The Fourth Post - Obamacare and personal choice

In researching the PPACA and its effects on the American people, I have had difficulty finding sources addressing the same issues. Supporters and detractors talk about different parts of the act, making it hard to synthesize opposing viewpoints. The issues are often so technical that they are hard to understand, and are even harder to synthesize because they use different, sometimes obscure facts.
               One success I have had is in finding plenty of data supporting either side of the issue. Depending on personal opinion, I think the facts easily lead someone to either supporting or opposing the bill. I have found myself supporting the bill because it allows for broader coverage of all individuals, especially people in need.
               Today I continue my investigation of the extent to which the Patient Protection and Affordable Care Act will benefit the American people.

            A hallmark of the American way of life is our right to freedom of choice. We all have the right to live how we want, as long as it doesn’t impede someone else’s right to do the same. Many people deride Obamacare because they say it infringes on that right. The Republican Party singles out the individual mandate as particularly threatening.

Individual Mandate

According to MichaelTanner, director of health and welfare studies at the Cato Institute, a think tank in Washington that promotes a philosophy of individual liberty and limited government,” an individual mandate crosses an important line: accepting the principle that it is the government’s responsibility to ensure that every American has health insurance. In doing so, it opens the door to widespread regulation of the health care industry and political interference in personal health care decisions. The result will be a slow but steady spiral downward toward a government-run national health care system.” I wonder what makes Tanner so sure that a "spiral downward" is a guaranteed outcome? What in the PPACA gives the government the ability to interfere in personal healthcare decisions, aside from the individual mandate? I think this quote accurately sums up the Republican fear of the individual mandate. The idea of an individual mandate has some bipartisan support, but the Republican Party, and thus half of congressmen and women, feels it is a step with unsure footing.

I believe the individual mandate does not violate an individual’s right to freedom. Without it, a careless individual can make more responsible parties pay for their medical bills should they get injured or seriously ill. Thus one person’s right to choose not to pay for insurance infringes on someone else’s right not to pay unfairly.

Enforcement

Another issue with the Individual Mandate is enforcement. A reasonable analogy is the requirement of car insurance in 47 states. Although insurance is required, roughly 14.5 percent of drivers remain uninsured. Despite hefty fines, potential loss of license and even the impounding of vehicles, these drivers choose not to purchase insurance. Because of this many insured drivers buy uninsured motorist insurance, to protect themselves should an uninsured motorist cause an accident. In the same way, insured parties pay more for health care in an attempt to create a cushion for those who utilize emergency room services but are uninsured and cannot pay.

A notable difference between the two is that the IRS will collect information on health insurance under the PPACA, while no agency collects information on car insurance among citizens. Still, many reputable opinions I have found cite potential logistic trouble as a reason to avoid the individual Mandate.

Although some potential problems exist for an individual mandate, I believe it is necessary if our goal is to reduce health care costs and protect each and every United States Citizen.

           

Sources:

Tanner, Michael. "Individual Mandates for Health Insurance Slippery Slope to National Health Care." Policy Analysis 565 (2006): n. pag. Web. 30 Oct. 2013.

Clemmitt, M. (2012, September 21). Assessing the new health care law. CQ Researcher, 22, 789-812. Retrieved from http://0-library.cqpress.com.catalog.poudrelibraries.org/cqresearcher/

The Third Post - Financial Downsides

Today I continue to wonder to what extent will the Affordable Care Act benefit the American people financially? Last time I looked at benefits, both to insurance companies and those whose income is near the poverty level. I have since read how PPACA’s methods for providing health care are not the most cost effective for the majority of us.

According to Eugene Steuerle of the Urban Institute, those who participate in the new insurance exchanges will get substantially higher subsidies than most households that remain in employer-provided insurance. Nonsensical penalties exist to keep people in the less-subsidized employer provided insurance plans. Logistic problems abound regarding information sharing between employers, exchanges, Medicaid systems and the IRS. Steuerle claims that the new exchanges would enable a new tax system which would collect 9 or 10 cents from each dollar earned for most insured households. Steuerle suggests that instead of a new, hard to administer system, we need to change our current tax system to provide fewer subsidies to those with higher incomes.

            Reihan Salam of National Review articulates that a healthcare reform like the PPACA could be beneficial to the American people as a whole. He supports equalization of tax treatment of employer sponsored health insurance and insurance purchased by individuals through a universal tax credit. Salam cites Capretta and Thomas Miller’s 2010 recommendation in National Affairs when he backs generous federal funding for high-risk pools. Capretta and Thomas Miller conclude that meeting the needs of high-risk pools through increased federal funding would be possible at a much lower cost to the taxpayer than the affordable care act.

            These alternatives offered by Steuerle and the Millers counter the arguments for guaranteed coverage for preexisting conditions in extreme cases. For those who do not qualify for high-risk pools but still need extensive medical care, Obamacare is a superior option. These authors want to adapt current systems to cover specific groups of people, but the overarching goal of Obamacare is to cover everyone.

Sources:

Steuerle, Eugene. "Fixing the Nation's Four-Tranche Universal Health System." : Next Steps for Both Republicans and Democrats. Urban Institute, 2012. Web. 28 Oct. 2013.

Salam, Reihan. "On Framing the Affordable Care Act | National Review Online." National Review Online. National Review, 1 Oct. 2012. Web. 28 Oct. 2013.

The Second Post - Financial Benefits

The facebook page for Barack Obama refers to the Patient Protection and Affordable Care Act as Obamacare, either as an attempt to reclaim the term or as proof that supporters of the law already have. I think that moving forward the term will stick as a tip of the hat to the president who pushed such a monumental movement forward. Plus it’s got a nice ring to it.

                Today I wonder to what extent will the Affordable Care Act benefit the American people financially?

                One segment of those who will benefit that I did not expect are the insurance companies. The PPACA allows young adults to stay on their parents’ health insurance plans for longer, to a maximum age of 26. Many young adults who would have lived without health insurance are now eligible to be covered under their parents’ plans. Young adults are the healthiest segment of the population, and the least likely to access care except in emergencies. Insurance companies are making a killing from the additional premiums for covering these infrequent utilizers of health care.

The blessing serves both parties; money saved by young adults covered under their parents’ plans is huge! According to the New England Journal of Medicine 3.1 million previously uninsured young adults are now covered. In 2011 they made 22,000 visits to hospital emergency rooms at an average cost of $7,000 per visit. If not for the extended coverage of their parents’ plans, those costs would have either been paid through the nose of the injured or shouldered by health care providers as uncompensated care.           

The final group I’ll examine is low income people. Medicaid, the health program provided by the U.S. government to low income people, is being expanded significantly. The standards for qualifying for Medicaid currently vary from state to state. Under the PPACA anyone with income less than 138% of the federal poverty level ($14,856 in 2012) can qualify for Medicaid. There are potentially 17 million new enrollees who will be eligible. However, Medicaid is run by each sate individually, and the United States Supreme Court ruled in National Federation of Independent Business v. Sebelius that states don’t have to agree to the expansion of Medicaid, and can instead stick with current eligibility standards and funding levels. If you’re impoverished and happen to live in a state that declines, all I can say is, bummer dude.

As far as I've seen, Obamacare is a financial blessing for Americans, both poor and rich. As for anyone outside of the significantly affected parties, they are able to continue with the status quo, so what's to hate?

Sources:

Health Care Collector: The Monthly Newsletter for Health Care Collectors. Sep2013, Vol. 27 Issue 4, p5-8. 4p.

Shaffer, Ellen R. "The Affordable Care Act: The Value Of Systemic Disruption." American Journal Of Public Health 103.6 (2013): 969-972. Academic Search Premier. Web. 23 Oct. 2013.

The First Post - The basics of Obamacare

The Patient Protection and Affordable care act, known as Obamacare by its supporters and detractors, is the most significant overhaul of the American healthcare system since Medicare and Medicaid. For 45 years the regulations of our countries healthcare system have remained relatively untouched, and now a massive overhaul is taking place.
            Obamacare has faced many hurdles while being actualized, culminating in its role as the cornerstone of Republican refusal to sign a national budget into law, causing a partial government shutdown for sixteen days. This shutdown cost us $24 billion, and reduced our projected fourth-quarter GDP growth from 3 percent to a piddling 2.4 percent. To be worth that much to half of senators, Obamacare must seem to be a dire manifestation. I am forced to wonder, to what extent will the Affordable Care Act benefit the American people?
            Guaranteed issue and community rating are a big part of the act to me, it seems right that someone can’t be denied coverage due to a preexisting condition, and that every one of the same age and area pay the same price. Life isn't fair, but insurance can rectify that to an extent with these simple requirements. Tobacco use is excluded from protected preexisting conditions, I suppose that’s thought of as fair because information on the dangers of tobacco use is widespread and easily available, and using is a choice.
            Another big part of the act is the individual mandate, which requires individuals not covered by an employer sponsored health plan, Medicaid, Medicare or other public insurance programs to acquire health insurance or pay a penalty. Certain exemptions exist for those facing financial hardship or members of a recognized religious sect exempted by the Internal Revenue Service. Requiring citizens to have health insurance seems like a huge step, though I’m not sure if it’s forward or backward. Citizens should have the right to live as they like as long as they aren't affecting someone else’s right to do the same. People living without insurance are likely to pay more for medical care, and are likely to put off or forgo medical care as a result. If an uninsured person does receive substantial medical care, it seems likely they would be unable to pay, because the less a household makes the more likely they are to be uninsured. Medical debts contribute to almost half of all bankruptcies in the United States. Why are we forcing people to get health insurance when it is common knowledge that it is a huge asset? Would providing access to cheaper insurance rectify the problem of uninsuredness on its own? The act already provides subsidies for insurance for low-income households, why bother requiring almost everyone to have it?

Test Post

This is a test post

This is a test link http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

Main blog post to come