Question

1. Describe in your own words the impact advances in technology and improvements in medical education had on the growth of U.S. hospitals and healthcare services from 1920 to the current period. (Chapter 2) Include references to:

• The Baylor Plan – (healthcare insurance as a benefit of employment)

• The Hill-Burton Act – (hospital construction in the U.S.)

• Medicare Title XVIII and Medicaid Title XIX – (differences between the two programs)

• TEFRA – (the change in hospital inpatient reimbursement)

• The Affordable Care Act – (merging the House bill with the Senate bill)

Complete the following questions, each in an essay format (no bullets).

Answer 1

A number of industry analysts have observed that increased accessibility of treatment is one of the most tangible ways that technology has changed healthcare. Health IT opens up many more avenues of exploration and research, which allows experts to make healthcare more driven and effective than it has ever been.Today, doctors and nurses use handheld devices to record patients' real-time data and instantly update their medical history. This makes more accurate and more efficient diagnoses and treatments. Centralization of critical patient data and lab results has really improved the quality of healthcare.

1.The Baylor plan

Baylor plan a method of staffing nursing units developed at Baylor University Medical Center; nurses work only 12-hour shifts on the weekend and are paid for a standard work week.care plan a document that identifies nursing orders for a patient and serves as a guide to nursing care.Baylor's prescription drug plan is CVS/Caremark. You are automatically enrolled in the prescription drug plan administered by CVS/Caremark when you enroll in one of the Baylor medical plans.Baylor Scott & White Health currently accepts Traditional Medicaid, Traditional Medicare and any Medicare Supplement plan/Medigap plan that does not use a network. Baylor Scott & White Health also participates as a contracted provider with the insurance companies and networks.

2.The Hill Burton Act

Hill-Burton provided construction grants and loans to communities that could demonstrate viability — based on their population and per capita income — in the building of health care facilities. The idea was to build hospitals where they were needed and where they would be sustainable once their doors were open.In 1946, Congress passed a law that gave hospitals, nursing homes and other health facilities grants and loans for construction and modernization.By 1975, Hill-Burton had been responsible for construction of nearly one-third of U.S. hospitals. That year Hill-Burton was rolled into bigger legislation known as the Public Health Service Act. By the turn of the century, about 6,800 facilities in 4,000 communities had in some part been financed by the law. These included not only hospitals and clinics, but also rehabilitation centers and long-term care facilities.In 1997, this type of direct, community-based federal health care construction financing came to an end. However, numerous Hill-Burton clinics and hospitals still exist around the country, specifically financed by a part of law to provide care to those unable to afford it."After the passage of Medicare and Medicaid, Hill-Burton ranks right up there among the most important pieces of health legislation in the 20th century," physician and historian Howard Markel told Shots.Hill-Burton introduced many ideas in health care financing that are still in use today. Chief among them is that hospitals receiving federal monies are obligated to provide free or subsidized care to a portion of their indigent patients. U.S. non-profit hospitals (still the vast majority) must demonstrate evidence of 'community benefit' to maintain tax-exempt status. Providing care to the uninsured is one of the most common ways to meet this obligation.

3. Medicare Title XVIII and Medicaid Title XIX

After lengthy national debate, Congress passed legislation in 1965 establishing the Medicare and Medicaid programs as Title XVIII and Title XIX, respectively, of the Social Security Act.Medicaid was established in response to the widely perceived inadequacy of welfare medical care under public assistance.Medicaid is a joint state-federal program.Its purpose is to provide health care to individuals who have low incomes, including persons who are blind or disabled.Medicare was established in 1965 under Title XVIII of the Social Security Act as a federal health insurance program for individuals age 65 and older, regardless of income or health status. Individuals pay taxes throughout their working lives and generally become eligible for Medicare when they reach age 65.When you visit a provider or facility that takes both forms of insurance, Medicare will pay first and Medicaid may cover your Medicare cost-sharing, including coinsurances and copays. If you are enrolled in QMB, you do not pay Medicare cost-sharing, which includes deductibles, coinsurances, and copays.

4.TEFRA

The Tax Equity and Fiscal Responsibility Act of 1982 also known as TEFRA, is a United States federal law that rescinded some of the effects of the Kemp-Roth Act passed the year before. Between summer 1981 and summer 1982, tax revenue fell by about 6% in real terms, caused by the dual effects of the economy dipping back into recession (the second dip of the "double dip recession") and Kemp-Roth's reduction in tax rates, and the deficit was likewise rising rapidly because of the fall in revenue, and the rise in government expenditures. The rapid rise in the budget deficit created concern among many in Congress. TEFRA was created in order to reduce the budget gap by generating revenue through closure of tax loopholes, introduction of tougher enforcement of tax rules, rescinding some of Kemp-Roth's reductions in marginal personal income tax rates that had not yet gone into effect, and raising some rates, especially corporate rates. TEFRA was introduced November 13, 1981 and was sponsored by Representative Pete Stark of California. After much deliberation, the final version was signed by President Ronald Reagan on September 3, 1982.

The original TEFRA bill as passed by the House would have lowered taxes.The Republican-controlled Senate replaced the text of the original House bill with a number of tax increases, and the bill became law after President Ronald Reagan signed it.A lawsuit was filed by an individual named Garrison R. Armstrong, claiming that TEFRA violated the Origination Clause in Article One of the United States Constitution which requires all revenue bills to originate in the House. The United States Court of Appeals for the Ninth Circuit ruled against Armstrong, saying: "We therefore conclude that the Senate did not exceed its authority under the origination clause when it proposed the extensive amendments that ultimately became TEFRA.

5.The Affordable Care Act.

The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act, and commonly known as Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965.

The law has 3 primary goals:

Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
Support innovative medical care delivery methods designed to lower the costs of health care generally.Two categories of individuals will benefit the most from the exchanges: those who don't have health insurance right now and those who buy insurance on the individual market.