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Health insurance in the United States is a rather complex, developed structure. Diagnosis-related groups are an essential component of the country’s health maintenance organizations.
In 1983, the US Congress adopted the system of diagnostically related groups (DSG) to pay hospitals for patients whose treatment is covered by Medicare (Chakravarthy et al., 2018). The reform was proposed by the Democratic Party and the stakeholders are the owners of the insurance programs who benefit from this HMO framework. The outcome of legislation is that this payment method has gradually become the primary means of reimbursing hospitals in the United States.
In 1945, President Truman introduced a bill to Congress on compulsory health insurance, the construction of new hospitals, and doubling the number of doctors and nurses. According to Bredenkamp, Bales, and Kahur (2020), after his re-election in 1948, Truman tried to return to the problem, but the war in Korea began, and the question remained open. Only in 1965, due to the growing influence of trade unions and the Democratic Party in Congress, President L. Johnson managed to establish two major national health care programs: Medicare and Medicaid.
The political climate of today has a lot of similarities with the political climate of the past. This includes strained relations with Russia, pushing for a health care race, and extreme conditions for the country that require its mobilization – these trends can be called recurring. Regarding the differences, the speed with which decisions are made in the healthcare sector can be noted – today, it is receiving increased attention, and the changes are happening much faster.
In my opinion, the polarization of healthcare is increasing in a situation of crisis that disrupts the usual course of life of citizens. Today, the coronavirus pandemic has become such a crisis trigger in society, contributing to the actualization of the political charge of the healthcare system.
References
Bredenkamp, C., Bales, S., & Kahur, K. (Eds.). (2020). Transition to diagnosis-related group (DRG) payments for health: Lessons from case studies. Washington, DC: World Bank.
Chakravarthy, V., Ryan, M. J., Jaffer, A., Golden, R., McClenton, R., Kim, J., … Johnson, J. T. (2018). Efficacy of a transition clinic on hospital readmissions. The American Journal of Medicine, 131(2), 178-184.
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