Health Care

1. Health Care Natalie Quinn

2. Health care policy in the united states • Health is one of the largest components of America’s economy, accounting for one-seventh of the gross domestic product. Costs of health care have been a major obstacle to balancing the federal budget and investing in the economy. Costs are rising for several reasons. Health providers have overbuilt medical care facilities. New technologies, drugs, and procedures have added to the costs. Patients do not ask for cheaper care because they do not face the full financial consequences of their care. Increased medical costs have caused insurance rates to skyrocket. Access to health care is not universal in the United States. Many people contract with a Health Maintenance Organization (HMO) that directly provides all or most of a person’s health care for a yearly fee. Most Americans have health insurance, but 16 percent of the public is without for the entire year. Millions of others are without insurance for shorter periods. Getting and keeping health insurance are often linked to having a job, especially a high-paying job. The United States has the most thoroughly privatized medical care system in the developed world with 46 percent of the country’s total health bill paid for by government compared to an average of 75 percent for all industrialized nations. Private insurance companies cover one-third and Americans pay nearly one-fifth of their health care cost out of their own pockets. Most countries have a national health insurance, a compulsory insurance program to finance all medical care. In 1965 Congress passed Medicare as part of Social Security to provide hospitalization insurance and short-term nursing care and inexpensive coverage for doctor fees for elderly Americans. Medicaid is a means-tested program designed to provide health care for the poor and serves about 35 million people. President Clinton made health care reform the centerpiece of his first administration. His main concern was guaranteeing health care coverage for all Americans. The program was to be paid for by a requirement that employers provide health insurance for their employees or pay a premium into a public fund. The reform failed because it was seen as bureaucratic and complicated. The middle class felt its health care threatened. After a long battle it died in Congress. Opponents to managed care claim that its cost-cutting bureaucrats impose stifling rules on physicians, block sick patients from seeing specialists, and delay or deny coverage for recommended treatments or medications. There has been a wave of state legislative action to protect patients’ rights, including an effort by President Clinton, which was killed by the Republican Congress in 2000. There have also been efforts, especially by the elderly, to add the cost of prescription drugs to Medicare.

3. This political cartoon implies that it is nearly impossible to get good medical help without it taking all the money you have alonng with it.

4. Health Care timeline • 1862-President Lincoln appointed a chemist, Charles M. Wetherill, to serve in the new Department of Agriculture. This was the beginning of the Bureau of Chemistry, forerunner to the Food and Drug Administration. • 1871-Appointment of the first Supervising Surgeon (later called Surgeon General) for the Marine Hospital Service, which had been organized the prior year. • 1891-Passage of immigration legislation, assigning to the Marine Hospital Service the responsibility for medical examination of arriving immigrants. • 1902-Conversion of Marine Hospital Service into the Public Health and Marine Hospital Service in recognition of its expanding activities in the field of public health. In 1912, the name was shortened to the Public Health Service. • 1906-Congress passed the Pure Food and Drugs Act, authorizing the government to monitor the purity of foods and the safety of medicines, now a responsibility of the FDA. • 1921-The Bureau of Indian Affairs Health Division was created, the forerunner to the Indian Health Service. • 1930-Creation of the National Institute (late Institutes) of Health, out of the Public Health Service's Hygienic Laboratory. • 1935-Passage of the Social Security Act. • 1938-Passage of the Federal Food, Drug and Cosmetic Act. • 1939-The Federal Security Agency was created, bringing together related federal activities in the fields of health, education and social insurance. • 1965-Creation of the Medicare and Medicaid programs, making comprehensive health care available to millions of Americans. • 1970-Creation of the National Health Service Corps • 1977-Creation of the Health Care Financing Administration to manage Medicare and Medicaid separately from the Social Security Administration. • 1988-.Passage of the McKinney Act to provide health care to the homeless • 1989-Creation of the Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality). • 2003-Enactment of the Medicare Prescription Drug Improvement, and Modernization Act of 2003, the most significant expansion of Medicare since its enactment, including a prescription drug benefit.

5. The Legislative Branch Committees on Health and Human Services and Appropriation committees propose bills on Health policies Legislative oversight Executive branch confirms policies

6. Executive Branch • The president may veto bills he vehemently disagrees with. Though with a large enough majority, congress and the Senate may overturn that veto, they rarely can. • The President may issue signing statements-- upon signing a bill into law, he may issue a statement of his interpretation of the law, that is, how he will instruct the Health Department to implement/inforce the new law • The Health and Human Services department in the cabinet helps the president and the White House staff members to look at health care legislation and connect with the bureaucracy

7. The Judicial branch-policymaking • The judicial branch interprets laws and tries to hold all cases accountable to the Constitution. They have recently been faced with the question of how much right the government actually has to force health care onto people and if the new health care reform bill is unconstitutional.

8. Three Branches Working Together

9. policymaking through all the branches

10. Non-governmental groups on health care • There are many lobbying groups that have a great impact on the government and the health care process. Powerful doctor and hospital lobbyists have been pushing to get Medicare to pay for the latest medical supplies and machines. However, one of the biggest lobbyists for health care is the elderly. They have created many interest groups and pushed for a lot of legislation to help in the medical field.

11. Impact on american public • The affect that health care actions and reforms have on the American public can be very controversial. The current programs set in place by the government are supposed to increase the amount of people able to receive health care, improve access to health care specialists, improve the quality of health care, and decrease the cost of health care. However, many citizens feel that a lot of the health care programs are actually hurting the public and giving people improper health services.

12. Current Status Of Policy Decisions • Reforms under the Affordable Care Act have brought an end to some of the worst abuses of the insurance industry. These reforms have given Americans new rights and benefits, by helping more children get health coverage, ending lifetime and most annual units on care, allowing young adults under 26 to stay on their parent’s health insurance, and giving patients access to recommended preventive services without cost. Many other new benefits of the law have taken effect, including 50% discounts on brand named drugs for seniors in the Medicare “donut hole,” and tax credits for small businesses that provide insurance to employees. More rights, protections and benefits for Americans are on the way through 2014. http://www.huffingtonpost.com/2010/03/22/health-reform-bill-summary_n_508315.html#s75143&title=Small_Business_Tax

13. Analysis of Health Care Policy I think that the new healthcare policy has implemented many good programs and has helped many Americans who may not have been able to get good health care with their monetary situation. The fact that they new reform policy is going to gradually be incorporated is going to help Americans, who for the most part do not adapt to change very well. However, with a vast majority calling the new policy “socialized health care”, I think that there will be many more disputes to come and the Supreme Court will be facing many cases on the Constitutional rights of Americans. The health care system in the United States is very disputed and has many problems. The fact that doctors get paid on the number of visits they receive and the number of procedures they perform not only decreases the quality of service that the patient receives, but it also increases government spending. Basically, people are paying more for poor quality service. If the government could change the incentives for doctors from the quantity to the quality of service they provide, then Americans would get better health care and health care costs could slow, which are projected to be around 25 percent of the nations GDP by 2025!

14. Works Cited • http://www.hhs.gov/about/hhshist.html#Top • http://wps.ablongman.com/long_edwards_government_11/0,7701,719608-,00.html • http://www.americanprogress.org/issues/2009/06/health_payment_reform.html • http://www.cbsnews.com/8301-503544_162-20000846-503544.html • http://www.healthcare.gov/law/introduction/index.html