? The new and improved health care system in America seems to fall short for many people. The Affordable Care Act made history after President Obama signed it into law on March 23, 2010. This bill is going to create a change in how the current system operates which has kept approximately 46. 3 million people uninsured. Those numbers are very disturbing by themselves but if we include all of those who are also underinsured then we add on another 25 million. The ACA is has promised to reduce those numbers dramatically. Even though the plan is to reduce these numbers there will still be people without health care coverage.
Some will fall in between somewhere which makes them not eligible for Medicaid but also not able to pay the premiums offered in the private market. Some of the ways that the ACA plans to reduce the number of both the uninsured and underinsured is by making health care insurance more affordable. The insurance premiums have gone up so much that it has passed the rate of inflation and many of those insured still pay a lot out of pocket without having the income level to afford to do so (Conners: 2521). The reduction in health care premiums was accomplished by created an individual mandate.
The individual mandate makes it a law for everyone to have health care insurance. It also means that the insurance companies cannot deny people insurance any longer due to preexisting conditions. The government plans to subsidize a portion of the premiums depending on income levels. If you choose to not participate then there will be penalties which start out low and increase over time. This can be difficult for people when you have deal with many other living expenses and then be forced to pay something you may not be able to truly afford even with the subsidies.
The ACA has expanded Medicaid to those with a higher income level than before and also to those who are single and without children. The problem with the Medicaid expansion is that it may be too limited and there may be still many out of pocket expenses that people just won’t be able to pay and the limited number of doctors willing to take this type of insurance. The Exchanges were created to give people a market place to choose which plan works for them as well as the premiums that fit within their budget. There will be the competiveness of the market that might help to drive cost down.
It also might just be too difficult for some to use which could result in much of the data being incomplete or incorrect. This type of confusion could mean much more work for those signing people of for plans. That could have a counter effect of costing more in administrative cost by sorting out all the data. These plans are all offered by private companies which mean they will get to choose how much they charge for the plans and what they are willing to offer. With the employer mandate it becomes a bit more complicated to understand.
It seems that employers will be mandated to provide insurance some will be offered subsidies and tax credits. If employers choose to not participate then they will receive a fine for each employee but this may not be enough to motivate some employers to participate in the mandate. Those employers may prefer the fine. When this happens then people will be forced to use the exchanges. If employers decide to change how much they contribute then this could raise the amount that employees have to pay for their health care premiums and if that happens then those people will be excluded from the exchanges and may not have as many options.
The hope is that the employers will embrace this new option for their employees and it will become a standard which benefits both employees as well as employers. Many may disagree with me and my proposed ideas of how to possibly fix some issues that I find with the ACA but I feel that some things need some changes to improve the function of this Health Care reform bill. The overall idea of this Health Care bill was a good one but it left out many of the things that it was meant to accomplish. One part that they should have left out was the part that they had to pay off many to just be able to pass the bill.
This alone gave certain people the power to express what they wanted and have it changed or eliminated from the bill itself. The public option was what would have greatly reduced administrative cost and increase the competition in the private market (Conners: 2522). The public option should have never been eliminated when that would have been a good way to transition people over to having more government control of the health care system so that cost could be highly regulated which would help sustain health care for all.
I have trouble understanding why Americans feel that less government is a good thing. This way of thinking has not gotten us very far and we can see that when it comes to health care we are far from number one. There should be much more government control and intervention when it comes the health of this nations people. If the government ran the hospitals and controlled the pharmaceutical companies then cost would not be an issue. Individualistic ideas and the mighty dollar control how much the government can and cannot do for the people who pay taxes in America.
I know I would get many people telling my I’m a communist for proposing that government take charge and own all hospitals as well as the drug companies. This would keep all the ineffective or duplicate drugs off the market. The government could then create a formulary that would be all the drugs that are most effective for each illness known to exist in humans according to research. This would drive the cost down and increase the chance for a better outcome.
When the drug companies have the control they can charge as much as they want for certain drugs and then give doctors incentive for prescribing these drugs which ends up not being in the best interest of the patient. In this case the more government gets involved then we will see that we really don’t need certain expensive drugs that cannot prove they are any better than the cheaper proven effective drug that have already been released for use. If we just added the two proposed items that I talked about in the previous two paragraphs we could create a better health care system which may not be perfect but effective.
What we need to tie these two together is a health care board that is composed of doctors and researchers that are paid by the government to make sure that both the hospitals and the drug companies are working together to provide the best care possible for the people they serve. I believe the amount of money saved could be used to purchase upgraded equipment as well as new technologies. I feel another good addition to this proposal is a better system of checks and balances within the health care system.
The current system seems to waste a lot of time and money on test that do not improve the outcome of the patient’s condition. The ACA does seem to detail how to handle this current problem. There needs to be a way to eliminate unnecessary test just for the sake of doing them. This too will provide savings within the system so that money can be put back into it to provide other much needed items to improve health. These items to improve health can be simple classes on nutrition and many other informational classes geared toward prevention.
The public has very mixed feels about the ACA and I can understand why many things that Americans feel are important are not really so important but that is all about perception. If you are wealthy then affordable health care means nothing you can afford whatever price tag is attached to the health care you receive. If you are poor then it means much more to receive care that you can afford. It is unfortunate that the people with the most power happen to be wealthy and it does not mean much to them when it comes to receiving good quality health care that they can afford.
What the ACA does is it make health insurance mandatory so that everyone shares the risk and the ones who are healthy share the cost for those who are sick to reduce the overall cost of premiums through risk pooling (Gruber: 52). I propose that we stay with the mandate that everyone have health insurance but that it cost nothing to the American people. If the government found a way to fund the subsidies to help pay for premiums through the private system then bringing back the public option and making free for everyone who wants it would be the best solution I think so that there will not be anyone left out.
The ACA will still leave some without health insurance and that is not what it how it was intended to work when it was thought up to begin with. I remember watching a speech given by Hillary Clinton and her statement that America needs universal health care. The ACA falls short of being universal. If the problem is funding then we need to raise taxes on the rich. We need to cut the amount of money that doctors are allowed to make as well as cap what can be charged for certain services. I have had a chance to try out the new system by logging onto to Covered California and I entered in all of my information.
I as well as my husband fall into the donut hole of those who will not have coverage. What became of all the time I spent on the site entering in all of this information was a premium that I would have to pay out of pocket before I could claim any of the subsidies during tax season. I looked at the monthly premium and looked at my household budget and I felt I could not afford to pay what they were asking. The difference between the Bronze and Silver plan was about a hundred dollars a month. I still felt I could not afford it.
There will be many American’s experiencing this same problem but yet we are being forced to buy insurance. This is why I feel that this part of my proposal is most important. The system being universal is the only way I see that America will be doing what is in the best interest of all of its citizens. We cannot let the rich push their money around and have a say in what the government should do when it comes to health care. We will need to model the system after some of the other developed countries who have made universal health care successful.
The hospitals as well as the doctors would be government employees and their salary would be based on a fair amount for the services that they provide. The hospitals will only use equipment and test that have proven to produce results at a low cost. The system will be single payer so producing a formulary is vital to the survival of the system. There are so many expensive drugs on the market which have not produced any better results than the drug that came many years before it. Research is very important and will be time consuming.
What we have is no regulation currently and that allows drug companies to charge prices that unreasonable. The government will provide the research and create a list of the most effective and beneficial drugs to dispense to patients with a cap on the amount they are allowed to charge for the drugs that they produce. This proposal may run into some problems when presented to the public when the ideas engrained in all Americans are to look out for number one. This type of individualistic thinking will cause many to disagree with this amount of government control that is being proposed.
First thing item that will be challenged will be the public option just like it was in the original ACA. The people that will resist this option are those who make money off of the current system which is private and for profit. The amount of profit that they make will be reduced if the government began selling insurance to the public and offering the same type of plans that private insurance companies offer. I feel this might end up tied up within the political system until we change to a better system that allows us pass these types of amendments without so much red tape.
I can see that moving to the single payer system will be the toughest to implement. There will be so many things that will be at stake if the government is the system of insurance available to the people. People will feel they are not given choices and that seems to bother Americans. Americans like having option and many of them to choose from. This would take retraining the public to understand that the system would work much better if there was a single payer. The regulation would be a benefit and would ultimately save the country money which will then be put back into the system.
This eliminates the profit and all the money being put toward bettering the system as it develops and matures. There are many drug companies that make huge profits from the system not being regulated. If the single payer system was in place then those corporations would fight for what they want and that is how much they can charge and what types of drugs they can sell. The elimination of bonuses to doctors for prescribing certain drugs will be something that doctors as well as the CEO’s of drug companies will fight against.
When the single payer system is in place then the doctors will only be able to make a certain amount of money depending on their title. This system will also eliminate overabundance of specialties that are really not needed in this country. I will close this proposal with the simple fact that what we have currently is a failing system with many Americans left without health care and a lack of quality in the health care that is provided. With these simple changes as well changing the mindset of the people in this great country we can healthier citizens and a much more cost effective system.
Work Cited Johnathan Gruber, H. P. Newquist, Nathan Screiber, 2012. Health Care Reform: What it is, Why It’s Necessary, Why It Works: New York: Hill and Wang. Pp. 50-80 Connors, E. E. and Gostin, L. O. , “Health Care Reform-A Historic Moment in US Social Policy. ” Journal of the American Medical Association, 303, 2521-2522. Harrington, S. E. “ US Health Care Reform: The Patient Protection and Affordable Care Act. ” Journal of Risk and Insurance 77:703-708