National Health Care Reform in US, Its Impact on Hospitals
Heidi A. Horner
New England College
NATIONAL HEALTH CARE REFORM IN US, ITS IMPACT ON HOSPITALS 2 Abstract
The national debate over health care reform in the US has been going on for decades. Although the debate continues, the landscape of health care in the US is certainly about to change as the Patient Protection and Affordable Care Act (H.R. 3590) was enacted on March 23, 2010. Many politicians, economists, health care providers and average citizens have weighed in on the topic with opinions as diverse as the country. The question is, will this reform be the cure for our ills or a bad pill to swallow? This paper serves as an examination of the economic and social impact of reform on the system of health care services and the delivery of same. In order to know where we are going, it is vital to know where we have been, therefore the background of national health care is reviewed and hypotheses about the impact it will have on the hospitals are made. In concluding the discussion of health care reforms’ impact on hospitals, it seems as though there will be both positive and negative implications and outcomes. It is the author’s contention that there will be a need to reestablish guidelines for service and delivery as well as cost containment of health care services. It is likely that the country will see a new model of health care.
NATIONAL HEALTH CARE REFORM IN US, ITS IMAPCT ON HOSPITALS 3 In order to evaluate the present and plan for the future, we must understand the past. The philosophy applies to health care reform. According to Ramachandran (2010), the idea of national health insurance emerged around 1915 when the American Association for Labor Legislation attempted to introduce a medical insurance bill to some state legislatures. These attempts were not successful, and as a result, controversy about national insurance was born. National groups supporting the idea of government health aid included the AFL-CIO, American Nurses Association, Chamber of Commerce and the Life Insurance Association of People, common players even today. In 1935, President Roosevelt signed the Social Security Act, but medical benefits were left out of the bill. While Roosevelt wished to include some sort of national health care clause in the bill, he believed the American population was not ready and the idea unpopular. Harry Truman took on the idea of national medical care and tried to integrate it into his Fair Deal program. Truman, too, was unsuccessful; however, during his presidency the fight for national medical care grew due to its focus on the aged. That argument did get play during the Eisenhower administration through the then newly-created Ways and Means Committee, but did not gain legislative traction. A couple of preliminary bills paved the way for a national health care program. In 1960, the Kerr-Mills Act gave states the power to decide which patients needed financial assistance; at the states’ decree, the federal government would provide individual assistance. Most of the states did not participate or abide by the Act. Another preliminary bill, the King-Anderson Bill, was formed in 1962. Under it, some hospital
NATIONAL HEALTH CARE REFORM IN US, ITS IMPACT ON HOSPITALS 4 and nursing home costs for patients 65 and older would be covered. Although this bill was defeated in committee, the vote was narrow (12-11), signaling a shift in attitudes. This was the turning point that enabled President Johnson to include in his ”Great Society” program Medicare and Medicaid programs as part of the Social Security Act of 1965 granting 19 million Americans health care coverage.
The effects of the Medicare and Medicaid on the US economy is evident today as overall health care comprises 1/6th of the US economy, or...