This plan would maintain competition between private insurers and expand coverage. A competing proposal was advanced by a familiar Nixon nemesis, the Kennedys; this time it was Sen.
Edward M. Kennedy of Massachusetts. Kennedy introduced the Health Security Act, calling for a single federal payer, providing comprehensive health coverage for nearly all Americans. Although the Health Security Act never advanced far in Congress, it was the beginning of a career-long effort by Sen.
Kennedy at major healthcare reform. The Ford Administration The abbreviated Ford presidency was consumed by healing the nation's post-Watergate wounds "our long national nightmare" as President Ford termed it, and fighting run-away domestic inflation. The unrestrained and federally incentivized growth of healthcare facilites, ushered in by Hill-Burton in , and exacerbated by the infusion of vast federal funds into the healthcare payment system, were seen as contributing causes to medical inflation.
The National Health Planning and Resources Development Act of was an effort to reign in escalating healthcare costs. The goals of the HPRDA were to reduce and avoid unnecessary duplication of healthcare facilities and services; it sought to do so by essentially mandating certificate of need programs in the states. The Carter Administration Jimmy Carter campaigned for president calling for national healthcare insurance with universal coverage, and as president he went to work to prepare a legislative proposal for the same.
The American Hospital Association endorsed the concept in principle, but had reservations about any system that took a universal, "one-size-fits-all" approach. The details of President Carter's plan never received much of a congressional or public audience, as a deep recession and other economic issues took priority.
Other than the tepid support of the AMA, little other healthcare industry or public support was apparent. President Carter later maintained he had strong support from the chairmen of the House and Senate committees with responsibility for healthcare legislation and could have succeeded in passing his proposal had it not been for the abrupt withdrawal of support by one of those chairmen.
Ironically, the vacillating Senate committee chairman was none other than Sen. Senator Kennedy was to run against Carter for the Democratic presidential nomination in The Reagan Administration In his inaugural address, after lamenting the consequences of excessive government borrowing and deficit spending, President Reagan declared: "In this current crisis, government is not the solution to our problem.
Government is the problem. During President Reagan's term of office several new laws were enacted aimed primarily at reducing the growth in federal spending on health care, and improving efficiencies. This was to be accomplished by changing Medicare reimbursement methodologies — in most cases reducing reimbursement to hospitals and physicians — and stepping up anti-fraud measures. But the Reagan Administration also advanced through Congress the first major expansion of Medicare benefits: the Medicare Catastrophic Coverage Act of The law expanded Medicare coverage for outpatient drugs, put a ceiling on out of pocket co-pays for hospital and physician services, and modestly expanded payments for long term care.
The program was to be funded entirely by Medicare beneficiaries through increased premiums and a surtax on wealthier beneficiaries based on income. The George H. Bush Administration President George H.
Bush inherited a political catastrophe in the Medicare Catastrophic Coverage Act of Among the elderly there was wide-spread disappointment over the level of expanded benefits and strong resentment over having to pay higher premiums and taxes to fund it. These sentiments led to a senior revolt against the law, and in — just 17 months after it was enacted — a bipartisan effort in Congress repealed most of the MCCA.
President Bush's agenda for healthcare legislation consisted of additional measures to reduce the growth of federal health care spending and reduce fraud and abuse in the Medicare and Medicaid programs.
Notable among the Bush healthcare legislative reforms was a prohibition on physician "self-referrals" for clinical laboratory services Stark I. The Clinton Administration Bill Clinton was the first Democrat elected president in 12 years, and his administration wasted little time in proposing major health care reforms. It proposed to provide affordable health insurance for all through a concept called "managed competition.
All health plans would be required to provide a minimum level of benefits. Employers would be required to provide insurance coverage for their employees and pay 80 percent of the premium. The AHSA was opposed by much of the healthcare industry and the health insurance industry. In the Progressive Era, which occurred in the early 20th century, reformers were working to improve social conditions for the working class.
Therefore the first proposals for health insurance in the US did not come into political debate under anti-socialist sponsorship as they had in Europe. During the Progressive Era, President Theodore Roosevelt was in power and although he supported health insurance because he believed that no country could be strong whose people were sick and poor, most of the initiative for reform took place outside of government.
They were a typical progressive group whose mandate was not to abolish capitalism but rather to reform it. In , they created a committee on social welfare which held its first national conference in Despite its broad mandate, the committee decided to concentrate on health insurance, drafting a model bill in The services of physicians, nurses, and hospitals were included, as was sick pay, maternity benefits, and a death benefit of fifty dollars to pay for funeral expenses. This death benefit becomes significant later on.
Costs were to be shared between workers, employers, and the state. They found prominent physicians who were not only sympathetic, but who also wanted to support and actively help in securing legislation. Times have definitely changed along the way. There was disagreement on the method of paying physicians and it was not long before the AMA leadership denied it had ever favored the measure.
They apparently worried that a government-based insurance system would weaken unions by usurping their role in providing social benefits. Their central concern was maintaining union strength, which was understandable in a period before collective bargaining was legally sanctioned. But because the reformer health insurance plans also covered funeral expenses, there was a big conflict. Reformers felt that by covering death benefits, they could finance much of the health insurance costs from the money wasted by commercial insurance policies who had to have an army of insurance agents to market and collect on these policies.
But since this would have pulled the rug out from under the multi-million dollar commercial life insurance industry, they opposed the national health insurance proposal. Other efforts during this time in California, namely the California Social Insurance Commission, recommended health insurance, proposed enabling legislation i n , and then held a referendum. New York, Ohio, Pennsylvania, and Illinois also had some efforts aimed at health insurance.
But in the Red Scare, immediately after the war, when the government attempted to root out the last vestiges of radicalism, opponents of compulsory health insurance associated it with Bolshevism and buried it in an avalanche of anti-Communist rhetoric. Opposition from doctors, labor, insurance companies, and business contributed to the failure of Progressives to achieve compulsory national health insurance.
In addition, the inclusion of the funeral benefit was a tactical error since it threatened the gigantic structure of the commercial life insurance industry. Political naivete on the part of the reformers in failing to deal with the interest group opposition, ideology, historical experience, and the overall political context all played a key role in shaping how these groups identified and expressed their interests.
By now, medical costs for workers were regarded as a more serious problem than wage loss from sickness. Medical, and especially hospital, care was now a bigger item in family budgets than wage losses. Concerns over the cost and distribution of medical care led to the formation of this self-created, privately funded group.
The committee was funded by 8 philanthropic organizations including the Rockefeller, Millbank, and Rosenwald foundations. They first met in and ceased meeting in The CCMC was comprised of fifty economists, physicians, public health specialists, and major interest groups. Their research determined that there was a need for more medical care for everyone, and they published these findings in 26 research volumes and 15 smaller reports over a 5-year period.
The CCMC recommended that more national resources go to medical care and saw voluntary, not compulsory, health insurance as a means to covering these costs. Most CCMC members opposed compulsory health insurance, but there was no consensus on this point within the committee.
We might have thought the Great Depression would create the perfect conditions for passing compulsory health insurance in the US, but with millions out of work, unemployment insurance took priority followed by old age benefits. It was therefore excluded. However, the election brought a conservative resurgence and any further innovations in social policy were extremely difficult. Most of the social policy legislation precedes He passionately believed in a national health program and compulsory health insurance.
Many of them, including Milton Romer and Milton Terris, were instrumental in forming the medical care section of the American Public Health Association, which then served as a national meeting ground for those committed to health care reform. The Wagner Bill evolved and shifted from a proposal for federal grants-in- aid to a proposal for national health insurance. First introduced in , it became the very famous Wagner-Murray- Dingell Bill.
Roosevelt, a Democrat, included a publicly funded health care program while drafting provisions to Social Security legislation, which was eliminated from the final legislation. Subsequently, multiple proposals were introduced, starting in with President Harry S Truman who proposed universal health care; the proposal by Lyndon B.
This was followed by an effort by President Bill Clinton and headed by first lady Hillary Clinton in , but was not enacted into law. Since then, the ACA, or Obamacare, has become a centerpiece of political campaigning.
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