The History of Healthcare:
Health
Care before 1920 wasn’t that important because doctors didn’t know much about
diseases to charge people a high price. People were able to pay out of the
pocket with no problem. When diseases and technology grew the health care grew.
Technology, diseases, the use of the hospital and the help of the great
depression began to cause prices to become less affordable for people. Health care was born
because of this; Baylor Hospital in Dallas created Blue Cross to help people
pay their hospital bills. Insurance for doctors began to grow, other insures
start entering the market making it so that not only were doctors covered but
employees at jobs and soldiers were also covered. The government then starts
having tax incentives and the health care starts to take a turn. Blue cross
were charging everyone the same price but when the business started to grow
they started charging people off of age, gender, health status and pre-existing
medical conditions. The health insurance business starts insuring the
healthiest people and avoiding the sickest. The different statuses start here
with birth of health care.
Healthcare started in the
1930’s to protect doctor payments. Originally healthcare was simple system
where people paid a flat fee and they were insured. But as private insurance
companies came in search for profit, political ideologies began to mold the healthcare
industry. Democrats applied their ideology by wanting healthcare for all but at
a higher cost. Republicans are in favor of free market and competition so they
are all for privatized healthcare. http://www.ft.com/cms/s/0/c9eb2ad6-d022-11e1-99a8-00144feabdc0.html#axzz28sgvfdJY
The
Democratic Party became part of the healthcare system in 1960 when John F.
Kennedy was elected into office. In 1965 he passed Medicare as a two part
federal program. Part A was the compulsory hospital insurance program where the
elderly upon reaching the age 65 was automatically enrolled. Part B provided
supplemental medical insurance, or subsidized insurance for physicians’
services (EH.net). Physicians benefitted from
Medicare out of the fear that patients wouldn’t be served, legislators agreed
to reimburse physicians their usual rate. Doctors could also bill patients
directly; charge patients more than what Medicare would pay. Funding for
Medicare came from payroll taxes, income taxes, trust fund interest, and
enrollee premiums for Part B. Medicare went from serving 19.1 million people in
1966 to 39.5 million in 1999 (Henderson 2002, pg.425)
To understand the healthcare
debate, one has to understand both healthcare plans proposed by Mitt Romney and
Barack Obama. One key idea to Mitt Romney’s healthcare plan is the proposal
that privatized healthcare promotes efficiency and competition. The correlation
to these two falls in the fact that companies compete to sell their services,
and they want to do it better than the competition. This drives research to
have the best goods and services available to medical patients, therefore
companies are always creating new products that improve the health of
Americans.
Another idea of Mitt Romney’s
healthcare plan is to shift the responsibility of managing healthcare from the
federal government to state governments. Romney would like to shift the
responsibilities to the individual states because regardless of what state one
is in, the state knows better than the federal government. Meaning that the
states are closer to the people therefore they should know how to care for
their people rather than the generalized federal government.
Consumer choice is another
product of Mitt Romney’s healthcare plan. Consumer choice does exactly what
Romney says it will: it “empowers the consumer” and puts them at the “center of
attention.” By empowering the consumer, the consumer has the ability to pick
goods and services that they need for their medical issues.
President Barack Obama:
After
decades of opposition from Republicans, President Barack Obama and Democrats
passed the Comprehensive Health Reform also known as the Affordable Care Act or Obama Care
into law on March 23rd 2010. This made health care available to all
Americans. This act provides tax cuts to small businesses, tax credits to help
families pay for insurance. It also lower costs to families, businesses, and
federal government reducing the deficit by more than 1 trillion dollars in the
next two decades. It strengthens Medicare by reducing fraud and improving quality.
It’s also said to be an eliminator of all discrimination for pre-existing
conditions and expand coverage for an additional 32 million Americans by 2014.
2008
Democratic Campaign:
In 2008,
Barack Obama along with other Democratic candidates (Hillary Clinton and John
Edwards) all proposed their plans for health care to be Universal Health Care
for all Americans in the United States of America. (U.S.A Today).
Implications:
What are the relevant implications
of healthcare in America. The implications of healthcare can fall into three
main categories: social, political, and economical. From a social point of
view, the main question is should all people in America have healthcare whether
they have the funds to pay for it or not. Obama would like all people to be
insured regardless of their financial status.
Mitt Romney on the other hand would like Americans to pay for the healthcare that
they need, regardless if they can afford it or not. The social aspect of the
controversy to the American people is which plan is fair?
The political implication of
the healthcare controversy lies in how much power is tied into healthcare.
Democrats are in favor of a larger government, while republicans, of course,
are in opposition to a large government and think government should be smaller.
In Obama’s healthcare plan, the government would have control of 1/6th
of the national budget, which equals a lot of power. While as Mitt Romney’s
plan to reduce government spending on healthcare and relocate healthcare to the
states would make the federal government smaller.
Last but probably most
importantly is the economic implication of healthcare. People care about the
money in their pocket and they care what it goes toward. With the two different
healthcare approaches from Obama and Romney, obviously each plan is not going
to cost the same amount and the goods and services that come from the plans is
different.
Expenditures:
Medicare
and Medicaid expenditures have grown since their commencement (Fig. 3 Chart). Expenditures rose greatly in
the late 60’s. Medicare expenditures rose sharply during the 70’s. This caused
a major change in Medicare reimbursement policies in 1983. Instead of regular
rates, providers were reimbursed according to a set fee based on diagnoses.
Medicaid expenditures were constant over the 70’s and 80’s. Medicaid started to
rise in the 90’s due to more eligibility requirements. In 1994 President Bill
Clinton proposed a health care reform package that would provide universal
health care for all Americans. The core element of the plan was a decree for
employers to provide health insurance coverage to all of their employees
through competitive but closely regulated health maintenance organizations. Libertarians, conservatists and the
health care industry opposed and eventually the proposal was rejected by the
senate. By 2001 Medicare and Medicaid together
accounted 32 percent of all healthcare expenditures in the U.S. (EH.net).
Medicaid
provided medical resources for the indigent. Federal portion of payments was
based on each states per capita income relative to national per capita income.
Unlike Medicare uniformed benefits and eligibility standards, Medicaid only
specifies minimum standards. Each state was responsible for determining
eligibility and benefits. Benefits and eligibility varied in different states.
The original legislation provided coverage for public assistance but now
narrowed the scope to beneficiaries. 10 million people had Medicaid in 1966 by
1999 37.5 million people had Medicaid (EH.net).
Two Sides:
When researching healthcare
the two sides that stand out are in the terms of Obama and Romney’s proposed
plans are citizens who are for the greater good and citizens who believe that
you work for what you get. Obama’s healthcare plan is for the citizens who
think in the greater good because they are willing to pay a little extra to
help cover other citizens who might not be able to afford their healthcare.
With Mitt Romney’s plan
you get what you pay for and that’s as simple as is.
Connected Argument:
As used in our class example
that Pro-life and pro-choice thinkers are really arguing for the “rights of the
individual” and “justice” therefore they are arguing for the same thing just in
different ways. But healthcare just isn’t that easy; the divide between the
Republican ideology and Democratic
ideology of healthcare is extremely different. Therefore they are not
arguing for the same thing. Obama want’s affordable healthcare for everyone,
while Mitt Romney is a promoter
of the free market and how competition drives the development of technology. So
they truly are not arguing for the same thing.
