Category: the business of health care

Life, Liberty, and the Pursuit of Health Care

update January 1, 2026

Since writing this post almost 10 years ago, I have done several updates and related posts. I recommend you read this more recent version and the one that follows. Keep exploring the Heart of health.

from 1776 to 2020-a vision for a “more perfect Union”

The United States’ healthcare system combines public health efforts with mostly private delivery of health care. Usually they coexist side by side with some but infrequent interaction. The public health emergency created by the pandemic forced them into a “union” that quickly became politicized, and unfortunately diminished the effectiveness of the response.

Keep reading

Even though the United States does not officially have “socialized” health care, a large proportion of our medical care is funded by the federal government. Even though I know that, I was still surprised by statistics in a recent article, which stated that  the federal government accounts for

  • 40% of healthcare  spending
  • $1.3 trillion /year

(stats from 2016)

Through 4 federal agencies

  • Department of Health and Human Services 
  • Department of Defense
  • Veterans Administration
  • Department  of Homeland Security

(JAMA (Journal of the American Medical Association), June 21, 2016)

The  United States Congress passed the Patient Protection and Affordable Care Act (ACA) in 2010 to guarantee basic health insurance to all citizens.  People who oppose the ACA ,aka Obama Care, dislike or even fear government involvement in medical care; they consider it interference, control, or even nationalization of the United States healthcare system.

a Veterans Administration clinic
a Veterans Administration clinic (photo by Dr. Aletha)

I think many people, even physicians, don’t realize or forget, how involved the government already is in healthcare. As far back as the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system evolved into the current military health care system which covers service members and the Veterans’ Administration system for veterans.

American soldiers serving in Afghanistan
American soldiers serving in Afghanistan

2015 marked the 50th anniversary of two other government healthcare programs- Medicare and Medicaid.

Medicaid provides insurance coverage for adults and children who are unemployed or low income.

Medicare covers disabled children and adults  and persons 65 years and older.

wheelchair-749985_1280
Disabled children and adults may qualify for Medicare.

The numbers are rather staggering.

  • Together these programs cover at least 30% of Americans.
  • Together they comprise 25% of all federal spending.
  • Together they pay 40% of total U.S. health care spending.

An infographic from the Kaiser Family Foundation and JAMA explains this further.

hospital-79605_1280
Children may be eligible for Medicaid if their families cannot obtain health insurance for them.

You may not be eligible for either of these programs now, but chances are eventually you or someone close to you will.

  • Anyone can become disabled from a serious illness or freak accident.
  • You or your spouse may lose your job and your employer sponsored health insurance.
  • Your child may have a disability that will prevent them from working when they grow up.
  • We may all live long enough to qualify for Medicare on the basis of age alone.  Your parents or grandparents are near or already at Medicare age.
Senior adults age 65 and older use Medicare.
Senior adults age 65 and older use Medicare.

It’s important to understand how Medicare works, since it’s not automatic; even if you qualify, you need to sign up to be covered (with a few exceptions). The rules are summarized here. Or consider an easy to understand book here. 

Several government agencies regulate, monitor, promote and/or support  both public and private healthcare through the Deparment of Health and Human Services and other agencies.

Food and Drug Administration- FDA
Centers for Disease Control and Prevention- CDC
National Institutes of Health- NIH
President Joe Biden visited the NIH
Occupational Safety and Health administration-OSHA
Drug Enforcement Agency-DEA

Congressional laws that regulate health care

 The Affordable Care Act- ACA
Health Insurance Portability and Accountability Act-HIPPA
Emergency Medical Treatment and Labor Act- EMTALA
Health Information Technology  for Economic and Clinical Health- HITECH
Americans with Disabilities Act-ADA
Family Medical Leave Act-FMLA
LIFE, LIBERTY AND THE PURSUIT OF HEALTHCARE

Sharing the HEART of health

In the Declaration of Independence, the founders of the United States created a nation based on the “self-evident truths”  of  “Life ,Liberty, and the pursuit of Happiness” as well as to promote “Safety and Happiness” . 

In the Constitution they vowed to “promote the general Welfare”.

I wonder if they envisioned that government would eventually spend so much timet and money providing and regulating health care, most of which was not imagined at that time? 

I appreciate your time reading this post and invite you to follow this blog and me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha

Expert Predictions about 2026 Health Policy

In this post I review some 2026 healthcare predictions for likely continuation of partisan gridlock, minimal congressional action, and increased focus on health care affordability amid midterm elections. Key issues to watch include ACA enrollment responses, Medicaid work requirements, rising insurance costs, and the impact of AI on consumer health care navigation.

Aletha Cress Oglesby, M.D.'s avatar by Aletha Cress Oglesby, M.D.

From the O.R. to the Oval Office- 3 Docs Who Ran- Part 2

This concludes a two part series about physicians who ran for U.S. President in 2016.

Updated August 6, 2026
Here is the link to Part 1

Benjamin Carson, M.D., Republican

These notes about Dr. Carson are taken from his 1992 autobiography

Gifted Hands: The Ben Carson Story
Gifted Hands: The Ben Carson Story
  1. Dr. Carson’s mother, Sonya, one of 24 children,  married at age 13 ;her husband abandoned her when Dr. Carson and his brother were young boys. An uneducated illiterate woman, she taught herself to read, and required her sons to read books weekly.
  2. While he was growing up, his family depended on food stamps to have enough to eat.
  3. At age 8, after hearing a missionary doctor speak at his church, he decided to become a physician.
  4. He had such poor vision, he was almost legally blind. His grades improved when he started wearing glasses.
  5. As a teenager, he had such a quick and fiery temper, her feared he might kill someone.
  6. Both he and his brother were in JROTC while in high school; his brother served in the Navy during the Vietnam War.
  7. In high school he played clarinet and developed a love of classical music, something he would share with his future wife Candy.
  8. He chose to attend Yale over Harvard, because Yale beat Harvard in the GE College Bowl television program.
  9. During college he worked at the Ford Auto plant and at Chrysler.
  10. He and Candy lived in Australia for one year so he could train in neurosurgery there- and his first child was born in Australia that year.
  11. His third child was born at home- and he did the unplanned, quick delivery while his mother dialed 911 for help.

Neurosurgical Notes

Neurosurgery is the surgical specialty that deals with the nervous system, including the brain and spinal cord. Long before Dr. Carson became involved in politics, he was known for his pioneering work in brain surgery. He discusses this work in his autobiography, which was also made into a movie of the same name. In the movie Cuba Gooding Jr. played Dr. Carson.

Dr. Carson specialized in two difficult and dangerous types of surgeries.

In hemispherectomy  half of the brain is surgically removed as a treatment for severe, intractable seizures. It is only used as a last resort, is not always successful and can cause paralysis on one side of the body. Dr.Carson was known as an expert in this surgery.

Conjoined or Siamese twins joined at the head are rare, occurring in 1 in 2 million births.

“In 1987, Carson attracted international attention by performing a surgery to separate 7-month-old occipital craniopagus twins in Germany.

Patrick and Benjamin Binder were born joined at the head. Their parents contacted Carson, who went to Germany to consult with the family and the boys’ doctors. Because the boys were joined at the back of the head, and because they had separate brains, he felt the operation could be performed successfully.

Gifted Hands movie
Gifted Hands- The Ben Carson Story movie version starring Cuba Gooding Jr.

Randall “Rand” Paul, M.D., Republican

“Paul officially announced his presidential candidacy on April 7, 2015. Within a day of his announcement, Paul raised $1 million.[221]Paul announced the suspension of his presidential campaign on February 3, 2016, shortly after the Iowa caucus, where he finished in fifth place.[233]

Paul supports repealing the Affordable Care Act[378] and opposes universal health care, having once equated it to slavery.[379] Paul says he instead favors expanding health savings accounts and providing a $5000 tax credit, allowing health insurance to be sold across state lines, and allowing individuals and small businesses to pool together to purchase insurance. His plan would provide a two-year window during which people with pre-existing conditions could not be denied coverage.[380][381][382]

Paul announced on March 22, 2020, that he had tested positive for COVID-19 amid the ongoing pandemic of the disease. He was the first member of the United States Senate to test positive.[414][415] Paul received bipartisan criticism from his Senate colleagues after it was discovered that he attended Senate lunches and used the Senate gym while awaiting his test results; he defended his actions because he had no symptoms of the illness and believed it was “highly unlikely” he was sick.[416] On April 7, 2020, Paul announced his recovery.[417]“

source:Wikipedia,https://en.wikipedia.org/wiki/Rand_Paul

Exploring the HEART of Health

I appreciate your time reading this post and invite you to follow this blog and me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha