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Health Care Reform Reforming U.S. Health Care and How It Impacts Revolution, Reform, & Protest from 1970-2011


Overview  Health care reform is a term used for discussing major

creation of or change to national health policy  It is Governmental policy that affects health care delivery in any given region  Typically refers to changes the government chooses to make consisting of:  Increasing the spectrum of population that receives coverage     

through either public or private sector insurance Expanding the options for health care providers that citizens can choose from Improving the access to health care specialists Improving the quality of health care itself Giving more care to all citizens Decreasing the cost of health care as a whole


1970s  1974  Richard Nixon’s 1974 State of the Union address called

for comprehensive health insurance.  Nixon introduced the Comprehensive Health Insurance Act on February 6th.  This plan would have mandated employers to purchase health

insurance for their employees, and provided a federal health plan, similar to Medicaid, that any American could join by paying on a sliding scale based on income.  It was related reported that that Ted Kennedy rejected the universal health coverage plan offered by Nixon because it wasn't ready and well thought out enough; however, Kennedy later realized it was a missed opportunity to make major progress towards his goal.


1980s  1982  Former President Jimmy Carter wrote that Kennedy’s

disagreements with Carter’s original health care plan lambasted Carter’s efforts to provide a comprehensive healthcare system for the country and negated any reforms made in recent years that could’ve helped build the new plan up  1985  The Consolidated Omnibus Budget Reconciliation Act of 1985

(COBRA) amended the Employee Retirement Income Security Act of 1974 (ERISA) to give some employees the ability to keep their own health insurance coverage after leaving their jobs.


1990s  1993  Clinton health care plan  Headed up by Hillary Rodham Clinton  Never passed into law

 1994  Health Security Express  Bus tour that started the end of July consisting of supporters of President Clinton's national health

care reform  Several buses left from sites such as Portland and Boston which crossed the country and stopped in many cities along their way to their final destination at the White House in Washington, DC  During each stops, riders on the bus would discuss their personal experiences, health care disasters and reasons why they think it is important that every American citizen be provided health care reform  Ended on August 3rd

 1996  Health Insurance Portability and Accountability Act (HIPAA)  Made it easier for employees to keep health insurance coverage when they change or lose a jobs  Also provided national coverage to protect personal health information for each citizen  Similar to 1985’s COBRA


2000s: Bush Era  2000  Health Insurance Association of America (HIAA) partnered with Families USA

and the American Hospital Association (AHA)

 proposal intending to seek common ground in expanding coverage for all uninsured U.S.

citizen

 2001  Patients' Bill of Rights  Would have provided patients with an explicit list of rights concerning their health care  Mirrored some ideas found in the Consumers' Bill of Rights and applied them to health care reform  Debated in Congress in an effort to ensure the quality of care of all patients by preserving the integrity of the processes that occur in the health care industry  Standardizing the nature of health care institutions in this manner proved rather provocative  Groups such as American Medical Association (AMA) and the pharmaceutical industry came out against this bill  Biggest problem with the bill was proved to be the fact that placing responsibility within the patient as well as promising support by the government was too contradictory and couldn’t be upheld fairly  As a result of all the opposition, the bill failed to pass in 2002


2000s: Bush Era (contd.)  2003  Medicare Prescription Drug, Improvement, and Modernization Act  Signed by President Bush  Included a prescription drug plan for elderly and disabled Americans

 2004  Presidential Election Debate  Both candidates’ campaigns included different health care proposals  Bush's proposals for expanding health care coverage were more modest than Senator Kerry’s approach o Comparisons were made of each plan, and most estimates indicated that the increase in coverage and funding requirements of the Bush plan would be lower than the Kerry plan which proved more comprehensive

 2007  America's Health Insurance Plans (AHIP) enacts new reform proposals  These guaranteed access to coverage in the individual health insurance market and a proposal for improving the quality and safety of the U.S. health care system


2000s: Bush Era (contd.)  2008  The Economic Survey of the United States referencing Health Care

Reform taken by the Organization for Economic Co-operation and Development including U.S. citizens views on health care in 2008  Results indicated that   

Tax benefits of employee insurances should be abolished The tax revenues which result out of that should be used by citizens subsidizing the costs for them to purchase health care themselves `These subsidies would benefit the government in turn by giving money back

 In December, America's Health Insurance Plans (AHIP) proposed a

set of reforms which included setting a national goal to reduce projected growth in health care spending by 30%

 AHIP said that if this goal were achieved, it would result in cumulative five-

year savings of $500 billion  Consisted of the establishment of a comparative effectiveness entity that would compare and evaluate the benefits, risks and costs of new and much needed supplies


2000s: 2008 Presidential Election Debate  2008  Both party’s candidates had different positions when it came to their stances of health care

reform

 John McCain   

Focused on open-market competition rather than government funding Tax credits ($2,500 for individuals and $5,000 for families) who do not subscribe to or do not have access to health care through their job Wanted to help people who are denied coverage by insurance companies due to pre-existing conditions so he proposed the “Guaranteed Access Plan”

 Barack Obama    

Proposed universal health care Called for the creation of a National Health Insurance Exchange that would include both private insurance plans and a Medicare-like government run option Coverage would be guaranteed regardless of health status, and premiums would not vary based on health status either Would require parents to cover their children, but did not require adults to buy insurance

 These two plans had different philosophical focuses  

McCain’s plan was making insurance more affordable and accessible Obama’s plan gave health insurance to all

 A national poll taken in November 2008 exclaimed that Obama’s supporters listed health care as their

second priority and McCain’s supporters listed it as fourth, tying with the war in Iraq.  

Affordability was the primary health care priority among both sets of voters Obama voters were more likely than McCain voters to believe government can do much about health care costs


2000s: 2009 Reform Debate & PPACA  2009  In March, AHIP proposed a set of reforms intended to address waste and unsustainable growth in the current health care market  These reforms included  An individual insurance mandate with a financial penalty as a trade off for guaranteed issues  Updates to the Medicare physician fee schedule  Setting expectations for safety and quality of diagnostics, technology & supplies  Promoting organization and patient care by inventing a home where health care could be organized and coordinated  Physicians would receive a periodic payment for a set of defined services designated to patient care, which benefit patient care, as well  Linking payment for each physician to the quality of their work, their disciple to follow to guidelines, and their desire to give better patient experience and lowering the total cost of care  Bundled payments rather than individual payments to manage common chronic diseases  An average payment for acute care episodes which follow a pattern

 In the summer of 2009, Tea Party members protested against these proposed health

care reforms

 2010  Enacted by President Obama, the PPACA provided planning for health care reform over the course of four years


2000s: Current & Future Plans to Reform the Health Care Bill [Patient Protection and Affordable Care Act]  2010  Ended the practice of recission  Allowed young adults to stay on their parents‘ plans until age 26  Allowed uninsured adults with pre-existing conditions to get health coverage through a new program     

for high risk pools diseases (expires in 2014) Solidified that insurance companies cannot deny group or individual coverage to citizens under age 19 due to a pre-existing condition Created a temporary reinsurance program to help companies maintain coverage for early retirees between the ages of 55 and 64. (also expires in 2014) Let Medicare drug plan beneficiaries gain money back Had a tax credit become available for small businesses to help provide coverage for employees Put a 10% tax on indoor tanning

 2011  Medicare provides 10% bonus payments to primary care physicians and general surgeons  Medicare will cover the full cost of annual wellness visits with little or no cost for new patients  A program under the Medicaid plan for poor people will go into effect in October allowing states to

offer home and community based care for the disabled that might otherwise require institutional care  Medicare Advantage payments will be frozen and reduced  Employers are required to disclose the value of health benefits on employees' W-2 tax forms  An annual fee is required of large pharmaceutical companies, taking advantage of big business while not hurting the smaller, independent companies who would not have to pay


2000s: Current & Future Plans to Reform the Health Care Bill [Patient Protection and Affordable Care Act] (contd.)  2012  Physician payment reforms are implemented in Medicare to enhance primary care

services and encourage doctors to form accountable care organizations to improve quality and efficiency of care  An incentive program is established in Medicare for hospitals to improve quality outcomes  The Centers for Medicare and Medicaid Services begins tracking hospital readmission rates and designs financial incentives to reduce preventable readmissions

 2013  A national program is established for Medicare on payment bundling to encourage

doctors, hospitals and other care providers to organize patient care more efficiently  The threshold for claiming medical expenses on itemized tax returns is increased with the exception of senior citizens  The Federal Insurance Contributions Act tax (FICA) is raised for individuals earning more than $200,000 and married couples with incomes over $250,000  A 2.9% tax is imposed on the sale of medical devices and equipment


2000s: Current & Future Plans to Reform the Health Care Bill [Patient Protection and Affordable Care Act] (contd.)  2014  State health insurance exchanges for small businesses and individuals open  Individuals with income up to 133% of the federal poverty level qualify for Medicaid coverage  Healthcare tax credits become available to help people with incomes up to 400% of poverty     

purchase coverage on the exchange Premium cap for maximum "out-of-pocket" pay will be established for people with incomes up to 400% of the federal poverty level Most people required to obtain health insurance coverage or pay a tax if they don't Health plans no longer exclude people from coverage due to pre-existing medical conditions Employers with 50 or more workers who do not offer coverage face a fine for each employee if any worker receives subsidized insurance Health insurance companies begin paying a fee based on their market share

 2015  Medicare creates a physician payment program to reward quality of care rather than quantity of

the types of offered services

 2018  A tax on high cost job-provided plans is imposed


Conclusion  Health Care Reform is a vital piece of Revolution,

Reform, & Protest from 1970 to 2011.  Health Care not only displays the ideal of reform, but the ideals of revolution and protests, as well, caused by the groups that got the health care bill and plans where they are today.

health care reform  

rrp powerpoint health care reform

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