Healthcare in the United States:

Task: This written assignment asks you to trace the historical development of a social welfare policy of your choosing while paying close attention to how historical events helped shape the policy and to compare it with today’s policies related to that issue. Due Date: _____________ Purpose: The purpose of this assignment is for you to gain an appreciation of the role that history (events, societal reactions and/or values) can play in the creation and amendment of social welfare policy at the local, state and federal level. Consider changes over time, where we are today and goals for the future. topic. Health Care Issues: Medicaid, Medicare, Affordable Care Act, – Then, Now and in the future. Address the following: 

Running head = HEALTH CARE IN AMERICA
Sociology
Health care in America
Evolution of health care act in America
Student Details
[Pick the date]

Health care in America 1
The principle right of existence applies, in terms of health assistance at the time of need
for every citizen and it should not be discriminated based on someone’s financial status or based
on an individual’s religious beliefs (Lagomarsino, Garabrant, Adyas, Muga, & Otoo, 2012). In a
report published by (Semega, Kollar, Creamer, & Mohanty, 2019) approximately 38.1 million
people, who come close to 11.8 percent of the total pollution comes under the poverty line. A
report published by (Montgomery , 2020) indicated that only 88 % of Americans had health
coverage in the year of 2018. The following paragraphs will elaborate on the history of health
insurance reform in America along with the current condition of government assisted health
insurance.
The efforts of political leaders, government officials, and some trade unions to provide
health benefits for their respective population can be traced back to late 1800; however, there is
still a long way to go in terms of providing universal health coverage. In the initial years, the
American government did not provide any insurance scheme for the public or working-class
people. The first health-related issuance policy was introduced by the American Association of
Labor (AALL) in 1915, though the bill only covered working-class people and who had their
income less than 1200 $ per year (Wegerer, 2014). In the prudential period of Franklin D.
Roosevelt (FDR) (1933-1945), FDR tried to include health insurance in his social security bill in
1935, however, due to its strong opposition by the American medical association later health
insurance was removed from social security bill. In 1943 a compulsory national health insurance
policy also named as Wagner-Murray-Dingell Bill, continually introduce for the 14 times in the
senate, however, it was not approved due to continuous opposition (Kendall Sr, 2014).
The introduction of Medicare/ Medicaid in the year as a program for the care of the aged
population, which was further refined in terms of coverage on voluntary insurance with

Health care in America 2
comprehensive welfares and general practitioner service. The proposal of Medicare was finally
introduced as law in 1965 (Baicker & Goldman, 2011). In the year 1972 Medicare service was
further extended to include people with a terminal illness, physically disabled and people aged
above 65 years (Blumenthal, Davis, & Guterman, 2015). The Medicaid program was initially
introduced to the citizen of the USA; provide help to people needing financial help. However, it
had evolved over a period of time due to various reforms introduced by congress and at present,
it includes physically or mentally disabled peoples, people with low income, pregnant women
and the people in the need of long term medical assistance. In the year 1997, the Medicaid plan
included children’s health insurance plan which delivered preventive health benefits to the 11
million children including all the 50 states along with the District of Columbia. The MMA act in
2003 further introduced the availability of prescription drugs for the elderly and for the person of
mental or physical disability (Kelly, 2011).
Although the United States of America (USA) is one the largest country in terms of total
area and ranked number 1 in terms of gross domestic product (GDP) it does not provide
universal health coverage to its population. Countries like France, Switzerland, Israel, Australia,
New Zealand, and the United Kingdom have its 100 % population under insurance coverage also
known as universal health coverage (Martinson & Reichman, 2016; Montgomery , 2020).The
aforementioned paragraphs indicate the struggle of various American governments in terms of
introduction and provision of universal health coverage for its citizens. However, the attempt
was opposed by various unions and political parties due to their personal views and political
mindset. The introduction of Medicare and Medicaid provided some relief for the American
population mainly coming under the category of elderly or physically or mentally disabled or
minor children. However, a large number of populations did not come under the government-

Health care in America 3
assisted insurance and were unable to afford private insurance. Therefore, In an attempt to
provide universal health insurance coverage for the people of America, the government under
president Barack Obama introduced a law in March 2010 named “Patient Protection and
Affordable Care Act (PPACA)” (Rosenbaum, 2011). PPACA was introduced keeping an aim to
assist and improve the lives of Americans towards affordable health insurance protection along
with the end-user protection from various companies’ beneficial private insurance policies.
The PPACA also is known as Obama care primary objective is to make health insurance
affordable and improved medical coverage by the mean of legislation and regulations. The
primary benefits of the PPACA were that the person would not be dropped from the benefits of
the insurance coverage after falling sick or due to some error in the application, further, the
insurance coverage was not dependent on the type of disease. The other benefit of PPACA was
the availability of the insurance to millions of the American which were earlier unable to receive
health insurance due to their financial condition or due to their unemployment also the person
who had chorionic diseases. It was reported that more than 16 million citizens of the USA
acquired health insurance in the first year of implementation of PPACA (Dickstein, Duggan,
Orsini, & Tebaldi, 2015). One more benefit of PPACA was the provision of affordability of
prescription drugs, as the number of drugs available as a part of insurance coverage for the
benefit of the people in need is increasing every year since the introduction of the law. A report
published by (Roland, 2019) indicated that recipients of the Medicare program have saved
approximately 26.8 billion dollars with the help of prescription drugs falling into the coverage of
Obama care.
Despite being highly beneficial for the public certain drawbacks of the PPACA were
enlisted to replace it by the next government. The high premium charged by the insurance

Health care in America 4
company as the range of benefits increased which caused a rise in premium for the people who
already had insurance. The earlier implication of PPACA was that a person either has insurance
or they should pay fines to the government, however, it was removed from the financial year
2019. To pay for the services of PPACA, the government introduced various new taxes which
further included taxes on medical instruments.
The current government has tried to amend some policies of PPACA based on economic
stress; The “Tax cuts and Jobs Act 2019” has removed any penalty which was earlier imposed on
the public who were not marinating their health insurance (Gale, Gelfond, Krupkin, Mazur, &
Toder, 2019). The government has ended its payment to the insurance company in the form of
subsidies, which resulted in economic stress on the insurance company as they need to maintain
their insurance plan under PPACA. However it was difficult for the insurance company to
maintain insurance plans under PPACA, therefore insurance organization has increased the price
of most of their silver plans.
Since the introduction of PPACA, the debate is going on its benefit to the American
people and the amount of stress it produces on the American economy. In a report published by
(Gnadinger, 2016)suggested that health care spending increased every year in the USA after the
introduction of PPACA. The expansion of the Medicare and Medicaid program under PPACA
has resulted in spending 5.8 % which was approximately 3.2 trillion US dollars or in terms of
cost per person it was approximately 9,990 dollars.
Despite being number 1 GDP country does not have universal health care for its citizens,
with only 88 % of citizens had health insurance till 2018. Medicare and Medicaid were the first
government-assisted program for the health need of the elderly, people suffering from terminally
ill diseases and children. The coverage of the Medicare and Medicaid program was expanded by

Health care in America 5
the introduction of PPACA in 2010. The primary goal of PPACA was to benefits those
Americans who were not able to afford health insurance or who were not eligible for health
insurance. However, President Trump's admiration has tried to abolish PPACA, but they have
not been able to introduce any insurance plan for the public to replace PPACA.

Health care in America 6
Reference
Baicker, K., & Goldman, D. (2011). Patient cost-sharing and healthcare spending growth.
Journal of Economic Perspectives, 47-68.
Blumenthal, D., Davis, K., & Guterman, S. (2015). Medicare at 50—origins and
evolution. N Engl J Med, 479-486.
Dickstein, M. J., Duggan, M., Orsini, J., & Tebaldi, P. (2015). The impact of market size
and composition on health insurance premiums: Evidence from the first year of the
affordable care act. American Economic Review, 120-125.
Gale, W. G., Gelfond, H., Krupkin, A., Mazur, M. J., & Toder, J. E. (2019). Effects of the
Tax Cuts and Jobs Act: A preliminary analysis. National Tax Journal, 589-612.
Gnadinger, T. (2016, December 2). National Health Spending Grows Faster In 2015.
Retrieved March 11, 2020, from HealthAffairs:
https://www.healthaffairs.org/do/10.1377/hblog20161202.057765/full/
Kelly, C. (2011). The balance between innovation and competition: The hatch-waxman
act, the 2003 amendments, and beyond. Food & Drug LJ , 417.
Kendall Sr, T. W. (2014). A tribute to AAPS. Journal of American Physicians and
Surgeons, 100-101.
Lagomarsino, G., Garabrant, A., Adyas, A., Muga, R., & Otoo, N. (2012). Moving
towards universal health coverage: health insurance reforms in nine developing countries in
Africa and Asia. The Lancet 380, 933-943.

Health care in America 7
Martinson, M. L., & Reichman, N. E. (2016). Socioeconomic inequalities in low birth
weight in the United States, the United Kingdom, Canada, and Australia. American journal
of public health, 748-754.
Montgomery , K. (2020, February 22). Differences Between Universal Coverage and
Single-Payer. Retrieved March 10, 2020, from verywellhealth :
https://www.verywellhealth.com/difference-between-universal-coverage-and-single-payer-
system-1738546#citation-3
Roland, J. (2019, August 14). The Pros and Cons of Obamacare. Retrieved March 10,
2020, from healthline: https://www.healthline.com/health/consumer-healthcare-guide/pros-
and-cons-obamacare
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: implications for
public health policy and practice. Public health reports, 130-135.
Semega, J., Kollar, M., Creamer, J., & Mohanty, A. (2019, September 10). Income and
Poverty in the United States: 2018. Retrieved March 11, 2020, from United States Census
Bureau: https://www.census.gov/library/publications/2019/demo/p60-266.html
Wegerer, J. (2014, January 08). 10 Moments in Health Care That Will Go Down in
History. Retrieved March 11, 2020, from aPlaceforMom:
https://www.aplaceformom.com/blog/2014-08-01-historical-health-care-moments/