reply to the following discussion post as a peer. Federal health care reforms have been considered in the United States since the 1930s. Society was supportive of guaranteed access to health care for all but stopped short when there were costs associated with this benefit for society. These findings continued throughout the 20th century (Dewar, 2017). Starting with the New Deal from 1934 to 1939, President Roosevelt addressed old age and unemployment issues as well as medical care and health insurance. Like Roosevelt, President Truman continued to push for legislation for access to medical care under the Fair Deal Package. However, due to fear of growing communism in the late 1940s, the public was more concerned about greater government control over the U.S. economy. At this time, private employer-based insurance was growing more popular (KFF, 2021).
From 1960-1965, reforms were focused on health care programs for the elderly and poor, thus Medicare and Medicaid were in were incorporated into the Social Security Act. Other national health insurance proposals from 1970 to 1974 were offered by Senator Ted Kennedy, who put forth a single-payer plan, and President Nixon, who countered with his own market-based insurance model that would include the replacement of Medicaid with another program that would cover the poor and uninsured. However, the numerous complex bills and the scandal of Watergate, and the resignation of President Nixon led to the defeat of national insurance efforts (Dewar, 2017).
From 1976 to 1979, President Carter was more concerned with containing costs and pledged to consider national health insurance once the economy stabilized. However, the economy was so unstable with inflation, recession, and uncontrolled health care costs that reforms were postponed. In 1983, Medicare Prospective Payment System was laid that changed the financial payments Medicare made to hospitals from a fee-for-service-based system to a predetermined rate per episode of care (KFF, 2021).
The Health Security Act under consideration from 1992 to 1994 was developed while the public was concerned about losing medical benefits and being unable to afford health care. President Clinton proposed a plan that called for universal coverage, employer and individual mandates, private insurer competition, and government regulations for cost control. However, the proposal was defeated due to its complexity and split along party lines in Congress (Dewar, 2017).
Lastly, in 2009 The Affordable Care Act (ACA) was developed under the Obama administration which provided universal health coverage to all Americans. However, even after the ACA was implemented, it was estimated that more than 20 million people remained without insurance. It was also concluded that the uninsured are forced to subsidize the insured patients which is adding up to higher costs for society. Historically, health care reforms are a complicated and daunting challenge for federal and state policymakers. People want change to happen but are often more concerned with the role of government and their costs in the reform (Dewar, 2017)
References:
Dewar, D. M. (2017). Essentials of health economics (2nd ed.). Burlington, MA: Jones and Bartlett Learning. ISBN-13: 9781284054620
KFF. (2021). Timeline: History of Health Reform in the U.S. Kaiser Family Foundation. Retrieved October 27, 2021, from https://www.kff.org/search/s=Timeline:%20History%20of%20Health%20Reform%20in%20the%20U.S.&fs=search&orderby=&tab=&layout=&facets
