Health Care Reform In The 1900s

America’s health care reform has come quite a ways from what it was a century ago. Before the 1900s, we see an intimate patient-doctor relationship, where anything involving health care was just between the patient and doctor. Doctors would bill patients for the services given and patients would pay the doctor for those services out of pocket. Health care has evolved from simplicity to “governmental institutions, controls, health care programs, drug regulations, and medical insurance” (Randolph, n.d., p. 1).

In the beginning of the 1900s, we start to see the idea of health care reform take shape. Medical insurance before this century was nonexistent. The only insurance there was, was one they called “Sickness insurance” (Sultz & Young, 2014),

In 1965, President Lyndon Johnson signs Medicare and Medicaid into law for the disabled and persons 65 years or older. Medicare consists of two parts, Medicare Part A and Medicare Part B, together they are known as the “Original Medicare”. Medicare Part A covers hospital care and any long term care services, while Medicare Part B covers preventative and medical services. Medicaid on the other hand, provides health coverage for the poor and disabled. Now with the existence of Medicare and Medicaid, many Americans are getting insured and the cost of care is rapidly increasing. To keep costs down, President Richard Nixon signs into law the Health Maintenance Organization Act to support health maintenance organizations (HMO). HMO is responsible for the financing and delivery of comprehensive health services for a prepaid, fixed fee for those who are enrolled (Shultz & Young, 2014). During this time, we also see the establishment of health insurance for federal workers and health insurance for the dependents of the Armed

In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was passed by congress. HIPAA helps with situations where insurance plans are limited based on preexisting conditions and also allows for “special enrollment” (Sultz & Young, 2014) periods where there is a change in family and employment status. HIPAA also maintains the privacy of medical records.

Currently now in the 21st century, we see the birth of the Affordable Care Act (ACA) by President Barack Obama. The Patient Protection and Affordable Care Act was signed into law on March 2010. The ACA was established to carryout insurance to millions of uninsured Americans, and also expands Medicaid by increasing the income threshold to allow more to be qualified. There was also funds allocated to help those who could not afford health insurance, with the costs. Beginning 2014, an individual mandate requires all Americans must have healthcare coverage, and there is a tax penalty for those not fulfilling the individual