Savior of the poor man’s wallet. A step forward. Hope to those that had none. Communism in disguise. The healthcare horror. The Affordable Care Act. Death. Yes, these are all names some would agree describe the law commonly known as Obamacare. Ironically, none of them are the official name of the law that has been the cause of so much chatter.
Obamacare has been talked about, ranted over, and heatedly discussed since it was passed in 2010 (Carroll, “Obamacare and October 1st: Healthcare Triage #1”). The politically correct name for Obamacare is The Patient Protection and Affordable Care Act (PPACA) (“Patient Protection and Affordable Care Act” 1); it derived its more common name, Obamacare, from the President who pushed it through, Barack Obama. The goals of Obamacare sounded simple; according to “Obamacare Facts: Facts on the Affordable Care Act”, Obamacare is an attempt “to give more Americans access to affordable, quality health insurance and to reduce the growth in U.S. healthcare spending.” Now, a couple of years after the Act fully took effect, the American people want to know if it worked, if it is sustainable, and how the system can be further improved if necessary.
Obamacare is often described as a three-legged stool; accordingly, all three legs need to be balanced for the stool to stand.
The first leg of the stool is subsidies; this is money that the government pays out to people who make 400% or less than the poverty line. For individuals, this is around $46,000 per year. Expanding
medicaid also falls under this category. In order to qualify for Medicaid, a person must make 133% of the poverty line or less. However, not all states are participating in the expansion of Medicaid (Carroll, “Obamacare and October 1st: HealthCare Triage #1”). In fact, in 2013, around twenty-five states opted out of the expansion of Medicaid (Wiley).
The second leg of the stool is the regulation created by Obamacare. These measures include cracking down on Medicaid fraud; requiring insurances to provide justifications for price hikes; creating incentives for hospitals to keep the elderly healthy; increasing medicare payroll tax for income over $250,000; and compelling companies employing fifty or more people to provide for their employees health insurance or pay a large penalty. (Carroll, “Obamacare and October 1st: HealthCare Triage #1”). These regulations are just a few examples drawn from the entire law.
The final leg is called the individual mandate, though others call it a tax. If a person refuses to buy insurance, they are obliged to pay a penalty fee of $95 dollars or 1% of their income. If a person refuses to buy health insurance and then gets sick, the health insurance companies have to accept them. Of course, it is not very economical or even feasible for insurance companies to take on only sick people. Therefore, a tax must be paid thereby encouraging people to buy health insurance and alleviating the cost when the ones who abstained get sick (Carroll, “Obamacare and October 1st: Healthcare Triage #1”). Some see the individual mandate as a punishment for not following the government’s demand while others see it simply as another tax (“Obamacare Facts: Facts on the Affordable Care Act” 14).
There are a few important, though less major, points to Obamacare. For instance, children can now stay on their parents’ plan until they are twenty-six. Also, an extremely pertinent perk to the law is the abolition of insurance companies being able to deny coverage based on pre existing conditions, “a phrase intentionally so broad,” John Green, a novelist and widely watched and reputable online educator, states, “that it encompassed, like, everything” (“Is Obamacare Working? The Affordable Care Act Five Years Later”). Bruce Hintz Sr., an American directly affected by Obamacare, was likewise pleased with the termination of caps stating that his “old cap was two million . . . The Affordable Care Act got rid of that. That’s a positive.” Finally, though there are many more points not mentioned here, Obamacare does not directly force a person to change health insurances, a worry that was very preeminent (Carroll, “Obamacare and October 1st: Healthcare Triage #1”).
Now for one of the big questions concerning Obamacare: did it work?
The answer really depends on who you ask. If a person was sixty-five or older, already had insurance from their job or family, or received Medicaid or other insurance from a government source, very little to nothing changed for them. (Carroll, “Obamacare and October 1st: Healthcare Triage #1”). However, uninsured citizens or those that might be uninsured at some point are affected. For example, Hintz was on his work insurance plan until he retired. When he did, he was thrown into the world of searching for health insurance. The number of people who fit into the category of having no health insurance was around thirty million in 2013, down from forty-seven million in 2012 (Carroll, “Obamacare and October 1st: Healthcare Triage #1”). These numbers sound quite large, but only four percent of the population bought health insurance on the exchanges set up by Obamacare (Green, “Is Obamacare Working? The Affordable Care Act Five Years Later”). Green sums up the results by declaring that, “the thing about the ACA is that it is not particularly radical” (“Is Obamacare Working? The Affordable Care Act Five Years Later”).
Nonetheless, for Raymond Wiley, a “producer, writer, and publicist based in Atlanta Georgia” (Wiley), Obamacare has made all the difference. For the first time, he will have health insurance that he believes will cost him around thirty dollars a month; the price is so low because his average salary is $18,000 per year. His girlfriend and his girlfriend’s daughter will be receiving insurance as well for what he claims will be thirty-two dollars per month. After his mother had surgery and, in his eyes, was thrown out of the hospital because she did not have insurance, Wiley concludes that “the system left her high and dry.” He was more than ready for a change.
On the other end of the spectrum is Hintz, who is not enjoying the effects of the ACA nearly as much. One of his biggest reasons for disliking the law revolves around the fact that “the deductibles have increased. Out-of-pocket has increased, which is, um, premiums have increased, and coverage has decreased at the same time of everything else going up [sic]” (Hintz). To add to that, the complexity of the law and its effects were also very displeasing to him as well as the fact that “every year it changes” (Hintz). Nonetheless, he also believed that “you knew what was offered and what you were choosing. That’s one thing they did right” (Hintz). The worst change to come to Bruce Hintz and his wife regarding health insurance has nothing to do with economic or intellectual challenges though. Joyce Hintz, Bruce Hintz’s wife, was proud to declare that her son was born in 1976 and, with insurance kicking in, she and her husband paid only $164 dollars, $696.72 in today’s money. Today, however, neither of them has any faith that any reasonably-priced insurance company could or would do that.
That still leaves the question of Obamacare’s effectiveness hanging. Let’s think of it this way for a moment: if Obamacare were repealed, what would the results be? America would go back to its former insurance system. Consequently, “tens of millions of Americans will be without good health insurance, and insurance companies will continue to be able to deny coverage for pre-existing conditions” (“Obamacare Facts: Facts about the Affordable Care Act” 42). At the same time, people such as Bruce Hintz, who believe they are worse off with higher premiums and less coverage, would be pleased. To add to the confusion, more people are supposedly covered by Medicaid, but more tax money is being spent on such programs. Wherever you can find a person who is better off, there is another behind who is worse.
The other looming question is if this country is able to sustain Obamacare.
Here’s a scary statistic: over seventeen percent of America’s gross domestic produce goes to health care. This is a stunning figure when juxtaposed to that of the Netherlands, Canada, and France who all spend less than ten percent of the GDP on healthcare and do not pay for the difference in quality of results (Green, “Is Obamacare Working? The Affordable Care Act Five Years Later”). Canada, the Netherlands, Germany, Australia, and the UK all spend less money on healthcare than the United States does per capita, but the other countries get at the very least the same amount and quality of healthcare as the U.S. does (Green, “Why Are American Health Care Costs So High?”). While much of that cost is due to the higher prices of surgeries and other medical procedures (for instance, a hip replacement in Belgium costs merely $13,000 while one in the U.S. costs over $100,000), the healthcare system is another culprit – and victim – of the enormous amount.
Expanding upon the idea of high price and low return, it is important to note that “a recent National Bureau Economic Research study estimated the value of Medicaid to its recipients at between 20 cents and 40 cents per dollar of expenditure, with the majority of the value going to health-care providers like doctors and hospitals. By comparison, the Earned Income Tax Credit – a cash transfer program designed to enhance the incomes of the working poor – delivers around 90 cents of value to its recipients per dollar of expenditure” (Kessler 2). Meanwhile, agreeing with Hintz, but occurring in the state of Florida, “15 health insurers are seeking an average increase in premiums of 17.7% for 2017” (Rubio 1). Marco Rubio also is quick to point out that “Obamacare was projected in 2012 to cut $156 billion from the program [Medicare Advantage] over a decade”, an action that will seriously, economically, and negatively impact numerous seniors across the nation. Finally, the last economic stinger that the law brings to the U.S. comes in the form of lawsuits; “the health-insurance lobby has teamed up with trial lawyers to sue the federal government . . . for not following through on a sweetheart bailout deal buried in the law” (Rubio 1). The original lawsuit failed, and Rubio predicts it will fail again (3). However, the question no longer is if the U.S. can sustain Obamacare, it is when is America’s economy going to collapse due to health care costs in general. Obamacare has just caused the bloated and inefficient health care system to change its clothes.
That leaves the last subject to be covered, what can be done to improve Obamacare and America’s healthcare system. While countless plans and theories have been spoken of, most boil down to three main proposals.
Some people are satisfied with Obamacare, such as Wiley, and are perfectly happy if nothing changed. Another group of advocates for no change, according to Green, just don’t want to pay for the unwise choices, such as smoking, overeating, and other health decisions that cause medical problems, people make. He claims this is the reason why a good deal of people do not want universal health care (“John Green’s Thought Bubble: Health Care Overhaul (Summarized Via Massive Pig)”).
Another solution suggested is for the government to set up non-profitable insurances to compete with private insurances. Of course, private insurance companies are displeased with this idea. Theoretically, the non-profitable insurance companies would, as a result of their definition, have lower prices, attracting more people, drawing profit away from private insurers. This is a problem for private insurers because they kind of like to make money (Green, “John Green’s Thought Bubble: Health Care Overhaul (Summarized Via Massive Pig)”).
Lastly, universal healthcare has been a topic to discuss. Green believes that we already have a type of universal healthcare, the type that is “if you get shot, we will try to patch that up for you universal healthcare” (Green, “Is Obamacare Working? The Affordable Care Act Five Years Later”). He also asserts that drastic measures such as universal health care need to be undertaken in order to fix our system (“Is Obamacare Working? The Affordable Care Act Five Years Later”). Hintz agrees that “universal health care is the way we should go in this country”, and, from the looks of the health care systems of other countries, they approve universal health care as well for “thirty-two of thirty-three developed nations have universal healthcare” (“List of Countries with Universal Healthcare” 1). Norway has had universal healthcare since 1912! Nations with universal health care would include Japan, Germany, Canada, Slovenia, Australia, Ireland, Singapore, and Iceland (“List of Countries with Universal Healthcare” 1). Furthermore, a Commonwealth Fund report found that the “level of health spending relative to GDP” in the U.S. “is about 50 percent more than any of the countries studied for the report, which are Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom” (Mangan 2) . The U.S. would certainly not be the first in adopting a economically pleasing universal health care system.
Regardless of what plan each individual believes is best, one thing is for certain: dithering about and discussing the options again and again will get America nowhere. Part of the reason the health care system got so amazingly out-of-control in the first place is because people forgot what the purpose of health care and health care insurance revolved about. The problems around health care insurance have gotten so entrenched with biases, desires, false information, and connotations that, no matter what side a person is on, it wouldn’t hurt to just step back for a second and remember. It wouldn’t hurt to remember that behind every ‘free rider’ is someone who truely can’t pay, that even the most expensive of taxes can have some of the best results, that it may cost an arm and a leg but save a life. Most importantly, it could never hurt to remember who is supposed to benefit the most from health care, people.
Carroll, Aaron. “Obamacare and October 1st: Healthcare Triage #1.” YouTube, uploaded by Healthcare Triage, 29 Sept. 2013, www.youtube.com/watch?v=wBr3fniyb4w.
CPI Inflation Calculator. data.bls.gov/cgi-bin/cpicalc.pl. Accessed 1 Dec. 2016.
Green, John. “Is Obamacare Working? The Affordable Care Act Five Years Later.” YouTube, uploaded by vlogbrothers, 24 Mar. 2015, www.youtube.com/watch?v=wMuXcuudvCc.
Green, John. “John Green’s Thought Bubble: Health Care Overhaul (Summarized Via Massive Pig).” YouTube, uploaded by Thought Cafe, 1 Sept. 2009, www.youtube.com/watch?v=svCQJvP1S8g.
Green, John. “Why Are American Health Care Costs So High?” YouTube, uploaded by vlogbrothers, 20 Aug. 2013, www.youtube.com/watch?v=qSjGouBmo0M.
Hintz, Bruce Sr.. Personal Interview. 28 Nov. 2016.
“List of Countries with Universal Healthcare.” True Cost: Analyzing our economy, government policy, and society through the lens of cost-benefit, 21 Jan. 2013, truecostblog.com/2009/08/09/countries-with-universal-healthcare-by-date/. Accessed 7 Dec. 2016.
Mangan, Dan. “US health-care spending is high. Results are…not so good.” CNBC, 8 Oct. 2015, http://www.cnbc.com/2015/10/08/us-health-care-spending-is-high-results-arenot-so-good.html. Accessed 8 Dec. 2016.
“Obamacare Facts: Facts on the Affordable Care Act.” Obamacare Facts, obamacarefacts.com/obamacare-facts/.
“Patient Protection and Affordable Care Act.” HealthCare.gov, www.healthcare.gov/glossary/patient-protection-and-affordable-care-act/.
Rubio, Marco. “Obamacare: A Crony Capitalist’s Best Friend.” Wall Street Journal, 25 May 2016, p. A.13. SIRS Issues Researcher, sks.sirs.com/webapp/article?artno=0000383675&type=ART. Accessed 1 Dec. 2016.
Wiley, Raymond. “Episode 311: Obamacare Explained!” from Out There Radio: Bizarre Undercurrents of the Human Psyche, 27 Sept. 2013, outthereradio.net/episode-61-obamacare-explained/.