Obama Care Controversy. Advantages and Disadvantages
On March 21, 2010, the US Congress approved the healthcare reform currently known as Obama Care. In fact, Patient Protection and Affordable Care Act has become one of the most large-scale projects in US history since the mid-1960s. The reform has been an initiative of the US President Barack Obama is considered to be one of the main achievements of his presidency. It has been the first attempt to reform the US health care system as well as help pensioners and the poor since the 1960's after the creation of Medicare and Medicaid programs. However, despite the positive intensions of government, currently Obama Care has the controversies being the issue of the various debates in the US. Taking into account the mentioned above as well as current situation in health services which require reformation, the following paper is aimed to provide the analysis of advantages and disadvantages of Obama care based on the methods of analysis and comparison of the recent scientific publications. In addition, the paper will provide the recommendations regarding the further development of the US health care system.
Conceptual Framework & Key Findings
Over the last 30 years the US has been characterized by the disproportionately increase of the health care costs without any objective prerequisites for the improvement changes in the quality of services. Over the last decades, the cost of insurance per employee more than doubled, while much of the population remains uninsured and the proportion of such people is growing. The insurance market provided by employers has been very monopolized, decreasing the mobility of labor and creating the discrimination of patients both before and after the conclusion of the insurance contracts. In addition, the ever-growing cost of Medicare and Medicaid has become one of the reasons of the US budget deficit. It means the US medical system has been characterized by the inefficient interaction of public and private sectors. Despite the fact that the state allocates huge sums in the industry, it has not had effective levers of control over the prices and costs of services and drugs. As a result, the medical and health care services turn out to be prohibitively expensive. Many poor people can not pay for it so that they can not be protected by the state. The US has been one of the few developed countries without universal health insurance system.
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The introduction of Obama Care has been aimed to overcome the mentioned issues and reorganize the national health care system. The key element of the reform implied the obligation of the US citizens to purchase health insurance if they are not insured based on the provision of the low-income subsidy. In addition, the reform has been aimed to improve the conditions of health insurance of the citizens who already had the insurance. According to the Patient Protection and Affordable Care Act, starting with the January 1, 2014, employers and their insurers can no longer be able to deny the provision of the health insurance to the employees or increase premiums for it in case of the confirmation of the serious chronic diseases of the employees (eg, AIDS, cancer etc). In other words, Obama Care established the possibility to get a policy for those who are unable to obtain insurance from the employers. The citizens can buy insurance without the help of employers in the specially created for centers with the administrative liability for those who refuse to purchase and companies that refuse to sell the policy. Since 2014 these penalties for the citizens have been estimated as $ 95 or 1% of revenue, and will gradually increase to $ 695 or 2% of revenue. It also implies the improvement of the medicines supply system for the elderly citizens. As a result, insurance coverage should cover 95% of the population compared to 84% in 2011.
The reform is expected to create additional 400 thousand of work places. It will be possible to reduce the cost of the individual patients and to invest more money into medicine. There will be also new taxes for the wealthy citizens and the pharmaceutical companies in the amount of $ 409.2 billion by 2019. Within the next 10 years, the reform is planned to reduce the budget deficit by $ 138 billion and another $ 1.2 trillion in the following decade. According to the authors of the bill, the effectiveness of the system as a whole will increase. Only the reduction of the administrative costs for insurance companies will be able to free up $286 billion.
Due to the fact that the reform implies an increase in government regulation, relying on powerful government apparatus at the federal level and the variety of budget spending, the reform itself as a whole and its individual provisions and / or stages in particular have been repeatedly sabotaged by the representatives of the Republican Party, which controls the US House of Representatives. However, from October 2013 to June 2014, the number of adult Americans who have health insurance increased by 10 million people.
The advantages of Obama Care imply the following:
- About 50% of uninsured Americans are able to get a low or even free health insurance through their National Health Insurance Marketplace, and many millions will be covered at the affordable price. The coverage is standard for both genders and no one can be excluded from the coverage even due to sickness or genuine mistake in the application process.
- Medicaid has been raised to include about 15.9 million people, including children who have not reached the poverty level.
- The State Children's Health Insurance Program has been extended to cover up nine million children.
- Small businesses can obtain loans of up to half of the premium cost of insurance for their employees.
- The young people under 26 years old are eligible to be covered by their parents plan.
- The pensioners received improved services to include the elimination of Medicare coverage gap, resulting in lower interest rates and extended preventive services.
- The plan of health insurance led to a decrease in total expenditure on health of the population.
The disadvantages of Obama Care include the following:
- To facilitate the plan, new taxes have been introduced, which directly affect high income population especially the individual mandate and the mandate of the employer.
- The expansion of the Medicaid, which follows from the plan, is carried out by the states, rather than across the country. Some states have decided to maintain the status quo, which may be an imbalance in the entire US population.
- There has been an increase in the current value of insurance premiums due to the fact that the fear of authorities requires providing the covered services.
- It is noteworthy that the big picture of Obama Care is based on the attention to all the citizens and their insurance coverage, but it is not focused on the result of the costs of care.
In addition, it was reported on October 28, 2015, 75% of Americans lost their coverage because they do not meet the standards of Obama Care. More than 1.5 million people received notice of cancellation insurance. Christopher Conover, Researcher the Center for Healthy Policy Inequalities at Duke University, said that by the end of 2016 by 50 million. Americans will lose their current insurance plans. According to the Congressional Budget Office (CBO), up to 93 million people can lose insurance coverage because of Obamacare.
Recommendations & Conclusions
The mentioned pros and cons of Patient Protection and Affordable Care Act known as Obama Care prove that it has the variety of the weak sides. Thus, it is recommended to revise the currently accepted program to assure the further efficient development of the US health care system. It is recommended to provide the changes which refer to the interests of the insurance companies as well as to the interests of the less protected citizens. The authorities should consider the program weakness to meet the interests of both people and private sector. Unfortunately, the current program still can not meet the interests of the whole population. The key goal of the updated Obama Care policy should refer to the establishment of the high quality medicine affordable and available to each US citizen.