The Evolution of Health Insurance in America

How did Medicare and Medicaid come into existence?

Dr. Patton dives into the origins of Medicare and Medicaid, created through the Social Securities Amendment of 1965 during President Lyndon B. Johnson's administration. These programs aimed to provide government-funded healthcare for vulnerable populations.

Dr. Patton traces the evolution from Baylor Hospital's early health insurance plan to the establishment of Blue Cross Blue Shield. And he covers the rise of HMOs and PPOs in the 1980s and the resulting impact on the American healthcare landscape.

Learn more at eddiepattonmd.com.

Five Conceptual Takeaways

1. Understanding the historical context, from President Lyndon B. Johnson’s Social Security Amendments creating Medicare and Medicaid to the emergence of self-insured employer plans, HMOs, and PPOs, helps us grasp the development and complexities of the modern American healthcare system.

2. The rising costs of healthcare significantly impact individuals and families, with hospitals, insurance companies, and the pharmaceutical industry being major contributing factors. Patient autonomy, choice, and accessibility remain critical in mitigating these impacts.

3. When selecting a health insurance plan, it is essential to understand co-pays, deductibles, reimbursements, coverage for preferred doctors and facilities, and prescription drug policies. Quality customer service and additional perks like gym memberships or wellness programs can also influence the decision.

4. Both vertical and horizontal consolidation within the healthcare industry reduce competition and patient choice while enabling insurers and providers to control costs by owning more of the healthcare process. This consolidation can affect pricing and accessibility of care for patients.

5. HSAs provide important benefits like pre-tax contributions, reduction in taxable income, and flexibility in spending on healthcare-related expenses. However, understanding the limitations, such as use-it-or-lose-it policies and restrictions on non-healthcare expenditures, is crucial for maximizing these benefits.

Timestamped Overview

00:00 Industrial revolution led to workers' protection laws.

05:11 Compulsory health insurance in 1916-1919 and opposition.

09:45 In 1933, New York labeled plans insurance.

13:20 Medicaid and Medicare provide health care support.

16:18 ERISA plans are federal, require federal advocacy.

19:03 Health insurance plans evolving to provide care.

23:38 Healthcare consolidation reduces patient choice, impacts insurance.

26:20 Healthcare insurance pros and cons for employees.

28:06 Employers must offer insurance to full-time employees.

33:51 Health providers need timely insurance reimbursements.

35:03 Challenges in basic services and insurance plans.

37:48 Inquire about insurance coverage for emergencies.

42:20 Telemedicine offers convenient health insurance options.

Learn more about Dr. Eddie Patton HERE.

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