1
IMPEDIMENTS TO AFFORDABLE HEALTH CARE
Impediments to Provision of Affordable Health Care in the United States
Eileen Salcedo
Georgetown University
Impediments of Provision of Affordable Health Care in the United States
Providing adequate healthcare can be regarded as one of the main concerns for many countries. Although, it’s a basic need and right, fulfilling it has many impediments. In order to best provide these services countries have developed and utilized different types of health systems whether private, public, or usually a combination of both. In an effort to achieve a more equal and thorough provision of health services, the Obama administration introduced the Affordable Care Act (ACA), also known as Obama care, which became a law in 2010 (Milstead, 2014). An overview of some of the components of this law illustrates the issues in providing affordable healthcare in the United States.
The first prominent issue is access to health care. According to the Census Bureau, population in the United States in 2015 was over 322 million people (“U.S and World Population,” 2010). Assuring that all citizens receive the necessary care poses a challenge simply due to the large size.When the bill was introduced in 2009, it was estimated that 45 million people were uninsured, which could’ve been attributed to the high cost of insurance, rejection because of preexisting medical problems, etc (Ventola, 2009). The Affordable Health Care Act attempted to eliminate these impediments by making it mandatory for all individuals to have health insurance(Milstead, 2014). This meant that insurance companies could no longer deny people due to their preexisting conditions and would be able to sign up for a variety of insurance plans, private and public, through the National Health Insurance Exchange (Ventola, 2009). Furthermore, the law limited the insurance companies’ ability to increase the cost of plans as people got older or poor health (“Obama: Health-care Reform, Part Two,” 2012). Another component of ACA is that it required for business of 50 employees or more to provide insurance for its workers; however, due to political opposition implementation of this was postponed (Milstead, 2014). Although, the concept of enforcing mandatory health insurance addresses the large uninsured population, it brings forth the issue of cost.
The all-inclusive nature of Obama care has significant impacts on the cost of health care. Since more people with illnesses and other conditions are more covered by insurance companies, premium costs could also increase to counterbalance the added demand for services. Because of this some companies, such as Blue Cross and Blue Shield, are trying to increase prices by 20 to 40% for 2016 (Pear, 2015). This is a major source of criticism of Obama care since it put strain on individuals and families, especially those in the low-income population. In an attempt to address this issue, the bill includes government subsidies for those in need, but may still be a significant burden (Ventola, 2009). Furthermore, it also includes an increase in the Children’s Health Insurance Program budget was increased by $32.8 billion dollars and will cover 4 million more kids(Manchikanti & Hirsch, 2009). However, much of the money for ACA comes from expected savings due to the increase of preventive measures that will hopefully reduce costs later onand from each state increasing their Medicaid budgets (Obama: Health-care Reform, Part Two,” 2012). This leads to further difficulties since actual savings may be varied and states may have different views regarding increasing the Medicaid budget.
A third issue connected to the cost is the current structure of the health care system in the United States. The method for billing is based on the test, procedures, or drugs given to the patient (Obama: Health-care Reform, Part Two,” 2012). The lack of focus on patient improvement or others measures of quality care created problems with unnecessary testing or medications (Obama: Health-care Reform, Part Two,” 2012). Due to this and other inefficiencies it is estimated that around $765 billion is unnecessarily spend on health care in the United States (“Obama: Health-care Reform, Part Two,” 2012). This leads to an expensive and inefficient use of resources that could be dedicated things such as preventive testing or health education. Furthermore, due to the provision of health care through employers, Medicaid and other government services it leads to higher administrative costs necessary for processing requests, billing, and other regulatory tasks (Manchikanti & Hirsch, 2009). Because of this, it’s necessary for structural changes to the health care system be put in place which is something not addressed in the Affordable Care Act.
There are many issues that arise when trying to provide adequate health care for a nation, as was seen in the case of the United States. The first is lack of access to it either because it was too expensive or simply did not qualify for insurance. This was addressed by making health insurance mandatory and preventing providers from rejecting individuals with preexisting conditions. Even though universal coverage is important it also leads to issue of cost. Whether these costs affect the individuals through increases in premium rates or are regarding budget for expanding Medicaid, higher cost and funding are a fundamental issue with the provision of health care. Finally, if the actual system doesn’t provide an efficient and adequate foundation for providing health services than any other positive changes will in the end be insufficient in improving the provision of affordable health care. From this investigation it’s clear that feasible structural changes are essential for long-term improvements in access and quality of health care and must be addressed through policy changes. Therefore, what are pressing structural changes that will provide an effective health system?
References
Manchikanti, L., & Hirsch, J. A. (2009). Obama Health Care for All Americans: Practical Implications. Pain Physician, 12(2), 289-304.
Milstead, J. A. (2014). No Law is Perfect: a Case Study of Obama Care. Ohio Nurses Review, 89(1), 12-13.
Obama: health-care reform, part two [Editorial]. (2012). The Lancet Oncology, 13(12), 1727-1728.
Pear, R. (2015, July 3). Health Insurance Companies Seek Big Rate Increases for 2016. New York Times.
U.S and World Population Clock [Infographic]. (2010, April 1). Retrieved from
Ventola, C. L. (2009). President Obama's Health Care Reform Policies. Pharmacy and Therapeutics, 34(6), 296-308.