The Affordable Care Act (ACA), famously referred to as ObamaCare, was enacted in 2010 to make major reforms in the healthcare industry. Its primary aim was to deliver cheap and quality healthcare to all Americans while also cutting on Government spending on healthcare. It uses insurance exchanges, taxes, subsidies, and consumer protection regulations to achieve these goals. By 2015, nearly a quarter of Americans had acquired a healthcare insurance policy for less than $100 a year, and 87% of those who opted for a marketplace plan had received financial aid. Nevertheless, the bill still received a lot of criticism (Pipes, 2010). This paper outlines the nature of ObamaCare, how it works, its pros, possible cons, and the issues raised by critics.
Most Americans admit to saving a lot through the HealthCare.Gov portal and other qualified brokers. Essentially, ObamaCare came to rescue Americans from the lethal practices of some Insurance and Healthcare providers. Contrary to popular belief, it does not replace Medicaid, Medicare or Private Insurance but only regulates them. One of the changes ObamaCare brought is the fact that young adults can enjoy protection by their parent’s insurance plans until they are twenty-six years old. In fact, insurance companies are not allowed to deny anyone services due to their health conditions or gender. In addition, the companies are not allowed to effect undue rate hikes and small businesses that insure their employees are offered tax breaks.
Further, it completely wiped out annual and life-time dollar caps, gave consumers the ability to quickly appeal healthcare providers’ decisions, subsidized costs to enhance the affordability of healthcare, and made it compulsory for large organizations to insure their workers. It also made it mandatory for insurance firms to provide cover to those with preexisting conditions, enhanced the quality of care for seniors, provided coverage for emergency room visits, and gave kids easier access to the Children Health Insurance Program (CHIP). All these new protections, rights, and benefits represent the act’s embrace of a free market structure. In this case, it would be correct to state that the public and the stakeholders run the industry.
The free market structure appears to have saved Americans from the suffocations of socialist systems. When socialism thrived, hospitals would often resort to increasing charges to the few insured individuals to avoid running bankrupt. As such, they would not serve the uninsured free riders. The uninsured individuals would for sure also turn up in emergency rooms in seek of, for example, insulin. To even out these losses, the government would use taxes to pay for these costs and increase taxes in effect. Now, the ACA avoids this socialization of costs by ensuring that everyone is insured and only uses the taxes to make medical insurance cheaper by subsidization rather than paying the free riders’ medical costs (McLean &Appelgate, 2013).
Therefore, healthcare insurance providers find no need to unduly hike rates. The tax also will not be increased to pay for free riders. The new strategy has also improved the situation of the workers. Previously, the worker or their employer spent nearly $1000 on health insurance. It was that high because of the free riders’ bills, which increased the total cost to about $2000 a year (Pipes, 2010). Since the Act eliminated these free riders, the worker enjoys tremendous savings and since their personal premiums are also subsidized, is much cheaper for them today. Further, the money saved by employers may be used to effect a pay rise, hence raising the living standard of the American worker.
The ultimate benefit of the free market economy is its effect on prices and choice. Within minutes, a consumer can compare a long list of insurance options and their prices and choose the most appropriate to them. The platform used, HealthCare.Gov, has created competition, which has led to quality care at fair prices (Sorrell, 2012). Therefore, the free market enables self-interest to thrive. As people go about in pursuit of self-satisfaction and quality for their money, the service providers are compelled to improve their services.
The ACA brought forth a series of ethical issues. However, in 2012, the Supreme Court judgment, which upheld the authenticity of the act, provided guidelines on the ethical questions. Ethically, it is adequate to believe that a good healthcare system should be affordable, offer high-quality services, offer the freedom of choice to users, and be shared among citizens in a way that does not burden only a few individuals. However, controversy still exists given the varying priorities, beliefs, and values across different American populations. Happily, ACA has done a great job eliminating social injustices and creating an atmosphere where the most fortunate help the less fortunate to sustain an ethically upright and moral society.
The biggest ethical issue surrounding the act is the ‘death panel.’ There are suggestions that a panel of physicians would be created to decide whether some people, such as the old and those with Downy Syndrome, are worthy of healthcare services. A big critic of Obamacare, the former governor of Alaska, Sarah Palin, coined the term. Though it was promptly and aggressively discredited, it was one the things that made Americans anxious such as the death panel.Americans were upset that they would lose control of their healthcare decisions. However, it was decided that there would be a panel to hold face-to-face counseling discussions with patients about end-of-life decisions. This provision was later removed, but 40 percent of the American public are still scared of an upcoming “death panel” (Sorrell, 2012).
Another myth was that the act would hurt small businesses and also increase the national budget and debt. Contrarily, the extra expenditure, which was previously used on free riders, is now saved, and only part of it is used to subsidize insurance costs. Therefore, the budget is practically reduced and has reduced the healthcare expenditure by $575 billion by the year 2019 is on course. In regards to businesses, the ACA requires only businesses with more than 50 workers to insure their employees. Helpfully, businesses with fewer than 100 staff can offer the insurance via state-supported insurance exchanges and those with less than 25 workers can be offered tax cuts (Sorrell, 2012).
The financial implications of the act have stirred up effervescent revolt. Insurance companies continue to invent incentives to counter the act’s effect of reducing their profits. Despite delivering economic justice to citizens, the act faces criticism over its war on insurance companies’ supernormal profits. Recently, four big insurance companies tried to merge; Anthem with Cigna and Aetna with Humana HUM in the quest to maintain high profits. The mergers were a calculated move to ensure that customers who chose to shift insurance companies still found themselves within the same company and would still pay the same high prices. In addition, the companies were trying to reduce competition amongst themselves in order to manipulate the market to favor their interests (Matthews, 2016).
Private health insurers have also responded by avoiding the government-linked exchanges because of the possible lower profits. In 2014, a survey by McKinsey & Co. claimed that an average health insurer, which enrolled to the exchanges, lost an average of $2.7 billion that year, and the losses only compounded in 2015. The companies that were reported to be intending to pull out of Obamacare included Humana and Aetna, after failing to merge and loosing $1 billion and $140 million respectively. Another insurer, Texas Blues Cross parent company, claims to have lost $2 billion while Oscar claimed to have suffered a $105 million loss to ACA exchanges (Matthews, 2016). These reports are yet to be justified, but the fact remains that despite slightly interfering with the supernormal profits, Obamacare will deliver financial justice to both workers and owners of these companies (McLean &Appelgate, 2013).
Lastly, people question the government’s role in Obamacare. Critics have gotten citizens worried that the government is taking over the healthcare industry. They thought that the government would employ all doctors and dictate what they do. On the contrary, the government increased funding for healthcare insurance from 43 percent to 49 percent and still left more than half of the healthcare spending to the private sector. In addition, it regulated the healthcare industry to ensure fairness. Moreover, it eliminated racial, gender discrimination, reduced the cost of healthcare insurance and made it available to the poor.
For the first time, an effort to reform the healthcare sector has had “human rights” in mind. As with any new system, Obamacare is far from perfect. Nonetheless, it is the most important and change-making attempt by the Obama administration to reform the expensive, unfair, discriminative and inefficient healthcare system which America had (Reece, 2014). Access to good healthcare will no longer be considered a luxury or privilege. It is completely reflective of the dreams that the likes of Franklin Roosevelt and Martin Luther King Junior nursed about equal access to healthcare for all, despite their color or social stature. It is thus adequate to conclude that through Obamacare, healthcare in the US is bound for the better.
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