The Affordable Care Act is the law of the land and just another chapter in how America will treat those who require medical coverage in their time of need. According to the Kaiser Family Foundation, over 47 million non-elderly Americans were uninsured in 2012. The fundamental issues are access to healthcare and the affordability of healthcare but these have always been concerns of medical coverage in the United States. Access to healthcare leaves roughly 16 percent of the population without health insurance while affordability of healthcare leaves many Americans with and without health insurance facing debt from their health care bills.
The function of health care is to improve a person’s health and the overall health of the population. The reason for healthcare insurance is to offset expenses from medical bills. The insurance company pays a certain amount so individuals don’t get stuck with the entire expenditure. A general topic of discussion asks the question does the private sector do a better job than government in administering healthcare. While there is a broad scope of opinions looking back may shed some light on this subject.
The history of the healthcare in the United States provides an understanding to the dynamics of which the system is built on for better or worse and the struggles that still remain today. Before 1920, most people didn’t have healthcare coverage, and most doctors didn’t possess the knowledge or understand diseases to provide suitable care to the sick. People were treated in their homes with doctors receiving little pay for services. There were a few major employers offering health insurance, but the majority of folks paid for care on their own.
Once physicians learned more about diseases and how to care for the sick, they began to charge more for services at times more than people could afford to pay. Physicians then began to treat patients in hospitals rather than performing house calls taking advantage of the latest technology that also added to the overall cost of medical care.
As healthcare costs began to rise Baylor Hospital located in Dallas Texas started a system that ultimately became Blue Cross which helped people to pay their medical bills. As medicine, science hospitals and technology advanced so did the cost of medical care. In the late thirties Blue Shield insurance began offering insurance for doctor time protecting payments for their services. Success in most endeavors breeds competitors and with Blue Cross and Blue Shield having an impressive impact, other insurers began to enter the healthcare marketplace.
The significant change in the healthcare market happened at the time of World War II when the war created a labor shortage of workers. Employers began to offer health insurance packages as an added benefit to entice employees to work for their company. Eventually, it became a common practice for employers to offer medical coverage while the government provided tax incentives to employers delivering coverage. Other countries during this time moved toward a national healthcare system where the government sets policies and pays for medical services.
In the beginning Blue Cross and Blue Shield were non–profit and everyone was charged the same premium for services. Healthcare took a dramatic turn when private for-profit insurers flooded the market and began to charge premiums based on a person’s gender, age, condition of health or if there was a pre-existing condition. The private insurers insured the healthiest and avoided the sick creating more profit for the company. At a certain point, Blue Cross and Blue Shield abandoned their non-profit status and became for-profit just to keep pace.
Commercial health insurance exploded in the forties to the sixties as more commercial insurance companies came into the marketplace, and the medical field grew with state-of-the-art technology. The government continued to encourage companies to offer health insurance as a compensation package to employees. Even unions negotiated healthcare benefits for its members. It was clear the private healthcare system was securely in place. However, America’s healthcare system failed to foresee hidden problems that over time would question how the country intended to take care of the less fortunate. The poor, small companies that don’t provide insurance, the self-employed and the unemployed without any medical coverage suffered due to the high cost of health insurance. Additionally, retired workers 65 and over lost employer-based health insurance leaving them without medical coverage.
In 1965, Medicare and Medicaid were signed into law and designed to reimburse physicians at a reasonable rate for providing medical coverage for the poor and elderly. Another area the healthcare system in the United States failed to address was costs in medical technology, competition between hospitals, the high price for prescription drugs, covering malpractice lawsuits and self-funded healthcare by larger employers.
All of this leads us to right now and the era of the Affordable Care Act. It’s not perfect but there hasn’t been a time in the history of the United States where medical coverage worked like a charm. Remember Medicare Part D the prescription-drug bill, it also took time to function properly. Science and technology will always continue to advance. However, healthcare coverage that leaves people off the roster or is too expensive placing people in debt is unacceptable. The function of healthcare will always be to improve a person’s overall health and to do so by creating access and affordability to the healthcare system.