How the American Healthcare System Got That Way

[slipslidingaway]

http://www.commondreams.org/view/2008/12/13-1

"As Americans respond to President-elect Obama call for town hall meetings on reform the American health care system, an understanding of how that system came to be the way it is can be crucial for figuring out how to fix it...

The rise of unions in the 1930s and 1940s led to the first great expansion of health care for Americans. But ironically, it did not produce a national plan providing health care to all like those in virtually all other developed countries. Instead, the special conditions of World War II produced the system of job-based health benefits we know today.

In 1942 the U.S. set up a National War Labor Board. It had the power to set a cap on all wage increases. But it let employers circumvent the cap by offering "fringe benefits" -- notably health insurance. The fringe benefits received a huge tax subsidy; they were treated as tax deductible expenses for corporations but not as taxable income for workers...

Employer-based plans tied workers to their jobs - something that benefited employers, but not workers or the economy as a whole. The quality of the coverage was spotty - some plans were excellent, others completely inadequate. Doctors accepted this revolution because it didn't challenge their power; but as a result the system provided no public control over medical costs.

This revolution had a subtle political effect as well. By giving much of the workforce health benefits, it reduced the incentive for them to pursue a system of universal care. And it gave unions a stake in the private, employer-based health care system. As one opponent of publicly financed health care put it, "the greatest bulwark" against "the socialization of medicine" was "furthering the progress already made by voluntary health insurance plans."

Since then, many layers have been laid on top of employer-based health care..."

[mopinko]

1. the demise of non-profit health care is a factor that is almost never mentioned

maybe i am just sensitive to this as my mom worked for a catholic hospital for 30 years. but back in the day, a big chunk of the hospitals were staffed and run by nuns. there was a stated moral obligation to care for anyone regardless of ability to pay. st joe's had a sign stating so at the front desk. they really did it back then. now the whole catholic system has been incorporated, and is a funding center for the church instead of the other way around.

don't take this as an endorsement of catholic health care. i had some deep differences with the church, and never really did believe. hated having the pope's nose in my health care from the 60's onward. women's unpaid labor is a crime, imho, as well. but all these corps are big money these days, and things have really changed.

[slipslidingaway]

2. Good point...

I know that many in our family were born in a Catholic Hospital, but not sure of the costs. Interesting and I'll do some asking over the holidays.

[mopinko]

3. my mom had the bill for my sister

10 days in bed back in those days. i think it was like $50. (she is 67)
iirc, my oldest was about $2K, everything included, 5 days in the hospital. (30 years ago) i remember that we did have a co-pay of a couple hundred bucks that we paid off at about $20/mo. but they didn't treat you like a maggot cuz you couldn't pay your bill. they expected people to need time to pay. my younger kids, they expected you to take a chunk out of that before hand. (born at home. no hospital bill.)
the last one was just midwives. they are so used to getting screwed that they wanted the whole fee upfront, even when they had checked your insurance. i thought that was pretty funny.

[slipslidingaway]

4. Thanks, I do not remember what the bill was for my children...

born mid 80's and early 90's, we had decent coverage so I doubt it was very much.

:hi:

[Cleita]

5. When I was in college, I worked at St. John's Hospital in Santa Monica

part time. The nuns were always visible in the halls in their white habits and staring at us when we were goofing off. They took in people I know, who couldn't pay for their health care, yet it was getting hard for them to do so and they had to change how they operated. I think the Catholic hospitals as well as others will do well if we get a single payer universal system in. They will be able to take care of all without having to worry about paying the bills. I really do hope that there aren't any strings attached about family planning. There are other medical centers that can do that. The nuns really do heroic and excellent medical work. Don't make them do what to them is sinful. I think many of them will be open to ideas actually when it comes to women's health.

[Yavapai]

6. All my Mom had to pay, was for the use of the manger,

and that was really covered by a trio of wise men who happened to drop by.

[Hissyspit]

7. kick nt

[slipslidingaway]

9. Thanks n/t

[Vinca]

8. Another important thing to point out is that the insurance companies

were not for profit decades ago. I remember working for a hospital in the late 1960's and we never even thought about insurance. It was cheap, it covered everything and you never in a million years would think you'd get a bill that would bankrupt you after an illness.

[slipslidingaway]

10. Thanks, how far we've come...the government (us) pays to insure

the elderly, with high medical costs, and the private insurance companies make a profit providing health insurance for the middle segment of the population who do not need as much care.

:shrug: