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Health Care Reform and How the United States Got There Essay Sample

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Health Care Reform and How the United States Got There Essay Sample

For over a decade our healthcare system has been flawed, and for over a decade several Presidents have tried to reform the health industry with little success. Advocates of health care reform have been met with great controversy and resistance since as early as 1854 when President Franklin Pierce vetoed the “Land-Grant Bill for Indigent Insane Persons” that would benefit the indigent insane, “by arguing that the federal government should not commit itself to social welfare, which he believed was properly the responsibility of the states” (“Senate Debates On the Land-Grant Bill for Indigent Insane, 1854). Those apposed to change have fought diligently to cease the passing of any bill that would benefit the people. However, on March 10, 2010 all that would change with the passing of President Obama’s Patient Protection and Affordable Care Act. The United States health care system would begin to move towards a more socialist approach and the start of a new era in healthcare would begin, but only time will tell what the ramifications the United States will face in the upcoming years as we continue to push toward change.

The problems we are facing today did not happen overnight; it took several years, decades, even a century. It took a multitude of problems compounding over time to put the United States into the health care turmoil we are facing today. In order to understand how the United States health care system failed we must know why it failed. The way the health care systems operates today, has not always been the case. In fact over the course of years, healthcare has transformed dramatically from the first time health care became a national issue in the early part of the twenty Century when Progressivism was influencing both the United States and Europe. During the beginning of the twentieth century, a time when the Progressivism movement was influencing both the United States and Europe, the United States came the closest to socialistic medicine it ever has come until present day. “However due to several contributing factors, employer-based sickness funds, the American Medical Association opposition to socialized health care, this initiative was shot down, and may have contributed to why the idea of government-based insurance did not take hold in the United States” (Truman, 1949).

While the United Kingdom and the rest of Europe moved toward nationalized health care for all citizens, the United States continued to struggle with how to approach health care. Prior to 1920, those who had healthcare coverage were those who worked for an employer who had a basic employer-based sickness fund, and the idea of universal healthcare would not surface again until after the Great Depression when President Roosevelt tried to initiate universal healthcare. When President Roosevelt proposed the “New Deal” legislation he proposed healthcare reform that many considered “compulsory health insurance” (Hoffman 2003). However, President Roosevelt’s initiative for reformation within the health care arena was short lived due to the continued opposition from the American Medical Association, and both state and local governments. President Roosevelt feared political attack from the American Medical Association, and for that reason President Roosevelt dropped all healthcare legislation from the “New Deal” agenda.

During the same era as the proposed “New Deal” legislation, a new group health insurance plan was formed by a group of teachers in Dallas, Texas. This group plan would come to be known as Blue Cross Blue Shield, and “the popularity of group health insurance policies began to increase tremendously due to the discounted contracts that were negotiated with doctors and hospitals, which were passed on to the consumer.” (Health Care in the United States, n.d) By the 1940’s the perception of health care began to change quite rapidly. Those who were purchasing individual policies were growing in numbers tremendously. The United States government and unions jumped into the arena, by pushing for legislation to support third party insurances such as Sidney Garfield’s Kaiser Permanente. (Kaiser Permanente, 2012) The Second Great War would also contribute to the cause, when restrictions were placed on higher paying jobs. “Since employers were unable to entice the most qualified worker to come work for them for higher pay, they instead improved their benefit packages, to include adding health insurance. (History of Health Care. 2009).

As the United States moved into the 1950’s, Congress and President Truman began to make some headway in the fight for healthcare for all, to include “federal matching grants to state payments for medical care for the poor.” (History of Health Insurance in The United States, 2009). As the United States continued to push forward with change and healthcare evolution, “Congress was being pressured to expand Social Security to include relief from medical bills for the aged.” (The History of Health Insurance in The United States), and for these reasons by 1965 the Medicare and Medicaid programs would be born, and the beginning of socialized healthcare would start to take shape.

According to Igel, in “The History of Health Care as a Campaign Issue,” the next eight years would see little change in healthcare reform after the adoption of the Medicare and Medicaid programs into law. By the early 70’s President Nixon was pushing for federal legislation to assist in the birth of Health Maintenance Organizations (HMO) throughout the country. “The birth of HMO’s soon consumed both political and business interests and problems would soon begin to mount” (Igel, 2008). The topic of major healthcare reform would not come to pass again, until the 1992 Election, when President Clinton “made health care reform a centerpiece of his campaign.” (Bok, 1998). After winning the election he quickly formed a committee to address the multitude of problems healthcare was having. After appointing Mrs. Clinton as the head of the task force and months of speculation, a 1000 page document was presented to Congress on September 1993 outlining the guarantee of basic healthcare for all Americans. “In a forceful tone, he urged the lawmakers to fix a health care system that is badly broken… giving very American health security — health care that is always there, healthcare that can never be taken away” (Bok, 1998). Like his predecessors in the past, his plan would come to a standstill on September 26, 1994 “when Senate Leader George Mitchell announced that the health care legislation was dead” (Bok, 1998).

By the time President Bush took office there was change in the air, but overall healthcare reform for all was not one of them. President’s Bush health care initiatives focused more on tax credits, Health Saving Accounts and changes in code for healthcare insurance, instead for the millions who lacked coverage. One of the biggest changes that came out of President Bush‘s term was the push today legislation that that would protect patient’s right in the healthcare arena. President Bush was also instrumental in the push for the adoption of new technology that would support the conversion from paper medical records to electronic medical records. In addition, he supported the passing of the Health Information Portability and Accountability act in 1998, which ensured that patient information was protected and kept private.

Our United States current healthcare industry is flawed and, “in fact, it’s not even close to being the best health care system in the world” (Harper, 2009). President Obama knows this, in fact previous Presidents have known this, but little has been accomplished to change the way the healthcare industry operates. For over a decade legislation has been proposed and for a variety of political and economical reasons, legislation has been squashed time and time again. There are several factors to consider as to why the United States’ healthcare system is one of the worst in the world. As far back as 1968, “a National Opinion Research Center reported that 87% of Americans polled believed that health care was a right of all American Citizens” (Harper, 2009). So why is it that the “United States is the only wealthy, industrialized, developed country in the world that does not offer health care to all of its citizens?” (Harper, 2009).

Our Healthcare system is riddled with problems and in order for them to be fixed healthcare reform is necessary. The simple fact is the American public pays more for the delivery of healthcare than any other country in the world. According to Zaldivar, in his article Health Care Costs to Account for One-Fifth of U.S. Economy by 2020 healthcare costs will account for one-fifth of the U.S. Economy by 2020. Due to the astronomical costs, millions of consumers go without adequate health insurance. Increasing insurance premiums, higher deductibles and the increase in health care charges have lead consumers to pay a greater share of the cost themselves. (Harper, 2009) When the National Coalition on Health Care provided statistics to a Congressional Committee the results were staggering. “Insurance premiums have risen at more than twice that of inflation, and the average employee contribution to company- provided health insurance has increased more than 120% since 2000 (Harper, 2009).

The second issue that the United States healthcare system faces and falls short on is the quality of care. Not only is it substandard and performs poorly, it is inaccessible to millions. According to Svencill, in “Why The U.S. Health Care System is Substandard”, the measures used to determine where the United States ranks are infant mortality, life expectancy and disability rates. In all three reports the United States fell well below the standards and ranked 72nd out of 191 nations that were studied according to the World Health Organization (WHO) (Harper, 2009). In that same report the United States ranks the lowest in regards to infant mortality, 7.2 deaths per 1000 live births (BLE 2001). This rate ranks the United States 26th amongst developed countries. (Svencill, 2011).

One would assume that life expectancy in the United States would be much higher than those of their counterparts, due to the technology that the United States possesses, but this is not the case. The United States again fell short. On an average, US citizens’ life expectancy is five years shorter than other developed countries. “Approximately 80,000 deaths in 2006 caused by conditions “amendable to healthcare” could have been prevented had those people received “timely, effective medical care” is also much lower than other developed countries. (The Commonwealth Fund, 2006) The One of the reasons that critics have argued that these statistics are so low is because out of all the developed countries in the world, the United States does not provide health insurance to all their citizens, where other countries have access to proper health care, that is required to stay healthy. This is a far cry from the best healthcare in the world.

The 47 million and growing without health insurance is probably the biggest problem our healthcare system is facing. “The lack of insurance is associated with worse health outcomes” (Institute of Med.., 2012). Also it is a proven fact that one out of every three bankruptcies result from financial hardship from accumulating medical bills. Increasing health insurance premiums have led many to drop their healthcare coverage because they simply could not afford the premium. As a result consumer’s taxes are increased to support the growing government programs.

President Obama saw the problems and set out to try and fixed the flawed healthcare industry after his victory. On March 10, 2010 this would come to pass and history would be made when the United States government passed the Patient Protection and Affordable Care Act. The Act set out to cut out waste, reallocate how government funding is distributed to the government programs such as Medicaid and Medicare, and lastly ensuring that every American is able to obtain health insurance. “Obama Care reforms the way American[s] purchase health insurance requiring all Americans to either purchase a private health care plan or pay a 1%-2.5% tax. It also guarantees that Health Care is available to any legal U.S. resident who cannot otherwise obtain “good” healthcare through their employer. Your access to health care is no longer in the hands of health insurance companies” (What is Obama Care. 2012). According to the International Human Rights Article 25.1 “Everyone has the right to a standard of living adequate for the health of himself and of his family, including food, housing, and medical care and necessary services” (Leary, n.d).

What many American’s have been led to believe about Obama Care, is that their rights as individuals to choose an insurance plan that best suits their needs will be relinquished and the government will take control of this right. This is a fallacy that those who oppose national health care have led Americans to believe. In fact The Patient Protection and Affordable Care Act does the opposite by “giving American worker more freedom, and not having to be dependent on their employers or insurance companies for care”. (Omamacarefacts, n.d) Instead Obama Care let individuals decide about their own health care, “and for those who are unable to afford health insurance will either qualify for Medicare/Medicaid or get assistance in the form of tax credits, tax breaks or assistance with up- front cost on Health Insurance Exchanges (HIX). (Obamacarefacts, n.d.) “The government just makes sure citizens get a fair shake and the insurance companies play by the rules”. (Obamacarefacts, n.d.). When The Patient Protection and Affordable Care Act is fully implemented in 2014 those 47 million Americans who currently not covered will finally have health insurance.

The United States public has also been lead to believe that health insurance companies have opposed Obama Care from the beginning, but in fact, health insurance companies have favored changes in health care reform from the beginning. . “If there is a group of people more anxious about how the Supreme Court will rule on the health care reform law than President Obama and the millions of Americans who are already benefiting from it, it is health insurance Executives” (Potter, 2012). Companies such as Cigna and Aetna lobbied for Congress to pass the mandated individual insurance clause, ensuring billions in new business.

Former Cigna president Larry English, testified to a Congressional committee that “There are many specifics in the President’s plan we believe should be supported enthusiastically. Among them are universal coverage, portability, the elimination of pre-existing condition limitations, the elimination of cream-skimming and cherry picking underwriting practices, the use of community rating, a standard benefit plan and malpractice reform.” (Potter, 2012). Obama’s law would expand their business, when the 47 million new customers who currently are without insurance would have to have “coverage through a mix of subsidized private insurance for middle-class households and expanded Medicaid for low-income people. Medicaid recipient would get signed up in commercial managed care companies, or pay a 2% tax.” (Potter, 2012)

Part of President Obama’s long term goals to create an economy that is stable and thriving also includes regulations on insurance companies and how they conduct business. No longer would insurance companies be able to dictate to consumers who would be able to obtain insurance and who could not because of preexisting medical issues. “Under the law, insurance companies would have to accept all applicants, including the sick. (Potter, 2012). Other important benefits would include preventative care such as yearly physicals. Women’s health benefits would be expanded to include yearly mammograms and pelvic exams. Programs such as the Annual Wellness Visit and new preventative screening will expand the benefits that seniors currently have.

Despite the hype that those who oppose healthcare reform have pounded into the heads of Medicare recipients the proposed cuts would come from “low sources: (a) a crackdown on Medicare fraud, estimated to currently cost the federal government as much as $60 billion per year and (b) a reduction in what is paid to the Medicare Advantage programs offered by private insurance”. (Unger, 2010). Medicare patients would continue to have the same medical benefits they had before all the cuts were made.

The benefits of the Patient Protection and Affordability Act are clear. This Act is a win, win for everyone. 47 million Americans who fall through the cracks to currently are without insurance will finally be able to afford medical insurance and be able get the medical care they need. The insurance companies, even though they have been regulated, stand to make billions of dollars once all Americans are required to purchase health insurance. The overhauling of how Medicare operates also stands to benefit from the Act. The crackdown of the fraud that is committed will save the federal government in abundance of $60 million dollars a year. That alone should be applauded. Will there be bumps in the road? Absolutely. Is the government moving toward a more socialistic approach to medical care, yes, but those who have opposed this approach fail to realize or better yet do not want to admit that our Medicaid program is a socialistic program for the poor that the working citizens of the United States support The Patient Protection and Affordability Act is a win, win situation.


OLPC Canadian and American Health Care Systems Compared. (n.d.). Retrieved December 8, 2012 from OLPC Wiki: htpp://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared. OLPC Bill for the benefit of the indigent insane. (n.d.).Retrieved December 1, 2012. From OPLC Wiki: http://en.wikipedia.org/wiki/Bill_for_the_Benefit_of_the_Indigent_Insane. OLPC United States Health Care Reform Under FDR. (n.d). Retrieved December 11, 2012. from en.wikipedia.org/wiki/User.Doc.Tropics/United_States_health_care_under_FDR. OPLC Health Care in the United States. (n.d.). Retrieved December 15, 2012. from http://en.wikipedia.org/wiki/Health_care_in_the_United_States Library of Congress. (1854). Senate Debates on The Land-Grant Bill for Indigent Insane Persons. Retrieved December 1, 2012. from http://www.docstyles.com/apacrib.htm#Sec68

Obama Care Facts. (n.d.). Obama Care Facts: Dispelling the Facts. Retrieved December 11, 2012. From http://obamacarefacts.com/obamahealthcare-summary.php

The History of Health Insurance In The United States. (2009). Web. 5 Retrieved December 10, 2012. from. http://www.neurosurgical.com/medical_history_and_ethics/history/history_of_health_insurance.html. Library of Congress. (1854). Senate Debates on The Land-Grant Bill for Indigent Insane Persons. Retrieved December 1, 2012. From http://www.docstyles.com/apacrib.htm#Sec68

Allen, J. S. (n.d.). Labs speak out against additional Affordable Care Act cuts . In Medical Laboratory Observer. Retrieved December 11, 2012, from http://www.mlo-online.com/articles/201208/labs-speak-out-against-additional-affordable-care-act-cuts.php. Bok, D. (1998). The great health care debate of 1993-94 . Public Talk Online Journal of Discourse Leadership, Retrieved December12, 2012. from http://www.upenn.edu/pnc/ptbok.html. Boychuk, G. (2008). National Health Insurance In The United States. Washington, DC: Georgetown University Publishing. Harper, K. (2009). The United States does not have the best health care system in the world. Retrieved from http://www.examiner.com/article/the-united-states-does-not-have-the-best-health-care-system-the-world. Hoffman, Beatrix. (2003). Health Care Reform and Social Movements in the United States. Retrieved December 5, 2012. From www.ncbi.nlm.gov/pmc/articles/PMC1447696 Kaiser Family Foundation. (2009). Trends in Health Care Costs and Spending. Retrieved December 15, 2012 from http://www.kff.org/insurance/upload/7692_02.pdf. Klein, E. (November ). In The American Project: Ten Reason Why American Health Care Is So Bad. Retrieved December 11, 2012, from www.prospect.org/article/ten-reasons-why-american-health-care-so-bad. Lawson, P. (n.d.). National health care in the United States: Exploring the options and possibilities. Retrieved December 7, 2012. from http://www.cwru.edu/med/epidbio/mphp439. Leary, Colleen. (2006) “Everyone in the United States Deserves Equal Access to Health Insurance.” Retrieved December 20. 2012. from <http://voices.yahoo.com/everyone-united-states-deserves-equal-access-25026.html?cat=5>. Mechanic, D. (2006). Truth about health care : Why reform

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