History of US Health Care System-Final Project

8/3/2019 History of US Health Care System-Final Project

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Running head: History of US Health Care System: Final Project

History of US Health Care System: Final Project

Antonio Abreu

Nova Southeastern University

BHS 3101

Professor Maryellen Antonetti MPH, PA-C


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History of US Health Care System: Final Project 2

Health insurance in US

Health care is arguably one of the most pressing concerns of governments all over the

world. All developed countries are characterized by having elaborate healthcare systems which

are in place to ensure that majority of the population has access to medical care when they need

it. Arguably, health care insurance is a relatively new trend in the US. Before 1920, doctors and

medical practitioners did not have many insights on diseases and curative techniques. As such,

the cost of receiving medical care was relatively low and affordable to many Americans.

However, as more discoveries were made and new techniques of delivering healthcare services

emerged, the cost of receiving the medical treatment began to increase. As a result, many people

could not afford quality care due to financial constraints.

To this effect, private companies started offering health plans to their employees.

However, the healthcare plans only covered against accidents related to travel by rail or water.

However, these plans paved the way to more comprehensive covers that catered for other

illnesses and injuries. In 1847, Massachusetts Health Insurance of Boston became the first

company to offer group policies that gave comprehensive cover to its clients. Consequently, in

1890, insurance companies started offering individual disability and illness policies to their

clients (Northern California Neurosurgery Medical Group, 2007).

By 1929, group insurance coverage had gained prominence in the US. Baylor Hospital

was the first organization to enter into a contract with a group of teachers from Dallas. This

agreement aimed at ensuring that these teachers receive room, board and medical services from

the hospital. The teachers on the other hand agreed to pay a monthly fee in exchange for these

services. Soon after, several life insurance companies joined this seemingly lucrative field. A


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precursor to future health care insurance schemes in America was Blue Cross which were the

first to establish a health insurance similar to the modern model of the health care system in

America today. This plan developed in 1930 advocated the payment of small premiums that

would provide coverage for medical costs should one be hospitalized. The rationale behind this

arrangement was that while huge medical bills were unaffordable to most people, little

deductions over a long period of time were affordable to the majority of the population

(Kooijman, 1999). This form of prepaid service were beneficial to both the hospital and the

consumer especially in times of economic difficulties since neither party had to worry about the

hospital bill being paid.

During the Second World War, employers started offering insurance cover to their

employees mostly as a way of attracting and retaining employees. However, this created a trend

and became almost mandatory as strong trade unions started to negotiate for insurance packages

for their employees. Northern California Neurosurgery Medical Group, (2007) notes that as of

1960, private health insurance was deeply imbedded into the American health care system and

over 70% of the citizens had some form of health care coverage.

In 1965, the U.S government created the Medicare and Medicaid programs with the aim

of subsidizing the escalating cost of medical services (United States Department of Health and

Human Services, 2009). This was mainly due to the fact that private sources catered for 75% of

their medical costs (Moon, 2006). At this rate, many citizens could not cover their medical costs.

However, these programs proved to be effective because as at 1995, individuals and companies

enjoyed reduced costs since they only paid about half of their medical bills while the government

covered the rest through these programs (United States Department of Health and Human

Services, 2009).


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History of Laser Eye Surgery

In the past few decades, inventions and breakthrough scientific discoveries in the

biological field have resulted in the prevalence of access to sophisticated equipment and

advanced diagnostic procedures that were once only in the realm of research institutes and few

specialist hospitals. One of these technological advancements has been in the form of laser eye

surgery. Documented evidence indicates that over the past one hundred years, there has been an

increased interest in refractive surgery (Taylor, 2011). By 1898, Lans, a prominent professor of

Ophthalmology had laid out the basic principles of radial keratotomy (Taylor, 2011). Before

1970, various eye specialists adopted different methods and techniques to treat eye related

problems (Taylor, 2011). However, there were many complications regarding these techniques

and in some cases, they made the situation worse.

The most significant breakthrough was made in Russia in 1970s. This was in a case

whereby Dr. Fyodorov was treating a boy whose glasses had broken and damaged his eyes

(Taylor, 2011). This situation gave the doctor an opportunity to test the effectiveness of radial

keratotomy. After the surgery, the doctor documented that the boys refractions were

significantly less than they were before the injury. This discovery prompted him to do more

research on the procedure. As a result, he came up with a formula that made refractive surgery

more predictable than it was before (Taylor, 2011). It was not until 1978 that American

ophthalmologist Dr. Leo Bores brought back the necessary technology for this surgery into

America (Lasersurgeryforeyes.com, 2002). It should be noted that until 1970, lasers were

primarily used to produce silicone computer chips in America (Lasersurgeryforeyes.com, 2002).


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The mode of production was referred to as Excimer laser process (Lasersurgeryforeyes.com,

2002).

After further research, it was discovered that the Excimer laser procedure could be used

to remove damaged tissues without the risk of heat damaging the surrounding tissues

(Dlxguard.com, 2009). This discovery was made in 1982 by three members of an IBM research

team (Dlxguard.com, 2009). Soon after, this technique was applied in an array of medical

procedures and treatments. However, it was not until 1982 that Dr. Steven Trokel, an American

ophthalmologist based in New York first conducted the first eye surgery using this technique

(Dlxguard.com, 2009). The following decade saw scientists and researchers devoting significant

efforts towards perfecting the technique.

It was not until 1996 that the government finally approved laser eye surgery in the US

(Dlxguard.com, 2009). This approval led to a surge in eye treatment options. It should be noted

that before this approval, some eye treatment options would leave the patient immobile for a long

period of time (six or more weeks), and the surgeries were very risky. However, laser eye

surgery presented practitioners and patients with a less risky, time saving, efficient and

convenient option to correcting eye problems. Arguably, if you were among the 80% of

Americans who require vision correction, the only option before the approval of laser eye

surgery would have been either glasses or contact lenses. However, this is no longer the case

since these techniques enable ophthalmologists to correct eye defects such as near or

farsightedness effectively through radial keratotomy. More research is being carried out to

improve the technique and facilitate better and safer eye correction services in the future.


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Michael DeBakey: Father of cardiovascular surgery

A life well lived is one that is lived in such a way that it makes a positive difference to

others. Throughout history, different people have been credited for their works in regards to

making a difference in the lives of others. Michael DeBakey is among such people in the medical

arena. Born in 1908, in Los Angeles, this American surgeon helped develop various treatments

and surgical procedures that have revolutionized the medical practice up to date (Notable Names

Database, 2011). Before he died of natural causes in 2008, Michael DeBakey had performed

heart operations in excess of 60,000 (Women's Internation Center, 2010). In addition, he had

published more than 1,500 scientific publications that helped other practitioners understand and

treat various medical phenomenons (Notable Names Database, 2011). His work has helped add

decades of years to some of his patients in America and abroad. Similarly, he has trained many

renowned surgeons across the world.

Of his many achievements and contributions to medicine and health care, one of his

major achievements included the invention of the roller-pump in 1932 (Notable Names

Database, 2011). Twenty years later, this invention became an essential component during the

development of the heart-lung machine which enabled cardiovascular surgeons to conduct open-

heart surgeries. NNDB (2011) further reports that in 1953, Michael DeBakey introduced

improved Dacron and Dacron-velour artificial grafts to replace damaged arteries (Notable

Names Database, 2011). He was among the leaders in the development of artificial arteries and

introduced the concept of bypass surgery in the healthcare sector (Notable Names Database,

2011). He is also credited for the creation and development of the Mobile Army Surgical

Hospitals (M.A.S.H) concept, which helped save many lives during the Korean and Vietnamese

wars (Women's Internation Center, 2010). I personally was part of a group in Iraq that was


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tasked with setting up mobile medical/battle aid station as we refer to them in the Navy; trust me

when I say a lot of logistics goes into setting them up.

Arguably, Michael DeBakey is best known for inventing the ventricular assist device

(VAD) that is commonly referred to as the artificial heart. He invented this device in 1968 so that

it would help patients whose hearts had weak cardiovascular muscles pump blood by assisting

the main pumping chamber (Notable Names Database, 2011). It should be noted that this

invention was never intended to replace the full heart but merely to offer assistance to weakened

hearts. However, it paved way for more research and consequently, the first artificial heart was

developed and implanted into a human being a year later (Notable Names Database, 2011). This

operation was carried out in 1969 by Dr. Denton Cooley who was a former colleague of Michael

DeBakey (Notable Names Database, 2011).

In his pursuit for perfection, Michael DeBakey together with another colleague invented

the Jarvik artificial heart (Notable Names Database, 2011). This heart was first fitted into a

human being in 1982 (Notable Names Database, 2011). Later on in the 90s, Michael DeBakey in

collaboration with NASA developed a miniaturized heart pump (Notable Names Database,

2011). This pump was so small that it could easily and comfortably be implanted in a child.

These are among the key contributions that the renowned surgeon and physician made during his

lifetime. Besides this, he was best known as being a Good Samaritan, a pioneer and a dedicated

statesman who strived to ensure that every person had a chance to live a long and healthy life

(Women's Internation Center, 2010). The WIC website states that Dacron arteries, arterial

bypass operations, artificial hearts, heart pumps and heart transplants are common procedures in

today's medicine, thanks to Dr. DeBakey (Women's Internation Center, 2010). This statement is

true as has been elaborated in this essay.


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Health care reforms in the U.S

The US government has always taken a keen interest in the healthcare provision of its

citizens. Kovner, Knickman and Jonas (2008) state that this idea of government involvement in

the health concerns of the citizens can trace its existence from as far back as the 17th century

(Koyner, Knickman, & Jonas, 2008). It is recorded that as early as the beginning of the 19th

century, a majority of American citizens were worried about the affordability and availability of

health care (Koyner, Knickman, & Jonas, 2008). It is for this reason that the public healthcare

option was conceived in the late 1800s (Koyner, Knickman, & Jonas, 2008). However, it was in

the era of President Theodore Roosevelt that health reforms took a definite shape. His

monumental declaration that "Nothing can be more important to a state than its public health:

the state's paramount concern shouldbe the health of its people (Sebelius, 2009). Highlighted

his dedication towards achieving a system that he perceived would afford the population the best

opportunity to acquire health care. Roosevelts continuous commitment to a national health

insurance plan through from 1912 was one of the key factors that shaped the public health

insurance policies in the United States (Koyner, Knickman, & Jonas, 2008).

Kooijman (1999), states that as of 1935, the efforts for national health insurance were

greatly derailed by medical practitioners who were greatly opposed to the arrangement

(Kooijman, 1999). This opposition stemmed from a misguided perception of what health

insurance implied. The practitioners mistook the national health insurance for a socialistic

system of medical practice whereby the government would limit the fee they received for their

services (Kooijman, 1999). This widespread lack of support for the system led to the exclusion


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of a national health insurance plan in the social security act thus dealing a great blow to the

public option (Kooijman, 1999).

In 1994, then, US President Clinton made a move to provide universal coverage through

an employer mandate in 1994 (Singer, 2009). However, his administration was against a public

insurance option which they deemed to be too expensive (Singer, 2009). President Bush also

dealt a blow to the universal health care system by his move to veto a proposed health insurance

program (Singer, 2009). He perceived the plan as a move towards a socialized health care system

which would be unwanted since it would end up benefiting people who did not need any

assistance (Singer, 2009).

The public option received a new lease of life with the election of President Obama in

2008 (Singer, 2009). One of his major campaign policies was the wide spread reforms in the

health care system. This has been perceived to be one of the major factors that led to his election.

President Obama sees a shift towards a healthcare system that is both affordable and places value

on quality service as the solution to the troubled system currently in place. His emphasis is on the

affordability of health care for all American citizens through the adoption of a public option that

would offer competitive prices to the people and therefore greatly regulate the health insurance

market. However, his aim towards this has been marred by opposition from senators and

financial institutions (Singer, 2009).

Vaccination: A preventive measure for all ages

Over the past few years there have been an increase in the number of diseases that affect

human beings. As such, researchers and medical experts have dedicated most of the available

resources to ensure that both preventive and curative measures are put in place in a bid to avoid


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further spread of the various diseases that pose a serious risk to the human race. The major

challenge being faced globally is creating awareness of the diseases and controlling or containing

their spread. Throughout history, vaccination has proven to be an effective strategy against many

life threatening infections and ailments.

In the United States, vaccines were used to eradicate life-threatening conditions such as

polio and small pox. Arguably, the rise and fall of small pox is among the best feat when it

comes to medical breakthroughs. The origin of the disease is not well known but it is believed to

have originated from Africa and spread through other parts of the world. However, it was

reported in most parts of America in the 17

th

and the 18

th

centuries. The fall of the scourge came

through the realization that the people who survived the disease became immune for life. This

knowledge led to the development of the process known as variolation (Brannon, 2004). This

process involved infecting a healthy person with a mild form of small pox in the hope that he/she

would develop some immunity against the disease in the future.

The process worked and people underwent this process. Statistics indicate that 2-3% of

people who underwent this process died of smallpox (Brannon, 2004). However, the majority

survived and the number of people infected by this disease reduced significantly. Edward Jenner

is credited for being the inventor of the first small pox vaccine (Brannon, 2004). The English

physician observed that milkmaids who developed cowpox were less vulnerable to small pox. As

a result, in 1796, the physician took a pustule sample of the cowpox infected maid and inoculated

an 8 year old boy with it (Brannon, 2004). Six weeks later, Jenner exposed the subject to

smallpox. To his own amazement, the boy did not show any symptoms of the disease. It is from

this result that Jenner came up with the word vaccine. The word came from the Latin word

vaca, which means cow (Brannon, 2004).


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Initially, many practitioners and people criticized his work but as his success rate

increased; his method was rapidly adopted by other practitioners. Statistics indicate that at the

wake of 1800, more than 100,000 people were already vaccinated against the disease. In

America, the last outbreak of the disease was reported in 1949 (Brannon, 2004). The outbreak

only affected eight people and claimed one life. However, the disease still claimed lives in other

parts of the world.

As a result, the world health organization initiated a campaign in 1967 (Brannon, 2004).

The main purpose of this campaign was to promote awareness and eradicate smallpox in all

regions of the world. This goal was realized in the ten years that followed. This was attributed to

the massive vaccination efforts that ensued during that period (Brannon, 2004). Consequently,

the last case of smallpox was reported in Somalia in 1977. However, measures were taken to

ensure that everyone was vaccinated against the disease.

Subsequently, in 1980, the World Health Assembly finally declared the world free from

this killer disease (Brannon, 2004). It should be noted that by the year 1972, America had

already vaccinated all its citizens but continued to vaccinate military personnel who were at risk

of infection due to the nature of their job (Brannon, 2004). Vaccinations have been used to create

immunity against other diseases. As a result, the infant mortality rate has decreased significantly

across the world as compared to the situation a century ago.


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Reference:

Brannon, H. (2004, September 25). Smallpoxhx: About.com. Retrieved August 5, 2011, from

About Corporation Website:

http://dermatology.about.com/cs/smallpox/a/smallpoxhx.htm

Dlxguard.com. (2009). Retrieved August 5, 2011, from Dlxguard.com:http://www.dlxguard.com/history-laser-eye-surgery

Kooijman, R. (1999). The Pursuit of National Health: the Incremental Strategy toward National

Health Insurance in the United States of America. Atlanta: Rodopi Edition.

Koyner, A., Knickman, J., & Jonas, S. (2008).Health Care Delivery in the United States. New

York: Springer Publishing Company.

Lasersurgeryforeyes.com. (2002).History: Laser Surgery for Eyes. Retrieved August 4, 2011,

from Lasersurgeryforeyes Corporation: http://www.lasersurgeryforeyes.com/history.html

Moon, M. M. (2006).Medicare: A policy primer. Washington: The Urban Institue Press.

Northern California Neurosurgery Medical Group. (2007, October 11).Medical History and

Ethics: History of Health Insurance in the United States. Retrieved August 5, 2011, from

Neurosurgical:

http://www.neurosurgical.com/medical_history_and_ethics/history/history_of_health_ins

urance.htm

Notable Names Database. (2011). People: Michael DeBakey. Retrieved Ausgust 4, 2011, from

Notable Names Database Corporation Website:

http://www.nndb.com/people/241/000027160/

Sebelius, K. (2009, August 15). healthcare.gov. Retrieved August 4, 2011, from Health Care

Goverment Website: http://www.healthcare.gov/healthreform

Singer, P. (2009, July 15).New York Times. Retrieved August 4, 2011, from Ney York Time

Website: http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html?_r=1

Taylor, J. (2011). Types: History. Retrieved August 04, 2011, from Laser Eye Surgery network:

http://www.lasereyesurgery.net/Types/history.html

United States Department of Health and Human Services. (2009).About: Health and Human

Services History. Retrieved August 4, 2011, from U.S. Department of Health and Human

Services: http://www.hhs.gov/about/hhshist.html

Women's Internation Center. (2010).Bio: Debakey. Retrieved August 04, 2011, from Women's

Internation Center Organization: http://www.wic.org/bio/debakey.htm

Documents

History of US Health Care System-Final Project