The Evolution Of Healthcare: Older Americans Act And Medicare
In early nineteenth century, care of the sick, birthing, and dying were all part of domestic life, whereas hospitals were places of last option for those without families or caring neighbors. Families that were financially fit hired doctors, midwives, or nurses to deliver care in the patient’s home when assistance was required. By the end of the nineteenth century, benevolent ladies across the United States were creating organizations to send trained nurses into the homes of the sick poor to prevent and provide care that spread dangerous contagious diseases.
Since the beginning, these organizations encountered the vexed question of the chronic patients: which how chronically ill-deserved care was and how long can they be treated due to the fact of financial stability. Therefore, they came up with the theory that limiting care to the acutely ill good nursing could be quickly returned to the care of their families because this was the most cost-effective investment. So, people started taking services from the practice of midwifery—a person who help women in childbirth and delivering babies—Since this became a common profession for women, and, most births took place at home. Until the mid-eighteenth century Western medicine was based on the ancient Greek principle of "four humors"—blood, phlegm, black bile, and yellow bile, they assume that balancing these among the humors was the key to health; they think too much or too little of the fluids was the cause for disease. Variety of plants and herbs, were also highly regarded as healing power of cold, hot, dry and wet.
People also started preferring "bone-setters" and surgeons for body fractures, were most of whom had no formal training, by year 1909 the financial circumstances were dramatically improved with the establishment of an insurance policy known as the Metropolitan Life Insurance Company (MLI) for home nursing care for their policyholders. The main principle of MLI’s was to contract with the visiting nurse associations restoration to health and work of policyholders. Then by 1920s, there began a dramatic upward trend in mortality since the proportion of elderly in the population rose in chronic disease.
Firstly, studied in 1928, it remained an unresolved policy dilemma in the United States, results showed that from an insurance perspective they can overcome the drawback of financial crisis. Later the new question raised and was - who would provide day-to-day care for the growing numbers of patients that failed to get well or die? In 1935, new policy created known as Old Age Assistance (Social Security) that rebalanced the care for the chronically ill patients. By the 1930s and 1940s, there was new argument going on that how the demands of the chronically ill were compromising the capacity of hospitals, and they concluded that home care could provide a less expensive preferred, and an alternative to hospital care. Again, there came question “How to pay” for such care.
In the end, in the 1960s home care was included in the Medicare, Medicaid, and the Older Americans Act. By the 1990s, Medicare, a program that was designed to meet the needs of short-term acute illness was now providing long-term care to the ill patients. On October 1, 1997, the Balanced Budget Act of 1997 radically transformed the Medicare home-care benefit enacted in 1965. By Twenty-first-century and mid-twentieth-century technology promises to continue changing the nature, costs of healthcare and complexity such as gene that is used by the healthcare system to extent that prevent genetically caused diseases and further invention of new technologies, such as x rays, antibiotics, vaccines, and surgical advances changed early.
