For those who were surprised at the vehement opposition to the Affordable Care Act, they need only to look back in history to understand the heated debate and resistance to change that took place. Kongstvedt (2013) discussed much of the unrest that began during the Great Depression when Shadid nearly lost his right to practice medicine for establishing a cooperative health plan. This paper discusses the development of the American healthcare system from the family doctor making house calls for a nominal fee to the billion-dollar industry it is today and the subsequent debate over healthcare reform.
Healthcare and Insurance in the United States
Health insurance as most people understand it today is a relatively new concept. Before widespread insurance coverage became common, the family doctor came to call, or more commonly, families cared for their ill at home. There was much less reliance on doctors or hospitals as is more common today. However, during the industrialization of America, households became more dependent on the chief wage earner and thus, the services of doctors and hospitals because illness interrupted the flow of income (Kelton, 2007). The first rudimentary health plans were not meant for general coverage, but more specific to travel. The more modern age of healthcare insurance began in 1929 at Baylor Hospital in Dallas, where teachers paid a monthly fee to gain access to medical services. As medical care became more sophisticated, it was apparent the average American could no longer afford to pay out of pocket for their healthcare needs. It was then the ubiquitous companies; Blue Cross and Blue Shield appeared and began negotiating with workers and companies to offer disc...
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...ions. Going forward, much depends on Congress, but the bitter, bipartisan leadership seemingly delights in opposing the other party. Moreover, unless the next general election dismantles the ACA altogether, the country is likely to experience many changes to the ACA, with the final incarnation years from completion.
Since the inception of health insurance, the weak link in the system has been those without coverage. President Obama’s ACA sought to close this gap, as did past presidents efforts toward Medicare and Medicaid. In the past, the AMA used some subtle and some very overt actions to derail the progressive movement toward universal coverage, and the same resistance has attempted to undo the ACA. It is with great hope for the future of the ACA and the will of the nation’s political system to improve lives with the guarantee of healthcare coverage.
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