Brief history of the national healthcare reform
For more than a hundred years, the United States has experienced an epic battle in improving the state of healthcare. At the start of the 1900s, proposals for improving health care were ignited. In 1912, Theodore Roosevelt conducted campaigns advocating for an industry in health insurance. Progressive reformers conducted futile campaigns based on a state-based system that made health insurance compulsory to all citizens in 1915. In the 1920s, group medicine, and voluntary insurance was proposed by the Committee on the Costs of Medical Care and this earmarked the introduction of socialized medicine. The main health care reforms undertaken in the 1900s include; the National Health Insurance (NHI) and the New Deal (1934-1939), the NHI and the Fair Deal (1945-1950), the Great Society, Medicare and Medicaid (1960-1965), the Competing NHI Proposals (1970-1974), the Cost-Containment Trumps NHI (1976-1979), and the Health Security Act (1992-1994) (Hoffman, 2009). The Health Insurance Portability and Accountability Act and the States Children’s Health Insurance Program were also key reforms in Clinton’s administration. The most notable reform during 2001-2009 was the introduction of The Medicare Drug Improvement and Modernization Act of 2003. The Obama administration passed the PPACA in March 2010, and this has been the greatest health care reform in the US (Tailor et.al, 2014).
Political struggle to pass PPACA
The Patient Protection and Affordable Care Act (PPACA) has always been a hotly contested continuing legislative debate in the United States. Before the bill came into law, it was faced by yellowing bare-knuckle politics between the Republicans and the Democrats. As a matter of fact, it created a mixture of intense emotions from the public as the proponents and opposers of the bill debated about the impact of PPACA in transforming health care in the US.
The bill faced political struggles because it failed to guarantee the provision of health insurance to the entire population. Moreover, PPACA prohibited the provision of health care insurance to undocumented immigrants and this presented problems for health care providers. The PPACA struggled politically because it failed to address the issue of shortage of physicians. Instead, it emphasized on health insurance but ignored that the fact that the workforce was shortage to provide affordable care.
Political impact of Medicare and Medicaid on the push for universal coverage
The political impact of Medicare and Medicaid has benefited the Americans because of their role towards the push for universal coverage. For instance, the programs have offered comprehensive coverage to the low-income families, and it covers more than 65 million persons. The programs have aimed at improving the access to health care for the disadvantaged persons, the low-class citizens, and people with disabilities. Medicaid was expanded so that it could cover the population that was left out when it was introduced (Kirsch, 2013). Both Medicare and Medicaid pushed for improved care and the appropriate use of health services. In the process, quality of health care is improved because of various factors. These include the improvement of the likelihood of disease screening and early detection, efficacious treatment of chronic conditions like heart attacks, and the management of chronic illnesses. The Congress has played a critical role in passing increased budgets to fund universal coverage.
Major issues from the legislative and executive (presidential) perspectives
Obamacare is faced with controversial legal issues in its implementation. The web-based enrollment system is said to prohibit millions of American citizens to renew the already acquired nonconforming insurance policies. The ACA aimed at expanding the private insurance coverage in different ways. For example, the provision of subsidies (on a sliding scale) assisted the uninsured persons and families to access private health insurance coverage with much ease. The government openly announced that all US citizens and documented immigrants could obtain health insurance. The law made it clear that those who will fail to have insurance coverage by the end of 2016 will face financial penalties as stipulated in the new legislation. The PPACA received support from Obama and Democratic leaders, while on the other hand, it was opposed by the Republicans.
The executive defended the implementation of universal coverage arguing that it will improve health care services in the US. For an extended period, health care was accessible to the high-income families and unaffordable to the poor citizens. Most of the US citizens could not afford the high costs of healthcare and opted to skip care. The government asserted that the legislation addressed the gaps that exist in health coverage for the benefit of the population. Although the PPACA for the expansion of public insurance coverage, the eligibility of Medicaid was questioned and was put optional at the state level by the supreme court (Jones et.al, 2014). The passing of the bill was faced with stiff competition from both camps, but the Democrats won slightly over the Republicans recording 220 votes compared to 211 by those who opposed the bill.
Politics surrounding the nation health insurance agenda and its impact on the PPACA
The opponents and proponents of health insurance agenda engaged in fierce politics regarding PPACA. The advocates of the legislation supported the increased role of the government in health care delivery claiming that it would improve services offered to the people. On the other hand, critics argued that strengthening the role of the government in managing and regulation health care could weaken the health care system and result in more failures. The opponents preferred a path characterized by the principles of patient-centered, market-based health care reforms (Kirsch, 2013). They argued that the system would allow citizens to make their choices since they will be empowered. The politics have affected the implementation of the PPACA because of the strong opposition it faces. For example, the Supreme Court passed a ruling that the expansion of Medicare was optional and not mandatory at the states level.
References
Hoffman, C. (2009). National health insurance: a brief history of reform efforts in the US. Henry J. Kaiser Family Foundation.
Jones, D. K., Bradley, K. W., & Oberlander, J. (2014). Pascal's Wager: health insurance exchanges, Obamacare, and the Republican dilemma. Journal of health politics, policy and law, 39(1), 97-137.
Kirsch. R (2013). The Politics of Obamacare: Health Care, Money, and Ideology, 81 Fordham L. Rev. 1737. Available at: http://ir.lawnet.fordham.edu/flr/vol81/iss4/4
Tailor, J. W., Burr, J. D., & Forman, L. (2014, February 11). A Brief History on the Road to Healthcare Reform: From Truman to Obama. Retrieved from http://www.beckershospitalreview.com/news-analysis/a-brief-history-on-the-road-to-healthcare-reform-from-truman-to-obama.html
