User:Manorhe18/Healthcare reform debate in the United States

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''***add to Health insurance in the United States, possibly in History section*** Some of the first evidence of compulsory health insurance in the United States was in 1915, through the progressive reform protecting workers against medical costs and sicknesses in industrial America. Prior to this, within the Socialist and Progressive parties, health insurance and coverage was framed as not only an economic right for workers health, but also as an employer’s responsibility and liability- healthcare was in this context centered on working-class Americans and labor unions.''

Conservative and libertarian arguments
Conservatives and libertarians arguments against a government role in healthcare emerged n the 1910s, as public concern was growing about the problems of health care access and high medical costs.Many of the conservative rhetoric throughout US history as centered on Cold war propaganda and economics. The American Medical Association (AMA) itself described universal healthcare policies as “socialized medicine”. The AMA and many physicians actively held political roles in preventing many grassroots movements of compulsory health insurance to take hold due to private/ profit incentives as well as a disbelief in “socialism”. In the 1930s, president Franklin D. Roosevelt's legislation for universal health care was vehemently opposed and attacked by the American Medical Association.

President Truman, who was a strong supporter of the Wagner-Murray-Dingell Bill which would instate a national medical insurance program financed by taxes, was elected in the late 1940s and the AMA spent over $1 million on an anti-health reform campaign, denouncing the bill and fueled even more by cold war rhetoric of socialism. As illustrated by these tensions, Cold war propaganda and socialism was so central in the debates of healthcare that ideas of health insurance and accessibility became inextricable from politics.

The republican President Reagan spoke out against Socialized Medicine, in which he “criticized Social Security for supplanting private savings and warned that subsidized medicine would curtail Americans' freedom" and that "pretty soon your son will not decide when he is in school, where he will go or what he will do for a living".

The economics of healthcare continues to be central within conservative arguments, as many politicians bring in the idea of the free market into healthcare. For example, Conservative GOP columnist Bill Kristol advocated several free-market reforms instead of the Clinton plan during the 1993–1994 period. Investigative reporter and columnist John Stossel has remarked that "Insurance invites waste. That's a reason health care costs so much, and is often so consumer-unfriendly. In the few areas where there are free markets in health care – such as cosmetic medicine and Lasik eye surgery – customer service is great, and prices continue to drop." Republican Senator and medical doctor Tom Coburn has stated that the healthcare system in Switzerland should serve as a model for U.S. reform. He wrote for New York Sun that reform should involve a market-based method transferring health care tax benefits to individuals rather than employers as well as giving individuals extra tax credits to afford more coverage.

Some critics of the bills passed in 2009 call them a "government take over of health care." FactCheck called the phrase an unjustified "mantra." (Factcheck has also criticized a number of other assertions made during 2009 by advocates on both sides of the debate). CBS News described it as a myth "mixed in with some real causes for concern." President Obama disputes the notion of a government takeover and says he no more wants government bureaucrats meddling than he wants insurance company bureaucrats doing so. Other sources contend the bills do amount to either a government takeover or a corporate takeover, or both. This debate occurs in the context of a "revolution...transforming how medical care is delivered:" from 2002 to 2008, the percentage of medical practices owned by doctors fell from more than 70% to below 50%; in contrast to the traditional practice in which most doctors cared for patients in small, privately owned clinics, by 2008 most doctors had become employees of hospitals, nearly all of which are owned by corporations or government.

Republicans also argue the proposed excise tax on medical devices and drugs would increase the tax burden on vaccine makers.

Some conservatives argue that forcing people to buy private insurance is unconstitutional; legislators in 38 states have introduced bills opposing the new law, and 18 states have filed suit in federal court challenging the unfunded mandates on individuals and states.

Senator Judd Gregg (R) said in an interview regarding the passage of healthcare reform: "Well, in my judgment we’re moving down a path towards... Europeanization of our nation. And our great uniqueness, what surrounds American exceptionalism, what really drives it is that entrepreneurial individualistic spirit which goes out and takes a risk when nobody else is willing to do it or comes up with an idea that nobody else comes up with and that all gets dampened down the larger and more intrusive government becomes, especially if you follow a European model."

Addressing the social safety net new section
''The social safety net refers to those providers that organize and deliver a significant level of health care and other needed services to the uninsured, Medicaid, and other vulnerable patients. This is important given that the uninsured rate for Americans is still high after the advent of the Affordable Care Act, with a rate of 10.9%, or 28.9 million people in 2019. Not only is this because the ACA does not address gaps for undocumented or homeless populations, but higher insurance premiums, political factors, failure to expand Medicaid in some states, and ineligibility for financial assistance for coverage are just some of the reasons that the social safety net is required for the uninsured. Most people who are uninsured are non-elderly adults in working families, low income families, and minorities. Social safety net hospitals primarily provide services to these populations of uninsured. For example, California's Public Health Care Systems are only 6% of the hospitals in the state, yet provide care for 38% of all hospital care of uninsured in California- 123,000 of which are homeless, and 3.6 million of which live below the federal poverty line .''

''One way in which the US has been addressing this need for a social safety net (other than formally/state recognized safety net hospitals) is through the advent of Free Clinics, an example of a Federally Qualified Health Center. A free clinic (for example, the Haight-Asbury Free Clinic and the Berkeley Free Clinic) is a clinic that provides services for free and target the uninsured, typically relying on volunteers and lay health workers. The creation of the National Council of Free Clinics reflects not only a need for licensed staff, but serves as filling the gap in healthcare access for primarily uninsured or underinsured populations.''