By Tom Hebert
One of the most hotly debated issues in the American political landscape today centers around the Patient Protection and Affordable Care Act, colloquially referred to as both the ACA and Obamacare. The ACA, passed by the 111 Congress and signed into law by President Obama in late March 2010, is the most gargantuan overhaul of the American healthcare system since President Johnson signed Medicare and Medicaid into law in 1965. The arguments for and against Obamacare are very much divided along party and ideological lines, with liberals generally supporting the ACA and conservatives feverishly opposing it. The overtly partisan divide that generally accompanies Obamacare created great waves of disagreement in Congress, with the most recent government shutdown engendered by an attempt by House Republicans to defund the act to undermine several of its crucial provisions. With the advent of the first Republican Senate in eight years, the ACA looks like it will be run through the mill once more.
Financial implications are inherent within any sweeping legislation like universal health care. There are two major funding models that are used to varying degrees around the world to pay for universal health care. The ACA is based on a model called compulsory insurance. Compulsory insurance is the equivalent of a government mandate to buy health insurance. This is enforced by legislation in which people can incur fines and penalties for not purchasing health insurance. In Obamacare, people who failed to purchase insurance by May 1 of this year had to pay a tax penalty. One of the only circumstances that this penalty can be avoided is if the income of the applicant is so low that they are not required by law to file for taxes. Another model of funding for universal health care is called single payer. Single payer health insurance is a system in which the government settles all costs from health insurance, as opposed to health insurance being paid for directly by the insurers. The government gets the money from a fund that US citizens pay into through taxes. The taxes paid in a single payer healthcare system effectively replace the premiums that were paid for by private insurers. Proponents of a single payer health care system argue that this is a cheaper alternative to privatized healthcare in that insurers are free from paying for the overhead costs of health insurance companies, therefore paying less through a tax than they would through an insurance premium.
The ACA has come under fierce opposition from many people, mostly conservatives, who typically value personal responsibility over government intervention. A major result of Obamacare is the introduction of new taxes. In order to compensate for the tens of millions of people who have recently been insured, new taxes on high-earners have been introduced. The Affordable Care Act has also increased patient demand. With an increase in the amount of insured Americans, the usage of health benefits has also increased. With the increased usage of health benefits, a shortage of healthcare professionals, longer waiting lines, and crowded emergency rooms are inevitable. Another effect of Obamacare is that it is an overly complex law that is rife with red tape, regulations, and confusion. A recent poll by the Kaiser Foundation shows that 47% of people view the law unfavorable, while 35% view it in a favorable light. It can be argued that the initial confusion over the ACA has waned, but a majority of people still view the law unfavorably. Some view it as a complicated and unnecessary addition to an already complicated and ancient health care system, and resent the fact that the government has mandated that they purchase health insurance. Also, insurance premiums have increased as a result of more people having insurance. This puts considerable stress on small business owners who provide health care for their employees, but fail to qualify for the aforementioned tax credits and government subsidies.
There is a solution to the health care issue that plagues this country. It is imperative that we look after the most vulnerable in our society first, and people that lack any kind of health insurance are definitely the most susceptible to massive debts that they simply cannot afford to accrue. The first step is obviously to repeal some key portions of the Affordable Care Act that put undue stress on the lower class, such as the individual mandate. The second step would be to implement catastrophic health care coverage for every eligible citizen. Doctor visits don’t kill the family budget; unforeseen and gigantic medical problems are bankrupting the lower class and the uninsured. If a medical problem in the family becomes too costly or expensive, the government should be there to incur a substantial portion of the costs, or all of the costs are deductible.
Finally, allowing people to buy insurance across state lines would drive down costs as well, making insurance more affordable for all. These simple changes would drastically improve the Affordable Care Act. It is imperative that we make these changes before it is too late.