Health Care Reform Summary
The Patient Protection and Affordable Care Act (PPACA) of 2010 may reduce the cost of health care in the United States.
Pros
The PPACA “would mandate that most US citizens and legal residents purchase 'minimal essential coverage'” (Grier, 2010, para. 5). An estimate from 2006 states that health care spending will account for 20% of the GDP of the United States by 2015 (Borger, 2006). The burden of unpaid medical bills on the economy may be relieved when more individuals have coverage.
This policy would improve Medicare financing. According to the Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) it is “estimated that the act would reduce [Medicare] Part A outlays by $246 billion and increase HI [Hospital Insurance Trust Fund] revenues by $69 billion during the 2010-2019 period” (Congressional Budget Office, 2009, para. 5).
The PPACA would invest in prevention of Medicare fraud rather than following the “pay and chase” model (Wachler, Colagiovanni & Laney, 2011, p. 24). Health care fraud accounts for a significantly large amount of health care spending in the United States and reducing Medicare fraud is a goal of this policy.
Cons
The PPACA may not directly reduce the cost of health care for individuals. Unfortunately, “[m]edical costs, out-of-pocket expenses, and the degree to which comprehensive health insurance coverage is available may have more to do with personal bankruptcy filings than does the lack of insurance coverage” (Brotman, 2006, p. 70-1).
Health Care Reform
Many people admire and respect President Obama because of the way he treats others. One aspect of being a good leader is making connections with others. Connecting to people as a leader means identifying with people and relating to them in a manner that grants the leader influence over the group (Maxwell, 2010). President Obama has displayed his communication abilities through his actions abroad and at home. Presidential candidate Barack Obama told reporters that his mother had delivered him when she was only eighteen upon being asked for his comment on the news that Sarah Palin’s teenage daughter had unintentionally become pregnant (King, 2008). Barack Obama demonstrated dignity and respect, even against his competitors. Connecting with people “reinforces a sense of community and teamwork, and expands influence and productivity” (Maxwell, 2010, p. 2). Internationally, President Obama has displayed his leadership ability across different cultures. When Barack Obama entered the position of President, he inherited a poor foreign public opinion. In a relatively short amount of time he has turned around the nation’s reputation abroad. As the President of the United States, he declared that “[t]he United States stands ready to help the Japanese people in this time of great trial” after Japan was hit with an earthquake, a tsunami, and a nuclear disaster in a short period of time (Japan Earthquake and Tsunami, 2011, para. 1). Putting the well-being of other people in his nation first is that mark of a good President. The mark of a great leader is understanding that people are connected so the success or failure of America’s international neighbors affects the success or failure of the United States.
In 2009, President Barrack Obama was sworn in as President of the United States. After three years of Barack Obama’s presidency the nation has seen the overhaul of a healthcare system desperate for revision since the early 1940s. The United States has seen many superior leaders as President and many leaders who have become only footnotes in the history of the nation. Despite the desperate need for national legislation recognizing the inherent right to health care it took nearly 70 years for a great leader to prioritize and push through the legislation reforming health care in the United States.
After World War II the health care system was the drastically changed by the radical new idea of pre-paid healthcare. The change began in the 1940’s, during the war. One of the ethical issues that I find has been ignored for a very long time is the effect that insurance companies have a on patient treatment. We are one of the richest countries in the world. Yet for years we have been letting our fellow citizens go without good health when we can prevent it. This strikes me as unethical. One Fridays I do clerical work at a hematologist and oncologist's office. It is amazing that any of her patients could (at any time) have a treatment or test denied by the insurance company. I hear things, even though I really try not to, and I am angry and amazed at what I've heard and seen insurance companies do to some of these patients. I remember once that the insurance company told Dr. Nanci that it would take at least a week before they would get back to her on the authorization of a treatment. The patient need the treatment urgently and had seriously low count of something in her blood. (Dr. Nanci said it was a miracle she was still standing.) Dr. Nanci advised the patient to go immediately the hospital and we would try at the office to get it authorized if we could, or we would work on a retroactive authorization. I really want it to become common ethics that insurance companies be limited or ruled more by doctors than the other way around. I don't think I could ever work for an insurance company because I consider them, largely, to be unethical (at least by my standards). The doctor knows the patient, knows the illness, and perhaps ordering medically unnecessary treatments or tests should be punishable in some way (unethical in itself) the denial or authorization / payment by insurance companies for a medically necessary treatment is unethical (to me anyway).
The pattern of rejecting government plans for national health programs began early and continued until 2010. In the 1944 during his State of the Union address President Roosevelt asked Congress for an "economic bill of rights," including the right to adequate medical care. "The Second Bill of Rights – FDR's Unfinished Revolution and Why We Need it More Than Ever" a book written by Cass R. Sunstein, Professor of Jurisprudence at Chicago School of Law, discusses how and why the Second Bill of Rights was never fully implemented in the United States (Tarvis, Dec. 13, 2006). Later, President Truman offered a national health program plan. He proposed a single system of health care that would include all American citizens. Truman's plan was denounced by the American Medical Association (AMA) and called a Communist plot by a House subcommittee (The Healthcare Crisis: Healthcare Timeline).
The whole "Communist plot" thing (the reason for this video on Upworthy, by the way) is a result of the Red Scare. The Red Scare (you can google Red Scare) was a period in our history that was extremely un-American. The government, as a part of the Cold War era, attempted to demonize the enemy (the Soviets / Communists) and initiated a nationwide witch hunt against anyone who held a particular belief in communist or socialist theories. This was a blatant violation of the Fourth, Fifth,Sixth, and Eighth Amendments to the U.S. Constitution---blatant and nationwide violations of the rights of American citizens. Accusing someone of being a Communist as if it is a bad thing is equivalent to accusing someone of being Jewish or Catholic like it is a bad thing. That is to say it is idiotic and reeks of bigotry.
Healthcare costs began to escalate rapidly in the 1950’s when hospital prices doubled. By the 1990’s the cost of healthcare rose at double the rate of inflation. This pattern continues today. Some of the increases were partially due to swift economic inflation or the expansion of hospital expenses and profits. Medicare costs contributed to the crisis because they were unexpectedly high for a number of reasons. Changes in medical care including greater use of technology, medications, and conservative approaches to treatment also ran up the bill. The refusal of government to pass legislature that would solve the legitimate healthcare needs of United States crippled the healthcare system. The system of health care developed with the underlying ethic that appropriate medical care would be expensive and only those Americans who could afford the high cost would be treated appropriately.
A freeze on wage and prices were placed on American employers during World War II. American companies found a loophole in the economic freeze by offering health benefits to employees to vie for the best job applicants; this practice brought about an employer-based health care system that still exists today. Private insurances came into being early on and by the 1960’s there were over 700 private insurance companies to encourage the high prices of medical care. It was at this time that it became especially difficult for Americans outside of workplaces that offer health insurance to afford medical care.
The changes in the health care system are important because as professionals within the system we must be aware of the impact health care reforms will have on our careers. As Americans we must be aware of the changes that are coming from a more personal perspective. On one hand, as a consumer I hope to benefit from health care reforms geared toward lowering the cost of medical care. On the other hand, as a healthcare administrator the reforms that lower the cost of health care might also increase the competitiveness of my career choice or decrease the average amount I will be paid in the future.
Despite the possible conflict of interest, I fully support President Obama's health care plan because I value the moral and ethical standard of universal health care. I also believe that universal health care is consistent with (if not required by) the inherent promises of a democracy. The health care industry deals with the most precious commodity, human life. The value of a human life is immeasurable for many people but the cost of health care resources may be expensive.
This policy would improve Medicare financing. According to the Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) it is “estimated that the act would reduce [Medicare] Part A outlays by $246 billion and increase HI [Hospital Insurance Trust Fund] revenues by $69 billion during the 2010-2019 period” (Congressional Budget Office, 2009, para. 5).
Nationwide access to health care is vital to the ethical and financial needs of the country because the right of universal health care is a part of the right to equal opportunities. Ethically and practically, universal health care preserves the health and success of the nation. In a speech presented to the 1936 Democratic National Convention Franklin D. Roosevelt said, “[l]iberty requires opportunity to make a living - a living decent according to the standard of the time, a living which gives man not only enough to live by, but something to live for” (Roosevelt, 1936, para. 17). It has taken many years to pass a national health care plan, so it is surprising that “most Americans favor a right to a job and a right to health care” (Sunstein, 2004, para. 24). The Health Care Reform Act of 2010 was sweeping legislation signed into law by President Obama providing the majority of Americans with access to medical care and reducing the cost of health care nationwide.
Health care resources are a sizable portion of the gross domestic product (GDP) of the United States. The problem is that the amount of money the United States spends on health care is as much or more than most countries in the world (Healthcare Spending in the United States and Selected Countries, 2011). The nation's spending on health careaccounted for "16% of GDP in 2008" (Healthcare Spending in the United States and Selected Countries, 2011, p. 4) and an estimate from 2006 states that health carespending will account for "20 percent of GDP by 2015” (Borger, 2006, p. W61). “The healthcare reform bill would mandate that most US citizens and legal residents purchase 'minimal essential coverage' for themselves and their dependents” (Grier, 2010, para. 5). For example, "[t]hose who are exempt, or under 30, can buy a policy that only pays for catastrophic medical costs. It must allow for three primary care visits a year as well" (Hossain & Quealy, 2010, para. 29). With the new reform bill, more individual will be covered, which will potentially lower the cost of medical bills.
“The federal government share of health care spending increased [...] in 2009 to 27 percent” of the National Health Expenditure (NHE) while household spending on healthcare made up 28 percent, private businesses 21 percent, and state and local government 16 percent of the NHE (NHE Fact Sheet, 2011, para. 1). Unfortunately, “[m]edical costs, out-of-pocket expenses, and the degree to which comprehensive health insurance coverage is available may have more to do with personal bankruptcy filings than does the lack of insurance coverage” (Brotman, 2006, p. 70-1). This information suggests that it is the out of pocket cost of health care, with or without medical insurance, that takes the heaviest toll on individual U.S. citizens.
Obamacare also includes measures to reduce and prevent fraud, specifically Medicare fraud. Recently, one of the largest health care fraud cases in the history of American medicine led to an arrest. Dr. Jacques Roy and his accomplices were arrested on February 28, 2012 for allegedly certifying and re-certifying Plan of Caredocuments for Home Health Agencies to bill Medicare for home health services that were neither necessary nor performed and fraudulently deprived Medicare "of nearly $380 million between January 2006 and November 2001" (Fink, 2012, para. 1). This arrest was in part made possible by President Obama's crusade to save our health care system. The PPACA would invest in prevention of Medicare fraud rather than following the “pay and chase” model (Wachler, Colagiovanni & Laney, 2011, p. 24). Health care fraud accounts for a significantly large amount of health care spending in the United States and reducing Medicare fraud is a goal of this policy.
I do have to mention one obvious drawback in the universal health care system: not enough doctors. The effect of expanding health care insurance to cover all United States citizens will be enormous. The current plan is to make health care as universal as possible but there is a risk that once everyone has the ability to go see a physician then everyone will go and there will not be enough doctors to handle the influx of new patients. Before the reform has even gone into effect the country is starting out with a shortage of primary care physicians: and when the reform goes into effect the shortage will become even worse. The demand for health care services will be high while the availability will be low which is a recipe for higher prices. Many doctors have already begun to change by becoming concierge doctors. This shift will widen the difference between the quality of medical care for the wealthy as compared to the quality of medical care for the poor. Yes, people will have health insurance coverage, but according to a November 2010 Physicians Foundation Survey so there is a concern that there will be many people paying for health care coverage without receiving care. To combat the shortage The cost of health care services may rise even with these provisions to increase the number of available doctors simply because doctors are not made overnight; it takes many years to complete medical school. The other possibility is that many states will be required by the sheer number of patients looking for care to allow more privileges to nurse practitioners so that the NPs can take the place of the physician in many cases.
References
Alban-Metcalfe, J. (2009). Decisive leaders: to be or not to be? International Journal Of Leadership In Public Services, 5(4), 50-52.
Borger, C., Smith, S., Truffer, C., Keehan, S., Sisko, A., Poisal, J., & Clemens, M. (2006).Health spending projections through 2015: changes on the horizon. Health Affairs (Project Hope), 25(2), w61-w73.
Brotman, B. (2006). The Relationship Between Medical Care Costs and Personal Bankruptcy. Journal of Health Care Finance, 32(3), 66-71.
Brooks, D. (2011). Convener in chief. The New York Times. Retrieved from http://www.nytimes.com/2011/06/28/opinion/28brooks.html?_r=1
Congressional Budget Office. (2009). Effects of the Patient Protection and Affordable Care Act on the federal budget and the balance in the Hospital Insurance Trust Fund. Retrieved from http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/108xx/doc10868/12-23-trust_fund_accounting.pdf
Fink, J. (2012). Rockwall doctor charged in biggest U.S. healthcare fraud ever. CBS News. Retrieved from http://cbsdallas.files.wordpress.com/2012/02/jacques-roy-indictment.pdf
Grier, P. (2010). The Christian science monitor. Retrieved from http://www.csmonitor.com/USA/Politics/2010/0319/Health-care-reform-bill-101-Who-must-buy-insurance
Healthcare Spending in the United States and Selected Countries. (2011). Medical Benefits, 28(11), 3-4.
Hossain, F., & Quealy, K. (2010, March 21). How the Health Care Overhaul Could Affect You. The New York Times. Retrieved from http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html?scp=1&sq=How%20the%20Health%20Care%20Overhaul%20Could%20Affect%20You&st=cse
Japan earthquake and tsunami (2011). The White House. Retrieved from http://www.whitehouse.gov/issues/foreign-policy/japan-earthquake-tsunami
King, D. (2008). One world, one heart. The Huffington Post. Retrieved from http://www.huffingtonpost.com/deborah-king/one-world-one-heart_b_141853.html
Maxwell, J. C. (2010). Everyone communicates, few connect. Business Book Review Library, 1-8.
NHE Fact Sheet. (2011). Centers for Medicare & Medicaid Services. Retrieved fromhttps://www.cms.gov/NationalHealthExpendData/25_NHE_Fact_sheet.asp
Roosevelt, F.D. (1939). A rendezvous with destiny. Retrieved from http://www.austincc.edu/lpatrick/his2341/fdr36acceptancespeech.htm
Silverman, F. (n.d.). PBS. Retrieved from http://www.pbs.org/healthcarecrisis/history.htm
Sunstein, C. (2004). Economic security: a human right. The American Prospect. Retrieved from http://prospect.org/article/economic-security-human-right
Tarvis, D. (Dec. 13, 2006.) American Politics Journal. Retrieved from http://www.apj.us/index.php?option=com_content&task=view&id=130&Itemid
Wachler, A.B., Colagiovanni, J. & Laney, C.J. (2011). One year later: the impact of health care reform on health care provider audits and compliance programs. Retrieved from http://www.michbar.org/journal/pdf/pdf4article1859.pdf
In 2009, President Barrack Obama was sworn in as President of the United States. After three years of Barack Obama’s presidency the nation has seen the overhaul of a healthcare system desperate for revision since the early 1940s. The United States has seen many superior leaders as President and many leaders who have become only footnotes in the history of the nation. Despite the desperate need for national legislation recognizing the inherent right to health care it took nearly 70 years for a great leader to prioritize and push through the legislation reforming health care in the United States.
After World War II the health care system was the drastically changed by the radical new idea of pre-paid healthcare. The change began in the 1940’s, during the war. One of the ethical issues that I find has been ignored for a very long time is the effect that insurance companies have a on patient treatment. We are one of the richest countries in the world. Yet for years we have been letting our fellow citizens go without good health when we can prevent it. This strikes me as unethical. One Fridays I do clerical work at a hematologist and oncologist's office. It is amazing that any of her patients could (at any time) have a treatment or test denied by the insurance company. I hear things, even though I really try not to, and I am angry and amazed at what I've heard and seen insurance companies do to some of these patients. I remember once that the insurance company told Dr. Nanci that it would take at least a week before they would get back to her on the authorization of a treatment. The patient need the treatment urgently and had seriously low count of something in her blood. (Dr. Nanci said it was a miracle she was still standing.) Dr. Nanci advised the patient to go immediately the hospital and we would try at the office to get it authorized if we could, or we would work on a retroactive authorization. I really want it to become common ethics that insurance companies be limited or ruled more by doctors than the other way around. I don't think I could ever work for an insurance company because I consider them, largely, to be unethical (at least by my standards). The doctor knows the patient, knows the illness, and perhaps ordering medically unnecessary treatments or tests should be punishable in some way (unethical in itself) the denial or authorization / payment by insurance companies for a medically necessary treatment is unethical (to me anyway).
The pattern of rejecting government plans for national health programs began early and continued until 2010. In the 1944 during his State of the Union address President Roosevelt asked Congress for an "economic bill of rights," including the right to adequate medical care. "The Second Bill of Rights – FDR's Unfinished Revolution and Why We Need it More Than Ever" a book written by Cass R. Sunstein, Professor of Jurisprudence at Chicago School of Law, discusses how and why the Second Bill of Rights was never fully implemented in the United States (Tarvis, Dec. 13, 2006). Later, President Truman offered a national health program plan. He proposed a single system of health care that would include all American citizens. Truman's plan was denounced by the American Medical Association (AMA) and called a Communist plot by a House subcommittee (The Healthcare Crisis: Healthcare Timeline).
The whole "Communist plot" thing (the reason for this video on Upworthy, by the way) is a result of the Red Scare. The Red Scare (you can google Red Scare) was a period in our history that was extremely un-American. The government, as a part of the Cold War era, attempted to demonize the enemy (the Soviets / Communists) and initiated a nationwide witch hunt against anyone who held a particular belief in communist or socialist theories. This was a blatant violation of the Fourth, Fifth,Sixth, and Eighth Amendments to the U.S. Constitution---blatant and nationwide violations of the rights of American citizens. Accusing someone of being a Communist as if it is a bad thing is equivalent to accusing someone of being Jewish or Catholic like it is a bad thing. That is to say it is idiotic and reeks of bigotry.
Healthcare costs began to escalate rapidly in the 1950’s when hospital prices doubled. By the 1990’s the cost of healthcare rose at double the rate of inflation. This pattern continues today. Some of the increases were partially due to swift economic inflation or the expansion of hospital expenses and profits. Medicare costs contributed to the crisis because they were unexpectedly high for a number of reasons. Changes in medical care including greater use of technology, medications, and conservative approaches to treatment also ran up the bill. The refusal of government to pass legislature that would solve the legitimate healthcare needs of United States crippled the healthcare system. The system of health care developed with the underlying ethic that appropriate medical care would be expensive and only those Americans who could afford the high cost would be treated appropriately.
A freeze on wage and prices were placed on American employers during World War II. American companies found a loophole in the economic freeze by offering health benefits to employees to vie for the best job applicants; this practice brought about an employer-based health care system that still exists today. Private insurances came into being early on and by the 1960’s there were over 700 private insurance companies to encourage the high prices of medical care. It was at this time that it became especially difficult for Americans outside of workplaces that offer health insurance to afford medical care.
The changes in the health care system are important because as professionals within the system we must be aware of the impact health care reforms will have on our careers. As Americans we must be aware of the changes that are coming from a more personal perspective. On one hand, as a consumer I hope to benefit from health care reforms geared toward lowering the cost of medical care. On the other hand, as a healthcare administrator the reforms that lower the cost of health care might also increase the competitiveness of my career choice or decrease the average amount I will be paid in the future.
Despite the possible conflict of interest, I fully support President Obama's health care plan because I value the moral and ethical standard of universal health care. I also believe that universal health care is consistent with (if not required by) the inherent promises of a democracy. The health care industry deals with the most precious commodity, human life. The value of a human life is immeasurable for many people but the cost of health care resources may be expensive.
This policy would improve Medicare financing. According to the Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) it is “estimated that the act would reduce [Medicare] Part A outlays by $246 billion and increase HI [Hospital Insurance Trust Fund] revenues by $69 billion during the 2010-2019 period” (Congressional Budget Office, 2009, para. 5).
Nationwide access to health care is vital to the ethical and financial needs of the country because the right of universal health care is a part of the right to equal opportunities. Ethically and practically, universal health care preserves the health and success of the nation. In a speech presented to the 1936 Democratic National Convention Franklin D. Roosevelt said, “[l]iberty requires opportunity to make a living - a living decent according to the standard of the time, a living which gives man not only enough to live by, but something to live for” (Roosevelt, 1936, para. 17). It has taken many years to pass a national health care plan, so it is surprising that “most Americans favor a right to a job and a right to health care” (Sunstein, 2004, para. 24). The Health Care Reform Act of 2010 was sweeping legislation signed into law by President Obama providing the majority of Americans with access to medical care and reducing the cost of health care nationwide.
Health care resources are a sizable portion of the gross domestic product (GDP) of the United States. The problem is that the amount of money the United States spends on health care is as much or more than most countries in the world (Healthcare Spending in the United States and Selected Countries, 2011). The nation's spending on health careaccounted for "16% of GDP in 2008" (Healthcare Spending in the United States and Selected Countries, 2011, p. 4) and an estimate from 2006 states that health carespending will account for "20 percent of GDP by 2015” (Borger, 2006, p. W61). “The healthcare reform bill would mandate that most US citizens and legal residents purchase 'minimal essential coverage' for themselves and their dependents” (Grier, 2010, para. 5). For example, "[t]hose who are exempt, or under 30, can buy a policy that only pays for catastrophic medical costs. It must allow for three primary care visits a year as well" (Hossain & Quealy, 2010, para. 29). With the new reform bill, more individual will be covered, which will potentially lower the cost of medical bills.
“The federal government share of health care spending increased [...] in 2009 to 27 percent” of the National Health Expenditure (NHE) while household spending on healthcare made up 28 percent, private businesses 21 percent, and state and local government 16 percent of the NHE (NHE Fact Sheet, 2011, para. 1). Unfortunately, “[m]edical costs, out-of-pocket expenses, and the degree to which comprehensive health insurance coverage is available may have more to do with personal bankruptcy filings than does the lack of insurance coverage” (Brotman, 2006, p. 70-1). This information suggests that it is the out of pocket cost of health care, with or without medical insurance, that takes the heaviest toll on individual U.S. citizens.
Obamacare also includes measures to reduce and prevent fraud, specifically Medicare fraud. Recently, one of the largest health care fraud cases in the history of American medicine led to an arrest. Dr. Jacques Roy and his accomplices were arrested on February 28, 2012 for allegedly certifying and re-certifying Plan of Caredocuments for Home Health Agencies to bill Medicare for home health services that were neither necessary nor performed and fraudulently deprived Medicare "of nearly $380 million between January 2006 and November 2001" (Fink, 2012, para. 1). This arrest was in part made possible by President Obama's crusade to save our health care system. The PPACA would invest in prevention of Medicare fraud rather than following the “pay and chase” model (Wachler, Colagiovanni & Laney, 2011, p. 24). Health care fraud accounts for a significantly large amount of health care spending in the United States and reducing Medicare fraud is a goal of this policy.
I do have to mention one obvious drawback in the universal health care system: not enough doctors. The effect of expanding health care insurance to cover all United States citizens will be enormous. The current plan is to make health care as universal as possible but there is a risk that once everyone has the ability to go see a physician then everyone will go and there will not be enough doctors to handle the influx of new patients. Before the reform has even gone into effect the country is starting out with a shortage of primary care physicians: and when the reform goes into effect the shortage will become even worse. The demand for health care services will be high while the availability will be low which is a recipe for higher prices. Many doctors have already begun to change by becoming concierge doctors. This shift will widen the difference between the quality of medical care for the wealthy as compared to the quality of medical care for the poor. Yes, people will have health insurance coverage, but according to a November 2010 Physicians Foundation Survey so there is a concern that there will be many people paying for health care coverage without receiving care. To combat the shortage The cost of health care services may rise even with these provisions to increase the number of available doctors simply because doctors are not made overnight; it takes many years to complete medical school. The other possibility is that many states will be required by the sheer number of patients looking for care to allow more privileges to nurse practitioners so that the NPs can take the place of the physician in many cases.
References
Alban-Metcalfe, J. (2009). Decisive leaders: to be or not to be? International Journal Of Leadership In Public Services, 5(4), 50-52.
Borger, C., Smith, S., Truffer, C., Keehan, S., Sisko, A., Poisal, J., & Clemens, M. (2006).Health spending projections through 2015: changes on the horizon. Health Affairs (Project Hope), 25(2), w61-w73.
Brotman, B. (2006). The Relationship Between Medical Care Costs and Personal Bankruptcy. Journal of Health Care Finance, 32(3), 66-71.
Brooks, D. (2011). Convener in chief. The New York Times. Retrieved from http://www.nytimes.com/2011/06/28/opinion/28brooks.html?_r=1
Congressional Budget Office. (2009). Effects of the Patient Protection and Affordable Care Act on the federal budget and the balance in the Hospital Insurance Trust Fund. Retrieved from http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/108xx/doc10868/12-23-trust_fund_accounting.pdf
Fink, J. (2012). Rockwall doctor charged in biggest U.S. healthcare fraud ever. CBS News. Retrieved from http://cbsdallas.files.wordpress.com/2012/02/jacques-roy-indictment.pdf
Grier, P. (2010). The Christian science monitor. Retrieved from http://www.csmonitor.com/USA/Politics/2010/0319/Health-care-reform-bill-101-Who-must-buy-insurance
Healthcare Spending in the United States and Selected Countries. (2011). Medical Benefits, 28(11), 3-4.
Hossain, F., & Quealy, K. (2010, March 21). How the Health Care Overhaul Could Affect You. The New York Times. Retrieved from http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html?scp=1&sq=How%20the%20Health%20Care%20Overhaul%20Could%20Affect%20You&st=cse
Japan earthquake and tsunami (2011). The White House. Retrieved from http://www.whitehouse.gov/issues/foreign-policy/japan-earthquake-tsunami
King, D. (2008). One world, one heart. The Huffington Post. Retrieved from http://www.huffingtonpost.com/deborah-king/one-world-one-heart_b_141853.html
Maxwell, J. C. (2010). Everyone communicates, few connect. Business Book Review Library, 1-8.
NHE Fact Sheet. (2011). Centers for Medicare & Medicaid Services. Retrieved fromhttps://www.cms.gov/NationalHealthExpendData/25_NHE_Fact_sheet.asp
Roosevelt, F.D. (1939). A rendezvous with destiny. Retrieved from http://www.austincc.edu/lpatrick/his2341/fdr36acceptancespeech.htm
Silverman, F. (n.d.). PBS. Retrieved from http://www.pbs.org/healthcarecrisis/history.htm
Sunstein, C. (2004). Economic security: a human right. The American Prospect. Retrieved from http://prospect.org/article/economic-security-human-right
Tarvis, D. (Dec. 13, 2006.) American Politics Journal. Retrieved from http://www.apj.us/index.php?option=com_content&task=view&id=130&Itemid
Wachler, A.B., Colagiovanni, J. & Laney, C.J. (2011). One year later: the impact of health care reform on health care provider audits and compliance programs. Retrieved from http://www.michbar.org/journal/pdf/pdf4article1859.pdf
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