The modern type of living in the United States has not only been beneficial to the Americans; it has also resulted in various health issues. The various health issues, according to the US Centers for Disease Control and Prevention (CDC), are as a result of modern eating habit which has made unhealthy foods common. The United States residents are the highest consumers of unprocessed and unhealthy foods across the world. Despite the knowledge of the danger of these foods, most Americans are less active – most do not exercise. Consequently, the number of overweight or obese Americans has increased. CDC indicates that a third – 1 in 3 – adults in the United States are obese. Another third are overweight. CDC reports that obese and overweight conditions have resulted in far-reaching health consequences. It has led to increasing in the number of Americans suffering from heart disease, type 2 diabetes, high blood pressure, stroke, liver and gallbladder disease, arthritis, particular cancers, respiratory problems, and abnormal menstrual period and infertility in women. It is not only the adults who are suffering from the conditions; also the children affected have been continuously increasing. In fact, CDC reports that about 17% of the children in the United States are either obese or overweight leading to various disease conditions. According to some health professionals, the children suffering from conditions are at higher risk for social and psychological problems such as low self-esteem and discrimination.
According to Koh and Sebelius (2010), these conditions have resulted in increased medical cost in the United States; both the federal government and the Americans affected. In fact, the duo (Koh and Sebelius) says that health care system cost the federal and state governments over 3 trillion dollars annually and this is still on the rise. Compared to other developed countries, the United States spends relatively more on medication per person. It is evident that the Health Care System of the U.S. requires immediate intervention. As the cost of healthcare is increasing and becoming high every day, most Americans are failing to afford it. Those who are in dire need of healthcare end up being bankrupt and getting deeper into debt. This consequently increases the United States deficit. As this happens, the health insurance companies have increased their rates of insurance due to the high cost of medication. Also, they have restricted some people like those with chronic conditions from acquiring medical cover. Private healthcare corporations, on the other hand, continue to rake more profits at the expense of Americans health conditions. Many health practitioners have described the entire system as "the health care crisis of the USA."
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The extent of the Health Problem
Research conducted by CDC (cited by Koh and Sebelius, 2010) indicates that the health care costs in the United States have increased by 10%. Today, CDC reports that health costs in the country increases by 18% annually (Stoddart & Evans, 2017). According to the United States health practitioners, the trend is as a result of lack of universal health care system that allows only a single payer who would enable the Americans to benefit from the lowest possible health care costs. Koh and Sebelius (2010) say that without a one-player system, most health facilities set their prices without regulations and standard provisions. The states and the federal government have failed to come up with policy and a long-lasting plan to regulate prices charged by the private healthcare providers.
Apparently, every American citizen and other residents of America are affected by the problem of high cost of healthcare provision. According to recent survey studies, over 30% of American adults and more than half of the children population have no access to primary care doctor (Stoddart & Evans, 2017). Concerning the health care crisis, residents with low- or middle-level income are the most impacted because they cannot afford the high insurance packages thus end up paying from pocket their medical bills which are very expensive (Protection & Act, 2010). This happens despite thousands of Americans living with lifetime chronic conditions like diabetes, hypertension, arthritis, gout, which require daily medication. However, in 2010, President Obama signed the Affordable Care Act, also known as the Obamacare, which was intended to help all the Americans.
Analysis of the Affordable Care Act of 2010
The Affordable Care Act of 2010 was formulated and signed into law by President Barrack Obama. It is divided into two acts namely Patient Protection Act and Affordable Care Act (Protection & Act, 2010).
Goals
The Obamacare was implemented with a goal of reforming both the healthcare and the health insurance corporations of the United States. Since its inception on March 23, 2010, ACA remained the policy of the health care system. The ACA aim is to ensure that over 44 million Americans that are uninsured have an access to quality and affordable health care in both private and public institutions regardless of the health cost.
Another main objective of the Obamacare was also to ensure that all the Americans who could not access medical coverage due to their health status could easily access health care. The ACA policy was designed in such a way that people already covered do not have to worry about their insurance covers dropped when they become sick. Also, because of the tax breaks and incentives provided, ACA enabled the small business employers to get insurance coverage for their employees (Protection & Act, 2010).
Some of the sub-goals identified under this act were:
To move the private healthcare domain into the public market and ensure that all public hospitals provide quality and efficient services (Protection & Act, 2010).
To improve access to health insurance coverage and workforce in the United States health care system.
To improve public health care by preventing medical errors and caring for the Americans suffering from chronic conditions.
To involve the communities in the provision of support and assistance services.
To protect Americans against discrimination due to gender and sexual orientation during healthcare process.
To realize free maternal, free birth control, and free emergency visits
Policy and Legislation
The bill that was brought to the House and Congress in 2009, was signed into a law on March 23 rd, 2010 and upheld by the Supreme Court on June 28 th , 2012. It was supported by most of the Democrats and is recognized in the American Constitution as The Patient Protection and Affordable Care Act (PPACA) which people commonly refer to as Obamacare (Protection & Act, 2010). Democrats and most Americans support Obamacare because it has enabled every American to access insurance cover without health restrictions or gender discriminations. Since most business enterprises in the U.S. have more than 50 employees, most workers support the policy because they get to be covered by their employers at no cost. Stoddart and Evans (2017) say that large portion of American population earns less than $45,000 annually thus are unable to afford proper medical care, as such, they feel that Obamacare is a blessing to them.
Despite the numerous benefits accrued to the Americans by the Obamacare, there are flaws on which the critics of Obama have dwelt on to ensure the policy is repealed. During the presidency of Obama, Republicans in the House of Representatives and those in the states tried to undermine the policy by not abiding by the plan. Most of the Republicans felt the Obamacare was inadequate and costing the country billions of dollars (Stoddart & Evans, 2017). Today, Republicans led by President Donald Trump have considered revising the Obamacare because of a number of reasons. In fact, they feel it should be scraped off. According to the Republicans, ACA imposes high costs on businesses. They indicate that the most affected are the Private institutions which the Republicans say run the American economy. Republicans and private institutions also indicate that Obamacare has failed to control healthcare costs which it was intended to do. They say that the insurance companies have increased their cover costs even higher, for instance, insurance companies are charging high premiums to cover individuals with pre-existing medical conditions. Private healthcare institutions have also been forced to charge higher fees because of the high tax imposed on them with an aim of controlling them.
Implementation of Social Welfare or Health Program(s)
Since the implementation of the Obamacare numerous health programs has been realized.one of such programs is the insurance coverage program. This program requires that everyone be health-care covered. According to Uberoi, Finegold, and Gee (2016), this program has helped reduce the number of uninsured in the United States by about 8% since its inception in 2010 – from 17% to 9% in 2016. The number of Americans who are able to afford health care has increased as a result of the program. However, as a result, the insurance companies have raised their premiums for people with medical conditions thus increasing government expenditure in terms of subsidies. Consequently, this has resulted in higher taxes which affect all the United States residents irrespective of whether they are suffering from a condition or not.
Another program is the employer mandate. This program requires that all businesses with more than 50 employees ensure all their workers. In fact, most employees on full-time occupation have since been covered by their employers successfully incurring zero costs (Protection & Act, 2010). Smaller businesses, on the other hand, were provided with subsidies to take cover for their workers. This program has, however, resulted in the loss of jobs across the United States. Most small businesses are trying to reduce the number of full-time employees below 50, as a result, the rate of laying off has increased immensely. The number of people employed part-time, on the other hand, has increased. Reports also indicate that the number of working hours for full-time employees have also been reduced by the employees below the time frame indicated in the ACA policy. The policy indicates that any person working 30-hours a week are considered full-time employees.
Another program is the expansion of the Medicaid cover to cater for more unemployed low- and middle-level income earners Americans. This program has seen over 15 million Americans getting adequate and quality medical care whenever they need it. However, this program requires funding which comes from Federal and State governments. As such some states failed to take part, especially the Red States. As such the program has left millions of poor Americans without means of accessing quality medical care (Uberoi, Finegold & Gee, 2016).
The other program is the Children’s Health Insurance Program (CHIP). This program requires that children are treated at low costs or even free. The program, just like the Medicaid expansion cover, requires government funding which consequently raises taxes. However, it is important to note that the program has seen more American kids getting covered.
Legislative Intended Impact
While implementing the Obamacare, the Democrats led by President Obama expected that the plan will reduce the healthcare crisis – the high costs of medication, the high number of Americans without cover, high chronic disease costs among others – that was gradually growing in the United States. The president and many Americans expected that ACA will ensure all Americans can afford medical costs despite their financial backgrounds (Protection & Act, 2010). Also, the team expected that the health insurance coverage to the lower- and middle-income Americans was going to be made affordable and accessible. Also, the administration expected that ACA would reduce wasteful expenditure in public health facilities since this was one of the factors causing high government expenditure on the healthcare departments.
The programs implemented as a result of the ACA was to ensure that all the Americans, irrespective of age, gender, race, income, health status, were all taken care of. Essentially, all Americans were affected: The unemployed, low- and middle-income workers were able to get health insurance coverage and afford proper medical care (Protection & Act, 2010); Children and youths up to the age of 26 years were able to be covered under their parents’ insurance plans; Small business employers were able to get subsidies and get insurance coverage for their workers; employees working in small firms were also able to cover by their employees at no cost.
There were also negative expected impacts of the legislation and policy. For instance, insurance companies and larger businesses with more than 50 workers were to be affected negatively. These institutions were to experience high costs of operation so as to abide by the regulations of the Obamacare. Stoddart and Evans (2017) indicate that the federal government expected to lower the cost of health care; however, they were unable to achieve this due to manipulations and high costs by the insurance companies and private healthcare corporations.
Actual Impact (Conclusion)
As of March 2015, Obamacare was costing US$1.35 trillion which is much lower than the over US$3 trillion that was being spent before implementation of the policy. Most of the expenditure is for funding marketplace subsidies, small business employer tax credits, expansion of Medicaid and CHIP (Uberoi, Finegold & Gee, 2016). On the other hand, ACA has enabled health insurance to be affordable to all Americans by subsidizing the premiums (Protection & Act, 2010). The plan improves healthcare provision by focusing on preventive care and quality treatment. Comparatively, expenditure from the government has decreased hence the taxation is relatively lower compared to the times when the plan was not there. The problems in the American healthcare system are too complex to be eradicated by one law. However, Obamacare has shown great positive impact in the sector to an extent that some critics of the policy have admitted that the plan has saved significant lives despite the cost of medication remaining more or less the same.
Statistically, the healthcare crisis that existed earlier before the implementation has been reduced by the Affordable Care Act of 2010. The rise in health care cost has decreased with the inception of ACA. For instance, in 2004 the average increase in the cost of medication was 4% while in 2016 it dropped to 1.2 % (Uberoi, Finegold & Gee, 2016). By raising the age of a child legible as being covered to 26 years, over 3 million previously uninsured young people in the U.S. were covered. By imposing more taxation on higher income families and larger business enterprises, the federal government has been able to reduce the cost of medication by more than 50% (Protection & Act, 2010). As a result, the budget deficit of the nation is projected to have reduced by US$143 billion by 2022. The hallmark of the plan is that millions of Americans that were previously uninsured have secured health insurance coverage and they are able to afford quality medication.
Despite the benefits of the Affordable Care Act of 2010, there are some unintended consequences that arose in the process of implementing the policy. Over four million workers in the nation lost their employment-based health insurance because the employers found it cheaper to pay the penalty other than covering their employees. In fact, larger businesses raised their cost of operation in order to take health cover for their employees. Similarly, many Americans found paying of the tax to be cheaper than taking insurance coverage. Also, many people evaded tax paying and thus, the budget set by the Congress was not met (Uberoi, Finegold & Gee, 2016).
References
Koh, H. K., & Sebelius, K. G. (2010). Promoting prevention through the affordable care act: New England Journal of Medicine , 363 (14), 1296-1299.
Protection, P., & Act, A. C. (2010). Patient protection and affordable care act: Public law , 111 (48), 759-762.
Stoddart, G. L., & Evans, R. G. (2017). Producing health, consuming health care: In Why are some people healthy and others not? (pp. 27-64). Routledge.
Uberoi, N., Finegold, K., & Gee, E. (2016). Health insurance coverage and the Affordable Care Act, 2010-2016 : Washington (DC): Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.
