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Controversial Health Bill (2003) and Policy Implications

In November 2003 the U.S. Congress passed a controversial health policy bill that President George W. Bush signed into law. The new legislation makes the most far-reaching changes to Medicare since the program was created in 1965. Please address the following questions:

Why were changes to Medicare deemed necessary?
What are the main provisions of the new legislation? Do you think they accomplish the desired goals?
Who was involved in setting the agenda for this policy change? Discuss the roles and interests of specific agenda setters and their influence on the development of the legislation.
Why was the legislation controversial? Discuss the claims of the law's supporters and detractors. Who will benefit from the changes?

These sites should suffice.

http://www.whitehouse.gov/news/releases/2003/11/20031125-5.html

http://www.whitehouse.gov/news/releases/2003/12/20031208-2.html

Thank you.

Solution Preview

Other sites to consider:
http://www.tommydouglas.ca/articles/articles-aug03.htm
http://abcnews.go.com/wire/Politics/ap20031125_717.html
http://www.cnn.com/2003/ALLPOLITICS/11/25/elec04.medicare/index.html

I will respond to your questions in the order that you presented them:

"In November 2003 the U.S. Congress passed a controversial health policy bill that President George W. Bush signed into law. The new legislation makes the most far-reaching changes to Medicare since the program was created in 1965. Please address the following questions:"

1. Why were changes to Medicare deemed necessary?

a. Too many of our citizens go without health care (i.e., refundable tax credits to help low-income people purchase their own health insurance to decrease the use ofexpensive emergency rooms as their main source of health care because they have no other options, preventative care and treatment before emergency room -- before they go to the emergency room by increased funding for community and migrant health centers all across the country). Men are more likely to be uninsured than women, people in the South and the West were more likely to be uninsured, fully one-third of the foreign-born population was uninsured, etc. (see URL: http://www.tommydouglas.ca/articles/articles-aug03.htm for statistical figures).

New York Times: By ROBERT PEAR WASHINGTON, Sept. 29 - The number of people without health insurance shot up last year by 2.4 million, the largest increase in a decade, raising the total to 43.6 million, as health costs soared and many workers lost coverage provided by employers, the Census Bureau reported today (http://www.tommydouglas.ca/articles/articles-aug03.htm).

b. The cost of health care is rising at the fastest rate in more than a decade (i.e., Research is costly. New technologies are expensive, frivolous lawsuits against good doctors, and the patients are paying the price, doctors in hospitals are overusing certain tests and treatments as defensive measures to avoid litigation).
c. If harm is caused by serious misconduct, patients should also be able to seek reasonable punitive damages (i.e., "We need to pass medical liability reform through both Houses" says President Bush).
d. Misuse of the legal system by lawyers (i.e., the legal system should work for our patients--Our legal system must address medical errors, but doctors don't want to put anything on paper to improve health care quality because it might be given to a lawyer who is fishing around for a lawsuit). Solution: Medical Liability Reform
e. The need for greater information sharing between doctors and nurses without the fear that the lawyers used this information to sue doctors and hospitals. ("I'm going to ask Congress to pass a law to make sure that information developed for the safety and care of patients is not used by lawyers against doctors and hospitals," says President Bush). Solution: Medical Liability Reform
f. The health care industry, while progressing in many areas, has lagged in information technology (i.e., increased need for modernization of information technology-- move from paper files, patient safety also improves when doctors can have access to health records without delay, etc.) Solution: New information Technology implementation
g. The need to renew that commitment and responsibility for the health of senior citizens, to make sure that the years of retirement are not years of hardship, needless hardship. by providing the seniors of today and tomorrow with preventative care and the new medicines that are transforming health care in our country. Solution: Drug Benefit Plans

h. The increased number of seniors and related medicare costs.

For example, Lubitz and colleagues, using Medicare and other billing records and interviews about health status from 16,964 Medicare beneficiaries surveyed from 1992 through 1998, used complex statistical calculations to determine average longevity and end-of-life costs. "They found someone healthy and mobile at age 70 could expect to live 14.3 more years and accumulate about $136,000 in medical costs, in 1998 dollars, over those years. Someone with at least one limitation in daily activities, such as not being able to bathe or use the toilet unassisted, could be expected to live 11.6 years more, with cumulative medical expenses of about $145,000. Senior citizens with no limitations ran up an average of $4,600 a year in health care costs, compared with $8,500 a year for people ...

Solution Summary

This solution addresses several questions about the controversial health bill passed in November 2003 by the U.S. Congress and that President George W. Bush signed into law. This includes reasons for why changes to Medicare were deemed necessary, the main provisions of the new legislation, who was involved in setting the agenda for this policy change; and, the roles and interests of specific agenda setters and their influence on the development of the legislation. Finally, it looks at both sides of the controversy, including the claims of the law's supporters and detractors, and who will actually benefit from these changes. 2735 words with references throughout.

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