Manchikanti Laxmaiah, Helm Ii Standiford, Benyamin Ramsin M, Hirsch Joshua A
Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Pain Physician. 2017 Mar;20(3):107-110.
Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt. In 1933, Franklin D. Roosevelt, a Democrat, included a publicly funded health care program while drafting provisions to Social Security legislation, which was eliminated from the final legislation. Subsequently, multiple proposals were introduced, starting in 1949 with President Harry S Truman who proposed universal health care; the proposal by Lyndon B. Johnson with Social Security Act in 1965 which created Medicare and Medicaid; proposals by Ted Kennedy and President Richard Nixon that promoted variations of universal health care. presidential candidate Jimmy Carter also proposed universal health care. This was followed by an effort by President Bill Clinton and headed by first lady Hillary Clinton in 1993, but was not enacted into law. Finally, the election of President Barack Obama and control of both houses of Congress by the Democrats led to the passage of the Affordable Care Act (ACA), often referred to as "ObamaCare" was signed into law in March 2010. Since then, the ACA, or Obamacare, has become a centerpiece of political campaigning. The Republicans now control the presidency and both houses of Congress and are attempting to repeal and replace the ACA. Key words: Health care reform, Affordable Care Act (ACA), Obamacare, Medicare, Medicaid, American Health Care Act.
重大卫生政策的制定或变革,包括影响医疗服务提供的政府和私人政策,均基于医疗改革。多年来,医疗改革一直是一个全球性问题,美国多年来也出现了多项改革提案。美国一项成功的、有联邦政府参与的医疗提案是在南方短暂建立起首个国家医疗体系。在20世纪,美国受到进步主义影响,在共和党总统候选人西奥多·罗斯福的支持下,开始努力实现全民医保。1933年,民主党人富兰克林·D·罗斯福在起草社会保障立法条款时纳入了一项公共资助的医疗保健计划,但该计划在最终立法中被删除。随后,从1949年哈里·S·杜鲁门总统提出全民医保提案开始,陆续出台了多项提案;林登·B·约翰逊在1965年提出的《社会保障法》创建了医疗保险和医疗补助;泰德·肯尼迪和理查德·尼克松总统提出的提案推动了全民医保的不同形式。总统候选人吉米·卡特也提议实行全民医保。接下来是1993年比尔·克林顿总统在第一夫人希拉里·克林顿的领导下做出的努力,但未成为法律。最后,巴拉克·奥巴马总统当选以及民主党控制国会两院导致了《平价医疗法案》(ACA)的通过,该法案通常被称为“奥巴马医改”,于2010年3月签署成为法律。从那时起,ACA或奥巴马医改已成为政治竞选的核心议题。现在共和党控制着总统职位和国会两院,并试图废除和取代ACA。关键词:医疗改革、《平价医疗法案》(ACA)、奥巴马医改、医疗保险、医疗补助、《美国医疗保健法案》