United States Health Care & The Injustice of the System

How was healthcare founded?

In the world internationally;
-”​Insurance, broadly speaking, is designed to protect someone from loss and has been used in
different forms since the second millennium BC. As medical knowledge became more advanced
it also became more valuable… … Life insurance has a long history that reflects humankind’s
awareness of its mortality.” (Malik)
-First appeared in history in Mesopotamia- health insurance was a fee under law, “ A person of
high status paid the successful surgeon more, but the cost of a failed surgery carried higher
costs for the surgeon. Compensation and liability, in other words, were determined by the
patient.”... Health care was only available to the higher class… (Malik)
-”Mesopotamia called the “Treatise of Medical Diagnosis and Prognosis”. The law was
documented on 40 tablets mentioning prescriptions and treatises” (Malik)
-”...​those borrowing more directly from the Egyptians, such as the Islamic tradition, medical
knowledge became the foundation for early examples of centralized medical practice.”
The U.S;
-The first instance of individual health insurance plans became available in the United States
during the Civil War. (April 1861- April 1865) The plans were accident insurance providing
coverage for injury related to travel by railroad or steamboat. (Malik)
-”...Late 1800s and early 1900s were full of medical advances… …. The abun​dance of
innovation transformed the public image of medicine, and people began to place more trust in
medical institutions.”
-”Massachusetts Health Insurance of Boston offered early group policies with a relatively
comprehensive list of benefits as early as 1847.”
-”The earliest forms of health insurance... ...did not emerge until 1850, when the Franklin Health
Assurance Com​pany of Massachusetts began providing accident insurance to cover injuries
re​lated to railroad and steamboat travel.”
-”...early plans began to evolve… ...that covered a broader range of illness and injury, including
early versions of disability coverage by the end of the 19th century.”
-In 1904, the Amer​ican Medical Association created the Council on Medical Education, which
developed standards for the medical licensee
-. In 1913, the American College of Surgeons was founded to oversee the accreditation of
medical schools. The new regulations ensured the quality of health care and resulted in a
smaller but more talented supply of licensed physicians.
-In 1929 a few Dallas-based teacher proposed to receive a set amount of sick and hospital days
for a fixed, prepaid rate. Prepaid hospital visits became very popular especially during the
Depression (Baylor plan) (Malik)
- “...in the 1930s, many other hospitals followed the model of the Baylor Plan, and medical
insurance became much more widespread. ...these single-hospital plans also generated price
competition, and to avoid this, community hospitals started to work together in creating health
coverage plans”
-In 1939, the American Hospital Association (AHA) first used the name Blue Cross to des​ignate
health care plans that met their standards. These plans merged to form Blue Cross under the
AHA in 1960.
-Pre-paid plans covering physician and surgeon services, includ​ing the California Physicians’
Service in 1939, also emerged around this time.
-The 1940s and 1950s also saw the proliferation of employee benefit plans, and the included
health insurance pack​ages became more and more compre​hensive as strong unions negotiated
for additional benefits.
- In 1954, Social Security coverage included disability benefits for the first time
-The market started to grow and in 1965 when Congress passed the Medicare and Medicaid
Services Act.
-In 1971 physician-sponsored plans, Blue Shield and Blue Cross merged into one company...
...flaws in the ​health care system​ led to higher costs for health insurance companies.
-​In the 1980s, responding to higher costs and other challenges to the health insurance
industry… ... Health Maintenance Organizations (HMOs) emerged… ...HMOs were originally
primarily nonprofit, but they were quickly replaced by commercial interests and managed care
only suc​ceeded in temporarily slowing the growth of healthcare costs.
-In 1993, Presi​dent Bill Clinton proposed a universal ​healthcare system​ in 1993 to address the
problems in the United States healthcare system… ...the bill was re​jected
-In 1996, Mental Health Parity Act and the Health Insur​ance Portability and Accountability Act
(HIPAA) was passed as development in healthcare insurance system including helping
employees maintain insurance between jobs, if they became self-employed, or were otherwise
separated from the employer-packaged managed health care plan.
-In 1997, the Children’s Health Insurance Program (CHIP) came out providing insurance to
low-income children
-Since 2000, numbers in health insurance has been on the decline..... “45.7 million Americans,
or 15.3% of the population, were uninsured in 2007.”... “As of 2010 just fewer than 84% of
Americans had some form of health insurance, which meant that more than 49 million people
went without coverage for at least part of the year”
“-In 2010 Affordable Care Act also called Obamacare… ...was designed to introduce due
healthcare reforms and extend health care insurance coverage to the Americans without it….
Americans are increasingly reliant on public insurance. Public programs now cover 31% of the
population and are responsible for 44% of health care spending. Public insurance programs
tend to cover more vulnerable people with greater health care needs.”

What can people who can’t afford health care do to get it?
-​The Health Resources and Services Administration (HRSA), an arm of the United States
Department of Health and Human Resources, has free clinics in most areas... ...The clinic bases
your cost on your income. Hill-Burton Facilities, one's that received grants from the government,
provide reduced-cost or free health care also.
-...the Children's Health Insurance Program… ...the federal government to provide low cost
health insurance to the working poor, families that make too much for Medicaid but can't afford
the cost of private insurance. Every state has a program that differs in qualifications based on
income.
-”The U.S. Uninsured Help Line offers 24-hour service 7 days a week to help families find free or
low-cost health insurance options. It tells you what options are available, connects you to the
plans you qualify for and provides additional resources that might benefit you.”

What groups do healthcare companies discriminate (directly or indirectly) against?

-Now, public programs for companies cover 31% of the population and are responsible for 44%
of health care spending.
-Major insurers, including Blue Cross, Aetna and Humana, have pulled out of many state-run
insurance exchanges, leaving residents of some counties with few, if any, options for coverage.
-”The emergency room staff not only did not treat her pain, but she recounted: “They treated me
like I was trying to play them... ….They couldn’t get rid of me fast enough.” There was nothing in
her history to suggest that she was pain medication seeking… ...She is convinced that she was
treated poorly by that emergency room because she is black.

- It is well-established that blacks and other minority groups in the U.S. experience more illness,
worse outcomes, and premature death compared with whites

- “...a large group of physicians published an open letter seeking to reassure patients. The letter
is a statement of commitment to health as a human right, women’s health, mental health,
LGBTQ health, evidence-based medicine, dismantling structural racism, and ending race-based
violence.”

-”“We — as physicians and society more generally — must realize that the struggles of one
marginalized community are struggles of all of us. My fight as a Muslim-American doctor to
serve my patients without fear of racism, and the fight of an African-American patient to be
treated with dignity and respect, should also be your fights.”

-”Health disparities adversely affect groups of people who have systematically experienced
greater social and/or economic obstacles to health and/or a clean environment based on their
racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive,
sensory, or physical disability; sexual orientation; geographic location; or other characteristics
historically linked to discrimination or exclusion.”

-Participants taking the test were asked explicit questions to indicate their preferences toward
heterosexual, lesbian, and gay individuals, like whether they’d endorse the statement “I strongly
prefer gay people to straight people” or “I strongly prefer straight people to gay people.”...
...Overall, researchers found a preference within health care providers for patients that had the
same sexual identification.”
-​The fact that sick elderly people without prescription drug coverage pay far more for drugs than 
do people with private health insurance has created a call for state and federal governments to 
take action. 
 
-People who lack coverage—many poor, sick citizens—pay the highest prices of all. 

Are we doing anything to mend the injustices surrounding healthcare?

-​“-In 2010 Affordable Care Act also called Obamacare… ...was designed to introduce due
healthcare reforms and extend health care insurance coverage to the Americans without it….
Americans are increasingly reliant on public insurance”
-​The Health Resources and Services Administration (HRSA), an arm of the United States
Department of Health and Human Resources, has free clinics in most areas... ...The clinic bases
your cost on your income. Hill-Burton Facilities, one's that received grants from the government,
provide reduced-cost or free health care also.

My Personal experience with healthcare ;

Medtronic is a huge company that happens to manufacture diabetic supplies. Five months after
my diagnosis in 2015 I was put on an insulin pump designed by them. My healthcare insurance,
United Healthcare, covered the 3,600$ device completely. They were bulky, old technology that
I had to take care of for three years before upgrading to the newest pump. After getting that
pump, I’d need to wait another three years to upgrade again. No matter how fast or better the
new pumps were, I’d have to wait. I went through two pumps before, two years later, they
replaced it with a slightly newer pump. The only reason they replaced it was because it wasn’t
the newest. The difference between my oldest pump model and the new 330 pump was the
layout was different and it was slightly less ugly. The sensor (blood sugar tester that was in my
arm which automatically told my pump my glucose levels) was extremely dysfunctional and
annoying, waking me up in the wee hours to tell me my sugar was low. When I checked it
manually, it was fine. Finally my Diabetic Educator told me about Libre, a different sensor that
didn’t talk to the pump but was much better than the medtronic one. United didn’t cover it, and
so we bucked up and paid $150 for three months, or nine sensors. Not a huge deal, we could
handle it to save my fingers from needles.
The pump, however, was still garbage. It was annoying, the sites hurt, old tech and we felt there
were better options to keep my sugar in control. We heard of a new pump by Tandem, the t:Slim
x2. It was a beautifully sleek pump which came with a sensor by Dexcom. The sensor itself was
covered this time around by United, the pump was not. $5,000 out of pocket for the pump. We
begged United, telling representatives who knew nothing about diabetes how much better the
pump was than the medtronic developed ones. There was a whole mob of diabetics, especially
juveniles, who felt this was a huge injustice to them. But United had a deal with Medtronic, they
wouldn’t cover anything that wasn’t their brand. We, and many others, tried to appeal. The only
appeal that got passed was a woman who’s medtronic pump had broken five times in a year.
Mine were only failing once a year.
Who is a health insurance company to tell me that they can’t cover something that so much
better for my health because they have a deal with the worst company?
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