April 15, 2017
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The Patient Protection and Affordable Care Act, dubbed “Obamacare” is the current system that was put in place by the Obama administration. According to a Washington Post – ABC survey, Americans are closely divided on repealing the Affordable Care Act, 46 percent in support and 47 percent opposed. There are many benefits, but also problems to be found within the Affordable Care Act (ACA).
One of the ways that the ACA gets funded, is through individual mandates, which means that everyone in America is required to buy insurance, or pay a penalty. This system was implemented as to avoid the “free rider” problem, and end the cycle of people avoiding insurance until they get sick. The Act also does not cover illegal immigrants, and denies them subsidies.
Individual mandates are one of the most criticized aspect of the ACA, Republicans cite this as an example of socialism, which would undermine our republic and capitalist system, as we are forcing citizens to incur the costs of others. This is socialism in the sense that everyone chips in, but some people benefit from the system more than others.
This tax system is the structure that supports universal healthcare in Britain, known as the National Health Service (NHS). CNN reports that citizens in Britain pay as much as a 50% income tax and 20% sales tax. According to Kaiser Health News, some people can be exempted from the insurance requirement, because of financial hardship or religious beliefs or if they are American Indians, for example.
There is also an “employer mandate” in the ACA. Businesses that employ 50 or more people but do not offer health insurance to their full-time employees, pay a tax penalty if the government has subsidized a full-time employee's healthcare through tax deductions or other means. This encourages more businesses to give healthcare to their employees, or risk paying tax penalties. However, those opposing the ACA argue that this employer mandate would cause employers to favor part-time employment over full-time employment. This would mean, permanent jobs would diminish, as employees and replaced would be fired so that businesses can avoid paying tax penalties.
The ACA would require everyone to be guaranteed “essential health benefits.” Healthcare.gov lists these essential health benefits as, doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy, childbirth, mental health services, and more. This would also include accessible health care for women, such as approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity. But states can't use federal tax credits and subsidies to offset the cost of abortions. Religious institutions would be exempt from mandate if they choose.
To convince private insurance companies to jump into the ACA market, programs such as the “risk-corridor program” were implemented. According to the New England Journal of Medicine, “For 3 years — from 2014 through 2016 — the Department of Health and Human Services (HHS) would cover some of the losses for insurers whose plans performed worse than they expected.”
This was to also create more competition, as to not turn healthcare into a monopoly and so citizens would have more options on healthcare. Unfortunately, it did not go as planned, Congressional Republicans "railed against" the program as a 'bailout' for insurers. The ACA ended up eliminating the risk-corridor program, prompting lawsuits from companies that did not get the funds they were promised.
The ACA also prevents patients from paying unaffordable fees. The Blue Care Network states, “An out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services. Once you've reached your out-of-pocket maximum, your plan begins to pay 100 percent of the allowed amount for covered services.” preventive care, vaccinations and medical screenings would not be subject to copayments or deductibles.
Though the jobs of doctors are to improve the health of their patients, many choose to keep them ill as to make a profit from them in the form of government subsidies. Kaiser News Health states that “One of the main ways the Affordable Care Act seeks to reduce healthcare costs is by encouraging doctors, hospitals and other health care providers to form networks that coordinate patient care and become eligible for bonuses when they deliver that care more efficiently.”
If doctors are motivated by financial bonuses to treat patients more effectively, this would mean that under the ACA, less people would be left ill.
Ultimately, we as citizens have the right to advocate for healthcare reform and have the government provide the best foundation for universal healthcare, so that everyone, whether rich or poor, old or young, can have access to the tools they need to live out the American dream.