Oscar Medrano Eng.

1010 Issue Exploration 4/24/2014

The Differing Viewpoints of Obamacare

I will admit that two years ago I had never given too much thought or been too concerned with the American healthcare system, whether or not people had insurance, or even the quality of our healthcare didnt cross my mind. As a young, healthy adult who has never had a broken bone, surgery, or really even been ill I obviously wasnt in need of it and so didnt think too much about it. During this last presidential election I watched a debate between the Republican candidate Mitt Romney and our President Barack Obama and they of course debated the issue of healthcare reform because President Obamas initiated the The Patient Protection and Affordable Care Act or more commonly referred to as the Affordable Care Act or even Obamacare in 2010. Of course both gentlemen were on opposite sides of the spectrum but the differing facts that each debated really struck an interest for me and finally gave me a reason to look at the positive, the negative, and what I consider a possible middle ground for improving our current healthcare system and what the Affordable Care Act would mean. To simplify: the Affordable Care Act was created to offer a sustainable insurance market. There has been a sharp decline in private coverage over the last decade, and concurrent increases in public coverage and the number of uninsured. The second goal is to increase competition among health insurers and to move that competition away from risk selection and toward competition on the basis of the cost and quality of the health services in their plans

(Custer 25). Keep in mind that the Affordable Care Act is a federal statute initiated through mandates and subsidies with the goal of increasing coverage as well as affordability. There are many that claim the Affordable Care Act is just what this nations health care system needs and it is probably the biggest change to be introduced to the system since 1965 when Medicare and Medicaid became available. Through this federal statute and its mandates is placed a guarantee of coverage from competitive insurance companies restricting them from denying coverage for a previous condition or even charging too much for it. In May of 2013 the Congressional Budget Office estimated that by 2021 the number of people uninsured under the age of 65 years old would drop from 55 million to 31 million, thats an increase of 24 million people insured. They also estimated that for 2014 11 million people will be insured (Francis 65). This is obviously fantastic news for the millions of Americans who have to neglect their health and adjust to a diminished human state because they cant afford the high cost of quality care and who do not qualify for reasonable health insurance because of age or pre-existing conditions. Besides the obvious benefits of good health care for millions and millions there are two other benefits to the Affordable Care Act that I think are well worth discussing, the first being that it will help in decreasing the percentage of Medicare fraud. Health care fraud has been a leading cause for our nations increasing health care expenses. It happens in many different ways ranging from overutilization to billing for services never rendered. The Medicare system pays millions of dollars a year due to fraud and as a result we as Americans are paying

the higher healthcare costs to help compensate. The National Health Care AntiFraud Association (NHCAA) has estimated that about three percent, or more than $60 billion, of national healthcare spending has involved fraud (Ghosh 68). In order to decrease fraud in Medicare, the Affordable Care Act will have Medicare train senior citizen beneficiaries on how to spot and report fraud along with partnering up with private auditing firms. They will also be reevaluating Medicare providers through licensure checks, site visits, and audits. The other significant benefit of the Affordable Care Act is with the increase of patient coverage more people will be seeking healthcare and with the increasing medical visits comes the demand of medical professionals especially midlevel professionals such as physicians assistants and nurse practitioners. These midlevel providers will be able to bridge the gap between retaining primary care and coordinating with specialists (Ghosh 68). This creates job security and opportunity. One of the many arguments against the Affordable Care Act is that it is infringing upon basic human rights because it is forcing people to buy insurance, whether through the government or privately, and if they dont then they will be fined. Of course the Affordable Care Act has defined the amount of the fine with a minimum fee of $95 and increases being based upon a percentage of your yearly income. By 2016 its projected to be more than 2.5% of your income (Mader). There is probably a small percentage of people (my father-in-law included) who do not want insurance of any type and for varying reasons will never seek medical care. Although this group is an extremely small percentage why force them? Who is it hurting if its their choice not to participate? The answer is nobody, and of course

with a ridiculous rule such as this its easy to assume that the government is looking for just one more way to gain money from the people and forcing them into something they do not want which is infringing upon their rights. And of course this notion brings a fear among many Americans that the Affordable Care Act will bring the nation one step closer to socialism. Half of Americans, at least those belonging to the Republican Party as well as a few others, predict that the Affordable Care Act will force premiums to go up, but costs will not go down (Troy 26). Resulting in employers laying off employees at a ridiculous rate due to the fact that they cant afford the new mandated requirements forcing businesses to provide certain coverage for certain types and numbers of employees or suffer a penalty fine, and so many business dont have another option beside laying off because they cant afford the higher coverage or the fine (Troy 24). So with the new Affordable Care Act millions will gain healthcare coverage, but in return many of them will lose their current coverage and possibly even worse their jobs because the government decided it wasnt adequate enough for them. A natural consequence of job loss is of course increased enrollment in welfare, which again is draining another government program that could easily be avoided. Many people who argue against the Affordable Care Act fear that its slowly putting our healthcare system into government hands and that this will in turn decrease the quality. Medicaid is operated by the government and in a recent study showed no improvement of health outcomes for those covered (Troy 24). So naturally there is a fear of whether or not our government is capable and if they really should have the power to rollout such a drastic law.

There is however a slight middle ground (no matter how small it might be) that I see between the two apposing arguments. Obviously having medical coverage is a great thing and everyone who wants it should be able to reasonably obtain it. There are plenty of Americans who do not qualify for coverage through Medicaid and maybe due to some reason or another (i.e. pre-existing condition, cost, unemployed) cannot obtain coverage through another source and for them something like the Affordable Care Act is great, and should be left just at that. Leave out adding fines and taxes for companies and individuals who do not use it, and leave out having it monitored by the IRS and maybe have another designated group monitor it. Another positive outlook that I discussed earlier is that through the Affordable Care Act healthcare fraud would decrease, but again we do not need a law that entails, forces, and changes so many different parts of healthcare to implement strategies to cut down on fraud. There are private auditing firms that could probably do a better and more time efficient process of this than the government (Ghosh 68). In conclusion, there are usually at least two if not more ways to look at something, and weighing the pros and cons. When we look at all possible options available we can usually find a common middle ground between differing sides. After completing this research I would have to agree that the negative outcomes of the Patient Protection and Affordable Care Act outweigh the positives. It is still new and as it rolls out more and we see glitches worked out and see it being adjusted to accommodate America then we will know of its full impact and if it is indeed the healthcare change we are looking for.

Works Cited
Francis, Theo. "The Affordable Care Act: An Annotated Timeline." Physician Executive 39.6 (2013): 64-67. Business Source Premier. Web. 18 Apr. 2014.

Ghosh, Chandak. "Affordable Care Act: Strategies To Tame The Future." Physician Executive 39.6 (2013): 68-70. Business Source Premier. Web. 18 Apr. 2014. Custer, William S. "Risk Adjustment And The Affordable Care Act." Journal Of Financial Service Professionals 67.6 (2013): 25-26. Business Source Premier. Web. 18 Apr. 2014 Thorpe, Natalie, et al. "Combating Medicare Fraud: A Struggling Work In Progress." Franklin Business & Law Journal 2012.4 (2012): 95-107. Business Source Premier. Web. 21 Apr. 2014. Mader, Lindsay Stafford. "Will 'Obamacare' Affect Natural Healthcare In The United States?." Herbalgram 100 (2013): 86-89. Alt HealthWatch. Web. 22 Apr. 2014. Troy, Tevi. "The Obamacare Blame Game." Commentary 135.6 (2013): 24-27. Religion and Philosophy Collection. Web. 23 Apr. 2014. Troy, Tevi. "The Three Failed Promises Of Obamacare: Why It's In Trouble Even As It Just Begins." Commentary 5 (2013): 20. Literature Resource Center. Web. 17 Apr. 2014.