Altman Part 4 and Epilogue

When Barack Obama was elected President in 2008, he promised to pass a comprehensive health care reform law that expanded the current health care system to include most uninsured Americans. That was his goal from the moment he took office, and it was one of the first bill he immediately began working on with Congress. However, not only did he have to make compromises with the members of Congress who opposed his plan, he also had to convince the doctors, the insurance companies, the hospitals, and even ordinary Americans that the reform was needed. With almost all the Republicans condemning the bill, it was hard for Obama to begin his plan, and he probably would not have succeeded without the help of many members of his own party. They were able to convince enough people that the reform would be beneficial to side-step the votes of the Republicans and still get the bill passed into law. Along with compromises and deals that the Democratic Party was able to make with the doctors, hospitals, and insurance companies, the bill seemed sure to be signed before the Christmas break. However, during the summer, the public erupted into near-riots, with lies going around (some spread by Republican Congressmen), that the new law would allow Congress to decide whether some people lived or died. Despite this setback, the Obama administration was able to pass the law, although with many amendments that had been added by its own members and by other organizations that they needed. The administration has been lauded for passing into law the most comprehensive health care reform bill in American history.

Altman Part 2

The part of this section of the book that got to me was how many presidents and members of the U.S. legislative branch attempted to get national health reform passed but failed due to many different circumstances. Many failed due to the power struggle in the legislative branch, where there was frequently never a party in control of both the House of Representatives and the Senate during any one presidency. Others failed due to the general public's unwillingness to trust anything that gave the federal government more power than they thought it should have. Many different leaders in Congress tried to pass health care legislation, but almost every one failed. Each time, the new proposal was shot down by a party, group of legislators, or even individuals who felt that some part was unfair. Bit by bit, more legislation was eventually passed through Congress, however, and that finally culminated in the 1990s with the passage of the MMA. This bill was the first major expansion of Medicare since its induction in 1965. It gave more health care benefits to the old, especially those in poverty, by helping them out with the expenses of prescription drugs that they tended to buy frequently. Prescription drugs had never been insured before, and this technique was revolutionary in the United States especially. It also provided insurance to millions of children who lived in families that were under the poverty line, enabling them to get benefits that they had never before been able to obtain. These ideas took many years to pass, with many representatives aggressively opposing them. It took may powerful people in the government for these bills to pass into law, but when they finally were, they were immensely successful. Poverty rates of both children and the elderly have both decreased, and the budget that was set for them has continued to shrink due to continued coverage. No one predicted how successful they have been, and they have been and continue to be an integral part of the national health care system of the country.

Paper Topic

Crimean War medicine and the effects on people from both sides

Altman Part 1

President Nixon was one of the first of his time to attempt to introduce comprehensive national health insurance reform. His stance on the issue was against what many thought the kind of person he was, but he still attempted to introduce it. At the time everyone in Congress had their own ideas on what national health insurance should be like for Americans, so there were very many arguments when the different ideas began to come into conflict with each other. Nixon eventually failed to get his bill passed, and the Watergate scandal forced him to resign before he could attempt to try again. Almost all of his major competitors also were forced out of positions of influence, and a major reform of any kind for national health insurance was considered a dead issue until over 20 years later, when Bill Clinton took office. Clinton attempted to introduce his own version of comprehensive national health care reform in what was termed managed competition. This would set budget ceilings on all the states for health care to their own populations and even regionalize the costs. However, after a lengthy debate that included many protests and an ad campaign that is called the "most destructive in history," Clinton's plan failed and was tossed out of consideration.
I found it interesting that everyone had their own ideas about what health care should be, and that was one of the main reasons why any kind of reform took so long to come about. No one could agree to any compromise without seeming "weak," and so the movement almost always ended in defeat for whoever was proposing the new ideas.

Hoffman Chapters 6-Epilogue

Medicare was a drastic improvement to the country's health care system. After many years of hard fought battles with doctors and the associations that represented their interests, Medicare was finally introduced. It helped the elderly pay for the increasing costs of the medical care that they needed in order to stay healthy, and most of them greatly benefited from this new program. Medicaid was also added, to help support those that did not qualify for the age requirements and were unable to pay their medical costs. Even though doctors frequently denied Medicaid patients due to lack of reimbursement, it was immensely popular throughout the United States. Despite its benefits, Medicare and Medicaid had their problems, but these problems were fixable and were rather small compared to the benefits. Most of these problems resulted in the fact that hospitals were continuing the tradition of discriminating against people that could not pay their bills. A good portion of these people included females, Latinos, and African-Americans, and activists for civil rights groups protested these deficiencies in the system to no prevail. Hospitals also continued to use the "dumping" method, which helped bypass the costs they would have to incur with patients who were unable to pay. This also exacerbated the new AIDS problem, with many people around the country scared to even go near an infected person for fear of contracting the virus themselves. These were all issues that the medical profession and the general population were having to deal with during these times of great changes in the health care system.