History of American Medicine Final Paper
PART I(a)
With the creation of Medicare in 1966 in order to expand access for the elderly to the American healthcare system, the ways in which medicine and its corresponding industries were conducted were irrevocably changed. Prior to its inception, only 65% of people over 65 actually had proper health insurance, as the elderly paid three times as much for healthcare as young people (Stevens, 1998). The private medical sector had much more control over who they would treat, how much they would charge, and more; the passing of Medicare freed up the elderly to have reasonable access to healthcare as a consequence of a lifetime of paying into the system.
The way Medicare was originally organized, the concerns of physicians and their prerogatives were kept largely in mind. The federal government allowed physicians to remain autonomous in terms of how they ran their organization, and no state doctors were hired to provide competition. The purpose of Medicare was simply to offer a greater base of people the ability to benefit from health care and proper treatments for their conditions, thus offering physicians no competition from a rigid state system. Doctors could practice as they always did, but merely had a higher base of patients they could work on, their operations and procedures being paid for through government subsidies and Medicare. Medicare imposed much more change on an administrative level than a direct influence on the doctor’s practice, making their work relatively unchanged. Physicians were able to see as many elderly patients as they wanted without the fear of impoverishing them, and making sure that they themselves were also paid (Stevens 1998, p. 451).
Another way in whi...
... middle of paper ...
...The solution for them is not to work around the clock for a cure by any means necessary (as in Seattle), but just to wall up the poor districts of the city and hope the sick die off. The lack of preventative or even active care in the treatment of the outbreak in Brownsville reveals a great deal about the way we frame disease as it relates to social class and race. Rich whites presume they are cleaner than poor minorities, and vice versa, which translates into the differences in the levels of response both outbreaks receive. By understanding this framing, we gain a better understanding of our reactions to disease and the assumptions we make about the people who contract them.
References
Stevens, R. (1998). Medicare: Triumph of the public voice. In American Medicine and the Public Interest: A History of Specialization. University of California Press.
The Civil War had more deaths than all previous wars combined. Most people think those soldiers in the Civil War died of wounds or amputations, but the truth is that most died from common diseases that they never had been exposed to. Twice as many soldiers died from diseases than those soldiers who died in battle.
The contributions of several doctors, researchers, and scientists helped improve the health of the growing population. In 1850 the average life expectancy was 42 years. By 1910 the average life expectancy had risen to nearly 55 years. Between 1850 and 1910 there were several advances in the medical field. The introduction of genes, white blood cells, blood groups, insulin, rubber gloves, aspirin, and vitamins and the discoveries of Pasteur, Charcot, Halsted, Zirm, Lister, and Koch were the starting point of an international fight against disease.
Wekesser, Carol. Health Care in America: Opposing Viewpoints. San Diego, CA. Greenhaven Press, Inc., 1994.
Many pivotal events over the last century have brought our healthcare system to where it is today. Some were indirect, such as World War II (and how it led to direct events such as medical advances that shifted focus from critical care and managing contagion to preventive medicine and health insurance as an employee benefit) and the internet (which has provided a wealth of tools and resources that were once only available to healthcare providers and has served to foster technological advancements such as Electronic Health Records and telemedicine). Others were targeted interventions, such as the Hill-Burton Act, which was enacted in 1946 and provided infrastructure dollars to healthcare facilities that agreed to provide a significant volume of free or reduced cost services to those with limited ability to pay (HRSA, 2014). Perhaps the most influential targeted event was the passage of Medicare and Medicaid programs, which was the point at which the government became the administrator for insurance programs for the poor, creating a system that would continuously grow and impact service delivery through regulatory control.
(II) The enacting of Medicare Part D in 2006 only helped to fuel America’s hunger for prescription medication. In 2003, President George W. Bush announced and signed the Medicare Prescription Drug, Improvement, and Modernization Act (also known as the Medicare Modernization Act, or MMA) on December 8th. The roughly $400 billion dollar measure was marketed to the American public as something that will provide care for the millions of senior citizens who, at the time, were struggling to afford prescription medication. This was the largest development of Medicare since 1965, which is when the program was initially created, and gave hope to those wishing for positive medical reform. According to title XI of the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003”, the most significant change will be the affordability of prescription drugs by implementing the importation of drugs from Canada, along with necessary safety measures, in order to lessen the cost (United States Congress, 832). For those who were in retirement homes and lacked a steady income, the affordability of drugs was often a deciding factor in the decision to seek medical attention and the idea that those individuals ceased to live simply because they lacked the funds tugged at the heartstrings of many Americans.
One of the fastest growing fields in America is that of the physician assistant profession. Physician assistants are medical professionals who provide diagnostic and preventative health care services under the supervision of doctors. Forbes magazine recently listed physician assistants as the fourth fastest growing profession in the United States. Although the profession is currently getting a wealth of attention, the idea of physician assistants has been around for centuries. More recently due to the shortage of physicians, there has been an increased need for physician assistants. We find it important to explore and understand the history of the profession and how it has evolved in order to understand the future direction of the profession.
Reese, Philip. Public Agenda Foundation. The Health Care Crisis: Containing Costs, Expanding Coverage. New York: McGraw, 2002.
The question, however, is whether or not such drug coverage is a worthwhile project to undertake. Is the problem indeed serious enough to call for the type of reform that the candidates are proposing? Medicare is already a very costly program to keep up, and adding prescription-drug coverage would increase these costs even more. In order to fund this project, there will need to be a tax hike. Should taxpayers subsidize this prescription-drug benefit? Is there a good reason why this redistribution should take place? What are the benefits and costs of this proposal? These and other questions will be addressed in this paper as we examine the following topics: the need for senior citizens to have prescription-drug coverage, the political rhetoric involved with this issue, the projected shortfall in the budget of the Medicare program, and who really would benefit if a prescription-drug benefit was added to Medicare.
Polsky, D. (2009, June). The health effects of medicare for the near-elderly uninsured.. Retrieved from http://web.ebscohost.com/ehost/detail?hid=105&sid=a55fa2f1-dfd5-41b9-a739-d67a1b9ba856%40sessionmgr114&vid=3&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&AN=39772605
Niles, N. J. (2011). Basics of the U.S. health care system. Sudbury, MA: Jones and Bartlett.
Berman, M. L. (2011). From Health Care Reform to Public Health Reform. Journal of Law, Medicine & Ethics, 39(3), 328-339. doi:10.1111/j.1748-720X.2011.00603.x
Medicare is the nation’s largest health insurance program. Generally, you are eligible for Medicare if you or your spouse worked for at least ten years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. Medicare-covered services include hospital insurance, inpatient hospital care, skilled nursing facility care, home health care, hospice care, and medical insurance (Medicare U.S.) With such an encompassing effect on the health insurance field, Medicare provides a haven for older individuals, and end-stage renal disease (ESRD) patients who require the best medical care for whatever possible reason. The only problem with this scenario is that doctors are turning many older patients away because they have Medicare. Why do doctors turn away Medicare patients? Is there a reason why certain doctors turn away certain patients?
Medicare and Medicaid are programs that have been developed to assist Americans in attainment of quality health care. Both programs were established in 1965 and are federally supported to provide health care coverage to vulnerable populations such as the elderly, the disabled, and people with low incomes. Both Medicare and Medicaid are federally mandated and determine coverage under each program; both are run by the Centers for Medicare & Medicaid Services, a federal agency ("What is Medicare? What is Medicaid?” 2008).
Medicare is a national social insurance program, run by the U.S. federal government since 1966 that promises health insurance for Americans aged 65 and older and younger people with disabilities. Being the nation’s single largest health insurance program, covering a large population for a wide range of health services, Medicare's funding is a fundamental part of it sustainability. Medicare is comprised of several different parts, serving different purposes, some of which require separate funding. In general, people at the age of 65 and older who have been legal residents of the United States for at least 5 years are eligible for Medicare. Same is true with people that have disabilities under 65, if they receive Social Security Disability Insurance benefits. Medicare involves four parts: Part A is hospital insurance. Part B is additional medical insurance, that Part A doesn't cover. Part C health plans, also mostly known as Medicare Advantage, are another way for original Medicare beneficiaries to receive their Part A, B and D benefits. Medicare Part D covers many prescription drugs, some of which are covered by Part B. Medicare is a major operation, not only needing adequate administering but the necessary allocated funds to keep this massive system afloat.
As the population of the United States ages and lifespan increases, the U.S. is being faced with challenges that could either hurt the country or benefit it if plans are executed correctly. By the year 2050, more than thirty-two million Americans will be over the age eighty and the share of the 80-plus generation will have doubled to 7.4 percent. Health care and aging population has become a great deal considering the impact it is having on the U.S. The United States is heading into another century with an outstanding percentage of people within the aging population. Today’s challenges involving health care and the aging populations are the employees of health professions being a major percentage of the aging population, the drive into debt, and prevention and postponement of disease and disability.