I also had to do another final on health care reform and as this is something that affects us all, and many people have not taken the time to research it, I thought you may like to read it!

Health Care Reform in America

                Health care is a necessity that some Americans are unable to achieve. Health care reform is something that makes the unachievable something more people are able to access. The federal government has been working on health care reform to assist people who have no insurance. Past proposals have changed the way that health care was provided in America. Current proposals will change many things in the health care system. There are positive and negative aspects of health care reform.

                Health care reform is a way of discussing and changing or creating major health policies. It takes place in congress and can provide many changes. Things that health care reform normally focuses on are the uninsured or underinsured populations. Health care reform commonly attempts to provide care to more citizens, improve the access to health care and health care specialists and decrease costs of health care. Often times there are strong opposition to health care reform because it can lose the larger corporations undeserved profits while making prices and policies more fair for consumers.

                Many times in the past health care reform has taken place. In 1912 President Theodore Roosevelt campaigned promising national health insurance (Goodridge, 2011). In 1929 Baylor Hospital in Dallas Texas began a prepaid program with a local teaching union (Goodridge, 2011). This was thought of as the first example of modern health insurance program. Then in 1931 in Oklahoma Dr. Michael Abraham Shadid formed the Farmers’ Union Co-operative Health Association (Goodridge, 2011). This was thought of as the first HMO or Health Maintenance Organization. In 1934 President Franklin D. Roosevelt tried to implement a national health insurance program, but because of legislation it was never seriously considered (Goodridge, 2011). Plans such as this are still opposed by the American Medical Association because they feel it would increase bureaucracy and limit physician freedoms (Goodridge, 2011).  In 1938 the popularity of prepaid hospital insurance increased and was advertised at three cents a day, but excluded persons 66 and older (Goodridge, 2011). In 1945 President Harry S. Truman called on congress to increase hospital coverage and double the number of doctors and nurses  in a 10 year plan, but was held up in congress after the American Medical Association warned it would create socialized medicine (Goodridge, 2011). Truman tried once again to implement this plan in his 1948 re-election but the plan was abandoned by outbreak of the Korean War (Goodridge, 2011). In 1954 a tax exemption was created to exempt employee benefits such as health insurance from income taxes, which has been hotly debated ever since (Goodridge, 2011). Just in 2008 the tax cost an estimated $226 billion in lost taxes (Goodridge, 2011).  The birth of Medicare and Medicaid occurred in 1965. In 1973 Nixon signed the Health Maintenance Organization Act (Goodridge, 2011).  1974 brought the Employee Retirement Security Act which exempted large corporations self-insured health plans from state regulations (Goodridge, 2011).  1986 was the year for Cobra. Congress passed the Consolidated Omnibus Budget Reconciliation Act allowing employees to continue their health care coverage for up to 18 months after losing their jobs (Goodridge, 2011). At the same time the Emergency Medical Treatment and Active Labor act was brought around, which required hospitals to screen and stabilize all patients coming into emergency rooms (Goodridge, 2011).  Before this act people would be turned away from hospitals and forced to seek care somewhere else or not receive any care at all. This has single handedly lowered death rates. President Clinton began a reform act which faced universal coverage based on the idea of managed competition in 1993, but the plan failed to pass through congress in 1994 because of powerful lobbying by interest groups such as drug companies and doctors (Goodridge, 2011). Clinton then created the State Children’s Health Insurance Program in 1997, which is now covering more than seven million children nationwide (Goodridge, 2011). Then in 2006 confusion was created when Medicare Part D began (Goodridge, 2011). This caused beneficiaries to report confusion through dozens of private plans trying to avoid the gap in coverage. This gap was nicknamed “the doughnut hole. In 2009 Barak Obama was elected president and began work on the current health care reform plan. March 23, 2010 President Obama signed the Affordable Care Act (U.S., 2011). This act will change the way we look at health care in America.

The new law is supposed to go into effect fully in 2014, but some changes will take place immediately. These essential changes will make life better for everyone. First and foremost a new Patients Bill of Rights will be put into effect to stop abuse of consumers in private health care (White House, 2011). Through this law up to four million small businesses will be eligible for tax credits (White House, 2011). This will make it so that it is easier for employers to provide coverage for their employees, and will make premiums more affordable. Another change that will take place is young adults being able to stay on their parents plans (White House, 2011). This will make it so that many young adults will have health care coverage on their parent’s plans until they are 26. Many people in this age group are unable to afford insurance and are not offered it through work. If these young adults are re offered coverage through their jobs they are also available to receive that aid. Out of 2.4 million young adults 1.8 are uninsured and nearly 600,000 people in this age group that currently purchase this insurance would be available to receive this change (White House, 2011).  Another part of the law that will benefit many people is that uninsured Americans with preexisting conditions will be able to get insurance through the new Pre-Existing Condition Insurance Program or PCIP (White House, 2011).  This means that many people who were before unable to attain insurance are now able to reach it. One incredibly beneficial policy is in effect for businesses, non-profits, state and local governments and unions. It will make it so that early retirees between age 55 and 64 will be able to maintain reliable health care (White House, 2011). More than 2,000 employers have been approved to participate in this $5 billion Early Retiree Reinsurance Program (White House, 2011).  The last immediate change that will be taking place is states receiving critical assistance from the $30 million grant program to establish consumer assistance offices (White House, 2011). This will make it so that consumers will have a place to receive help when needing assistance with their insurance company. Because of this 46 states are using resources that were provided by the Affordable Care Act to make sure that there are no unreasonable premium increases (White House, 2011).

2014 will begin a new revolution of changes for many people. Competitive private health insurance exchanges will provide millions of Americans with the ability to pool together funds and purchase affordable and quality coverage (White House, 2011). The health care market place will be changing completely. Health care will be made affordable for all. The new law will take steps to cut health care costs and reduce deficit. The law will reduce deficit by over $100 billion the first decade and $1 trillion the next decade (White House, 2011).  The law ensures that seniors will still be protected and guaranteed Medicare benefits. Waste, Fraud and abuse will be fought. The new law is supposed to close the donut hole gap for seniors by 2020 and the seniors who fall into that gap will receive $250 rebate checks and a 50% discount on brand name prescription medications (White House, 2011). The new health care market will be established in 2014.  Many things will change in the new market. There will be a new competitive private health insurance exchange that will offer some of the same choices of coverage as some members of congress. This will make it so that people are able to purchase affordable coverage the same way as large employers do. Small businesses with less than 25 employees will be eligible for enhanced tax credits to pay for their employee’s coverage (White House, 2011).  Small businesses with up to 100 employees in one state will be able to join SHOP exchanges where they can pool together with other businesses and get larger plans with affordable quality insurance (White House, 2011). All together the provisions of the law are supposed to expand coverage to 32 million Americans (White House, 2011).  There are things that this law is doing to strengthen Americas Fiscal Health as well. The law is cutting health care costs and reducing deficit in different areas. When this new law goes into effect Americans will be able to purchase comparable insurance to what they had before, but the premiums will fall by 14 to 20 percent and the total cost to Americans would fall by $3,000 a person (White House, 2011). The new law will provide tax credits for Americans whose income is up to 400 percent of the poverty level (82,200 per year for a 4 unit family) so that they are able to purchase health insurance through a state based exchange (White House, 2011).  Persons who are in the individual market who qualify for tax credits could see premiums drop by 60 percent (White House, 2011). Strategies that this new law will do to increase fiscal health are to fight waste, fraud and abuse, to reward providers for delivering high quality care, and to reform our health care delivery systems by developing innovative ways to manage patient care, especially with chronic conditions (White House, 2011).  These changes will encourage providers to deliver higher quality services because payment structures that promote value will be used. Over all the deficit will be reduced by $100 billion this decade and $100 trillion in the next decade.  The protection of our seniors is a necessity. Before the Affordable Care Act the fiscal health of Medicare was weak at best, this new law took steps to shift the course of Medicare and secured its long term future. This law will extend the life of the Medicare trust fund by 12 years from 2017 to 2929 so that future generations of seniors will be able to use it (White House, 2011). Today Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than Original Medicare and the payments are paid by increased premiums by all Medicare beneficiaries, so this new law will make it so that overpayment to insurance companies like this will be eliminated.

                There are many people that are completely for health care reform. There are also many positive aspects going for health care reform.  The positive reason for health care reform is that fewer uninsured people will lead to a lower costing health care system. The health care reform could make it possible for 30+ million uninsured Americans to be able to have coverage (Johnson, 2010).  This is a benefit not only to the people who will be receiving insurance, but to everyone else too. Health care provided to people who have no insurance is a burden to everyone and creates higher costing health care benefits. The next beneficial change will be no more cap on coverage. This is a big change because previously insurance companies were able to cut service on specific things when a patient had hit a specific amount paid out for that service. This will help people who have chronic conditions or who are injured and need temporary care. The next change will be that insurance companies will no longer be able to refuse coverage based on preexisting conditions. Many people were unable to seek medical care or had to use the emergency room as a basis for medical treatment because they were denied insurance because of a preexisting condition. Starting in 2014 this will change and everyone will have an equal opportunity to access health insurance (Johnson, 2010). The next positive change is keeping children on their insurance plan unless they are able to access care through their jobs. Keeping kids on their parents plan is cheaper than if they are insured individually (Johnson, 2010).  More employers will also be offering coverage because they will be able to afford it either with low cost group plans or by grouping with other like companies. Possibly the largest change will the change in preventative care coverage. The new law says that these things should be free (Johnson, 2010). This will cover things such as physicals and other preventative care. A better appeals process has also been created. More assistance for seniors has also been added to the law.

With everything there are positives and negatives. The thing is that this reform has not been fully passed through congress so it may not even go through. Another feeling that many people have is that over the next 10 years the cost of the reform is expected to come just short of a trillion dollars. Many people say that this is a terrible thing, but others state that it will still be saving money even though it is costing money. There will be more fees for drug companies and insurers, and fees on employers who don’t offer coverage to their employers (Johnson, 2010).  These places feel that this is going to cost them too much money if they don’t want to comply with the new law. Increased governmental involvement in healthcare is one of the largest concerns of many individuals (Newport, 2009).  Many people are worried that they will not have adequate access to the same healthcare they previously had and that the quality of health care will be diminished because there will be more patients (Newport, 2011).  Others feel that healthcare will not expand to enough people in enough areas.

Health Care reform is a necessity for America. We can see that through past health care reform many things have changed  or been created. The current health care reform program will slowly begin to change things now and continue to change them until 2014 when the program will be fully put in place. There are many positive things about the changes that will be occurring. There are as in everything people who oppose this change, and don’t want it to go through. Although it has not been put through congress yet, it is needed and will happen sooner or later. The current plan is strong and will help many Americans. Many changes in the past have been beneficial to Americans while other changes have been overturned by congress due to excessive lobbying.