The Road to Healthcare Reform One of the significant challenges for health polic
ID: 454623 • Letter: T
Question
The Road to Healthcare Reform
One of the significant challenges for health policy is not necessarily the implementation of programs but the influence of the political climate in regard to both the financial support and control of the programs.
Based on your understanding of the topic, conduct a research and create a report on the political battle for universal healthcare in the United States.
Your report should include the following elements:
History of the national healthcare reform starting from the early days struggle for a national health plan to the present day.
Political struggle to pass PPACA.
Political impact of Medicare and Medicaid on the push for universal coverage.
Major issues from the legislative and executive (presidential) perspective. Who were the opponents and supporters?
The politics surrounding the national health insurance agenda and its impact on the PPACA.
Explanation / Answer
A. History of the national healthcare reform starting from the early days struggle for a national health plan to the present day.
The earliest healthcare reform at the federal level was in 1854 called as "Bill for the Benefit of the Indigent Insane" for Indident, Insane, blind and deaf. Though it was passed both houses but rejected by the then president Franklin Pierce who had thought, the health and socail welfare are the responsibilites of the states.
In the 1900-1920 Theodore Roosevelt had proposed the health care reforms but he was defeated. Also the American Medical Association (AMA) had opposed the idea.
In 1930-1950, Franklin D. Roosevelt had brought up the health care reforms again but was not successful as it was again opposed by AMA and other insurance providers. Though the local hospitals and other insurance have formed a syndicate and started selling thier own insurance policies.
In 1960-1980, After Lyndon B. Johnson was elected president in 1964, the stage was set for the passage of Medicare and Medicaid in 1965. However, it is only avilable for only elders who are 65 years old or elder or some special criteria.
Later to this, many US Presidents have tried to start the health insurance plans with several different names but none of them are passed due to 1. its opposition by AMA 2. Opposition by health insurance companies of then.
In 1993, When Bill Clinton become the President, he started "Health Security Express" which was a bus tour which started from many places across the country to Washinton DC. In the tour, each rider had talked on the necessity of the health care reforms and importance of having a health insurance plan.
George W. Bush has introduced a new bill to the houses in 2001 which had taken some important ideas from the consumers bill of Rights but as it offered the treatment for everyone irrespective of thier insurance status, it failed to pass the houses.
In 2008, the Obama Plan things went well but after some starting troubles and hiccups in 2010, the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare, was enacted.
B. Political struggle to pass PPACA
Federal health care reform has been an issue since it was signed by President Obama in 2010. After months of struggling to pass legislation aimed at reforming the current system, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law on March 2010. However, within minutes of the bill becoming law, the PPACA was challenged by 13 state attorney generals jointly filing a lawsuit alleging the new law violated the Constitution. This suit was filed in the U.S. District Court of Pensacola, FL. The National Federation of Independent Business and 7 additional states joined the suit as co-plaintiffs. Of the 20 states involved, all but Louisiana, Nevada, and Mississippi had Republican attorney generals at the time. The suit was filed on the grounds of the PPACA violating Articles I and IV and the 10th Amendment of the Constitution. Virginia’s attorney general filed a separate suit and 33 other states continue to consider legislation to nullify the federal individual mandate for their state citizens.
Report by commonwealth fund identifies difficult issues that the states and the federal government face in implementing these exchanges. they are
1. Governance of the exchanges
2. Adverse selection against and within the exchanges
3. How to make self-insured plans compatible with the exchanges
4. Making the exchanges attractive to employers
5. Exercise of regulatory authority in certification of health plans that can participate in the exchanges
6. How to make descriptive and evaluative information available to the consumers
7. How to decide eligibility determinations under the Affordable Care Act
8. Reducing administrative costs and attracting funding
C. Political impact of Medicare and Medicaid on the push for universal coverage
Both the programs have been introduced in 1965 and faced several issues with the states due to vast coverage and benefits and other facilities offered. It transformed from time to time due to the opposition that these two progrmas had faced by the several states in USA. On the other hand Medicaid helps the poor and needy who cant afford the health insurance policy.
Both programs when they introduced went well but as the time progressed corruption took in place in both programs which had become a strong point for opposition to criticise the Government.
Then the Goverment came up with a plan called united care, which filled the gap in these two programs and become successful in many aspects,although it did not resolve the issue completely.
D. Major issues from the legislative and executive (presidential) perspective. Who were the opponents and supporters?
The major legislative issues with health care programs are they need to money to support and the states are not ready to fund.
From the executive perspective, though the Government wants to offer health care programs, it wants the states to support and cooperate to fund and guide and follow the rules of the programs.
Apart from that the organizations like AMA (American Medical Association) have opposed the bills strongly.
The supporters are mostly from the followers and supporters of the Presidents who have introduced and submitted the healthcare bills to the houses for approvals.
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