Federalism Issue

Total Page:16

File Type:pdf, Size:1020Kb

Federalism Issue © lunamarina/Shutterstock CHAPTER 2 How We Got Here: U.S. Health Policy History This chapter is designed to give healthcare leaders an understanding of U.S. health policy history by covering the following topics: ■ The history of health policy ■ How the U.S. health system developed ■ How selected major components of the Patient Protection and Affordable Care Act developed practice of medicine lacked standardization, ▸ History of Health with almost anyone who desired to practice medicine being able to open a practice and Policy and assume the title of doctor. With the rise of sev- eral alternative options to allopathic medicine, Development of the including homeopathic (1796), osteopathic U.S. Health System (1874), naturopathic (1895), and chiropractic (1895) medicine in the 1800s, the public was he history of health policy development not always certain about what they were get- in the United States had its beginnings ting when receiving treatment from a “doctor.” at the state, as opposed to federal, level, Doctors of Medicine were concerned about Twith few exceptions. These exceptions, begin- distinguishing themselves from alternative ning with the Sailors and Marines Act of 1798,1 practices with the establishment of licensing addressed the narrowest of constituencies. laws based on ensuring the quality of treatment State-level action began with a series of medical received from individuals claiming the title of licensing laws passed circa 1800, abolished circa “doctor.” While ensuring quality is the claim 1830, and re-established post-Civil War. Prior every trade group uses when seeking licensure, to post-Civil War era licensing regulations, the economists view licensure as a restraint of trade 1 This laid the foundation for what would become the U.S. Public Health Commissioned Corps. 22 Chapter 2 How We Got Here: U.S. Health Policy History or a legal method for keeping the “ undesirables” Insurance Law (1883) established sickness out of the business (AMA, 1847). Ironically, funds paid for by the employee (2/3) and there were legal disputes among the alternative employer (1/3); the Accident Insurance forms of medicine, such as the 1907 lawsuit in Law (1884) was employer-funded and pre- Wisconsin in which a chiropractor was jailed cursor to workers’ compensation laws; and for practicing osteopathic medicine (State of Old Age and Disability Insurance (1889) was Wisconsin v. Morikubo). an old-age pension plan and precursor to The Bill for the Benefit of the Indigent Social Security in the United States. About Insane in 1854 was the second recorded fed- 40 years later, British Prime Minister David eral healthcare legislation. This bill’s intent Lloyd George sponsored the enactment of was for the federal government to provide several social service policies, including the land for the establishment of asylums for National Health Insurance Act (1920) that the insane, deaf, and dumb. It was passed by provided laborers protection against illness both houses of Congress but vetoed by Pres- costs and unemployment. ident Franklin Pierce (D), who viewed this as a federalism issue. He claimed that the states, not the federal government, should be responsible for social welfare concerns. ▸ Brief History of Little, if anything, happened in the United Payment States for another 70 years, with the next mention of federal involvement in healthcare In the United States, health insurance had its provision being Theodore Roosevelt’s presi- beginnings in the 1860s through the late 1920s dential platform in 1912. The third piece of in a series of disability insurance offerings federal healthcare legislation was the Pro- (sickness funds) by a variety of insurance com- motion of Welfare and Hygiene of Maternity panies that were designed to protect laborers and Infancy Act (1921). Also known as the from loss of wages, as opposed to payment Sheppard-Towner Act, this progressive piece for medical costs.2 The Baylor Plan, estab- of legislation, which passed both houses of lished in 1929, was the first organized health Congress and was signed by President Wood- insurance plan, cost 50¢ per month or $6 per row Wilson (D), provided federal funding for year, started so university professors could maternal and child care. pay their hospital bills. The Baylor Plan was During this same 70 years, Germany soon followed by a flurry of similar plans that and Britain enacted social support legis- were ultimately chartered by state laws as Blue lation that would eventually be replicated Cross plans. A decade later in 1939, physician by the modern industrial world and would payment was organized in a similar manner ultimately influence the United States. In under Blue Shield plans. While it may seem an effort to gain the support of labor, Ger- intuitive to assume that physicians would wel- man Chancellor Otto von Bismarck was the come these insurance products that ensured first to propose social support legislation payment, the opposite was what actually hap- and have it passed into law. The Sickness pened. Physicians were vehemently opposed 2 The average length of illness during this era was 4–6 weeks, resulting in no income for the employee during this period of illness and convalescence. Thus, the need for income stability or disability payments was provided through sickness funds costing employees 1% of their wages. When the first sickness (medical) insurance was offered through Baylor University Hospital to help university professors pay their hospital bills, it also cost employees approximately 1% of their wages. Brief History of Payment 23 to these plans, fearing the payer’s interven- non-cash wage benefits in the form of health tion between them and their patient, and fre- insurance coverage. In 1949, the Supreme quently cited that they were “… opposed to Court upheld a National Labor Relations rul- anything that intervened between the physi- ing allowing benefits to include in collective cian-patient relationship.” bargaining, and in 1954, health insurance There was quite a bit of administrative premiums were declared a tax exemption for and legislative activity during the Franklin businesses. Roosevelt (D) and Harry Truman (D) pres- During the decades of the 1940s and idencies that sought to enact national health 1950s, the public became aware that health- insurance legislation. However, none of it care needs of the elderly were often not was fruitful. Both Presidents faced consider- addressed, or addressed in a limited fashion, able and aggressive lobbying efforts against due to their lack of financial resources. Thus, national health insurance by the American the Kerr-Mills bill (1960) was passed to pro- Medical Association (AMA), who continued vide funding for states to care for the poor with their campaign regarding the sacredness elderly, and although the bill was helpful, it of the physician−patient relationship saying was incomplete. The major healthcare legis- that no one should intervene in that relation- lation that came from the 1960s is Medicare ship. President Roosevelt (D) was concerned (1965) and Medicaid (1965). The battle for enough about the aggressive physician lob- these two bills was legendary, with the AMA bying that he dropped his consideration of opposing them until after their passage, and including health insurance as a part of Social was remarkable and exemplary for how Pres- Security legislation, for fear of it causing the ident Lyndon B. Johnson (D) managed the legislation to go down in defeat. The quest for legislative and implementation processes. national health insurance received its final This legislation ushered the United States into blow with the defeat of President Truman’s (D) the provision of national health insurance Fair Deal (1949). With this defeat, the Dem- for the general population, albeit to limited ocrats realized they needed to change strate- populations. gies and, while pursuing the ideal of national The 1970s and 1980s continued to wit- health insurance in some format, they began ness a flurry of legislative and administrative to do so on an incremental basis. Three sig- activity, with the result of the activity primar- nificant healthcare laws passed under Presi- ily being incremental increases in programs dent Truman (D): the National Mental Health ensuring access and legislation addressing Act (1946) established the National Institute the increasing cost of healthcare services. of Mental Health, the Hospital Survey and The most significant of these legislative Construction Act (1946), also known as the actions was the Social Security Act of 1983 Hill-Burton Act, had a goal of establishing 4.5 (Prospective Payment Act) that ushered in beds per 1000 people and required participat- bundled payments based on diagnostic and ing hospitals to provide uncompensated care, historic data. The hospital prospective pay- and the Federal Water Pollution Control Act ment system was introduced as Diagnostic (1948) provided federal funds for the elimina- Related Groups (DRG) in 1983; the Outpa- tion of waste from tributaries. tient Prospective Payment System consist- Due to post-World War II wages and price ing of Ambulatory Payment Classifications freezes, employers were unable to provide (APC) for hospital-based outpatient services their employees with additional cash wages. In and Current Procedural Terminology (CPT) an effort to provide some type of pay increase, for other outpatient-based services were employers began providing employees with launched in 2000. 24 Chapter 2 How We Got Here: U.S. Health Policy History One federal law enacted in the 1970s—not the National Committee on Quality Assurance often associated by the public with health care, (1990) that broadened the federal govern- although it has had profound, long-term effects ment’s list of concerns from access and cost to on state-level healthcare reform efforts—is the include quality. Employee Retirement and Income Security Act One of the healthcare system’s greatest (ERISA). ERISA was intended to accomplish obstacles has been defining quality. Providers (in addition to many other goals) two health- do not seek to provide poor care, yet they have care goals: to establish a legal requirement for trouble defining quality care.
Recommended publications
  • Debunking the Government Takeover Myth
    Debunking the Government Takeover Myth By Stan Dorn and Stephen Zuckerman Of the many unfounded claims now coloring the health care debate, at least one can be taken off the table. As President Obama told the nation September 9, it’s time to stop making “wild claims about a government takeover of health care.” He’s right and here’s why. For starters, pending legislation would leave our largely private medical care system intact. Right now, more than 90 percent of doctors are in private practice and 84 percent of all hospital admissions are to private facilities. That wouldn’t change as a result of any reform proposals. If it’s Big Brother in the examination room that seems chilling, that’s not at issue either. Nothing in the thousand pages of reform proposals would give the federal government any new authority to intervene in private health care decisions. “Death panels” are as imaginary as Lord Voldemort, and government’s role would be largely what it is now: helping low-income Americans pay for health coverage and regulating insurance companies so they better serve consumers. Under the new proposals millions of Americans would see their health care options increase. Workers covered through small firms, for instance, could choose from a range of health plans available in a new health insurance “exchange,” a convenient new marketplace that could make both private and public options available. Today, three fourths of these workers are offered only one health plan by their employer. And when people work for themselves or a company that doesn't provide any insurance at all, they are on their own today.
    [Show full text]
  • Republican Leader Michael C. Burgess, MD
    Republican Leader Michael C. Burgess, M.D. Energy and Commerce Health Subcommittee “Proposals to Achieve Universal Health Care Coverage” December 10, 2019 As Prepared for Delivery Thank you, Madam Chair. Thank you for holding this hearing on various universal heath care coverage proposals, including Medicare for All. Ranking Member Walden and I requested a hearing on Medicare for all numerous times this year, and I appreciate that you took our request seriously enough to hold today’s hearing. I would like to ask unanimous consent that our two letters be included in the record. Coverage does not equal care. Chairman Pallone and Chairwoman Eshoo stated in noticing this hearing that “universal health care coverage has long been the North Star of the Democratic Party.” Every bill before us today is paving that road to the North Star – to accomplishing one-size-fits-all health care coverage. Page 1 of 6 I’m not sure the three wise men would appreciate your comparison, as this North Star journey would lead our health care system as we currently know it to disintegrate into ashes. If we’re listening to Joni Mitchell, then the northern star is not very reliable as it is constantly in the dark. Medicare for All would eliminate private insurance, employer- sponsored health insurance, Medicaid, and the Children’s Health Insurance Plan, upon which many Americans depend. I am concerned about the consequences for existing Medicare beneficiaries, as this policy would raid the Medicare Trust Fund, which is already slated to go bankrupt in 2026. Our nation’s seniors have been depending on the existence of Medicare for their health care needs in retirement for their entire lives.
    [Show full text]
  • Single-Payer FAQ's Americans Spend Over Twice As Much Per Capita On
    (https://fixithealthcare.com/) –FAQs FAQs Home (https://fixithealthcare.com) / By The Numbers (https://fixithealthcare.com/by-the-numbers/) / FAQs Single-Payer FAQ’s (http://fixithealthcare.com/wp-content/uploads/2011/07/Single-Payer.jpg) Simply put, single-payer is health insurance. A public agency organizes all healthcare financing. Delivery of care remains private. The confusion of thousands of insurance policies, (https (http://fixithea manuals, and uncertainties about coverage will be ended. A single-payer system could eliminate deductibles, co-pays, and out- of-pocket expenses (at the point of care), while providing healthcare for all Americans. Savings anticipated in the US: $504 billion a year. (https://w All Americans would be covered for all medically necessary services. Patients would regain choice of doctor and hospital, and doctors would regain autonomy over patient care. Americans spend over twice as much per capita on health care as the average developed country. Q? How will it be funded? A. First, recognize that approximately 50% of US healthcare is currently funded through taxes – and 50% through business and household pockets. A single-payer system would be financed through a transfer of money that Americans and the country’s employers currently pay insurance companies. The premiums we and employers now pay insurers would be transferred to a federal program, which would be the single-payer for health care services. The cost to all of us – either through taxes or out-of-pocket expenses goes way down, with savings of over $700 billion per year, including negotiation for prescription drugs, a unified fee schedule, and greatly reduced administrative expense.
    [Show full text]
  • Getting Ready for Health Reform 2020: What Past Presidential Campaigns Can Teach Us
    REPORT JUNE 2018 Getting Ready for Health Reform 2020: What Past Presidential Campaigns Can Teach Us Jeanne M. Lambrew Senior Fellow The Century Foundation ABSTRACT KEY TAKEAWAYS ISSUE: The candidates for the 2020 presidential election are likely to Campaign plans are used by emerge within a year, along with their campaign plans. Such plans will supporters and the press to hold presidents accountable. Though include, if not feature, health policy proposals, given this issue’s general voters are unlikely to believe that significance as well as the ongoing debate over the Affordable Care Act. politicians keep their promises, GOAL: To explain why campaign plans matter, review the health policy roughly two-thirds of campaign components of past presidential campaign platforms, and discuss the promises were kept by presidents likely 2020 campaign health reform plans. from 1968 through the Obama years. METHODS: Review of relevant reports, data, party platforms, and policy documents. Health policy will likely play FINDINGS AND CONCLUSIONS: Proposals related to health care have a significant role in the 2020 grown in scope in both parties’ presidential platforms over the past election, with Republicans focused on deregulation and century and affect both agendas and assessments of a president’s capped federal financing success. Continued controversy over the Affordable Care Act, potential and Democrats backing the reversals in gains in coverage and affordability, and voters’ concern Affordable Care Act and a suggest a central role for health policy in the 2020 election. Republicans Medicare-based public plan will most likely continue to advance devolution, deregulation, and option. capped federal financing, while Democrats will likely overlay their support of the Affordable Care Act with some type of Medicare-based public plan option.
    [Show full text]
  • Provide a Better Prescription Than Medicare-For-All
    PROVIDE A BETTER PRESCRIPTION THAN MEDICARE-FOR-ALL The current U.S. health care system is plagued by high costs, Quick Take industry consolidation, and a poorly functioning marketplace. Democrats believe the prescription for these challenges is a form Medicare-for-All amounts to a federal takeover of of single-payer system. Socialized medicine won’t solve the American health care. challenges our health care system faces – it would nationalize the entire health care sector and wreck the economy. Democrats cannot answer how to fund their socialized medicine plans without wrecking the BACKGROUND American economy. Congress should consider U.S. health care spending accounts for approximately 18 percent reforms that address the burdens plaguing our of America’s gross domestic product (GDP).1 Government current system. spending on health care makes up a substantial portion of that amount. In 2018, Medicare accounted for 21 percent of health care spending at $750 billion, and Medicaid carried a 16 percent share at $597 billion.2 Nationwide, “personal healthcare spending is currently projected to be $3.859 trillion in 2022,”3 while national health expenditures are estimated to reach $4.562 trillion in 2022.4 According to one estimate, average households spend more of their income on hospital visits (18.6 percent) than they do on federal taxes (13.9 percent).5 Source: Avik Roy, Foundation for Research on Equal Opportunity6 REPUBLICANPOLICY.HOUSE.GOV @GOPPOLICY [email protected] Democrats have introduced two major so-called “Medicare-for-All” proposals which have received national attention. The first is Sen. Bernie Sanders’s (I-VT) plan, S.
    [Show full text]
  • Moore's Sicko Offers No Cure for U.S. Health Care
    Moore’s Sicko Offers No Cure for U.S. Health Care 2007-20 by Paul Guppy, Vice President for Research There he goes again. Michael Moore health care results in rationing, price controls, earlier this year released Sicko, a new waiting lists and low-quality care. “documentary” movie about American health care. I put the word in quotation marks For example, the Canadian courts because documentary films usually present recently ruled in favor of patient George facts. Zeliotis, who lived in pain for a year while waiting for a hip operation under Canada’s But for Moore, a film is called a socialized “health care for all” system. The documentary not because it is based on fact – justices found that Canadians had suffered and his films actually contain serious errors – but even died while waiting for care. because he does not use professional actors, meaning he does not have to pay the people In Britain, waiting lists for routine care who appear on camera. Apparently, the only are so long that one of the most popular person who gets paid for appearing in a products sold in drug stores are do-it-yourself Michael Moore film is...Michael Moore. In dental kits. Sicko, Moore attacks for-profit health care and calls for adoption of a socialized, state- Socialized health systems are managed health care system. chronically plagued by rationing, shortages, labor strikes and disputes over doctors’ pay. Yet Moore is not adverse to securing The poor quality of socialized medicine helps handsome profits in his own field. Disney explain why so many foreigners travel to the Corporation paid Moore a dazzling $21 United State to receive medical care.
    [Show full text]
  • “Socialized” Medicine: Oppositional Rhetoric and Obama’S Health Care Reform
    Bryant University Bryant Digital Repository History and Social Sciences Faculty Journal History and Social Sciences Faculty Articles Publications and Research 3-2013 The Enduring Narrative of “Socialized” Medicine: Oppositional Rhetoric and Obama’s Health Care Reform Richard Holtzman Bryant University, [email protected] Follow this and additional works at: https://digitalcommons.bryant.edu/histss_jou Part of the Oral History Commons, and the Other Social and Behavioral Sciences Commons Recommended Citation Holtzman, Richard, "The Enduring Narrative of “Socialized” Medicine: Oppositional Rhetoric and Obama’s Health Care Reform" (2013). History and Social Sciences Faculty Journal Articles. Paper 71. https://digitalcommons.bryant.edu/histss_jou/71 This Article is brought to you for free and open access by the History and Social Sciences Faculty Publications and Research at Bryant Digital Repository. It has been accepted for inclusion in History and Social Sciences Faculty Journal Articles by an authorized administrator of Bryant Digital Repository. For more information, please contact [email protected]. The Enduring Narrative of “Socialized” Medicine: Oppositional Rhetoric and Obama’s Health Care Reform Richard Holtzman Associate Professor, Bryant University To Cite this Article: Richard Holtzman (2013): “The Enduring Narrative of ‘Socialized’ Medicine: Oppositional Rhetoric and Obama’s Health Care Reform.” Itineration: Cross-Disciplinary Studies in Rhetoric, Media, and Culture March 2013. Itineration: Cross-Disciplinary Studies in Rhetoric, Media and Culture March 2013 itineration.org ISSN: 2169-561X © Abstract President Barack Obama and his promises of health care reform were met with strong public support when he took office in January 2009. By the time Congress ultimately passed legislation in March 2010, not only had a majority of citizens turned against health care reform, but many had come to interpret it as inimical to American values.
    [Show full text]
  • Exploring Single-Payer Alternatives for Health Care Reform
    Dissertation Exploring Single-Payer Alternatives for Health Care Reform Jodi L. Liu This document was submitted as a dissertation in May 2016 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Robert H. Brook (Chair), Christine Eibner, and Jeffrey Wasserman. PARDEE RAND GRADUATE SCHOOL For more information on this publication, visit http://www.rand.org/pubs/rgs_dissertations/RGSD375.html Published by the RAND Corporation, Santa Monica, Calif. © Copyright 2016 RAND Corporation R® is a registered trademark Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.html. The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org Abstract The Affordable Care Act (ACA) has reduced the number of uninsured and established new cost containment initiatives.
    [Show full text]
  • The Value of Socialized Medicine: the Impact of Universal Primary Healthcare Provision on Mortality Rates in Turkey
    NBER WORKING PAPER SERIES THE VALUE OF SOCIALIZED MEDICINE: THE IMPACT OF UNIVERSAL PRIMARY HEALTHCARE PROVISION ON MORTALITY RATES IN TURKEY Resul Cesur Pınar Mine Güneş Erdal Tekin Aydogan Ulker Working Paper 21510 http://www.nber.org/papers/w21510 NATIONAL BUREAU OF ECONOMIC RESEARCH 1050 Massachusetts Avenue Cambridge, MA 02138 August 2015, Revised May 2017 Previously circulated as "The Value of Socialized Medicine: The Impact of Universal Primary Healthcare Provision on Birth and Mortality Rates in Turkey." We thank Dr. Emel Ergu n Seyit for providing insights about the operational details of the family medicine program. We also thank Bulent Anil and seminar participants at the University of Connecticut, University of Alberta, University of Manitoba, University of South Florida, Yasar University, Izmir University of Economics, Ghent University, European Society for Population Economics in Turkey, TUSIAD-KOC ERF Conference on Health, Education and Worker Productivity in Turkey, Western Economic Association International Conference in Singapore, Association for Public Policy Analysis and Management Conference in United Kingdom for their helpful comments and suggestions. Erdal Tekin gratefully acknowledges support from the Gary and Stacey Jacobs Fellowship. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications. © 2015 by Resul Cesur, Pınar Mine Güneş, Erdal Tekin, and Aydogan Ulker. All rights reserved. Short sections of text, not to exceed two paragraphs, may be quoted without explicit permission provided that full credit, including © notice, is given to the source.
    [Show full text]
  • One Purpose of the Film Sicko Is to Get Some of the Facts out to the American People About the Things That Are Wrong with U.S. Health Care
    SiCKO One purpose of the film SiCKO is to get some of the facts out to the American people about the things that are wrong with U.S. health care. Michael Moore points out that wealthy stakeholders make huge investments to maintain a status quo which supports excessive industry profits instead of meeting our health care needs. His premise is that, because of those special interests, sometimes we are left with information that simply is not true. Affordable health care for everyone is referenced in a variety of ways in the film, depending on the country being highlighted, or the perspective of the person speaking. In the U.S. the terms often are used interchangeably and incorrectly, especially when we hear reports on the Town Hall Meetings or listen to the political pundits. Here are the different kinds of insurance referenced in the film and used in dialog about healthcare. When analyzing facts for your paper, be sure these definitions are clear to you. Universal Health Care – very simply… a health system designed to guarantee that everyone has access to quality health care which is comprehensive and affordable (All industrialized democracies except the U.S. have some sort of Universal Health Care.) National Health Insurance – insurance coverage provided by a nation that guarantees health care for all of its citizens, regardless of whether the health care is provided by government-employed health professionals (England) or private practitioners (France, Canada) Socialized Medicine (National Health Service) – a health system in which health care providers are government employees, health care facilities are run by the government and the government pays for health care services.
    [Show full text]
  • Single Payer Healthcare
    Position Paper: Single Payer Healthcare Alliance4Action Healthcare Action Team January, 2018 Issue The United States has a fragmented “system” of healthcare coverage funded by private insurance, governmental programs and individuals’ out of pocket payments. We spend more on healthcare than any other industrialized country yet health outcomes are poorer than those of comparable nations and coverage is not universal. Our Position We support a single payer or single payer hybrid model of healthcare funding. Why we have this position We feel quality healthcare is a right and should be affordable and accessible to all. A single payer or hybrid system is the best means to achieve universal coverage because it is the most cost-effective model, the least complex administratively, and offers opportunities for better quality control. Background A single payer healthcare system is one where the insurer, usually a government, pays for all covered health care costs. A hybrid system includes private insurance as part of the system. Three main models of universal healthcare systems, based on single-payer or hybrid systems, have been implemented around the world:1 Beveridge Model: This system, established in postwar England, Spain, New Zealand, Hong Kong, Cuba, and most Scandinavian countries, is named for the British social reformer, William Beveridge. This model is typically referred to as “socialized medicine”. Healthcare is universal and is funded by taxes. Most clinics and hospitals are owned and run by the government. Physicians and other providers are generally government employees. However, private insurance is still available for purchase by those individuals who can afford it and who prefer non-governmental healthcare providers and facilities.
    [Show full text]
  • A Comparative Analysis of the Origin and Structure of Public Health Financing for HIV Care in the United States and England Steven R
    Notre Dame Law Review Volume 83 Issue 3 Symposium: Stare Decisis and Nonjudicial Article 9 Actors September 2013 A Comparative Analysis of the Origin and Structure of Public Health Financing for HIV Care in the United States and England Steven R. Keener Follow this and additional works at: http://scholarship.law.nd.edu/ndlr Recommended Citation Steven R. Keener, A Comparative Analysis of the Origin and Structure of Public Health Financing for HIV Care in the United States and England, 83 Notre Dame L. Rev. (2008). Available at: http://scholarship.law.nd.edu/ndlr/vol83/iss3/9 This Note is brought to you for free and open access by NDLScholarship. It has been accepted for inclusion in Notre Dame Law Review by an authorized administrator of NDLScholarship. For more information, please contact [email protected]. NOTES A COMPARATIVE ANALYSIS OF THE ORIGINS AND STRUCTURE OF PUBLIC HEALTH FINANCING FOR HIV CARE IN THE UNITED STATES AND ENGLAND Steven R Keener* INTRODUcTION The growing number of Americans without medical coverage has elevated the possibility of universal health care in the public debate. Presidential candidates vying for votes in 2008 are being pressed on how they plan to cover the 46.5 million uninsured Americans.' Michael Moore's documentary, Sicko,2 came out in June 2007 with animated criticism of the American health care system. In typical staged bewilderment, Moore walks the halls of an English National Health Service (NHS) hospital, marveling that patients don't have to pay for treatment. American activists, critics, reformers, and even Presidents have often looked across the Atlantic to the NHS as an example of what universal coverage could look like.
    [Show full text]