U.S. Healthcare Reform

Since the inception of Social Security spearheaded by Franklin D. Roosevelt in 1935, Democrats had desired to include some government health insurance plan for those who could not afford coverage (New York Times, 2011). Historically, insurance companies were notorious for creating barriers for insures who had pre-existing conditions or for the insured who became sick during the coverage term. Such disparities continue to divide the U.S. On monumental proportions between the haves and the have-nots. Subsequently, the issue contains both social and economical underpinnings that have created a gap: 1) people who do not have insurance; 2) costs imposed on employers and insurance companies. Bridging the gap has been addressed by several presidential administrations; however, much momentum was not gained until the Obama administration.

Issue Defined

Undoubtedly, insurance companies make money. In fact, during the recession, the industry was unscathed by societal economic conditions, while all other industries were immensely affected, thus needing government bailouts. Hence, the issue stems from simply financial greed, which required federal government intervention. People need and opponents do not want to pay. Dissension between the Democrats and Republicans continue, as the Republicans appeal the law by eliminating certain provisions, plus will stall financial efforts to enforce state’s compliance. Despite all the complexities of diversion surrounding a societal problem, the issue is fundamental. Legal roadblocks purporting violation of certain rights, unfairness of federal mandates imposed on states, cries of financial burdens by insurance companies and employers, and government subsidies all have positive effects on the delivery of health care services in the United States. However, this premise is based on the beneficiary’s perspective: uninsured and government.

Effects on Healthcare Delivery

The issue improves access to health care services and accountability of insurance companies. Although the costs must derive from a financial source, all must share in the burden to ameliorate such dichotomy in society. Currently, oversight of health insurers, the expansion of coverage to one million young adults and more protections for workers with pre-existing conditions are already well cemented and popular (New York Times, 2011). Additionally, the law, along with economic pressures, has forced major institutions to wrestle with the relentless rise in health care costs.

Potential Variable Tradeoffs

With any public program or federal mandates, potential trade-offs exists between increased costs and access. Increased costs will be borne by insurance companies who will be required to insure pre-existing conditions and will not be able eliminate coverage for insurers who become ill during the coverage term. Additionally, the law will cost the government about $938 billion over 10 years, according to the Congressional Budget Office, which has also estimated that it will reduce the federal deficit by $138 billion over a decade (New York Times, 2011). Insomuch, the law will require employers with more than 50 employees to reimburse the government for some or all of the cost of subsidies provided to employees who buy insurance on their own.

Effects on Current Position

With “The Patient Protection and Affordable Care Act,” many healthcare professionals are affected (Democratic Policy Committee, n.d.). Nationwide, hospitals are scrambling to buy hospitals in an effort to control costs. Doctors are leaving small private practices. Large insurance companies are becoming more dominant as smaller ones disappear because they cannot stay competitive (New York Times, 2011). Furthermore, Republicans denounced the law as an intrusion by the government that would prompt employers to eliminate jobs, create an unsustainable entitlement program, saddle states and the federal government with unmanageable costs, and interfere with the doctor-patient relationship. As a result, the law would exacerbate the steep rise in the cost of medical services, thus affecting the elimination of many healthcare positions. Ironically, less healthcare professionals will ensue, but an increase in patient care will be needed, as a result in more people becoming insured.

Challenges & Opportunities

Moreover, many are concerned with the quality of care if a universal healthcare program was imposed on the states. To eliminate this powerful argument, the government would allow states to determine specific healthcare provisions. Such a move would allow significant variations in benefits from state to state, much like the current differences in state Medicaid programs and the Children’s Health Insurance Program. By giving states the discretion to specify essential benefits, the Obama administration sought to deflect one of the most powerful arguments of imposing a rigid, bureaucrat-controlled health system on Americans and threatening the quality of care. Beginning in 2014, significant insurance reforms will be implemented (New York Times, 2011). New rules will end medical underwriting and pre-existing condition exclusions. Insurers will be prohibited from denying coverage or setting rates based on health status, medical condition, claims experience, genetic information, and other health-related factors (Democratic Policy Committee, n.d.). Although providing affordable access to quality healthcare for the insured is an opportunity, allowing states to have such discretion will create inconsistencies in providing healthcare, thus presenting challenges.

Conclusion

Bridging the insurance gap has been addressed by several presidential administrations; however, much momentum was not gained until the Obama administration. Although a great deal of efforts have been expended, more efforts will prove essential as the Democrats continue to ward of the darts of the Republicans and state opponents. As with any societal change, it will be met with resistance. In time, the resistance will evolve into acceptance of the greater good.

References

Democratic Policy Committee. (n.d.). The patient protection and affordable care act. Retrieved from http://dpc.senate.gov/healthreformbill/healthbill04.pdf

The New York Times. (21 Dec 2011). Healthcare reform. Retrieved from http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html