The U.S. health care delivery system is often described as a kaleidoscope, puzzle, or patchwork quilt to emphasize that health care delivery in this country involves multiple, loosely coordinated components, and does not function through one integrated system (Shi & Singh, 2015). The organization of this “system” has a significant impact on the delivery of services. As a health care administrator, it is important to understand how the health care industry has been shaped over time and the various factors that influence health care delivery today.

To prepare for this Discussion, select one legislative act from the list below:

  • 1937 Social Security Act
  • 1946 Hill-Burton Act
  • 1965 Social Security Amendments (Medicare/Medicaid)
  • 1973 Health Maintenance Act (Managed Care)
  • 1983 Introduction of Diagnostic Related Groups (DRGs) by Medicare
  • 1986 Emergency Medical Treatment and Active Labor Act (EMTALA)
  • 1986 Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • 1996 Balanced Budget Amendment
  • 1996 Health Insurance Portability and Accountability Act (HIPAA)
  • 2006 Medicare Part D Drug Benefit
  • 2006 Massachusetts (Chapter 58) and Vermont (No. 191) legislation to expand health coverage for state residents
  • 2010 Patient Protection and Affordable Care Act (PPACA)

Review the information about your selected legislation in this week’s Learning Resources, including the chapters of the Shi and Singh text (2015). Conduct additional research using resources available in the Library and on credible websites. As you research each legislative act, identify historical events or circumstances that brought about the need for that legislation, and examine the positive and/or negative consequences that followed the implementation of each act.

Post by Day 3 a substantive and cohesive response to the following:

  • Analyze the historical events or circumstances that created a need for the legislative act you have selected.
  • Describe the legislative act and analyze how it has influenced the U.S. health care system.
  • Evaluate positive and/or negative consequences that arose following implementation of the act you have chosen.

Support your posting and subsequent responses to your colleagues’ postings by identifying and explaining key points and/or examples presented in the Learning Resources and other credible sources.

General Guidance on Discussion Posts: Your original post, due by Day 3, will typically be 3–4 paragraphs in length as a general expectation/estimate. Refer to the Week 1 Discussion Rubric for grading elements and criteria. Your Instructor will use the rubric to assess your work.

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