For a long time, the social status of Americans has been a key consideration for determining the quality of care that patients receive. Different presidents have tried to come up with healthcare policies that aim at reforming the system and ensuring all residents in the U.S. have access to quality and affordable care. President Barrack Obama came up with the Affordable Care Act (ACA) in 2010 that faced a lot of criticism at initial stages. The planners fully implemented ACA in 2014 (St. Onge, 2015). ACA encompassed all the previous efforts by expanding Medicaid coverage, increasing availability of healthcare services, and reduction of out-of-pocket expenditure, among other arrays of benefits. ACA has its pros and cons to the economy and health outcomes, and it has been the topic of discussion among Americans since its inception.
Position in Favor of the Policy
The Affordable Care Act has allowed lower- and middle-income earners to access affordable and quality care services. Upon ACA implementation, over 20 million uninsured Americans got health insurance covers, which saw an approximate reduction of $350 million in the annual out-of-pocket expenses. Through ACA, private insurance companies can no longer deny people access to affordable insurance premiums due to pre-existing chronic conditions such as hypertension and diabetes (Esper et al., 2015). The policy protects Americans with chronic diseases from paying more than healthy individuals. On implementation, ACA saw millions of children, including legal immigrants covered under the Children’s Health Insurance Program (CHIP). Expansion of the Medicaid program under ACA to provide affordable coverage options to more low-income Americans has tremendously reduced the individual patient expenditure on medication. The requirement by ACA that all health insurance plans cover preventive health screenings has further lowered the mortality associated with chronic illnesses, especially cancer due to early screening. According to the Congressional Budget Office, ACA reduced the federal and state expenditure on medication between 2010 and 2019 by $143 billion. Sommers et al. (2017) believe that making preventive care affordable is the main contributor to healthcare cost reduction. The authors base their argument on early screening and diagnosis of diseases to avoid development of chronic illnesses.
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Furthermore, ACA through Small Employer Health Care Tax Credit requires business owners to provide insurance covers for full-time employees. The government supports the employers by taking care of almost 50% of the insurance premiums for the employees. Full implementation of the policy might help reduce further the number of uninsured Americans and make healthcare accessible (Gardner, 2016). The policy further rewards healthcare workers who provide quality services and those who go out of their line of duty to promote patient health and recovery. These provisions are bound to reform the healthcare sector in many ways. Lower-income Americans, as the main target, would obtain insurance covers, making them eligible to afford quality care (Esper et al., 2015). People living with chronic conditions would have improved quality of life due to the availability of the required medications.
Position Against the Policy
ACA moves the healthcare system from a patient-centered format to government-owned. Such a system reduces innovation and competition that helps to maintain and further improve the quality of care. Sommers et al. 92017) found out that most people are not opposed to the ACA policy, but they are afraid of the economic implications. The authors base their findings on the overall cost of full implementation of the ACA policy estimated by CBO at $2.5 trillion in ten years (Sommers et al., 2017). Such an extra amount incorporated in the federal and state government budgets would certainly have financial liability implications on the economy. The ACA policy would reduce competition among insurance firms leading to higher premiums and deductibles to cater to the provision to protect the chronically ill. Medicaid cost is as well bound to increase to cover preventive care and children. In the long run, the policy might become unaffordable to the government due to the increased amount of revenue required. Such a trend could lead to a breakdown of the national healthcare system due to a lack of innovation, competition, and subsequent poor health services.
One of the provisions of the policy is a requirement for small business owners to provide insurance covers for their full-time employees. Employers could easily avoid policy requirements by employing workers on a part-time basis to avoid being responsible for their health insurance. The introduction of fines for those who are not insured might end up increasing opposition against the policy, which could further worsen the implementation process (Sommers et al., 2017). Several new taxes created could raise the tax rates to provide enough revenue for the implementation process. With time, high tax rates could end up increasing the number of policy opponents making the implementation process difficult.
Argument in Favor of the Policy
ACA, commonly known as Obamacare, has expanded Medicaid, CHIP, and preventive care, thus making healthcare services affordable and accessible. As a result, more Americans would most likely end up seeking screening and medication services. In the process, it would reduce the cost of drugs and lower the rate of preventable illnesses such as cancer that have greatly impacted our society. With ACA, the rich would pay more taxes to fund the program, thus decreasing income inequality and ensuring people have access to quality services without worrying about the high cost of medication. Centralized healthcare would provide the government, through its various health organizations, to collect adequate medical data for proper planning of health sector development projects (Sommers et al., 2017). Patient health records help in deriving insights into the trend of health and diseases that impact people in a particular region and plan accordingly to address the issue using well-informed decisions and solutions.
Obamacare has introduced policies that ensure accountability and strict regulation of the premiums charged by insurance firms. Shifting control of the insurance firms to a central government would ensure equality and accessibility of care despite the financial or medical background of an applicant. Through ACA, patients with chronic conditions can now easily access medical care, routine screening services such as blood sugar and pressure determinations, and prescription medication without spending anything directly from their pocket (Sommers et al., 2017). Consequently, the policy has improved patient compliance and positive health outcomes that have greatly reduced the cost of medication to the government. The government loses a lot of revenue due to chronic illnesses that leave millions of American working-class bed-ridden due to preventable diseases (Gardner, 2016). Arguably, ACA has an array of benefits ranging from making healthcare affordable to improving health outcomes for Americans suffering from chronic conditions.
Argument Against the Healthcare Policy
ACA, as healthcare policy, does not address all the various functions of the economy that implementation of the policy might impact. The planners of the policy did not adequately address the issue of raising funds to finance the implementation process of the program. Opponents of the ACA plan believe that it would increase the taxation rates with minimal or no positive impact on the health systems. The planners of the ACA policy suggested the introduction of a wealth tax that would see wealthy Americans and business corporations funding most of the costs of the ACA implementation process (Jung & Tran, 2016). The burden of poor people should be the responsibility of the government and not a few rich individuals. Targeting the rich as the source of funds for the program is among the main reasons that President Donald Trump promised his supporters to repeal the policy once he takes office.
The introduction of a tax penalty for people who do not enroll in an insurance plan was a forceful plan that many Americans disliked. According to the ACA individual mandate, Americans, unless they qualify for an exemption, should have health insurance coverage or pay an annual tax penalty (Jung & Tran, 2016). Republicans considered this provision a controversial aspect of the program. With the assistance of President Trump, they got rid of the tax penalty, making it not mandatory for the Americans to enroll in insurance plans if they do not want. The success of the ACA implementation process depended on the reception of the Americans. The planners were supposed to come up with robust plans for resourcing funds to finance the policy. However, they depended on the tax payers which forced more Americans to oppose the policy due to financial implications. The ACA policy is capital-intensive and using taxation to fund the project could not be sustainable the moment an administration opposed to the project takes the office. It explains why President Trump’s administration started removing some of the functions of the ACA policy.
Anecdote and Evidence Arguments
Argument by Anecdote
ACA policy has reduced patient flexibility. Provisions of insuring patients with chronic illnesses have led to issues of under-insurance, limiting consumers on the quality and extent of care they could receive (Jung & Tran, 2016). For instance, a patient with chronic obstructive pulmonary disease (COPD) once came to the facility. I was doing my rural experience at the hospital. However, he never received adequate care because his insurance was not comprehensive to cover all the respiratory tests required. A few months later, he came back coughing blood. His condition was worse than the previous time, and I was assigned to look after him. I learned that he had lost his job and acquired a cover that he could afford, which did not cover many medical services. The man failed to get adequate medical attention, just like many Americans who still cannot afford the comprehensive plans due to high premiums. The premiums rose rapidly after President Trump removed the penalty tax for those who are uninsured.
Argument by Evidence
President Barrack Obama wanted a healthcare system that would ensure every American has access to quality care services. The current system was too costly for both the patients and the government. The private hospitals and insurance companies were controlling the rates of medical costs and set premiums that favored their businesses. The annual cost of medication was taking up over 15% of the budget, amounting to about $2.5 trillion (Sommers et al., 2017). The government was spending a lot on medication errors, preventable chronic conditions, and on wages and salaries of caregivers. Implementation of ACA could reduce the cost medication by more than 65% in 10 to 20 years after application (Gardner, 2016). Economically, implementing the ACA policy was the only solution to curb the ever-rising cost of healthcare.
References
Esper, G. J., Hartung, D., & Avitzur, O. (2015). The patient protection and affordable care act and chronic neurological illnesses: Benefits and challenges. JAMA neurology , 72 (7), 739-740. https://doi:10.1001/jamaneurol.2015.0273
Gardner, D. B. (2016). Election 2016: Where are we with the affordable care act? Nursing Economics , 34 (5), 251.
Jung, J., & Tran, C. (2016). Market inefficiency, insurance mandate, and welfare: U.S. health care reform 2010. Review of Economic Dynamics , 20 , 132-159.
Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health - what the recent evidence tells us. The New England Journal of Medicine , 377 (6), 586-593.
Sommers, B. D., Maylone, B., Blendon, R. J., Orav, E. J., & Epstein, A. M. (2017). Three-year impacts of the Affordable Care Act: Improved medical care and health among low-income adults. Health Affairs , 36 (6), 1119-1128. https://doi:10.1377/hlthaff.2017.0293
St. Onge, J. (2015). Health care reform as “socialized medicine”: The formative years of a political myth. Western Journal of Communication , 79 (3), 348-366. https:// doi:10.1080/10570314.2015.104165
