 To 2006 (US National Library of Medicine, 2012).” The government has delved into The Commonwealth Fund Health Care Reform Resources and reviewed the expenditures and budgets in partnership with the Congressional Budget Office (CBO) (US National Library of Medicine, 2012; Ubokudom, 2012). The government has likewise developed the State Legislative Tracking Database with contained all the health reform legislations and also the Health Reform Resource Center and Timeline for immediate and easy access to database on health care system concerns (US National Library of Medicine, 2012). Part of the online information that can be optimized by health information users are Health System Measurement Project of the Department of Health and Human Services (HHS) and Health Tracking Poll that tracked the public views on Affordable Care Act (US National Library of Medicine, 2012). The George Washington University focused on healthcare system has also developed a portal on National Health Reform Law and Policy Project that contain national health reform proposals and the comparative legislative analysis (US National Library of Medicine, 2012). Extensive researches were also conducted under National Academy for State Health Policy in partnership with Robert Wood Johnson Foundation (RWJF) (US National Library of Medicine, 2012). The government has also accorded grant and funds under Affordable Care Act State Health Insurance Assistance Program (SHIP) and Aging and Disability Resource Center (ADRC) with Options Counseling for Medicare-Medicaid Individuals in States with Approved Financial Alignment Models (US National Library of Medicine, 2012; Colesca & Dobrica, 2009). Other data can be accessed in AFL-CIO Health Care Reform, American Medical Association (AMA) Health Care Reform, and American Nurses Association (ANA) Health Care Form Resources (US National Library of Medicine, 2012; Colesca & Dobrica, 2009). Expert health researchers likewise developed a strategy to optimize data sourcing and management for enactment of health care reform. Some studies are supported by the Kaiser Family Foundation (KFF) specially matters pertaining to private insurance access and use (US National Library of Medicine, 2012). Academy Health, Commonwealth Fund also took part in health reform agenda and research development. Likewise, a comprehensive study was undertaken on the implications of coverage, affordability and costs of Health Insurance Provisions of the 2009 Congressional Health Reform Bills (US National Library of Medicine, 2012). There were also other in-depth research analyses by numerous institutions, all of which are contributory to continuing healthcare reform in consonance to the principles and standards laid by the National Institute for Health Care Reform, an institution that conducts policy and financing analyses for affordable healthcare (Gravelle, 2012). All of these efforts of the present regime are aimed at affording all Americans of health care as part of the preventive measures of citizens in case illnesses and the like pervade (National Conference of State Legislation, 2012, p. 1) With Obamacare policy, children are no longer discriminated to enjoy health insurance coverage and they will be considered as parents beneficiaries until they will reach the age of 26 years old. Experts bared that the healthcare reform has nationalized its system at the cost of $940 billion (NCSL, 2012), that lower a bit the national fiscal deficiency by $1.2 trillion (NCSL, 2012). This was thought of as strategic resolution to 32 million Americans who have no health insurance (NCSL, 2012). Obamacare is perceived as essential in bridging the gaps on financial resources in case of hospitalization. What is more appreciable in this system is that the healthcare reform provided non-discrimination clause in its policy; restrictions are imposed to pre-need companies to make them customer-centered in delivering insurance benefits; it obliged insurance companies to insurance rate increase; and, consumers are provided with options to avail healthcare based on their income bracket and employment (NCSL, 2012). Now that healthcare is nationalized, the DoH and Family expects also total quality improvement in healthcare system (Ciampa, 1992; Datta & Vandegrift, 201; Meltzer, Chung, Khalili, Marlow, Arora, Schumock, & Burt, 2010). This likewise means that the reform agenda require more accountability among health providers to make its services patient-centered and attuned to innovative ways of medication (Anderson & Squires, 2010; Shin & Sangho, 2005). It’s hoped that health sector will be able to completely address the perennial causes of mortality and morbidity as well as the emergent public health threats with reformed health services, albeit such require also improved management of services at the hospital levels (Whetten & Cameron, 1991). All federal states must also endeavour to transform its governance to make their services truly within the standards expected of them. Performance measures will likewise be enforced through regular evaluations and monitoring to ensure that total quality management is exercised to complement the Obamacare policy (Weeks, Helms, & Ettkin, 1995). The government will likewise work to strategize the necessary changes that should be instituted for competitive leveraging. Dysfunctional offices must be re-evaluated and systems be enhanced too to require improved documentation and reporting are accrued by all respected offices because these will become empirical bases for evaluations and in the crafting of recommendations. These records will also become sources of statistical facts about how DoH performs its administrative and operational aspects in health care management to achieve targeted goals and programs (Weeks, Helms, & Ettkin, 1995). All threats and weaknesses in the implementation of the program can be better addressed with proper channelling of feedback mechanism and constant development of human resources to learn more from technological innovation and new health discoveries (Laschober, M. A. & Maxfield, 2005). References Anderson, G. F. & Squires, D. A. (2010). Measuring the U.S. Health Care System: A Cross-National Comparison, The Commonwealth Fund, US. Ciampa, D. (1992). Total Quality. Reading, Addison-Wesley, Massachusstts, US. p.1. Colesca, Sofia Elena & Dobrica, L. (2009). Information management in healthcare organizations, Economia. Seria Management, Faculty of Management, Academy of Economic Studies, Bucharest, Romania, vol. 12(1 Special), pages 133-138. Datta, A. & Vandegrift, D.,(2011). Effects of welfare reform and the state children’s health insurance program on medicaid and total health expenditures. MPRA Paper 36486, University Library of Munich, Germany. Garson, A. (2012). The US Healthcare System 2010: Problems, Principles and Potential Solutions, Current Perspective, Circulation, American Heart Association,  Bethesda, MD, US. http://circ.ahajournals.org/content/101/16/2015.full#sec-11 Accessed: 8 December 2012. Gravelle, J. G., (2012). Tax Options for Financing Health Care Reform. Congressional Healthcare Service, National Conference of State Legislation, US., p. 1-27. Gill, K. (2012). The Healthcare System In The US. US Politics, About.com Guide, US, Web, http://uspolitics.about.com/od/healthcare/tp/health_care_overview.htm Accessed: 8 December 2012. Laschober, M. A. & Maxfield, M., (2005). Hospital Public Reporting Summit: The Link Between Public Reporting and Quality Improvement. Mathematica Policy Research Reports 4682, Mathematica Policy Research. Washington, DC. National Conference of State Legislation, (2012). 2011 and 2012 Health Insurance Reform Enacted State Laws Related to the Affordable Care Act, Washington, US, p. 1. Meltzer, D., Chung, J., Khalili, P., Marlow, E., Arora, V., Schumock, G., & Burt, R., (2010). Exploring the use of social network methods in designing healthcare quality improvement team, Social Science & Medicine, Elsevier, 2010, vol. 71(6), pages 1119-1130. Shin, J & Sangho, M. (2005). Utilization of Home Healthcare Service by Medicare-Medicaid Dual Eligibles, Annals of Economics and Finance, Society for AEF, vol. 6(1), pages 89-104. US National Library of Medicine (2012). Healthcare Reform , Health Economics and Health Policy., Health Services Research Information Central. NLM National Institutes of Health, Bethesda, MD, US. Web. http://www.nlm.nih.gov/hsrinfo/health_economics.html Accessed: 8 December 2012. Ubokudom, S. E. (2012). United States Health Care Policymaking. Springer Texts in Business and Economics,vol. XV, 282 p. 3 Weeks, B., Helms, M., & Ettkin, L., (1995). A physical examination of health care's readiness for a total quality management program: A case study. Hospital Material Management Quarterly. vol.17, pp. 1-68. Whetten, D.A., Cameron, K.S., (1991). Developing Management Skills. 2d ed. Harper-Collins, New York, N.Y., US. Read More