Healthcare in America is the most debated, regulated, and systematized industry that is supposed to be patient-centered, but the future of healthcare in America now seems bleak. Healthcare providers’ interest has shifted form value-driven care to volume driven-care since World War II, and policy makers as well as political leaders tried to interpret and rein this shift through numerous bills and acts in the congress. Affordable Care Act (ACA) aka Obamacare is one of those bills that was designed to implement a healthcare model focusing patient-provider relationship in which both patient satisfaction and provider growth are prioritized. However, with landslide victory of the Republicans in 2016 election, the fate of the Affordable Care Act or Obamacare is now certainly uncertain, and the future of healthcare in America is once again undefined.
What is “soon-to-be was” Obamacare?
Nicknamed as Obamacare, the Affordable Care Act (ACA) is the combination of laws on healthcare, health insurance, fiscal responsibility, student aid, food, drug, and public services act. The Act is so vast that even the summarized version is more than 1000 pages long as it includes reforms on new benefits, rights and protections, rules for Insurance Companies, taxes, tax breaks, funding, spending, the creation of committees, education, new job creation and more.
At the heart of Obamacare is the patient: patients as consumers are in charge of their healthcare. The Affordable Care Act tries to make health care more affordable, accessible and of a higher quality, for families, seniors, businesses, and taxpayers alike. Millions of previously uninsured Americans are now under coverage and many more who had insurance but were denied adequate or required treatment due to different conditions set by insurance providers now get adequate coverage. The Obamacare does the followings:
- Ensures that all Americans with insurance will get treatment when they need it.
- Reduces premium and out-of-pocket costs: 32 million Americans who could not get health insurance can now afford it
- Spreads risk equally to all insured to end discrimination: insurance providers cannot not charge someone more due to age, gender, pre-existing conditions or other issues
- Sets up a new competitive health insurance marketplace(gov) where patients can compare plan prices and use group buying power
Why Republicans Hate Obamacare?
Eduardo Porter explains it interestingly why the G.O.P. dislikes the Obamacare: because Americans like it. Republicans called it “the most dangerous piece of legislation ever passed” and predicted that it would be “a killer of women, children and old people.” Republicans were so furious over the Affordable Care Act that it was the reason behind the two-week government shutdown in 2013. So, why do they hate it so much? Experts say that for several reasons, like:
It redistributes resources: Americans who can afford to buy insurance directly from a provider are charged higher premiums to help to pay for the subsidies provided to those who buy their coverage from government-run marketplaces. It subsidizes insurance coverage for people of modest means by raising taxes on people of less-modest means. Republicans are scared of this economics of redistribution.
It is expensive: High premium prices demotivate the young and healthy Americans to sign up, as the Republicans argue. This again prices will again rise up and the system will eventually collapse. Data shows the opposite: the uninsured population among low-income white people without a college degree has dropped from 25% in 2013 to 15% this year. The biggest beneficiaries of Obamacare are relatively poor whites in red-states who are also devout supporters of the Republican Party. Republicans claim the policy was tailored to hide private-sector expenses from the federal budget that made Obamacare seem cheaper than what it actually was.
Less government is better: Henry Truman’s effort to form a “social insurance system” has been labeled as “Socialised medicine” by the Republicans in 1946. The G.O.P. encourages firms to offer private insurance plans to employees, and thus healthcare becomes entwined with employment when the Republicans are in office. Most Democratic presidents—Lyndon Johnson, Bill Clinton, Mr. Obama—have tried to form a universal health-care provision for all with or without work.
Why Americans Dislike Obamacare?
As Kaiser Family Foundation tracks Americans’ attitude towards Obamacare, it shows that 53 to 57% do not like it. Why? Because they do not really know what Obamacare or Affordable Care Act is. Majority of Americans believe that Obamacare has increased Healthcare prices and that many people lost coverage for it. Moreover, media corporate backed by the Republicans played another significant role in highlighting the darker sides of the ACT. Another factor behind general peoples’ discomfort with the Obamacare is the imposed mandate, also known as individual mandate: it is a fee or penalty for not having health insurance. Republicans use this section of the Obamacare that many people do not like as well. If someone can afford health insurance but chose not to have it must pay the fee or penalty when she or he files federal tax return. The penalty is 2.5% of household income or $695/person minimum.
What is the Future of Healthcare in America?
Well, it is completely uncertain. Most Republicans as well as the new president are totally against the Obamacare or Affordable Care Act which according to them is a disaster. Unfortunately, nothing significant has been planned or promised to the public as a replacement for Obamacare. The existing healthcare model might remain in force or be completely changed once the Republicans join office in January—we can only speculate on the events that will occur. During his campaign Trump has offered almost no alternative and demonstrated much misunderstanding of basic tenets of the Affordable Care Act and the American medical system. In the absence of any concrete plans from the president-elect, it is difficult to imagine the Future of Healthcare in America.