Question

The United States Healthcare System is unique and has changed dramatically over the last 100 years. summarize how the United States Healthcare System has evolved since the early 1900s. Identify two characteristics of the United States Healthcare System and explain why those characteristics are unique to our system.

The course is Health Care Management

Answer 1

In the past century, the US has been witnessing drastic social and technological changes that lead to changes in healthcare delivery and healthcare system. There was widespread segregation on the basis of race with poor facilities for the nonwhite category till almost the 1960s. Patient empowerment was comparatively less and they were left to recover at the provider’s mercy. The history of the US healthcare system has been eventful and interesting. In the 1900s, employers were liable for workplace injuries under law, but there was no health insurance. Mandatory health insurance issue was raised and campaigned by Theodore Roosevelt. In the 1920s, the cost of healthcare started to increase and became unaffordable for the middle class. During the 1930s, the Great Depression emphasized the need for government-sponsored benefits but didn’t end up in a health insurance program as it was strongly opposed by AMA. In the 1940s, during the Second World War, employers started offering health insurance, which can be considered as the beginning of today’s employer-based health insurance system. The proposal of the national healthcare system with mandatory coverage by President Truman was opposed by AMA. During the 1950s, tax incentives were given to those employers who offered health insurance plans to employees. New treatment methodologies and medicines were developed as the healthcare sector continued to advance with the first successful organ transplant to its credit. Hospital expenses also saw an advance with these inventions.

In the1960s, Medicare was signed into law by President Lyndon Johnson, which was aimed at providing coverage to people aged 65 and above. Medicaid was meant for long-term care coverage for the disabled and poor. Along with this, there was a boom in private insurance companies offering health insurance. With all these changes, the era of specialists began with 69% of physicians enlisted as specialists.

In the 1970s, healthcare costs saw an exponential increase with the presence of Medicare and Medicaid. This lead President Nixon to sign the Health Maintenance Organization Act aimed to reduce healthcare costs. The 1980s saw increased healthcare privatization with the consolidation of healthcare businesses to create hospital systems. The 1990s saw the rise in healthcare costs at double the inflation rate. There was an increase in managed care groups to mitigate the cost. President Clinton introduced the health security plan in 1993, which failed in 1994.

During the 2000s Medicare sustainability was questioned and doubts were raised about the efficacy of employer-sponsored health insurance. Enactment of healthcare reform laws meant for the expanded coverage of a large number of uninsured people was also witnessed during this time. The medical field also saw the introduction of direct-to-consumer advertisements. In 2010, President Obama signed the patient protection and Affordable Care Act (ACA) known as Obama Care. The ACA expanded coverage to more citizens, made coverage available to individuals with pre-existing conditions, and took out lifetime caps on insurance claims. This resulted in all except a mere 9% of the population getting coverage by 2016. Despite positive outcomes, the ACA lead to increased tax and premium rates.

In 2017, the AHCA (American Health Care Act) was introduced as a bill, which was passed by the House of Representatives but was not passed by the senate and was withdrawn. Obama Care is still there but its fate will be decided by the Supreme Court as the court accepted an appeal by 21 states to decide whether the ACA should be continued or not. The court accepted a cross-appeal to invalidate the ACA by the states opposing ACA. The court will issue its decision most probably in 2021.

Two unique characteristics of the US healthcare system are:

1. Technology-driven system with more specialties and specialists. The number of general physicians is comparatively less. The US specialists are well known for their immense knowledge in their respective fields and their technological know-how.

2. High-cost but average in outcome with unequal access. This unique feature has resulted from the disproportionate increase in lifestyle diseases and higher health insurance premiums.