TheSignificance of the Affordable Care Act
Healthcare is now considered a critical element in sustainable development.Indeed, this perspective is plausible because a failure to provideequitable care would be accompanied by different health problems thatwould rob the society of the resilience and capacity to pursuesustainable development. In acknowledgment of this view, variousgovernments of the world are committed to embracing health carereforms to align with sustainable development (Eibner, Hussey &Girosi, 2013). Parts of these changes are evident in the case of theUnited States. For instance, in 2010, President Barrack Obama signedinto law the Affordable Care Act, a health care reform statute alsoknown as Obamacare. This act is regarded as the most significanthealth care overhaul since the 1995 Medicaid and Medicare reforms.The main objective Affordable Care Act was to increase theaffordability, as well as the quality of health care insuranceschemes. It also sought to lower the uninsured rate through expansionof the coverage of private and public insurance for the government,as well for individuals. Several mechanisms for realizing the goalswere introduced, and these include the insurance exchanges,subsidies, and mandates, which were purposed at increasingaffordability and coverage. The act stipulates that all the insurancefirms should cover all their clients unconditionally (Buchmueller,Carey & Levy, 2013). Obamacare legitimizes the expansion ofgovernment authority over individuals, insurers, hospitals, employersand doctors. It created the allowance for the establishment of over150 new bureaucracies, commissions, agencies, and programs to governhealth care. The government authorities possess the power to dictatemedical practices and health insurance, specifying the benefits thatworkers and employers should be entitled. In the cases of lack ofcompliance, tax penalties would be imposed. The Obamacare alsoredistributes premium incomes to the insurers (Blumberg, Buettgens,Feder & Holahan, 2015).
Althoughthe act was objective, it has been a subject of debate regarding itsability to deliver desirable outcomes. Recently, President Trump andhis supporters attempted to abolish the act in the premise that itdoes not achieve the desired social, health, and economic outcomes.The efforts fell through. However, such a scenario only awakens thediscussions regarding the legitimacy of the Affordable Care Act. Thispaper explores the contributions of the act in the American society.
TheSupporting and Opposing Premises of the Act
Inexamining the successes of the Affordable Care Act, it is firstimportant to review some of its goals and the opposition concerns,for these would serve as the points of evaluation on whether thepolicy has benefited the society. In introducing the Affordable CareAct, the Obama’s government was aimed at addressing different formsof disparities experienced in health care delivery. The policy washinged on the basic human rights principles such as the kindenvisaged in the Universal Declaration of Human Rights that everyindividual has a right to decent living, which includes access toessential welfare privileges such health care. Secondly, entitlingpeople the right to health care would be a way of pursuingsustainable health care development and provide an opportunity torise above the social and economic barriers. This step essentiallymeant that every individual would be able to access the health careat an affordable cost and be treated for different forms ofcomplications, giving them an opportunity to be constructive tosocial and economic development. In part, the policy was informed bythe fact that the cost of health care had significantly gone up, withas significant as 62 percent of budgetary expenditures directed onmedication (Hall & Lord, 2017).
However,the policy was met with opposition on different grounds. Apart fromthe view that the government does not have the mandate to guaranteehealth care for every individual, the advocates were concerned thatthe policy could increase taxes and the cost of living. Secondly,given the rich would also be entitled the affordable care, theeconomic disparities between the rich and the poor would widen.Additionally, there were concerns that the act would raise the demandfor health care, resulting in overstretching of resources because thehealth care would be readily available to everyone. These limitedresources will limit incentives for health care facility investmentsin services and technologies. This scenario implies a reduced numberof citizens would be in a position to access advanced technologiessuch as CT scans and MRI (Goodman, 2014).
Theopposition was also concerned that Obamacare would increase taxes foreven the poor people. In particular, the government would impose newtaxes, amounting to over 500 billion dollars within 10 years ofimplementation. Some of these taxes were expected to cumulate inrising health care costs and insurance premiums, which are passed tothe patient seeking the health care services. The opposition wasconcerned that even with the allowance of subsidies, the process ofacquisition of the high costs of insurance will have a significantimpact on the payrolls of the working population, ranging from 2.8percent for low-income workers, to about 10 percent for those withrelatively higher incomes. The penalty for failing to act incompliance with the Act is $695 per family member and can go as highas $2,085 in one year. This penalty measure applies to everyone anddoes not consider the levels of income. The taxes are a contraventionof the pledge by President Obama that people with income less than250,000 per year would not be taxed. Obamacare would also beaccompanied by increased deficits. This strategy is likely to createa deficit of about 3 trillion, which could lead the nation intobankruptcy (Koff, 2013).
TheImpact of the Affordable Care Act on Americans
Havingexamined the objectives of the policies and the concerns ofAffordable Care Act evidenced by the time of implementation, it isnow of particular interest to question what really became of thepolicy several years down since its implementation. Several questionsare worth considering: Has Obama care delivered the intendedoutcomes? Has the Policy increased Health care costs? Hasthe Obama Care Short-circuited the innovations? The answers to thesequestions are addressed as follows.
HasObamacare Delivered the Intended Outcomes?
Severaldiscussions have pointed out that Obama Care Act has played a crucialrole in assuring equitable care to the citizens, especiallyindividuals with low socioeconomic status and marginalized minoritiessuch as the Latinos. Besides, the Obama care has increased insurancecover for American communities. The law has succeeded in reducing theuninsured population from 18 percent to 9 percent. The policy hasincreased the health insurance to about 9 million (Hall & Lord,2017). Certainly, these are positive results. Part of the remainingchallenge now is how to continue reducing the proportion of thepopulation without an insurance cover.
Hasthe Policy Increased Health Care Costs?
Therewere concerns that the Obamacare would result in soaring costs ofhealth care. In particular, the gains associated with enhancedcoverage would motivate insurance companies to increase the cost ofhealth care. The insurers would raise the rates to keep abreast withthe market operation demands. The requirements for the health careservices would increase following the incentives obtained from thethird-party payment schemes, as well as from the government and theinsurers (Mark & Goodman, 2013). However, since itsimplementations, these feared scenarios have not been evidenced. Thecosts of health care have remained more or less the same. The demandhas also not exerted excessive pressure on the available resources,and insurers have not raised their health cover rates (Hall &Lord, 2017). The market changes not affecting the insurance company’sprofitability and prices, too. If only, the prices for the insurershave remained remarkably low.
Theopposition was also concerned that Obamacare would cause thegovernment health care rationing. They were worried that thegovernment, in striving to prevent escalating costs of health care,would adopt health care rationing scheme. It was feared that thiswould start with restricting the resources allocated to hospitals anddoctors through implementing cuts to finance the guaranteed care.This scenario would have involved creating a democratic butunaccountable and independent Medicare Advisory Board to exercise thecuts. The opposition was concerned that the restrictive paymentpractices would be adopted by the private insurers and this wouldeventually spread the impact to individual consumers and the rest ofthe health care system (FamiliesUSA, 2012). However, in contrast, these concerns have not happened.Nevertheless, certain forms of dynamics of the market that havesignificantly affected the medical practice, for instance, limitingthe networks of insurance to fewer providers and requiring thepatients to pay more for the costs of treatment from their pockets,have accompanied the health care act.
HasObamacare Short-circuited the Innovations in Health Care?
Theopposition was also concerned that the approach would short-circuitinnovations. Obamacare would disillusion private investment ofdeveloping new drugs and medical technologies. Instead, thegovernment would use limited resources to sustain the promisedaffordable care. As the health care technology investments decline,the citizens would not be able to benefit from innovations. Theserationing approaches would worsen over time (Henry J Kaiser FamilyFoundation, 2013 Blumberg, Buettgens & Feder Holahan, 2012).However, there is no evidence that the implementation of Obama Carehas short-circuited innovations. If only, the trends in research andinnovation practices have remained the same. The government costshave not increased too.
Inconclusion, the primary aim of this paper was to explore thecontributions of Obama Care on the United States’ social andeconomic development. The analysis has shown that, to some extent,the affordable care act has played a crucial role in improving thehealth and wellbeing of the American communities, especially peoplewith the low socioeconomic status and the marginalized. In contrastto the concerns of the oppositions, the policy has not resulted inincreased insurance rates and medical cost. To a certain extent, itseems part of the challenge for Obama Care is how to increase the 100percent insurance cover and access to health care. Nevertheless,another inherent limitation is limitingthe limiting the networks of insurance to a limited number ofproviders and demanding the patients to pay more for the costs oftreatment from their pockets.
Certainly,these are the key areas that need to be addressed. Therefore, theequitable and affordable care could be efficiently delivered withoutvarious elements of Obamacare. Indeed, these reforms can be actuallyachieved through the expansion of the patient control over healthcare, while reducing the government overly authority. An alternativeapproach would entail repealing all the 159 created bureaucracies,boards, agencies, programs, and commissions in Obamacare. Such a stepwould go a long way in reducing the federal taxes and expenditure byover 1 trillion dollars, cutting down the deficits by eliminatingunnecessary costs and regulation while expanding choices for healthcare consumers and providers.
Certainunnecessary regulations in health care should be repealed. The rulesinclude guaranteed issue, mandated benefits, and the certificates ofneed and prompt pay laws. The interstate sales of health insuranceshould also be allowed. This position follows that, to a certainextent, the state regulations of health insurers has created barrierswithin each state, so that consumers cannot purchase insurance out ofstate. The costs are likely to reduce if customers are allowed toacquire insurance of from other countries since states would now bepressurized to repeal coverage mandates considered unnecessary.
Themedical entrepreneurship should be encouraged. The state and Federalregulations should be reconsidered to eliminate barriers againstspecialty hospitals, medical tourism, opening health clinics, andtelemedicine. These developments are expected to reduce health carecosts while expanding services. Medical malpractice liability shouldalso be reformed. Traditional standards of torts should be enforced,creating an allowance for hospitals and doctors to takeresponsibility for damages in which they are the cause. Large,medium, and small civic associations, businesses, trade unions shouldbe allowed to establish own market-based insurance exchanges to offermembers and employees the competitive cover choices.
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