The History of Health Reform and Politics

¡Supera tus tareas y exámenes ahora con Quizwiz!

1986-COBRA(Consolidated Omnibus Budget Reconciliation Act)

contains specific regulations that allow employees who lose their jobs to continue with their health plan for 18 months.

Carter

* National health reform efforts are completely stalled in the face of an economic recession and uncontrollable health care costs - President Carter prioritizes health care cost containment over expanding coverage

1950's

* President Dwight D Eisenhower takes office in 1953 - Had opposed government health insurance during his campaign * The AMA's war chest helps to defeat over 80%of pro-health insurance legislators in elections. * Minimal advances toward health insurance in the 1950's so private insurance steadily grows... - One exception: Military "medicate" program enacted, providing government health insurance for dependents of those in the Armed Forces.

1980,s Reagan Administration

* Reagan administration arrive in Washington with an agenda that include reducing federal regulatory intervention and cutting social programs - The Medicaid program experienced major cuts - Medicare survived in a large part because of the powerful political mobilization of senior citizens. * 1986-COBRA(Consolidated Omnibus Budget Reconciliation Act) contains specific regulations that allow employees who lose their jobs to continue with their health plan for 18 months. - Medicare Catastrophic Coverage Act (MCCA)-to protect seniors from bankruptcy from medical costs.

The "Three Layer Cake"

* Kerr-Mills bill gets combined with Johnson administration bill to create a "three layer cake" - State-based health insurance for the poor - Federal hospital coverage for the elderly - Federal physician coverage for the elderly * Which health insurance programs do these sound like? Medicare and Medicaid

National Health Insurance and the New Deal

* 1934-FDR creates the committee on Economic Security to address elderly and unemployment issues, as well as medical care and insurance. - Committee on Economic Security issues final recommendations, none of which explicitly address national health insurance; however principals of health reform are outlined. * They consider adding health insurance to the Social Security act but The is opposed by the AMA

National Health Insurance and the New Deal

* 1939-Senator Wagner introduces a National Health Bill incorporating recommendations from a recent (1937) National Health Conference - Would create federal funding for states to expand public health, maternal and child health services, medical care for low income, short-term disability insurance, hospital construction, and prepaid medical insurance. - The bill would enable states to uses funding towards universal or mandatory Health insurance programs if they chose to * But once again the opposition from the AMA

1970's

* 1971-Senator Edward M Kennedy holds hearings around the country before issuing a report, "The Health Care Crisis in America" - He presents a plan for universal, single payer system run through the government and financed through payroll taxes * 1974- President Nixon counters with a proposal calling for universal coverage and voluntary employer participation. - The AMA, insurers, and others sponsee their own competing legislative proposals. -Support splinters among various plans and they fail.

The Baylor Plan

* A group of Dallas teachers create a contract with Baylor University Hospital - They would receive up to 21 days of hospitalization at fixed price of $6 - contract ensured teachers has access to hospital care and that the hospital would be paid - Considered the forerunner for Blue Cross plans

1960's

* By the early 1960's, three quarters of Americans have some form of health insurance. - However, this covers only 27% of their medical bills - Because health insurance is so closely tied to full-time employment, retirees, the self employed, the unemployed, and the underemployed are largely left out.

1990's Clinton And The Health Security Act

* Clinton makes national health reform a priority early in his Presidency - Within his first week in office President Clinton convenes WhiteHouse Task Force in Health Reform, and appoints First Lady Hillary Clinton as chair *Clinton proposed a "managed competition" approach, sending a detailed plan to Congress in 1993 - It called for universal coverage, employer and individual mandates, competition between insurers, with government regulation to control costs.

1910-1920's

* First Health Insurance Bill * Sheppard Towner Act * Baylor Plan

Kerr-Mills Proposal

* In 1960, Mills works with Senator Robert Kerr to stifle a drive toward Medicare by passing a limited program that provides health insurance to only poor elderly citizens -The guidelines for participowerecso stringent that only one percent of elderly received benefits - Senator John F Kennedy calls this inadequate and makes Medicare a major part of his campaign for presidency...

Opposition to the Sheppard-Towner Act

* In Jan 1927, a group of senators initiate a filibuster on the act, with one Senator arguing the the bill was championed by - "...neurotic women, ...social workers who obtained pathological satisfaction in interfering with the affairs of other people'...and Bolsheviks who did not care for the family and its perpetuity ( Bolsheviks became the community party in Russia) * Politicians allow it to expire in 1928 despite it substantially decreasing infant mortality rates in the US ( roughly a net decrease of 19 deaths per 1000 live births)

King-Anderson Bill

* Kennedy administration supports a new bill, the King-Anderson Bill, soon after his election... - Under this bill, some hospital and nursing home costs for patients 65 and older would have been covered - Resistance to the King-Anderson bill comes from providers, the insurance secto, other business interests, conservative national political organizations, and certain members of Congress ( including Wilbur Mills) -Although this bill is defeated in committee, the vote is narrow ( 12-11), signaling a shift in attitudes - A slightly revised King-Anderson bill is reintroduced. - A compromise is reached after much debate, but before it could go anywhere...

1960's

* Kerr-Mills Proposal * King Anderson Bill * The "three layer cake"

The "Three Layer Cake"

* The AMA knee it had that it had been beaten ( Once it lost Mills, it lost Congress) * The House passes the final bill * In the Senate, liberals try to add amendments (which would increase the cost of the legislation) - However, in the conference Committee, Mills blocks each amendment. - Mills makes only one major compromise, that hospitals and doctors would determine "reasonable charges" for costs rather than the government doing so through regulated prices. -He assumes that this would not result in huge costs...

Opposition to the National Health Bill

* The AMA strongly opposes the bill during public hearings - AMA establishes "National Physicians Committee for the Extension of Medical Service" to fight Wagner bill - The proposal dies in the committee * Plans are laid to report out an amended bill in the next session, but the outbreak of WW2 brings about a change of concerns for congress.

Opposition to the Sheppard-Towner Act

* The National Society of the Daughters of the American Revolution ( which had supported the act of 1921) accuse the Sheppard Towner bill of being a communist plot. * The AMA sees the act as a socialist threat to its professional autonomy and increase their lobbying efforts. - The Pediatric Section of the AMA actually endorses the endorsement of the acts renewal and this actually causes them to split off to form the American Academy of Pediatrics.

1921-Sheppard-Towner Act

* The Sheppard-Towner Act established federal subsidies for state run child and maternal health programs - Leads to the creation of 3,000 child and maternal health care centers, many of the in rural areas. - Addresses the need for medicalization of pregnancy and childbirth and high infant mortality rates. * However, when it is time to renew the act, it faces opposition from multiple groups.

1993-1994 Health Security Act

* The opposition was led largely by two groups: the Health Insurance Association If America and the National Federation of Independent Businesses, both believing reform would create hardship for their smaller members - Health Insurance Association If America begins airing "Harry and Louise" television ads * Congressional Democrats we're divided in their support and further splintered by a variety of alternative proposals

1940's

* Truman and the Fair Deal * Wagner, Murray, Dingell Bill

Truman and the Fair Deal (1945-1953)

* Truman campaigned in 1948 on national health insurance * After elected, Truman's health care message to Congress had 5 key health reforms: 1) Hospital construction 2) Expanded maternal and child health 3) Program for medical education and research 4) National Health Insurance ( prepayment of medical expenses) 5) Disability insurance to protect from sickness and injury

Wagner-Murray-Dingell Bill

* WW2 significantly altered the politics of healthcare. As with most counties during the war, the US government dramatically expanded its involvement in medical care - This Bill was the first to propose a nationally administered health plan, including compulsory medical insurance for all employed workers and their dependents. - It fails to survive committee hearings... -Truman was consideredan "accident of history -AMA has launched a national campaign against national health insurance

The Baylor Plan

1929- First Private Health Insurance Program in The US

July 30 1965

Medicare and Medicaid signed into law as Social Security amendments ( Lyndon Johnson)

1930's

National Health Insurance and New Deal

1915-First Health Insurance Bill

The American Association for Labor Legislation(AALL) published a draft bill for government health insurance to be enacted at the state level and promote campaigns in several states. *Bill calls for protection of low income workers and broad hospital and medical benefits to both workers and their dependents * By 1916, 12 states show interest and had sponsors for the bills * Important Groups including the AMA agree to study it and seem supportive * However it fails to pass in important states including NY and CA. * Then the AMA reverses course and declares that it is opposed to this coverage. - Until the Affordable Care Act, the AMA will be one of the leading opponents to universal health coverage * The bill doesn't pass in a single state and the idea is generally forgotten as the US enters WW1...

Medicare Catastrophic Coverage Act (MCCA)

to protect seniors from bankruptcy from medical costs.


Conjuntos de estudio relacionados

Federal Tax Considerations for Life Insurance and Annuities

View Set

Clinical Psychology EPPP Test Questions

View Set

Business ethics final: ch 17 business and its suppliers

View Set