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In this paper, I will discuss the development of social policy since the Second World War using welfare ideologies about health in America. Social policies are guidelines targeted to change, maintain or create a living condition that is conducive to the welfare of humans. Hence, the social system is perceived as a part of public policy related to social issues, for instance, public access to social programs. The social plan aims at improving human welfare to meet human needs in health, education, social security, and housing. Welfare ideologies have been responsible for establishing healthcare policies since 1945 in the United States. These ideologies influencing health policies are not political but pioneered by public discussion. These ideologies have shaped policies on public health with the help of scientific networks, for instance, chronic disease epidemiology findings. After the Second World War, nations’ economic recovery did not depend on labor. Governments were asked to satisfy significant needs of its vulnerable and impoverished populations by the war. When state competences increased in many sectors during the Second World War, it resolved itself in the years that followed in attempting to consolidate federal social systems. The departure of health modernization systems was marked by the development of hospital organization as well as social services for the disabled. The health insurance that existed was expanded due to increased services to many recipients. Because of the many losses incurred during the time of war, countries focused on the issue and started to acknowledge the right to minimum guaranteed help for sickness or disability. Significant changes were done after the world war two. For instance, in Britain, the most significant difference involved the development of the National Health Service. Moreover, much advancement was done to manage childbirth and pregnancy. It included the ability to use epidurals and inducing labor to ease pregnancies difficulties. In order to balance this, states did intervene less in the development of women right in having more natural childbirth. Moreover, there was more development of vaccines for controlling childhood diseases.
In the year 1945, national health policy was passed by President Truman. The plan required the government to play a role in healthcare to improve the health of American children. This bill ensured that every community regardless of size could access medical support (Nottingham, pg 163, 2006). Due to lack of enough doctors, nurses as well as other health practitioners in rural areas, this policy was formed to ensure that the communities in these areas receive the required medical support. Moreover, because of the war that had just ended, there were poor health facilities in the country. Due to this problem, Truman created the policies to ensure these health centers are improved to reach the required standards. Many new diseases and infection were developing which caused severe harm to the public population (Nottingham, pg 163, 2006). The war had exposed people to deadly infection, and this pioneered this policy to direct funds into medical research for epidemiology purposes. President Truman created this plan to be operated by the government, and it was supposed to be open to every American. The participants were required to pay some monthly fees to keep the plan going although the government would pay the doctors who will be involved.
Moreover, in 1945 of November, two months after the end of the Second World War, President Truman created a Hospital Survey and Construction Act. It was before; he recognized the need to build more hospitals in order to accommodate more people who had suffered as a result of the war (Richards, pg 141, 2005). There was considerable destruction during the war and funds were directed to warfare in the war. Therefore, there was a need to refocus and start to head more money in the health sector. The policy required more construction of clinics and hospitals to serve an increasing and rapidly crippled population. The plan allowed the development of loans and grants to communities that demonstrated viability in construction healthcare facilities. The objective was to construct hospitals where they are required as well as where they would sustainably operate when they are opened. On reaching the year 1975, the policy had resulted in the construction of almost a third of the hospitals in the United States.
Additionally, due to the need for people to access medical care, President Harry signed a policy that was called an executive order (Richards, pg 141, 2005). The plan became approved in 1951 on 18th of December. During this time, it was very significant for the country to evaluate the health requirements both longtime and immediate hence recommend the action to meet the needs. By this policy, healthcare provision became both local and national concern. It was crucial at this time for the country to seek to slow the rate of death and illness in the country due to the aftermath of the world war (Richards, pg 141, 2005). By this time the government had made significant efforts in medical research, hospital construction, child and maternal health. Considerable attempts were made to ensure proper living standards for both the rich and poor by the access to medical care.
In the year 1954, there was a significant need to improve the healthcare system in the United States. In order to prevent the American from turning to socialized medicine eventually, President Eisenhower pushed for amendments to Hill-Burton Act that was created in the year 1946 (Zabinski, pg 30, 2014). The Bill-Burton act authorized funds to build new hospitals. In contrary, President Eisenhower amended the bill to include diagnostic or research centers as well as chronic care facilities. This policy was engineered by rising of fatal infections such as heart ailments as well as cancer which had caused many deaths. Due to this more nursing homes, rehabilitation centers, as well as diagnostic centers, were constructed.
The aged were increasing at an alarming rate in the United which led to the need to develop nursing home to aid them in their old time. There was a great need for the old hospital insurance which triggered the Forand bill in the year 1959 (Cohen, pg 698, 1958). The law suggested social security contributions be raised to offer up to 120 days of healthcare as well as nursing-home care together with the required surgery for the ones getting social security retirement fund (Cohen, pg 698, 1958). The policy was introduced to cater for the rising need for elderly medical aid. There was a need for the aged to receive exceptional medical care that they were not able to obtain in regular hospitals. Hence, this bill intended to solve the problem by creating the nursing homes where the needs of the elderly were able to be met.
As time passed, there were difficulties among the elderly people from poor backgrounds in receiving medical care (The Social Security Act in 1960, pg 1765, 1960). Since they were not able to afford the funds required for nursing homes, many end up suffering even losing their lives in the process. Due to this problem, the Congress perceived that there was a great need for improved access to health care among this population. After some extensive debate in the Congress, legislation was passed in the year 1960 referred to the ‘’Medicaid assistance to the aged.’’ This policy made it easy for aged individuals who were less poor who needed healthcare assistance to access with ease.
In spite of this policy, there was still inadequacy of welfare health care in public assistance. Some lengthy debates were conducted from 960 to 1965 in the national discussion. At the beginning of 1965, the Debates were settled by the establishment of the Medicaid and Medicare programs as title XIX AND XVIII respectively of the social security policy (Hoffman, pg 185, 2000). The Medicare was established in response to the specific medical care needs of the elderly. This plan was a cover added in 1973 for specific disabled people and the ones having kidney infections. The Medicaid policy was established. This system permitted the provision of health care for the Americans of the age of 65 and above under medical insurance.
In the 6th of February, President Nixon presented a comprehensive health insurance plan to members of Congress in the effort to bring into light his healthcare intentions for his reform program that would be implemented in the year 1976 (New Nixon Health Insurance Plan, pg 179, 1974). This policy was designed due to the risen overall healthcare cost which had gone up with a percentage of 20% since the beginning of 1971. Moreover, the average standing cost involving spending a whole day in the hospital was over 110 dollars. In addition to the high cost of health care, more than 25 million Americans still were not insured by 1974. Additionally, although 40 percent of the Americans were protected, they were not covered for physician’s office visits as outpatients. Also, insufficient private healthcare policies covered preventative services. Moreover, less than half of the citizens that were below 65 years of age possessed significant health coverage. Therefore, due to these issues, the Nixon’s plan was created to ensure that doctors were incentivized to attend to their patients neither for insurance companies nor the federal government (New Nixon Health Insurance Plan, pg 179, 1974). The plan did not need new federal taxes since the federal and state government, insurer, consumer, and provider, had a direct stake in pushing for a system to work.
Nixon’s plan also required three existing health branches to be incorporated namely assisted health and employee health insurance as well as the improved Medicare version. In this plan Employee, health insurance was intended to cover the majority of the Americans through their working places (Waldman, pg 505, 1971). The cost would be shared between the employee and the employer to lower the financial burden on either of the side. Through assisted health insurance, in low- income people required the state and the federal government to pay for every Medicare cost that was beyond the amount an insured individual was able to spend. Additionally, under this plan, the improved Medicare plan would cover an individual who was aged 65 and above of age through a modified system that offered additional benefits. The plan was intended to benefit every individual in America regardless of economic status or age (Waldman, pg 505, 1971). The provided benefit from the program would cover physician, cares, hospital stays as well as prescription medications, as well as other required care.
Nixon’s plan would as well cover alcoholism, illness or addiction regardless of the location of the treatment. This plan was indeed a great revolution in the healthcare. It additionally, mandated that health insurance to provide every full-time employee health coverage, as additional coverage benefits could be added if there is an agreement (New Nixon Health Insurance Plan, pg 179, 1974). The coverage was intended to be jointly financed with the employer paying 65% premium for the first consecutive three years and the years that proceeded to pay 75%. The workers would pay the remaining premium balance. Additionally, federal subsidies would be offered to ease the burden cost. In order to improve the Medicare system, the Nixon plan was aimed at lowering the cost burden and at the same time improving the health care quality for all Americans.
Before the Consolidated Omnibus Budget Reconciliation Act, employees were only covered while they were working (Fleming, pg 125, 2012). Their medical cover expired once they retire or leave work. Due to this problem, many of the people who left work were unable to access medical care due to rising medical cost of healthcare. The Consolidated Omnibus Budget Reconciliation Act created in the year 1985 by President Ronald Reagan allowed employees to continue with their health insurance even after retirement or after leaving work under insurance program. Moreover, this plan mandated the employer to keep paying for the cost of providing continuous coverage. The programs forbid Employees as well as their dependents from continuing maintaining coverage at their expenses by paying for their full premium cost that was previously paid by the employer.
In 1988, a significant need grew for the disabled as well as the elderly in accessing better healthcare. This is because the previous efforts were not enough due to the growing aged as well as the handicapped population together with the developing health issues on the rise. In order to solve this problem Medicare Catastrophic Coverage Act was designed in the same year (Aaronson, pg 776, 1994). The act was intended to develop the Medicare remuneration to include outpatient drugs as well as limiting enrollee’s copayments for the covered services. This bill became the first to expand Medicare benefits since the commencement of the program. Moreover, due to the federal budget discrepancy at that time, this supplemental premium progressed hence avoiding hardship for the poor citizen who enrolled.
Due to employees and dependents discrimination based on their health status at the place of work, health insurance portability and Accountability Act was passed in the year 1996 as federal law (Becker, pg 9, 2004). This policy was meant to protect these employees by offering protection and rights for beneficiaries and participants in group health plans. It also allowed some exceptional opportunities for them to enroll in a program for individuals in a particular situation. By this, the workers will have a right to buy individual coverage if they do not have any group health plan and have also exhausted other coverage. This plan, in general, offered federal protection for personal health information in custody by covered entities. The plan eliminated any form of discrimination in healthcare.
At the beginning of 1997, it was realized that close to 11 million children were not uninsured. In 1 out of every seven children lived in low-income working families. The need arose to cover these children in a health insurance program triggering the development of the State Children’s Health Insurance Program the same year (Lewis, pg 152, 1998). This plan intended to allow states to offer ‘’child health aid’’ to the uninsured and the low-income children efficiently and effectively coordinated with other sources of health remuneration coverage for the children. Additionally, this plan mandated that all eligible children be enrolled in the Medicaid program.
Since 1965 when Medicare was created, the patient’s drug prescription had substantially increased. Due to this increase, drugs had grown to be very expensive making citizens who were targeted by Medicare to have difficulties in affording medicines (Ember, pg 4, 2002). Due to this issues, the Medicare Prescription Drug, Improvement and Modernization Act also referred to as the Medicare Modernization Act was created in the year 2003 and signed by President Bush. The plan allowed drug importation from Canada where they were cheap. The plan also offered subsidies to private insurers for competition with traditional Medicare offering citizens an opportunity to join managed-care plans that typically reduced costs by restricting patients in accessing specialist (Ember, pg 4, 2002). Furthermore, the plan provided a subsidy for big employers to discourage them from eradicating medicine coverage to retired employees. Moreover, by this plan, the government is prevented from bargaining price cut with Drug Corporations.
Barrack Obama during his term as the United States president realized that chronic illnesses and emergency rooms were costly and many people were unable to afford the services (Amadeo, pg 10, 2017). Moreover, emergency care was expensive to be afforded by low-income citizens. Due to this issue, he sought to create and implement the Patient Protection and Affordable Care Act that was commonly referred to as the Obamacare. In this plan, he not only intended to attempt to lower the costs of health care but also improving the quality of life for the citizens who were not able to obtain health insurance in their working places. Due to this policy, coverage was made affordable for more citizens allowing them to receive preventive care and avoid expensive emergency care (Amadeo, pg 10, 2017). Additionally, medications were subsidized for the aged to treat their chronic diseases. This plan became law in the year 2010 impacting the healthcare significantly.
Welfare ideologies shape public debated intended to develop social policies. These ideologies are meant to address social problems. In health, policymaking drove ideologies that helped in policy decisions. In the history of the United States’ health, there is proof that welfare ideologies had shaped the great healthcare revolution since the Second World War. Healthcare has dramatically expanded since 1945, and it has addressed many social problems in healthcare. Many needs have been covered in these policies that were created from 1945 up to date. The issues encountered have resulted in ideologies that have shaped these policies hence closing the gap in healthcare. Therefore, this shows that welfare ideologies have been a significant determinate in developing these strategies.
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