The Affordable Care Act (ACA) is a law that was signed by President Obama on March 23, 2010, to make healthcare affordable to all American citizens universally. The legal concept behind the introduction of the law was to provide insurance coverage for over 50 million individuals that are uninsured and are facing the extremely higher costs of medical services. This follows the previous increase in healthcare expenditures that reached $2.6 trillion by 2010, which represented a significant percentage of the gross domestic product (Ho, 2011). Additionally, the government, trough the ACA, strives to improve the quality of care for the insured citizens and to reduce costs and educate citizens on financial compensation. Based on an ethical point of view, the ACA aims at providing topnotch quality health care that assures citizens of the greatest good. This would give patients freedom of choice and enable them to make health care decisions regarding who, where, and when. Consequently, the health care system will become affordable; thereby, enabling citizens to share medical costs as well as benefits of care.
Both the ethical and legal aspects of the ACA tend to provide justice to US citizens to ensure the provision of quality health care to all without compromising the fundamental rights of even a few. This is why the provisions of the act are at the forefront of expanding insurance coverage, controlling costs, and targeting prevention. Generally speaking, the relationships between legal and ethical aspects of the ACA have significant impacts on cost containment. For example, the coverage expansions led to a predictable increase in expenditures directed towards health care. Although the coverage expansion eased access to health insurance by millions of citizens, the Medicaid expansion increased costs by about 5.3% four years after its introduction.
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Although the Medicaid expansion program remains controversial, there is a plethora of evidence showing that it has achieved its goals. For example, the number of uninsured US citizens reduced from 48.6 million to 28 million six years after the ACA. Consequently, the rate of uninsured fell by 16% and 9% in 2010 and 2016 respectively (Jost, 2019). Access to and utilization of care have equally improved. This is evident in the current quality care services in relation to the country’s reduced medical debts. Patients have also experienced a significant reduction in out-of-pocket medical expenditures and cost-based needs (Stabile, et al., 2013). A typical case of cost containment is Germany’s introduction of out-of-pocket payments that were intended to reduce health care costs. The country demanded 2% of the household income and 1% for the case of citizens with chronic diseases (Stabile, et al., 2013). Additionally, Germany eliminated user charges in healthcare settings that relied on hospice care. Fortunately, the country further expanded entitlements to cater for individuals with dementia during long-term care.
Reference
Ho, V. (2011). The Affordable Care Act: A New Way Forward. AMA Journal of Ethics: Illuminating the Art of Medicine . https://journalofethics.ama-assn.org/article/affordable-care-act-new-way-forward/2011-11
Jost, T. S. (2019). American Bar Association. Human Rights: Health Care in the United States and the Affordable Care Act. https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/healthcare-in-us-aca/
Stabile, M., et al. (2013). Health Affairs. Health Care Cost Containment Strategies Used In Four Other High-Income Countries Hold Lessons For The United States. Bethesda: Health Affairs. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2012.1252
