The Importance Of Healthcare Reform

Healthcare Reform: It’s a right, not a privilege. New words are coined all of the time. There is one that spread like wildfire when President Barack Obama was first elected, “Obamacare,” also known as The Patient Protection and Affordable Care Act. This has been one of the prime issues during the last two elections because it is basically performing a radical and invasive surgery on our current health care system. Basically this entails extending affordable and same health insurance options to all American citizens that their government has by mandating a tax be paid every month for. During the last decade healthcare has become a lucrative industry that all types of businesses and hospitals have been built around. Obamacare threatens this
structure as it aims to turn healthcare into as normal a right as having fire or police protection, rather than a retail product available to few Americans. The benefits of this healthcare reform will not be seen immediately, but President Obama is integrating a plan that will slowly shift the way healthcare system is run. Most health care takes place in the tertiary phase, which is when diseases and illnesses have reached their absolute worst due to poor preventative care. The long-term goal is to shift this into primary care that focuses on preventative measures by being able to receive regular check ups, consultations, and
Williams 2 education as needed. Some would argue that Obamacare could eventually lead to a higher percentage of healthier citizens, but unfortunately America’s citizens are still very divided as to whether or not the Presidents plan is worth the wait. The Patient Protection and Affordable Care Act (PPACA) was signed into law by Barack Obama on March 23rd of 2010, and is scheduled to take full effect in 2014.
It is the most significant regulatory overhaul of America’s healthcare system since Medicare/Medicaid (Wikipedia). According to the U.S Department of Health and Human Services, part of the new “Patient Bill of Rights” includes making it illegal for insurance companies to discriminate against people with pre-existing conditions (Healthandhumanservices.gov). The Health and Human Services website also states that Americans will be able to purchase insurance through the Affordable Insurance Exchange where they can compare plans and choose the best fit for themselves and families, rather than being offered only one kind of insurance by an employer (Healthandhumanservices.gov). The Act also allows states to require insurance companies to justify premium increases and bans a yearly cap on what can be spent on healthcare per year for an individual. As well as, eliminating co-payments for contraceptives, mammograms, colonoscopies and other annual basic preventative care measures for all age groups. There will also be tax credits given to small businesses for providing insurance to employees. There will be a sharp decrease in the number of uninsured citizens, which would decrease the overall costs of health care in
the
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Controversy also springs up around issues of money distribution and a individual mandate. In 1994, the Congressional Budget Office issued a report describing an individual mandate to buy insurance as “an unprecedented form of federal action” (Healthandhumanservices.gov). Many states even joined litigation in federal court arguing the power to ‘regulate’ commerce does not include affirmative power to compel commerce by penalizing inaction in 2010 (Healthandhumanservices.gov). At this rate citizens will have to pay an annual penalty fee if they opt out of paying the monthly tax. The economic and financial turn that the PPACA will induce is one of the primary concerns of everyone from the restaurant industry, insurance companies, to clinics and hospitals. By law it restricts insurance companies to alter rates based on pre-existing conditions therefore forcing insurance companies to set rates to cover costs. The worry is that this puts healthy individuals under economic pressure to opt out of buying insurance, which will increase rates until the insurance company markets collapsed. Although this is more of a concern to the majority of the Republican Party, according to the Obama administration, mandated insurance is intended to prevent this downfall (NPR). It is also projected by the Congressional Budget Office that this will lower future deficits and Medicare spending (Healthandhumanservices.gov). Money for new healthcare will be funded by a variety
of taxes according to sources at Politico.com “...increases on Medicare tax by 0.9% and impose added tax of
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3.8% on unearned income for high income tax payers” (Politico.com). There will be an annual fee on health insurance providers and makers/importers of brand names drugs estimating a staggering 87 billion dollars, as well as decreases that will aid in helping to pay for government funded healthcare such as a Medicare home health care and certain hospital payments (Politico.com). Overall the goal is to have the currently uninsured covered. The few groups who will not be covered are illegal immigrants-- as they will be exempt from health insurance mandate but will be eligible for emergency room services-- and young and single citizens not covered by parents and opting to pay penalties (US Business Weekly). No matter which party one sides with, it seems inevitable that all of America will notice the financial fluctuations in one way or another. Given the controversial mandate and threat of more economic upheaval, public opinion of PPACA has shifted significantly over time from general support to opposition since it was signed in 2010. According to a public opinion poll published in an October issue of TIME Magazine, “56% of Americans are against Obamacare and 44% are for it. Even though a majority does not support PPACA, 82% of citizens favored banning insurance companies from denying coverage to people with pre-existing conditions, while 61% favored young adults staying on their parent’s coverage until they turn 26 years old. Additionally, 72% supported requiring companies with more than 50 employees to provide insurance” (Healthcare Reform and American Politics,113). Much of the opinion
Williams 5 will depend however on factors such as adequate advertising of health exchange rates, availability, and speed of websites and services to sign up when it is put into action in 2014. Public opinion will continue to be split until the Obamacare is carried out and everyone buying into it (or paying the penalty) experiences the effects of having healthcare at all times. History has shown us that it is perfectly natural for people to have strong reactions in regards to governmental policy. There has not been as big of a reform in healthcare since the Medicare/Medicaid act was signed into law in 1965. Terms such as communism and socialism were thrown around lightly due to the fear that these two programs could bankrupt the country. Healthcare reform has been an ongoing fight for over 70 years (Glenn Beck’s Common Sense, 55). In 1912 social and health insurance were endorsed in the platform of the Progressive Party and espoused by candidate Theodore Roosevelt (SocialSecurity.gov). In 1918 the American Medical Association passed a resolution stating principles to be followed in government health insurance plans, and in result the first federal grants to states for public health services were made (SocialSecurity.gov). Come 1932, a committee on costs of medical care endorsed group practice and voluntary health insurance, which is still the main system used today. Around this time the American Hospital Association leading to the establishment of Blue Cross and Blue Shield approved private hospital insurance. With similar significance, the Federal Emergency Relief
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Administration provided emergency medical care to the needy, which is still the primary mode of healthcare for all citizens today without health insurance despite whether or not the injury or ailment is defined as a ‘true’ emergency. One of the last major mentions of government-sponsored healthcare was in 1944, when Franklin D. Roosevelt outlined in his state of the Union message the ‘Economic Bill of Rights’ including “the right to adequate medical care and opportunity to achieve and enjoy good health” (Healthcare Reform and American Politics, 37). A sincere sentiment to be sure, but no specific recommendations were made. Inaction occurred again in 1947 and 1949 when President Truman requests to Congress that a National Health Program Hearing be held. Unfortunately, the true proceeding did not take place until 1965 when President Johnson signed Medicare--as a part of the Social Security Amendment--into law. Now in 2012, we are at the beginning of another action that we will ultimately have to wait to see what plays out. On the bright side of healthcare, our newly re-elected President and representatives have wasted no time putting the Obamacare plan into action. According to news source The Guardian, as quickly as November 23rd, 2012, “Obama brought in a grassroots team to cut a deal on the fiscal cliff concerning tax increases, spending cuts, and its corresponding reduction in budget deficit in 2013 to implement problem solving strategies” (Gaurdian.com). He basically called on his campaign team to spread word about looming deadlines when the
Williams 7 fiscal cliff will hit the nation. The president also relies on his campaign team and it’s expansive network to make it known that he is working with leaders of both parties in Washington to reduce deficit in a balanced way so we can lay the foundation for “long term middle class job growth” and prevent everyone’s taxes from going up substantially. Specifically, this balance will be achieved through tax cuts for 98% of the population, eliminating tax cuts for the wealthy and cut other national budget spending by $3 trillion (Healthcare Reform and American Politics,103). On top of these challenging problems, solutions need to be signed into law quickly as the Senate has already passed a bill to keep taxes low and are waiting for the House to pass it to Congress which will then circle back to the President. The framework concerning this bill has been unfruitful due to both Republicans and Democrats relaying their disagreement in their standard party policies, with little leeway for compromise. One major issue according to Politico website is that Republicans want to freeze Bush era tax cuts that included the wealthiest and cutback welfare programs (Politico.com). However, this may be a matter of the two sides negotiating positions before moving forward. Either way, the looming issue is that if the reform is to be fully implemented by 2014, it will involve huge increases in spending and reducing federal deficit that must be discussed and understood thoroughly. Overall Obama says he views health reforms as eventually contributing to reduction in care costs, which is inline with healthcare moving from emergent to primary and preventative. Williams 8 While everyone is going to be affected, hospitals are also undergoing tremendous changes concerning spending. They will push hard on the states they are in to create exchanges and expand Medicaid. Politico reports that States have until mid December to tell Health and Human Services whether they will be running their own exchange (Politico.com). Doing so puts more of the law into the State’s hands thereby hopefully mitigating the common idea that law is just a ‘federal government takeover.” Hospitals are also working on the problem of how to cover all of the uninsured patients they treat under a new law that will make it more difficult to receive money from Medicare. The assumption about the new law is that fewer people would go to the emergency room once they actually have insurance. Nationwide hospitals have already agreed to cuts in the Affordable Care Act, “so we have to make those work,” says Rick Pollack, executive vice president of the American Hospital Association (Huffington Post). Pollack continues to claim, “we think we have made all of the contributions we can make. . . that’s our view.” Medicare Payment Advisory Commission recommends making hospital outpatient and doctor office visits equal which is estimated to save $10 billion over 10 years (Huffington Post). Much of the costs of hospitals depend on whether or not they are safety net hospitals. These hospitals treat patients with increased health risks who live in places where access to traditional doctors offices are limited and are many of the poverty population’s primary means of care. Specialized hospitals with outpatient clinics
Williams 9 can treat diabetics, COPD, heart disease and other common chronic conditions with extensive-but costly- emergency care (Huffington Post). Hospitals may not need to spend so much on one patient if people began receiving regular care throughout their lives. Although many people claim victory for the Affordable Health Care Act passing, others are skeptical and in search of loopholes within the plan itself. Author and popular conservative Glenn Beck states in his book ‘Glenn Beck’s Common Sense’ that “the new healthcare reform is not sustainable from a financial standpoint (20). Coverage plans with employers will quickly fade into obscurity since penalty for not providing insurance is far less costly than premiums employees currently pay. This will lead to a larger number of people needing insurance through the government which will end up paying more than they should for basic insurance” (21-22). Beck continues on claiming that $575 billion in Medicare payment reductions to Medicare providers will cause more and more physicians to stop seeing Medicare patients, which could exacerbate problems for regular healthcare checkups (22-25). Although, the government my end up spending more, work is being done to balance the budget in other areas so that a collapse will not happen. According to one poll on the Huffington Post, doctors want to call for repeal of Obamacare and “that 64% of MD’s said they are in favor of repealing and replacing this signature piece of legislation because it fails to address tort reform.” Tort reform concerns issues relating to regulations
Williams 10 surrounding malpractice and lawsuits (Huffington Post). There are also claims that the government will have too much control over doctor decisions as payments will be made not on quantity anymore but by value, quality reporting requirements and government run effectiveness boards. Conservative party members report that nearly half of all physicians are seriously considering leaving practices resulting in an obvious severe shortage of doctors. However, it is still only speculation because little is known about what the surveys will ask about a doctor visit, and patients may not necessarily put stock in government issued surveys anyway. Beyond the concerns of having inadequate funds for basic healthcare, many religious groups are equally flustered that funds will be given to mandate contraception since it is now covered in the reform as well. In this case they are providing the public a choice to use contraceptives and not attempting to enforce it as law. Many citizens are still upset that they have to be mandated to pay for anything in the first place. Paying extra for a service should not be a new concept to anyone, especially the people who have ever been a part of the workforce. It appears that no matter what sides of the fence people are on, or if they are still on it: changes elicit concern and of course fear. Both of which are natural human responses, which will inevitably change once the healthcare reform is implemented and the changes slowly become the norm. Justice Scalia hit the problem on the head in NPR’s transcript of the Supreme Court Health reform
Williams 11 hearing: “You 're not regulating health care. You 're regulating insurance. It 's the insurance market that you 're addressing and you 're saying that some people who are not in it must be in it and that 's — that 's the difference from regulating in any manner commerce that already exists out there.” Through my research, and collective experiences of family, friends and myself concerning basic physical and mental well being, the negativity Americans have against PPACA is strongly rooted in the money they stand to lose as a business or taxpayer rather than the health they and their families can stand to gain by resting assured that no matter what their economic situation, they will have not an option, but a right to heal. In the same transcript from NPR, Chief Justice Roberts said, “When you need health care the government will make sure you get it. Well, when you need police, fire or ambulance assistance the government is going to make sure to the best extent it can that you get it.” President Obama is not aiming to put a Band-Aid on an evisceration, he is setting up a system that will have citizens utilize the healthcare system to keep themselves educated and cared for before a small preventable issue snowballs into a blizzard. Given enough time and money, citizen’s concerns and hospital’s concerns will equalize and primary healthcare will be as normal and expected as a turkey on Thanksgiving. In my humble opinion, it is better late than never to make simpler access to healthcare more than just a privilege, but a right as a human being.

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