Our healthcare system is a big issue in America, it is sad how many people struggle to have good insurance and still are unable to access a doctor when they need one. Since we have this issue so many Americans struggle through sickness instead of getting the necessary care they need, and they end up with expensive hospital bills. We need a strong health care system.
“The history of health care in America is a long and winding road.”- Jeff Griffin. America has always had their own system of health insurance that has changed a lot over the years. In the late 1800’s is where heath care started. The industrial revolution brought steel mill jobs to many people in America located in many cities, but since that field of work was so dangerous it led to many work place injuries. Since these jobs started to come all around more Americans wanted to join the field in the union. The union members wanted to offer something so when their employees were out due to an injury or illness, so they didn’t suffer from a lot of financial losses, so they began to offer various forms of sickness protection. At the time, there was very little organized structure and most decisions were made on a trial and error basis.
In the 1900’s the American Medical Association came into place and they hired over 62,000 physicians. The 26th President of the United States, Theodore Roosevelt, believed health insurance was important because “no country could be strong whose people were sick and poor.” Even so, he didn’t lead the charge for stronger healthcare in America. Most of the initiative in the early 1900’s was led by organizations outside the government. One of the organizations heavily involved with advancing healthcare was the American Association of Labor Legislation, who drafted legislation targeting the working class and low-income Americans even children. Under the proposed bill, qualified recipients would receive sick pay, maternity benefits, and a death benefit of $50.00 to cover funeral expenses. The cost of these benefits would be split between states, employers, and employees. The American Medical Association initially supported the bill, but some people that were apart of the medical field were starting to have concerns over how doctors would be paid, so they backed down. Private insurance companies also were opposed to the bill because they were worried it would mess with their income. If Americans received compulsory insurance through the government, they might not see the need to purchase additional insurance policies privately (especially life insurance), which could put them out of business. The bill never passed because so many Americans wouldn’t support it.
After World War I started, Congress passed the War Risk Insurance Act, which covered military servicemen in the event of death or injury. The Act was later amended to extend financial support to the servicemen’s dependents. The War Risk Insurance program essentially ended with the conclusion of the war in 1918, though benefits continued to be paid to survivors and their families.
In the 1920’s insurance became more expensive because physicians were charging more than Americans could afford. Americans knew health care needed to offer more because people that are retired, on disability or unemployed could not get insurances unless they had a job that offered it to them. The Wagner-Murray-Dingell Bill was introduced in 1943, proposing universal health care funded through a payroll tax.
In the 1950’s health care doubled even though it wasn’t affordable already for Americans. When John F Kennedy became president, he tried to get a bill to pass for senior citizens to have health care benefits, but the bill was denied by the American Medical Association. When president Kennedy was assassinated his vice president Johnson took his place and tried again to force the health care for senior and disabled citizens, so they could afford it. The bill passed, and it was called Medicare and Medicaid. Even though this bill was passed no one expected it to be so expensive and it still was not affordable. Business started to offer health insurances, but they made their employees agree to pay for the premium package which was still unaffordable. Over the course of the 20th century, insurance companies began denying coverage to individuals with pre-existing conditions, such as asthma, heart attacks, strokes, and AIDS.
You have choices when you shop for health insurance. If you’re buying from your state’s Marketplace or from an insurance broker, you’ll choose from health plans organized by the level of benefits they offer: bronze, silver, gold, and platinum. Bronze plans have the least coverage, and platinum plans have the most. If you are under 30, you may also be able to buy a high-deductible, catastrophic plan. Each one pays a set share of costs for the average enrolled person. The details can vary across plans. In addition, deductibles the amount you pay before your plan picks up 100% of your health care costs vary according to plan, generally with the least expensive carrying the highest deductible.
Platinum covers 90% on average of your medical costs; you pay 10%, gold covers 80% on average of your medical costs; you pay 20%, silver covers 70% on average of your medical costs; you pay 30%, bronze covers 60% on average of your medical costs; you pay 40%, and catastrophic policies pay after you have reached a very high deductible. Catastrophic plans must also cover the first three primary care visits and preventive care for free, even if you have not yet met your deductible. You will also see insurance brands associated with the care levels. Some large national brands include Aetna, Blue Cross Blue Shield, Cigna, Humana, Kaiser, and United. Each insurance may offer you certain plans such as PPO, HMO, EPO, POS, HDHP, or HSA.
An HMO delivers all health services through a network of healthcare providers and facilities. With an HMO, you may have the least freedom to choose your health care providers, the least amount of paperwork compared to other plans and a primary care doctor to manage your care and refer you to specialists when you need one so the care is covered by the health plan; most HMOs will require a referral before you can see a specialist. Any of HMO’s network, if you see a doctor who is not in the network, you’ll may have to pay the full bill yourself. Emergency services at an out-of-network hospital must be covered at in-network rates, but non-participating doctors who treat you in the hospital can bill you.
If you have PPO you have a large amount of freedom to choose your health care providers, you do not have to get a referral from a primary care doctor to see a specialist, higher out-of-pocket costs if you see out-of-network doctors vs. in-network providers, and more paperwork than with other plans if you see out-of-network providers. Any in the PPO’s network; you can see out-of-network doctors, but you’ll pay more.
If you have EPO, a moderate amount of freedom to choose your health care providers, you do not have to get a referral from a primary care doctor to see a specialist, no coverage for out-of-network providers, if you see a provider that is not in your plan’s network other than in an emergency you will have to pay the full cost yourself. Lower premium than a PPO offered by the same insurer. Any in the EPO’s network; there is no coverage for out-of-network providers.
A POS plan blends features of an HMO with a PPO. With POS plan, you may have more freedom to choose your health care providers than you would in an HMO, a moderate amount of paperwork if you see out-of-network providers, and a primary care doctor who coordinates your care and who refers you to specialists. You can see in-network providers your primary care doctor refers you to. You can see out-of-network doctors, but you’ll pay more.
If you are under the age of 30 you can purchase a catastrophic health plan. With a catastrophic health plan you may have, lower premium, 3 primary care visits before the deductible applies, free preventive care, even if you haven’t met the deductible. Any in the plan’s network; individual plans may have additional rules on specialists. Like the catastrophic plan, you may be able to pay less for your insurance with a high-deductible health plan.
If you have an HDHP you may have one of these types of health plans: HMO, PPO, EPO, or POS, higher out-of-pocket costs than many types of plans; like other plans, if you reach the maximum out-of-pocket amount, the plan pays 100% of your care a health savings account to help pay for your care; the money you put in an HSA is not taxed and can be used tax-free on eligible medical expenses. In order to have an HSA, you must be enrolled in a HDHP, many bronze plans may qualify as HDHPs depending on the deductible.
Experts have some theories on what could happen as we look ahead after a half century of health care crisis; three possibilities face us. The first is that value-based purchasing, consumerism, use of innovative new technologies, and a host of other initiatives implemented by dint of the wisdom of this and future administrations and the health policy experts who advise them essentially fix the problem. Crisis solved. The second possibility is the opposite. “The health care industry is bound to collapse soon.” The final possibility is that we’ll continue to muddle through.
Doctors and hospitals are called the bad guys in the discussion regarding the rising cost of health care. Eric J. Furst states “I speak for the doctors, who have few allies in the fight for fairness regarding compensation for the care we provide. It is a myth that we may charge “higher prices” to the private insurance carriers. They pay an “allowable” fee for any visit or procedure, the amount of which decreases virtually every year. Or, they pay nothing if they can find a way to “deny” a payment.” Many doctors are struggling to pay their escalating overhead, while receiving whatever crumbs the insurance companies choose to throw at them. Meanwhile, the insurance companies are exacting higher premiums and higher deductibles from consumers. At the same time, their executives are making ridiculous incomes and bonuses.
Control or eliminate the insurance industry, and you will rein in the cost of health care. Doctors are doing the very best they can for you, and they’re not getting rich doing it. Americans tend to blame the doctors for how expensive health care is, but they aren’t the issue it’s the health insurances that create all the pricing. Americans pay an allowable fee for any visit or procedure and that is determined by insurance companies. Doctors struggle more and more every year because insurances companies add on more and more fees. People need to understand that insurance companies are the real enemies.
In my opinion our health care system has never been good and will never be good unless something is done. People need to understand how important it is that each American has good healthcare. The most important thing to do is reduce the cost of health care in this country is to control prices. Researching all this information it is depressing how cruel insurance companies really are in America. It seems all they care about is the money and not losing any profit. Insurance companies are really making it hard for people to have insurance and being able to get the care they need. There have been some good changes since health care started but when I think about it, Insurances hasn’t got too much better. The only thing I see that has got better since health care began is, they offer more now than they ever have, but any chance they get, insurance companies increase their prices. Physicians are also very unpaid for what they do. An increasingly amount money every year gets taken from them because things get cut out and insurance companies find a way to charge them more for what they do. Since I started working in the medical field its unfortunate to see how much people work in the health care and as much as they do, to see they don’t get paid much from any of it. I have also noticed when a patient injures themselves, they may need some kind of brace or cast and when I realized how expensive these prices are because insurances take a large amount of it and the doctors need to make something out of it since they’re the ones spending this time with the patients. For example, where I work if a patient needs a cam walker which is a cast boot that you can walk in, the price of it is almost $400. This is the price that gets billed to insurance and doctors are lucky if they get a good amount of that, but it doesn’t always happen. Americans need to realize If insurance companies keep doing what they’re doing and add more expenses in the medical field people will start to no longer want to be involved in that field and it will begin to crash, when the medical field is one of the most important things.
