Health Care Reform Wayback – A Brief History of Health Care Reform in the USA

Is Health Care Reform New?

As somebody who is very interested in the progress of health care reform as a taxpayer, private consumer of health insurance and services, and as a professional, I have been trying to follow the current health reform debates. I am getting a little frustrated with the lack of progress on either side of the aisle, and also by some of the knee jerk reactions by politicians and their groupies.. You would think that the current administration, and its political adversaries, had just invented health reform or the cries of outrage that sound against it.

I decided to do my best to outline some of the highlights of the health reform attempts, failures, and progress in the past 100 years or so. I am not a professional historian, by any means, so some may feel as if I left out important things or took them out of context. I am trying to be balanced, but take all the blame if I neglected something you feel is important.

Teddy Roosevelt In the 1910’s

Teddy Roosevelt ran on a very progressive platform in the early part of the last century. His campaign promises for 1912 included protection for workers safety on the job women’s right to vote, and a national health care program. He was president of the United States, by the way, from 1901 – 1909. But he lost the election of 1912 to Woodrow Wilson. It is interesting to note that this Roosevelt was a Republic. Wilson was the Democrat. Never assume that American party politics are set in stone.

Early Models of Current Health Insurance and Cries of Socialism

In 1929, Baylor Hospital in Dallas, Texas came up with a pre-paid program for a large areal teacher’s union. This is considered one of the earliest models of health insurance. Now here’s the irony. A few years later, an Oklahoma doctor formed a farmer’s association with a pre-paid plan. Members of the association would pay into the plan, and then get services covered. The American Medical Association called this doctor’s plan socialism!

Despite this, pre-paid hospital and doctor plans continued to grow in popularity around the US. However, they usually left out the unemployed and elderly.

The New Deal in the 1930’s

Another Roosevelt, FDR, also wanted to implement national health reform. He wanted to include it as part of social security legislation. That did not work out, but even Truman wanted to set up a national fund. for health care. He figured everybody could pay in, like we do for social security, and then it could make sure that people’s most severe health needs were met. All of this was left out of the New Deal, and the AMA continued to criticize it as socialism.

Post World War II

By the end of the second world war, it became a lot more obvious that there was a big gap between health care costs and what mos people could afford. Congress did pass a bill to build a lot more hospitals. They also required hospitals to provide charity care. They had a clause to forbid discrimination on race, religion, etc. But they did allow separate but equal care, which did not always turn out to provide equal care to everybody.

In the 1950’s, labor unions began adding health benefits to their collective bargaining agreements. This really formed the basis for the group health insurance many people enjoy at work today. So group health plans became more popular, and in 1954, Congress voted to make this benefits tax-exempt.

The 1960’s

JFK fought hard for national health care, but again he was met with cries of socialism. But Medicare and Medicaid, regarded as American institutions now, did emerge despite this. Medicare is the US national health plan for seniors and disabled people. Medicaid is the national health plan for very poor people.

Despite the fact that millions of Americans had heath insurance coverage for the first time, in the 1960’s, health care spending and costs were beginning to rise.

The 1970’s – Nixon and Carter

President Nixon, a Republican, worked for health reform. He proposed a bill that would require employers to provide minimum health insurance coverage. Under his administration, money was allocated for the development of HMOs and managed care to contain costs.

Carter ran for president, and national health care was a large part of his campaign platform. Even though he won, the severe recession put these plans on hold.

The 1980’s and COBRA

COBRA is the national law that requires some employers to extend group health benefits to terminated employees for several months.

The 1990’s and The Clintons

Probably the most famous previous attempt to dramatically reform health care was under President Clinton. Hillary Clinton, then first lady, spear headed this work. You will probably not be surprised to learn that political critics of the pan delighted in calling it socialism. Experts contend that the plan failed because of partisan politics on both sides. The drug and insurance companies, and the American Medical Association (AMA) also spent a lot of time and money getting the Health Security Act defeated.

CHIPS - I cannot leave the 1990’s without mentioning CHIPS. This is the state and federal children’s health insurance program which covers millions of children from lower and moderate income families.

21st Century Health Reform

I have to credit George Bush, a Republican, with passing the Medicare Prescription plan in 2003. This is also known as Medicare Part D, and it helps fund prescription insurance for Medicare beneficiaries.

Obama ran on a platform that included health reform. It seems like it is as tough to pass now as it was during the time of Teddy Roosevelt, FDR, Truman, and Bill Clinton. Politicians are still making deals behind closed doors, and of course, people are still shouting socialism.

But some things have changed. The AMA now supports health reform. Many businesses are concerned about spiking costs of covering employees, and representatives have admitted they would like to see some reform that would help them. Even insurance companies have said they will cooperate.

Hopefully, we can see some progress. I have no idea what will (or should) happen next.

Is Certified Health Coach Training in Your Future?

Undergoing a certified health coach training program can be very rewarding. There are many things in store for you if you decide to pursue the health and wellness industry as a health coach but before anything else, you have to know what a health coach exactly is, what his responsibilities are and what is expected of a good and health and wellness coach.

A health coach is someone who is tasked to help people in efficiently managing their health conditions and even some illnesses. Most of these conditions are chronic and are hard to handle. When you are a health coach, you are expected to guide your client in properly addressing and discovering their own strength to deal with lifestyle and behavior changes. You are not tasked with diagnosing an illness or becoming a substitute for a physician’s care.

A good wellness coach undergoes certified health coach training which provides a framework which they can use to assist their clients in identifying issues, concerns and problems. These issues are often hindrances that stop the client from taking full responsibility of different lifestyle and health changes that he or she should do to achieve wellness goals.

Like all other forms of coaching, being a health coach requires you to utilize various forms of goals for a particular purpose, identify obstacles as well as become a personal support system for your client. The relationship that you build with your client has an accountability nature and is focused on achieving overall wellness goals that are defined early on. The client defines these goals with the guidance from the health coach.

There are many definitions of what a health and wellness coach really is. Some scientists describe a coach as one who practices health promotion and education in a schooling and instruction context and aims to promote the well-being of his or her clients. Achievement of different health-related goals, most commonly losing or gaining weight, is also facilitated by the coach.

A good coach motivates behavior change in order to make it easier for the client to change his or her lifestyle in order to achieve a clearly stated set of health goals. Client-centered counseling is also expected since it is a good form of eliciting change in behavior of the clients.

Clients who require health coaches are often ready for change, which significantly decreases their ambivalence for lifestyle changes. However, they might meet obstacles along the way and may need their coaches to help them get back on track.

Health and wellness coaching is different from other types of coaching since it does not instruct clients what to do, but rather help them overcome obstacles and motivate them in case they lose hope in the middle of the change or simply get tired of the lifestyle changes that they need to do.

The core principles that govern health coaching include encouragement, motivation and health attention. The atmosphere that is set within every session with a coach is directed to the client and on different ways of paving the way to self discovery and self motivation in order to achieve a healthier lifestyle.

A Psychologist’s Suggestions For Improving Your Health Insurance

Health insurance company earnings were released, showing billion dollar profits by the major insurance companies. Despite these earnings, all of the insurance companies continue to increase their premiums on an annual basis. I am writing as a small business owner, health care provider, and health care consumer to describe my concerns about health insurance abuses.

As a small business owner, the annual 15% to 45% health insurance premium rate increases are unaffordable. Each year, as our employees age, we reduce benefits to afford minimal health coverage. As health consumers, our care is inferior and restricted by insurance company bureaucracy, and we have additional increased out of pocket costs. Just this past week, it was reported on how health insurers have posted billion dollar profits, at the cost of reduced care for the insured. How is this fair? It is time to remove the anti-trust exemption that protect insurance companies, and permits them to abuse the public.

As a health care provider, my income has systematically been reduced, as insurance companies increasingly dictate the care I provide, the fees I receive etc. Additionally, we have been forced to spend more time and money on hiring administrative staff to deal with insurance company errors, obfuscation, and refusal to pay for things that they must. Thus, health insurance companies increase health care costs tremendously simply through their administrative harassment of health care providers. As an example, I counted more than 200 claim errors from one insurance company in one year. This meant that over 200 hours were spent rectifying insurance company errors! Resolution of the problem only occurred after I sought assistance through Congressman Pascrell’s office (for which I am immensely grateful). It is no surprise that private insurance administrative costs of 35 to 40% are way higher than those of Medicare, which are 3 to 5%. This high rate of administrative costs is unacceptable, and insurance accountability must be implemented.

In my quest to resolve the high rate of insurance company errors, I learned that insurance companies routinely employ personnel to deal with bad publicity. They employ entire departments to deal with legislators and the public. They spend unknown amounts of money on advertising and lobbying. In this time of economic distress, and with so many problems funding proper health care, what are insurance companies doing spending so much money on advertising and public relations? Who is looking into the huge burden they add to rising health care costs through all of their administrative errors, public relations gambits, advertising, etc?

In the early 1990s, I joined several health insurance panels as a participating provider. Initially, the insurers offered reasonable fees, I signed up, hoping to be part of the solution to the country’s health care woes. Within two years, our fees were slashed dramatically. I maintained provider participation with a few panels whose rates were acceptable. Although I dropped out of the lower paying plans (whose compensation would have left me with an income that is similar to the starting salary of a teacher), it was amazing how my name remained in their list of participating providers (a phenomenon known as the “phantom panel”). In all of these years, the fee has never been raised in the few panels in which I remained. In contrast, my medical health insurance rates have risen dramatically, as have my rents, taxes, utilities, malpractice insurance, etc.

There is something wrong in a society when the healers, who require great educational training, are paid at far lower rates than those that deny health care, as is the case with the insurance company executives. Their compensation packages are in the millions of dollars each year, while the health care providers struggle to maintain a middle class standard of living. Health insurance companies contribute to the spiraling, out of control health care crisis.

In my opinion, any successful health care reform must include:

1. Limits on the compensation of insurance executives (in the same way that incomes of all medical health providers have been reduced).

2. Financial limits on insurance company expenditures on lobbying, advertising and public relations efforts. Those funds need to be re-directed towards actual health care.

3. Insurance companies exemption from anti-trust regulations must be eliminated.

4. Insurance company accountability and reduction of their claims processing errors and administrative costs must be reduced so that they fall in line with that of Medicare (3 to 5%). Stringent penalties need to be assessed upon insurance companies that fail to follow this ruling.