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    1. In 1977, the Health Care Financing Administration was established within the Department ofHealth, Education, and Welfare (renamed the Department of Health and Human Services in1980). The National Medical Care Expenditure Survey (NMCES) of that year provided detaileddata on how much individuals were spending on health care

      This shows how health policy continued to develop by focusing on both access and the cost of health care. The creation of the Health Care Financing Administration in 1977 and the National Medical Care Expenditure Survey helped the government better understand how much people were spending on health care. I think collecting this information was important because policymakers need to understand the financial burden of health care in order to make effective decisions.

    2. The Social Security Act was passed in 1935, which includedgrants for Maternal and Child Health, which restored many of the programs established under theSheppard-Towner Act.4 It also expanded the role of the Children’s Bureau to include childwelfare services.

      The history of health policy shows that the United States has been debating access to health care for a very long time. I found it interesting that during the Great Depression, the government recognized the need for policies that could provide employment, retirement, and medical care, but national health reform still did not move forward. The Social Security Act of 1935 did provide grants for maternal and child health, showing that the government was beginning to take a larger role in protecting people's health.

    1. palpable change in the economic scene during these years that was crucial to thedefeat of universal health care and other progressive reform plans. For some threedecades following World War II, as Dean Baker explains in The End of LoserLiberalism, strong economic growth in the United States had been accompaniedby a growth of income at all levels on the economic ladder.

      This section stood out to me because it shows how economic conditions and political influence can shape health care policy. The growing cost of health care was used to argue against universal health care, while corporations were becoming more active in influencing government policy. It makes me wonder whether decisions about health care were based primarily on what would improve patients’ health or on concerns about controlling costs and protecting economic interests. As a nursing student, I think this is important because health care policies ultimately affect patients’ access to treatment and the quality of care they receive.

    2. In his 1960 The Constitution of Liberty, Hayek presented what is essentiallythe philosophical essence of health care neoliberalism, an ideology that wouldlater be complemented by developments in the arena of health economics andhealth policy. Hayek argued that the case for “a free health service” rested on afundamental philosophical error, namely on the idea that people’s medical needscould have “an objectively ascertainable character.

      I find this argument interesting because it treats health care more like a personal consumer choice than a basic need. Hayek’s view suggests that individuals should decide how much health care they want based on what they are willing or able to give up financially. However, this could create inequality because people with lower incomes may have to choose between necessary medical care and other basic needs. This makes me question whether health care can truly be treated like an ordinary commodity when people’s health and survival are involved.

    1. Excessive Profit Making. Many Americans express preference for a health care system that doesnot include or at least does not depend on profit-making companies. Even more Americans oppose thehuge profits made by some health care companies knowing that those profits can make services availableto fewer people.

      suggesting that profit-making companies can encourage unnecessary or excessive use of health care services. I agree that financial incentives can influence health care decisions, but I do not think profit is always negative. Companies that make profits can also invest in new medications, technologies, and services that improve patient care. The more important issue may be finding a balance between making health care available and preventing financial incentives from becoming more important than patients' needs.

    2. Many experts believe that the most important factor driving up health care costs is expensive new med-ical technologies. There is more emphasis in the United States than in any other country on quicklyincorporating new medical technologies. This occurs for several reasons. Medical providers want tooffer the best possible care to patients, and high-technology innovations are often viewed as the high-est-quality treatments. Hospitals often engage in fierce competition with each other and want to attracttop physicians and other providers. Having the latest equipment (whether or not it substantially improvespatient outcomes) can be an effective marketing device both to the community and to medical providers(Bodenheimer 2005).

      This paragraph explains that the increasing use of expensive medical technology contributes to higher health care costs. However, the cause seems to go beyond simply having new technology. Hospitals may purchase advanced equipment to attract patients and physicians, and once the equipment is available, there is a financial incentive to use it. This creates a cycle where technology increases availability, availability increases use, and increased use contributes to higher spending.

    3. on average paid US$6,200 (83 percent) and the employee paid US$1,270 (17 percent). Employeestypically pay a moderately higher percentage for a family policy. In 2020. The average family insurancepolicy cost US$21,342 of which employers paid US$15,579 (73 percent) and employees paid US$5,763(27 percent).

      The reading states that the average family health insurance policy cost $21,342 in 2020, with employees paying $5,763 of that amount. This number makes me wonder how affordable employer-sponsored insurance really is for families with lower incomes. Even when an employer pays most of the premium, the employee still has to pay additional costs such as deductibles, copayments, and coinsurance. The numbers suggest that having insurance does not necessarily mean that health care is affordable.