Healthcare in the United States: Timeline and Reforms
1. Introduction
The essay has been divided into three major sections as follows: 1. Introduction 2. Historical Overview and Discussion of Major Reforms and 3. Current Challenges in the U.S. Healthcare System. The first section provides a brief background of the U.S. healthcare system and the major issues the country faces. This is done to provide context for the subsequent discussions in the essay regarding healthcare reforms. The second section, as the title suggests, provides a historical overview of major developments and reforms in the U.S. healthcare system. The discussion starts from the early 20th century and moves through different time periods to the present. Major legislative reforms are discussed in detail in this section, including the Social Security Act of 1935 and the Tax Equity and Fiscal Responsibility Act of 1982. Next, the essay examines the current challenges facing the U.S. healthcare system.
1.1 Background
The healthcare system in the United States is complex and multifaceted, and the country’s health history can provide some insights into these complexities. According to DeLeire and Dague, the US has been attempting to deal with issues of healthcare allocation for nearly a century. It was in the 1920s that many influential American physicians and organizations began to advocate for some kind of government health insurance program and in 1929 Baylor Hospital in Dallas, Texas came up with a novel way to cover patients’ hospital expenses. It offered a deal whereby people could pay a small amount of money every month; in return, their stays in the hospital would be covered. This is often seen as the beginning of healthcare insurance in the United States and this type of cover would eventually be referred to as ‘Blue Cross’. However, this did not become widespread until the 1930s and it has also been noted that the doctors who were involved with the Baylor Hospital plan were somewhat wary of its long-term success. During the early part of the 20th century, most American healthcare took place in the home, a situation that was quickly changing by the middle of the century. The number of hospitals in the US doubled between 1929 and 1946, and many of these establishments were seen as community symbols of civic pride. By 1940, healthcare spending accounted for an estimated 3.5% of the gross national product in the US, almost double what it was in 1929. However, despite the increased political emphasis on healthcare and the innumerable debates and discussions that had taken place, there was still no sign of a national policy on either health insurance or the funding and provision of healthcare. This is not to say that presidents and presidential candidates did not attempt to change this: for example, in 1912, former president Theodore Roosevelt included health insurance as part of his ‘Progressive Party’ platform when he fancied returning to the top job.
1.2 Purpose of the Essay
The purpose of the essay is to give insight into the origins of the US healthcare system and, more importantly, to make known the various reforms that have taken place in the healthcare system, starting from the 20th century. This is because healthcare in the US is provided by many distinct organizations. The US spends more on healthcare as a share of the economy – 16% – the highest share in the world. This is mainly due to high costs, technology, and salaries. In 2017, America’s spending on healthcare reached $10,224 per person. This makes the western nation’s overall spending on healthcare at the same level as a few of the eastern European countries and Turkey. This means that in terms of funding per person, the US healthcare system is more similar to the healthcare systems of developing nations than it is to the Western nations which its leaders so often seek to distinguish it from. Healthcare in the US is very costly in comparison to other countries, and the majority of it is funded either through health insurance from private insurers or from the government, i.e. Medicare/Medicaid programs. For more than 50 years now, the importance of health policy making has been growing, especially in the area of finance and delivery of services. As well as the significance of managing healthcare costs has grown too. Chris Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, has said of America’s health system: “Spending that much of the GDP on healthcare is like a tapeworm on the American economy.” He also went on to say that “It’s a big weight on the economy and it’s going to affect the quality of life for our children, yet for the past 35 years, we’ve done very little about it.” This continuous struggle to transform the US healthcare system has transformed it year after year. Also, the various reforms are characterized by the type of impact that they had on the general healthcare system and, more importantly, the effects that they have had over time as the reforms continue to be implemented. So basically, different reforms are implemented and they each represent a different solution. Some changes are radical and have a significant impact on the way that healthcare is provided. Others change the existing healthcare. Also recently, other US healthcare systems, e.g. the Obama administration, brought the largest change to the US healthcare system since the 1965 creation of the Medicare system with the introduction of the Affordable Care Act. It is also referred to as “Obamacare”.
2. Historical Overview of Healthcare in the United States
The second section “2. Historical Overview of Healthcare in the United States” starts with the discussion of the development of health insurance in the United States. Health insurance in the United States can be traced back to the 1920s and the 1930s when the Baylor Hospital in Texas, in order to give teachers access to its facilities, formed an agreement with Dallas teachers and Dallas-based. The agreement provided them with 21 days of hospital care a year for a premium of $6 a year, which is equivalent to by today’s standards and utilizing simple inflation just under $80. This is the first example of a pre-paid hospital insurance plan. These plans started to emerge around the country, and at the national level, the American Medical Association was formed in 1847 and has been opposed to the idea of national health insurance, and he argued against the public option. However, by the mid-20th century, there were significant efforts left on the creation of the national health insurance system. For example, President Harry Truman had a proposal in 1945; and President John F. Kennedy had a proposal in the early 60s. But the proposal of Lyndon B. Johnson, as being elected as president in 1964 and the convincing election victory, arguments can be passed and that laid the groundwork for the establishment of Medicare and Medicaid. If we go to the 21st century, in 2003, the first significant health data standards were proposed by the Department of Health and Human Services under then-President George W. Bush. It’s important legislation, mainly HIPAA, requires all United States citizens’ medical records are kept confidential and access to them is limited to those who need to view them and that this kind of legislation works well with the implementation of electronic health records, which was furthered in 2009 by Barack Obama and his famous Obamacare or ACA act.
2.1 Early Developments
Many medical doctors, with their vested interests in maintaining high fees for service, were opposed to the formation of medical boards. Nonetheless, by 1870 both the Pennsylvania and New York state legislatures introduced and passed bills for the establishment of state medical boards. The following decade saw the widespread formation of medical boards across the United States. As more and more stringent qualifications for practicing medical physicians were introduced, access to such practices became increasingly restricted to those with medical degrees from recognized medical colleges; in itself a profound change from the rather haphazard system of medical training and approval formerly in place. These centuries saw great leaps forward in the regulation of the healthcare industry and the laying down of legislation designed to protect both doctor and patient. For example, the American Medical Association was founded in 1847, which at the time was a radical body committed to medical education and better practices, as well as the establishment of ‘permanent and uniform’ state medical boards. By 1900, two thirds of the states in the US had formally established such boards. Equally, the Flexner Report of 1910 represented a sea change in the delivery and quality of healthcare in America. Ordered by the American Medical Association, the report investigated and evaluated 155 medical schools in the United States and Canada. Many were found to be offering little or no practical medical training and the resulting report, which called for widespread reform of medical education, led to the closure of nearly half of such institutions and the imposition of far more professional and research-led practices to the teaching of medicine. The Medical Service Association of Pennsylvania, inaugurated in 1935, helped to popularize the concept of group medical insurance that spread throughout the country. It used the effective technique of enrolling large blocks of subscribers and paying member physicians a regular income for their services on a fixed fee basis. This in turn persuaded many doctors to join the plan, attracted by the promise of a defined and stable income for their medical work. This model would endure and evolve into more complex systems such as Health Maintenance Organizations and Preferred Provider Organizations, and would contribute to the establishment of the Blue Cross and Blue Shield plans in hospitals and medical care.
“Early Developments”
2.2 Rise of Private Insurance
However, the National Academies concluded that the great limitations to adopting a national system like that of the UK are cultural and social values held by the citizens and residents within the US towards independence and freedom of choice. As such, it is widely believed and generally accepted that society is responsible for the welfare of its citizens and residents who may be in need and therefore subject to the changing moral and ethical beliefs and attitudes of the community.
This contrast in ideologies and health policies between the UK and the US is best and most fittingly summarized by a report made by the National Academies, which noted that the UK system – that is, a national and publicly funded system – is based on the core principle that healthcare should be for the good of the population rather than the profit of the service providers. Nevertheless, private healthcare in the UK is present and widely available to those who wish to pay for it, albeit the majority of citizens and residents opt for the public national health service.
Despite attempts to introduce a system of social health insurance, the American Medical Association actively fought against it and ultimately prevented its formal adoption, arguing that it would lead to a system similar to what the UK had adopted, which in the eyes of the members was both ineffective and inefficient. The AMA also feared that the system would lead to a state-run health service that doctors and other healthcare professionals would be forced to join, and as a result, their collective bargaining position as independent and individual care providers would be weakened.
The private health insurance system expanded greatly during the Second World War when the government-funded wartime economy decided to implement wage and price controls to maintain a strong and efficient economy during the global conflict. However, as a consequence of not being able to offer potential and newly recruited employees higher wages, employers instead began to offer employment-based and tax-subsidized private health insurance packages, which could legally be classified as part of the employee’s overall wage. This was further encouraged when the Internal Revenue Service announced in 1954 that it would not treat the contributions that employers made to the employees’ health insurance premiums as taxable income. The employers themselves could also have their share of the costs exempted from federal and state payroll taxes. As a result, a tax subsidy was created for providing and receiving employment-based insurance, which has over time been a primary factor in the continually increasing proportion of Americans who are able to access some form of private health insurance.
Private health insurance in the United States exists in two main forms – the health maintenance organization (HMO) and the preferred provider organization (PPO). There are no restrictions on any person to either give or receive insurance. Both the private and public systems in the US are designed to encourage patients to use full and total access to all available and applicable healthcare services.
2.3 Medicare and Medicaid
In 1965, President Lyndon Johnson established Medicare, a health insurance program for the elderly, and Medicaid, a health insurance program for the poor. At that time, more than a third of the elderly in the United States had no health insurance. The cost of hospital care was rising. Most families simply could not afford adequate medical care. Medicaid enabled poor people to receive medical attention, thus being able to prevent chronic disability. In the years that followed, more categories were added to both Medicare and Medicaid. For example, Medicare Part B, which serves as supplementary medical insurance to assist in paying for some of the physician’s services and outpatient care, was established. Today, Medicare covers not only the elderly, but those under 65 with certain disabilities, and people of all ages with permanent kidney failure. The establishment of President Johnson’s Medicare and Medicaid initiatives could be traced back to when President Harry Truman proposed for the establishment of a national health insurance plan and when President John Kennedy also proposed to Congress to assist the elderly with hospital and medical bills. In fact, the other two presidents also had the same visions as President Johnson to achieve a better quality of life for the citizens of the United States. As the Medicare and Medicaid programs have been updated, millions of men, women, and children have been able to gain access to modern medical care that previously was denied to them. Both programs, Medicare and Medicaid, have continued to be a major force in the nation’s efforts to control the rising cost of health care. Also, Medicaid has also performed an important function in the national welfare program by enabling the states to offer better medical services to those who desperately need it. This is not only in line with the goals of Medicaid, but also the objective and opinions of President Lyndon Johnson, who also pointed out that any person who may be medically indigent in any state could receive the necessary medical care through Medicaid. However, as much as Medicaid would like to help as many people as possible, there are still eligibility criteria for Medicaid in every state to ensure that the services and the benefits of Medicaid are provided to people who really need it more. As of today, the enforcement and implementation of Medicaid program are now in the hands of the state. This is because each state has a wide version of its Medicaid program. However, despite the differences in the Medicaid programs, they all must comply with federal guidelines. Also, by having the state involved in the operation of the Medicaid program will allow a better management and the opportunities to discover new benefits for the Medicaid patients.
3. Major Healthcare Reforms in the United States
First, in the late 1990s and early 2000s, there were limits placed on the ability of health insurers to use pre-existing conditions to deny coverage. HIPAA also allowed individual workers and their families to sign up for new health coverage if they had lost their previous coverage. This was significant as many Americans relied on their jobs for healthcare; if they left their jobs for a new opportunity or if they were let go, they would leave behind their health insurance. With HIPAA, they could port their coverage. Critics of the legislation saw HIPAA as an instrument to erode privacy and limit patients’ rights. This is because the Act expanded the ability of the government to audit a covered entity without having to first seek permission from the entity and it worked to make transparency between the government and the public. The MMA focused on making prescription drugs more affordable for seniors. The Act estimated that the number of Americans over the age of 65 who are without prescription drug coverage and who do not yet have Medicare Part D coverage is somewhere between 11 and 13 million. MMA helped to establish a new part of Medicare – the prescription drug plan, or Medicare Part D. This was huge for seniors, many of whom require multiple medications to stay healthy. The new coverage made using discounts and preventive care to reduce the need for high cost medical procedures a viable option, and it also created a financial incentive for employers to maintain prescription drug coverage. It is available to all Medicare beneficiaries, regardless of income, health status or prescriptive drug expenses. The final major points of the Act related to payment and program reforms, such as providing bonus payments for high quality care and promoting the use of preventive care. The overall trend of HIPAA’s implementation has been to increase federal leadership and involvement in the administration of health laws and policies. Although most medical professionals today have become accustomed to the fact that personal health information has to be protected, some doctors feel that their work environment has become more complicated. However, most experts’ opinions agree that the nation’s healthcare system has greatly benefited from HIPAA and the fundamental principles it established.
3.1 Affordable Care Act (ACA)
The Affordable Care Act, commonly known as “Obamacare”, is a landmark piece of federal legislation that has transformed the landscape of American healthcare. The ACA was signed into law by President Barack Obama in March 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer, and the main provisions of the law were phased into the healthcare system starting in 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay. The central aim of the ACA is to make healthcare more accessible and affordable for all Americans. The law includes a vast range of reforms designed to improve the availability, quality, and cost of healthcare. One of the most well-known aspects of the ACA is its provision preventing insurers from denying coverage to individuals with pre-existing conditions. This was a major breakthrough for many people who had previously struggled to obtain decent insurance. The health insurance marketplaces, known as “exchanges”, were also created to help individuals navigate and compare different insurance options, ultimately empowering people to choose the best policies to suit their own needs. Another core component of the ACA is the expansion of Medicaid. Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program (CHIP), provides healthcare coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. The ACA aimed to broaden the eligibility standards for this program, meaning that more and more Americans can receive vital health benefits through Medicaid. Moreover, the ACA established the Prevention and Public Health Fund, which is an unprecedented investment in prevention, funding such initiatives as immunization, support for community and clinical prevention efforts, and research on environmental and other factors that impact public health. The law also contains a number of measures designed to promote innovation in healthcare and improve care quality. For example, the creation of the Center for Medicare & Medicaid Innovation has enabled the testing of numerous innovative payment and service delivery models that aim to improve patient care and lower costs. Such models include accountable care organizations, primary care medical homes, and bundled payments. The ACA emphasizes the use of interdisciplinary care teams and the implementation of new technologies to support and advance quality and efficiency. The legislation provides financial and technical assistance to support the uptake of electronic health records, which have the potential to massively improve the coordination and consistency of care through the digitization of patient information and health data. Popular with many progressive healthcare professionals and patient groups, these pioneering initiatives have the capacity to shape the future of American healthcare over the coming decades. Overall, the ACA represents the most far-reaching and comprehensive reform of the US healthcare system since the 1960s. Through the ambitious…
3.2 Health Insurance Portability and Accountability Act (HIPAA)
It was not until the 1980s when the advancements in technology became somewhat of a concern for patient privacy. Healthcare data was beginning to be stored digitally, as opposed to in a filing cabinet. With technology advancing and making it easier to transfer and share data, patient information was at risk and on the move. The growth of the internet and the increase in its use in the healthcare industry from around the year 2000 meant that new national standards were required to protect individuals’ personal and health information. HIPAA was enacted in 1996; however, it was not until 5 December 2000 that the new privacy rule was signed and became active in 2003. The HIPAA privacy rule regulates the use and disclosure of protected health information and gives rights to patients over their healthcare information. It also defines for the first time what is included in the term ‘marketing’ and sets out new, more clearly defined parameters on fundraising. Further advancements in technology, the growth in social media, and smartphone apps for health have led to the creation of tYELLOW, the first all-encompassing, real-time personal health management service that combines all aspects of healthcare – from patient medical records to medication management, from a single environment. tYELLOW markets itself as HIPAA compliant and puts great emphasis on the security and support of their system, something they have not necessarily been able to achieve in similar personal health record systems. And finally, the Patient Safety and Quality Improvement Act was signed in 2005. The PSQIA was designed to both encourage the reporting and analysis of medical errors in a confidential and protected environment and improve healthcare quality through the collection of data and information on patient safety. The Act allowed healthcare providers to have a framework in which to improve safety and was the first time a bill has looked at improving safety from a systemic perspective.
3.3 Medicare Modernization Act (MMA)
The Medicare Modernization Act (MMA) was signed into law in December 2003 and brought about the most sweeping changes to Medicare and Medicaid since their inception in 1965. MMA introduced the Medicare Part D prescription drug benefit, providing eligible persons with help paying for prescription drugs, as well as other changes such as the ability for Medicare beneficiaries to apply for coverage under private health plans, including private fee-for-service plans, under a new program known as Medicare Advantage. In addition to other changes and initiatives, such as providing coverage for prevention and management of obesity, MMA included a major modernization of the Medicare Part C program to reflect changes in the way managed care plans are operated and a range of new consumer protection measures. One such measure was the introduction of a national approved drug formulary which standardizes the list of covered medications that can be prescribed to those aged 65 and older and ensures that the most effective and cost efficient medicines are prescribed to patients. Additionally, MMA at Section 911 contains amendments to the Medicaid Act that require providers to ensure that they provide patients with a notice at the time of service explaining the right to medical assistance and the prohibition on billing those receiving such assistance. Such a notice informs the patient of the prohibition on balance billing the applicant and specifies sources of legal aid which may be contacted for further. The final part of MMA that I will mention is that it permits the Health and Human Service Commission’s Office of the Inspector General to remove a physician or supplier who has furnished goods or served that are substantially in excess of the needs of patients or of a quality that fails to meet professionally recognized standards. This authority is written into the Social Security Act at 42 U.S.C. sec 1320a-7(e)(5).
3.4 Other Reforms and Initiatives
The “other” category is diverse, but a few specific approaches and programs have been singled out for particular attention. In the 1990s, the Health Resources and Services Administration launched several initiatives to increase the racial and ethnic diversity of healthcare providers (“Minority Health”). These included grants for recruitment of students from minority or disadvantaged backgrounds, curriculum development focused on cultural competency and interdisciplinary collaboration, and mentorship and faculty development for new and current healthcare professionals. In 2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers, the Veterans’ Mental Health and Other Care Improvements Act created a number of new programs to help veterans, especially those returning from Iraq and Afghanistan. But funding for these programs was not actually provided until after the passage of the Affordable Care Act. Similarly, some began to question then-current levels of healthcare quality and the validity of some healthcare costs and spending. This led to increased attention to and efforts to promote “evidence-based medicine,” or the use of current best evidence, combined with clinical expertise and patient values, in making decisions about the care of individual patients. In 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer, the Affordable Care Act created a new Patient-Centered Outcomes Research Institute, (“PCORI”). The institute’s goal is to help people make informed healthcare decisions and improve healthcare delivery and outcomes by producing and promoting high-integrity, evidence-based information that comes from research guided by patients, caregivers, and the broader healthcare community. By 2013, some of the programs and reforms under the Affordable Care Act had already begun, but many of them were still to take effect or not to begin until at least as late as 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay. This gave rise to a growing practice of referring to the upcoming changes as “Obamacare,” a way of encapsulating or referring to any or every new development in health reform that was based on or somehow connected to the Affordable Care Act. The term was used in a wide variety of ways, but it was often applied when something was seen as radical and revolutionary, when somebody bemoaned a change that was coming, or when people appeared to be simply embarrassed about a change or discussion. Often, the term functioned as a rhetorical shorthand for more widespread or comprehensive change, but not always. For example, it was reported that a town hall meeting on the future of the American healthcare system in Grand Junction, Colorado, received a great deal of criticism for “promoting Obamacare” by providing information about how healthcare delivery and payment systems worked, and could be improved, using “medical records, digital x-rays or error-reducing systems”. Also, following the Supreme Court’s decision to uphold the constitutionality of most of the main provisions of the ACA in 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap, a popular White House website “We the People” received a petition asking that any law known as “Obamacare” should apply to members of Congress and their families as well as “everybody else”. This led to a certain degree of national conversation about the term and its use in presidential speeches. The White House, for its part, took the position that it was ready to accept the name for the health reform law, arguing that the term had originally been coined by opponents and was intended to be disrespectful to the president. However, the White House also noted that it was “inherent in the American political process of debate and democracy” that citizens would make use of a term they found powerful and poignant. In that sense, even the controversial title given to the Act can be understood as an example of the ongoing public engagement with political and legal process, reflecting the “petition of the governed” that continues through its implementation and experience every day.
4. Current Challenges and Future Directions
Rising healthcare costs have plagued the United States for decades. Over the last 30 years, healthcare costs have risen at a much higher rate than inflation. One of the main reasons for high costs is the lack of measures in place to control them; for example, the US doesn’t have a limit on expenditures as in the UK (NHS). If there was a limit to how much the United States could spend each year, it could lead to the elimination of things such as the high administrative costs. In a typical physician’s office, 21% of the salary goes towards administration. However, high costs can also be blamed on an aging population, expensive medicines, and a large number of chronic conditions like obesity and diabetes. Secondly, the United States is well known for its low-cost business model – companies rely on fast production, quick services, and value for money. As a result, over the years, health insurers as well as Medicare, a public provider of healthcare, have adopted a more ‘Americanized’ business model which is centered on making as big a profit as quickly as possible. For example, the US spends about 19% of its GDP on healthcare while the UK only spends 6%, suggesting that the US is aiming to get more money out of healthcare. Similarly, the simple American concept of ‘fee-for-service’ medicine could also be blamed; this is where doctors can make money from prescribing treatment and medicine to patients. Doctors don’t always favor the best and most efficient treatments because they’re getting rewarded for just about any type of patient ‘throughput’ (the number of patients that they can handle in a particular time). However, although the American healthcare system has often been regarded as the worst in the developed world, it does now seem that help is on the horizon. In fact, a recent analysis from the Federal Government seems to have concluded that the Affordable Care Act is really working. This act has, amongst other things, helped slow the rise in costs due to higher transparency and competition. The analysis suggests that health spending growth in 2013 was a record low, just 3.6%, and this will continue to increase over the coming years. Furthermore, an early provision of the act requires insurance companies to spend the majority of the premiums directly on patient care and, if they don’t, they will have to provide rebates to their policyholders. For example, in 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap, 77.8 million dollars were returned, and this was used to offset healthcare costs for the general public.
4.1 Rising Healthcare Costs
One approach to explaining rising healthcare costs focuses on the supply side: the costs of providing healthcare services. These costs arise because the supply of healthcare is subject to increasing returns. This means that the price of healthcare services is usually affected more by the quantity and scope of those services than by improvements in the productivity or efficiency of producing those services. In business and economics, “increasing returns” describes a situation in which the cost of producing an additional unit of a good or service falls as its total output rises. In contrast, the dictated price setting by insurance companies and the lack of consumer knowledge about the price of healthcare services are characteristics of healthcare economics that many believe ultimately stem from the high costs of healthcare services. This is because health insurance overwhelmingly operates with an interventionist model, meaning that patients are partially or completely shielded from the costs of their healthcare. Because of the additional buffers against the true cost of healthcare services for patients, healthcare providers know that they can more easily charge higher prices to insurance companies. That is, when patients do not face the full cost of their healthcare decisions, healthcare providers can inflame the supply side factor that population theory would predict. This can ultimately increase the demand for healthcare services and helps to explain continuously rising healthcare costs. And because there is little price transparency concerning healthcare services in America, many patients do not have the opportunity to have an active role in managing their healthcare costs, further enabling healthcare providers to inflate those costs. These costs spiral to expand not only the respective profits of healthcare providers but also the overall costs of nationwide expenditures on healthcare. All of these factors that contribute to the consistent rise in healthcare costs can be linked and understood in the context of economic theories such as population theory and supply side theory.
4.2 Access to Care
The lack of affordable health insurance has prompted many physicians to set up practices in wealthier areas where patients are more likely to have the means to pay out of pocket. This urban sprawl of physicians with less frequent buses and an expanding aging population can create many access to care barriers. The number of different health insurance plans and standards for patient care has continued to rise, making it difficult for practices to turn a profit and keep their doors open. The shortage of doctors in rural areas during a time of increasing provider retirements and higher medical school admission standards, as cited by the Act, are other significant barriers to access to care. The Obama administration recognized some of these access to care barriers and began implementing the first mandatory health insurance coverage for all Americans. In 2015 – Research Paper Writing Help Service, the Affordable Care Act was passed, and the new health insurance marketplace was created. Thanks to these measures, by 2016: 2024 – Do my homework – Help write my assignment online national uninsured rates decreased by 43% for African American adults and by 47% for Hispanic adults. The percentage of Americans who were unable to see a doctor due to costs was reduced by 5%. The Census Bureau reported that in 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer, 22% of Americans living at or below the poverty line were uninsured. By 2016: 2024 – Do my homework – Help write my assignment online, the uninsured rates were cut in half to only 11%. Still, there is a long way to go and much left to be done in the continual effort to improve access to care for all Americans. For years now, the population of the United States has been recognized as one of the least healthy, and America is unique in that it is the only high-income yet highly populated country that does not have a uniform health system that guarantees access to medical appointments. Access can mean the difference between novel surgeries and treatments and the difference between life and death. However, underprivileged and vulnerable populations throughout American society have been diagnosed with serious health conditions at later stages in the disease process, and many have a reduced chance of recovery. Symptoms are managed and controlled when patients finally get the chance to see a doctor, but at that point, the condition is irreversible. Too many must rely on emergency services and last-minute treatments instead of preventative care that can lead to a healthier life when primary care services are a feasible option for them. This causes far more strain on the national health service budget. Well-documented health disparities among different socioeconomic groups make accessibility to care and treatment that much more important. For the wealthy, access to health care is easy and nearly always available. For the underprivileged and those who are part of a lower income bracket, life, health disparities are more significant and many lead to lower chances of overcoming serious health conditions. Programs such as Medicaid serve the underprivileged, but still, the requirements for even obtaining government assistance provide a barrier to many who need those essential services. Social and behavior health best practices as relayed by the Department of Health and Human Service budgets show an increased emphasis on moving towards a more integrated system of health care each year. Furthermore, initiatives and challenges to the future success of promoting integrated practice are being outlined as funding is being made available for the purpose of promoting innovative patient care.
4.3 Health Disparities
Health disparities are differences in health outcomes between groups that reflect social inequalities. The US Department of Health and Human Services (HHS) defines health disparities as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.” It is noted that certain racial and ethnic minority groups have higher rates of chronic diseases and suffer from higher mortality rates than non-minority groups. African Americans, Hispanic Americans, American Indians and Alaska Natives, and some Asian Americans suffer from a burden of diseases that is more severe than that suffered by white Americans. One of the key sources of health disparities is the constellation of social, economic, and environmental disadvantages faced by many racial and ethnic minorities. Access to quality healthcare, proximity to healthy food choices, safe neighborhoods, and opportunities for regular physical activity and health education are important contributors to good health. As a matter of fact, children from undocumented immigrant families are at a disadvantage when it comes to accessing healthcare services. They are less likely to be insured, are more likely to be in fair or poor health, and are more likely to experience an unmet medical need. Reluctance to seek out services due to fear of deportation was also reported among parents of undocumented children, leading to a higher prevalence of unmet health needs among this population. In order to eliminate health disparities, we need to address differences in access to medical services. When racial and ethnic minorities are not able to obtain the healthcare services they need, it is referred to as a “service disparity”. The lack of access to healthcare can be due to the inability to pay for services, cultural beliefs and practices, or a lack of information. The implementation of the Patient Protection and Affordable Care Act (ACA) in 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay was an important step in addressing service disparities. By expanding health coverage and protections for millions of Americans and implementing new benefit provisions, the ACA helps to make services more accessible and cut down on the differences that exist between the kinds of care provided to racial and ethnic minorities and to white Americans. By providing insurance coverage in a number of different ways, such as through the creation of health insurance marketplaces and the expansion of Medicaid, the ACA strengthens the services available to racial and ethnic minorities and helps to bridge the gap between these groups and white Americans. The essay “Healthcare in the United States: Timeline and Reforms” discusses a range of current challenges and future directions that US healthcare is focused on, including rising healthcare costs, access to care, health disparities, and technological advancements and innovation. By focusing on healthcare disparities based on race and ethnicity, this section of the essay provides important real-world information that brings the long history of health policy reform in the US to life. It explains the ways in which the healthcare system is working to minimize these types of differences and takes a special look at some of the most innovative and successful current efforts to reduce disparities and improve the health status of racial and ethnic minorities. This section is connected to the rest of the essay in the sense that it discusses some of the solutions that certain reforms and policy changes have put forth, and it connects to the overall conclusion of the essay by providing a “real life” application of policy research and findings.
4.4 Technological Advancements and Innovation
One of the most exciting developments in the field of health care is the use of new technology and better ways of communicating between patients and doctors. Some people think that advances in technology will solve the health problems of the world. It is true that research into new treatments and cures is very important. For example, nanotechnology, which involves manipulating matter on an atomic and molecular scale, is being used to find ways of detecting diseases such as cancer much earlier than was previously possible. Also, progress is being made all the time in the field of regenerative medicine. This is a new branch of medicine where doctors are able to repair, replace and even regenerate cells, tissues and organs in the body. Young people will especially benefit from these new discoveries, such as new limbs which can grow with them instead of children having to have a new wheelchair or callipers made every year which is the current situation. However, it is not enough just to develop new technology if it is not available to all people. Inequalities in access to medical technology can have huge effects on the health and life span of people in different sectors of society. Such inequalities may be perpetuated by lack of government funding. For example, the NHS is always in need of money in order to update its use of information technology in hospitals and GP surgeries. Also, groups in America like the National Science Foundation promote the use of discoveries in aiding society but little is done to enforce that and ensure that no medical discoveries benefit only the rich. Yet, the benefits of health IT as a form of innovative medical technology have managed to reach an overwhelming number of patients over the last decade, linking the health landscape in many cases towards more effective care and lower costs. For example, one current medical software company has pioneered means of helping smokers quit, with a solution that has been proven to be three times more effective as a form of producing successful results. The use of technology, such as 121doc Online Doctor based services, has been proven to provide more accurate diagnoses and treatments compared to more traditional practices, so it is important that new advances reach every corner of the globe. Also, modern science has recognised that people’s health is not just affected by medicines and surgical techniques. Sociological, economical and psychological factors all play a role, known as ‘Social Determinants of Health’. This approach has widened the scope of medical research, helping to improve the health and well-being of different societies. However, research and technology have made huge impacts on find new ways of delivering care and enhancing how people live on a day to day basis. The telehealth service, formerly known as ‘NHS Direct’, provides health information and advice over the telephone. Video conferencing and ‘virtual consultations’ are currently reducing the need for some patients to have to travel long distances to a hospital by allowing physician to share knowledge from specialists. Also, the use of ePrescriptions and the digital scanning of personal records have greatly reduced the risk of patients being given the wrong medication. All these technological advances have gone towards reducing the pressures faced on primary and secondary care in many industrialized nations that have adopted these methods, with similar successes being seen in private medical practices too.
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