The world's ever-growing populace and the emergence of incurable diseases offer enormous health challenges. Having medical treatment that takes social discrimination into account while providing health services causes problems for people. In order to prevent and lessen the effects of incurable diseases and end social discrimination, laws must be developed in every nation. The most pressing problem in American society has led to a number of reforms in the country's health care system.
Obamacare involved the implementation of health insurance that was designed to meet the needs of all social classes in the society. The care saw a significant transformation in the medical care due to the creation of the Affordable Care Act (ACA), designed to meet the medical care for the Lesbians, Gay, Bisexual, and Transgender (LGBT) members of the community. The Act helped the LGBT members, who had been discriminated for a long time, together with people of low income to get an easy access to health insurance. Before the enactment of the ACA, many people who were being discriminated by the absence of comprehensive health care that could incorporate them into the system had nowhere go. Obama care, therefore, assisted in increasing medicare equality during his eight-year term. Many HIV/AIDS people were discriminated in the society and were unable to get easy access to medication, an issue that was solved by the Affordable Care Act under the Obamacare (Veldhuis, 2017). The ACA provided federal protection rights for LGBT people through the elimination of sexual discrimination. This paper is going to answer crucial questions on why the ACA was enacted, significant achievements and the challenges on its implementation. The paper will also dwell in answering why the Trump administration seeks to eliminate the Obamacare and the consequences of the new American Health Care Act on the people who have been historically discriminated. The paper will cover the historical development of the American health department and how the recent medical developments have changed health care on the American population.
History of Healthcare in America
Industrial revolution increased job-related injuries which significantly reduced health standards for the Americans (Bovbjerg, 1993). As a result, many employers started providing various forms of illness cover. However, there were no organized medical structures which could meet high levels of work-related injuries. Most of the operations were based on trial and error basis resulting in many health complications. Many people thus failed to get fast and reliable medical attention. These conditions led to an increased research on how to solve the increased failure in the provision of all-inclusive Medicare.
In the early 1900s, there was a creation of the American Medical Association (AMA), which started giving solutions to the looming healthcare crisis. The then president, Theodore Roosevelt, believed that economic growth could never be achieved with sick and needy citizens. He, therefore, developed a compulsory healthcare that could raise healthcare standards for all the American people (Bovbjerg, 1993). However, Roosevelt failed to give full support to the health developments, leaving most developments to be done by the non-governmental organizations.
On the eve of 1910's, there were various advancements in the American health care. Early 1910 the American Association of Labor Legislation (AALL) drafted legislation which targeted to raise the medical standards of the working class, lowly paid citizens, and children. The bill provided qualified recipients with maternity benefits, seek pay, and provision of funding of up to $50 for meeting the funeral expenses. Regardless the high support that AMA accorded the implementation of the new Act, there was an intense objection from many medical societies.
The union leaders believed that compulsory health insurance could weaken their powers in bargaining for better healthcare for the members. The bill also faced resistance from the private insurance companies who felt that their business was in jeopardy. The private insurance bodies believed that people could not have any reason for having an extra insurance cover in addition to that of the government. The start of World War I led to massive deaths of the American servicemen prompting the Congress to pass War Risk Insurance Act (Edwards, 2017). The Act provided cover for the military servicemen in case of injury or death. Amendment to the Act led to an extension of financial assistance to the servicemen's dependents. The 1910's medical developments created better health care for all the American people. Following the end of World War I, the cost of Medicare went high prompting the formation of pre-paying medical services whereby there was an advance payment of up to 21 days, giving rise to Blue Cross.
President Franklin Roosevelt, 1933-1945, staged high profiled campaign which was geared to provide old age insurance. While there was widespread of Blue Cross and Blue Shield across America, President Franklin knew that healthcare was growing to be a significant problem. Thus, the President embarked on the creation of a health insurance bill including the desperately needed old age benefits (Nathanson, 1967). However, once more the AMA did not agree with the proposed bill and therefore staged a fierce opposition. AMA'S opposition to the national health system caused Franklin Roosevelt to drop the newly proposed national health insurance portion of the bill resulting in the formation of the Social Security Act of 1935. The new Act created benefits for the old-age allowing states to formulate provisions for the people who were either unemployed or the disabled.
The bombing of Pearl Harbour in 1942 resulted in a detrimental economic crisis in the US. As a retaliatory effort, President Roosevelt supported the advancement of the Ameican forces to enter into the war (Urry, 2015). There were high financial expenses directly related to the war in Europe. These financial costs led to the enactment of Stabilization Act of 1942 to fight the looming inflation through reducing wage increase. The government prohibition on businesses to offer higher salaries prompted the emergence of measures that were directed to reduce employee turn-over by improving their medical services. The result was the foundation of employer-sponsored health insurance coverage (Oberlander, 2014). The new health insurance helped the employees to receive cheaper health care because it was no longer a must for them to pay taxes. The employees were thus able to get healthcare for themselves and their family members. The entry of Harry Truman as the 33rd United States president led to more development in the health system.
Truman embraced Franklin Roosevelt's national insurance platform but with significant changes. Under the changes, Truman's plan involved the inclusion of all Americans rather than only the poor and the working class (Bovbjerg, 1993). However, the Congress strongly opposed the new proposed plan which they said that it was a socialist move. AMA came in to vigorously oppose the Truman plan's relating the Administration to the socialist Moscow party. Consequently, AMA introduced a new plan which supported the private insurance options, coming out from the former platform that opposed third-party healthcare insurance policy (Winter, 2015). The 35th American president, John F. Kennedy immediately after his inauguration started working on a health care plan for senior citizens.
Kennedy's proposed bill to increase benefits for all the retirees also faced opposition from the AMA on the fear that the bill could lead to socialism ideologies in the healthcare sector. Upon the assassination of Kennedy in 1963, Lyndon, the then Vice President took over in the presidency and continued to implement Kennedy's senior citizen health plan. Lyndon proposed an expansion of the 1935 Social Security Act and the Hill-Burton Program (Cohen, 2010). The Hill-Burton Program provided medical facilities grants to the government as an aid to modernizing the health care. Provision of the grants was on condition that the government was to provide reasonable medical services to the citizens who failed to pay. Johnson's plan became the first healthcare reform that was not opposed to the previous legislation. The 37th American president, Richard Nixon, proposed a health care plan that required employers to cater for the medical expenses of their employees. The move led to many employees having access to health insurance.
Under the Reagan presidency (1981-1989), the Consolidated Omnibus Budget Reconciliation Act (COBRA) was enacted to allow former workers to continue being enrolled in their former employer's group health plan (Cohn, 1984). The benefits under COBRA were on condition that the employees were to pay employee contribution together with employee portion fully. The move provided health insurance access to the increasing number of the unemployed citizens who had difficulty in purchasing private insurance. The health insurance caused increased health expenses from the government, a state that was later corrected by President Bill Clinton.
President Bill Clinton, 1993-2001, proposed the 1993 Health Security Act. Bill Clinton gave support to the ideas of presidents Franklin Roosevelt and Nixon. Due to the ever-rising global demands of having better medical care for all citizens of a particular country, Bill Clinton influenced the Congress to enact Balanced Budget Act of 1997 which was directed to change the health insurance policy. The Act provided for the expansion of private insurance plan to form an original fee-for-service service program. The Act resulted in the creation of a new insurance program for the children that had a provision for the Children's Health Insurance Program. These changes in the healthcare significantly raised the American health standard because most people could now get easy access to Medicare. A major move to raise old age medical care came into effect in 2003 when the Congress formulated the Medicare Prescription Drug, Improvement, and Modernization Act (Meyer, 2007). The Act came into effect due to the looming international outcry in meeting the health care for the elderly. The Act, therefore, helped the elderly to meet the costs of drug prescriptions. The historical development in healthcare had never touched on bringing equality into the health system leading to the enactment of the Obamacare, Affordable Care Act, to cater for the increased numbers of the discriminated members of the society.
The primary objective of the new Act was to enable discriminated people to get easy access to quality medical care. Poor people, HIV/AIDS, and Lesbian, Gay, Bisexual, and Transgender (LGBT) now could get easy access to healthcare without high discrimination. Obamacare was intended to cure high level of disparities that people of colour and the LGBT faced. The two groups of people formed the largest percentage of new HIV/AIDS infection in the United States (Badgett, 2007). For instance, Gay and Bisexual men by 2010 accounted for 66% of the new HIV/AIDS infections, a population of approximately half of the 1.2 million people living with the disease. The LGBT and people of colour also account for the highest number of smokers in the United States. Obamacare came in to cure the highest disparity that these groups of people were facing and provide affordable healthcare. The new law, therefore, brought many benefits to all Americans from all walks of life.
The Affordable Care Act brought many benefits and changes to the lives of the LGBT community. The Act helped to improve prevention and wellness of the LGBT people ranging from depression screening, tobacco use screening, and free HIV/AIDS testing and counseling. The Act also has helped all people to access affordable health insurance. The Act also has provided for the continuous research and development strategies that are directed to improve the lives of neglected individuals in the society (Kendler, 1947). Upon the expiry of Obama Administration, the LGBT communities have faced nightmares due to the continuous measures the Trump Administration is developing to repeal the Obamacare and replace it with the American Healthcare Act. The repeal will lead to massive impacts on the entire American population which may lead to a population of up to 32 million people losing their insurance packages. More especially, the LGBT will the most affected members of the American community (Dawson, 2017). After the inauguration of Trump, he signed for the repeal of Obamacare because he believed that the ACA was an unnecessary expense to the American economy. The LGBT members faced the most significant challenge of getting easy access to medical care.
Impacts of the repeal on the LGBT community
There will probably be high poverty index among the LGBT community. The Affordable Care Act provides the community with cheaper medical care whereby they do not spend much of their low income in meeting their health care expenses. Most of the LGBT people receive less than $35,000 per year implying that failure to have an affordable medical care may subject them to hardship conditions (LaSala, 2010). Most of the LGBT people who may fail to get cheaper health care may resort to using their little income to cater for their health leaving them with less income for their daily life.
The LGBT community will lose benefits of non-discrimination included in the Obamacare. The proposed American Health Act will lead to changing all the regulations that are well established under the ACT. As a result, most people will lack access to equitable health care based on their skin colour or sexual orientation. Most HIV/ADS people also face high cases of discrimination. Therefore, the proposed American Health Act failed to show improvements on the existing affordable health care.
Conclusion
American health care has undergone various reforms that have seen many people getting easy access to better health care. There have been various progressive health reforms since the 1900s up to 2010, but none of the reforms was directed to solve the high level of disparities among vulnerable communities' members. The LGBT account for a significant number of members of the society who faced discrimination due to their sexual orientation. But the Obamacare came in to address their predicaments since the enactment of the Affordable Care Act led to the formulation of legislation that was directed to solve discrimination in the healthcare. However, the ACT has been facing high resistance from the Trump Administration due to the continued efforts to repeal Obamacare. Repealing Obamacare will lead to numerous challenges to the LGBT community because they will face discrimination in receiving affordable health care. Due to the many difficulties that will face LGBT community, women, and people of the colour. Further research should be done on how to incorporate the proposed American Health Act into the health care without affecting the present Act. I suggest that efforts directed to repealing Obamacare should be stopped and rather supported.
References
Veldhuis, C. B., Drabble, L., Riggle, E. D., Wootton, A. R., & Hughes, T. L. (2017). “We Won’t Go Back into the Closet Now Without One Hell of a Fight”: Effects of the 2016 Presidential Election on Sexual Minority Women’s and Gender Minorities’ Stigma-Related Concerns. Sexuality Research and Social Policy, 1-13.
Edwards, M. (2017). Gotham: A Rhetorical Analysis of President Donald J. Trump’s Republican National Committee Acceptance Speech (Doctoral dissertation, University Honors College, Middle Tennessee State University).
Urry,M. (2015). Science and gender: scientists must work harder on equality. Nature News, 528(7583), 471.
Winter, E. A., Elze, D. E., Saltzburg, S., & Rosenwald, M. (2015). Social services for LGBT young people in the United States: are we there yet?. Lesbian, Gay, Bisexual and Trans Health Inequalities: International Perspectives in Social Work, 113.
Cohen, S. H., Gerding, D. N., Johnson, S., Kelly, C. P., Loo, V. G., McDonald, L. C., ... & Wilcox, M. H. (2010). Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infection Control & Hospital Epidemiology, 31(5), 431-455.
Mallon, G. P. (2011). Permanency for LGBTQ youth. Protecting Children, 26(1), 49-57.
LaSala, M. (2010). Coming out, coming home. New York, NY: Columbia UniversityPress.
Oberlander, J. (2014). Unraveling Obamacare—can Congress and the Supreme Court undo health care reform?. New England Journal of Medicine, 371(26), 2445-2447.
Badgett, L., & Frank, J. (Eds.). (2007). Sexual orientation discrimination: An international perspective. Routledge.
Cohn, S. F., & Gallagher, J. E. (1984). Gay movements and legal change: Some aspects of the dynamics of a social problem. Social Problems, 32(1), 72-86.
Meyer, I. H., & Northridge, M. E. (Eds.). (2007). The health of sexual minorities: Public health perspectives on lesbian, gay, bisexual and transgender populations. Springer Science & Business Media.
Dawson, J., & Gerber, P. (2017). Assessing the Refugee Claims of LGBTI People: Is the DSSH Model Useful for Determining Claims by Women for Asylum Based on Sexual Orientation?. International Journal of Refugee Law, 29(2), 292-322.
Kendler, H. H. (1947). SF, a case of homosexual panic. The Journal of Abnormal and Social Psychology, 42(1), 112.
Bovbjerg, R. R., Griffin, C. C., & Carroll, C. E. (1993). US Health Care Coverage and Costs: Historical Development and Choices for the 1990s. The Journal of Law, Medicine & Ethics, 21(2), 141-162.
Nathanson, C. A. (1977). Sex, illness, and medical care: A review of data, theory, and method. Social Science & Medicine (1967), 11(1), 13-25.
