Heath insurance reforms have been debated in the United States since the beginning of the 20th century. Over the years, it has been a hot political issue that has featured in sveral presidential campaigns with the latest being President Obama and Senator John McCain’s 2008 battle for the white house. In 2010, president Obama pushed for the enactment of two bills; the Patient Protection and Affordable Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (H.R. 4872) which helped in amending the PPACA and became law on march 30th 2010 (Jackson, Jill, and John 2010).
The PPACA is to be implemented in phases over a period of four years with the final phase taking effect in 2014. It aims at providing far reaching reforms to the way insurance companies conduct business in America among them being the elimination of pre-condition screening and premium loadings, annual and lifetime coverage caps as well as setting a minimum ratio of direct health care spending to premium income among others. All these reforms have numerous effects on the American public and the health sector at large.
Problems that Health Care Reforms seek to overcome in America
- Denial of coverage and claims by insurance companies on the basis pre-conditions.
- Annual coverage caps set and reviewed regularly by insurers to both potential and existing customers respectively.
- Inadequate funding of medical research
- Consumer misinformation with health insurance companies not disclosing all the necessary information to potential buyers of medical cover.
- Poor members of the American population being incapable of buying insurance for its high cost.
- Privatization of the entire health onsurance sector without room for direct government participation
- Small businesses not being able to provide health insurance to employees.
- High cost of providing universal health care to the American population.
- A reasonable number of illegal immigrants in America who are not eligible for government support in accessing health care.
Solutions to the Problems as contained in the PPACA( the Obama health care reform)
Today, patients with certain health conditions like diabetes are denied cover by insurance companies, or provided with the option of paying colosal premiums to access cover. This leaves out a majority of strugling members of the American population who cannot afford the high premiums and as a result remain stay without any medical cover.The risk of loosing lives to these citizens can never be quantified, it is against this back drop that the PPACA’s provision that after full imlementaion in 2014, patients with pre-existing health conditions will be offered cover comes as a relief to many who are currently either left out or paying unbelivable premiums for their covers (Jackson, Jill, and John 2010).
American health insurance industry just like any other industry is libral and other than the little legislative framework put in place by both federal and state governments, it is generally left to private insurers to set the rules that take care of their bottomlines without much government participation. This has led to companies setting caps which are reviewed regularly. This leaves patients stranded when faced with medical situations that require financing beyond their set caps in which case their insurers bail out or require them to reach the huge difference. To the many poor Americans, this situation is usually dire to both the patients and their families who have to then fund raise in the process loosing their hard earned property. Removing this cap as provided in the PPACA is a solution that is long overdue to the American people.
Statistics show that nearly 45 million American are uninsured for various reasons but the main one being poverty that leaves many juggling between the varius needs and health inssurance, choosing housing and others over insurance. To help this situation the government has provided for Medicaid to people making upto 133% of federal poverty level (FPL) and insurance premium subsidy to those making upto 400% of the FPL, this will as a result improve their annual premuim payment from 2% to 9.8% of earnings. Businesses will consequently get the incentive to provide health care benefits. Subsidy is an expensive but effective solution whose benefits out weigh cost given that human life is at stake in the case of health insurance (McNeal & Gloria 2010).
Small businesses find it very difficult to provide health care to their staff, offering tax breaks to bisinesses that provide health insurance as contained in the PPACA will bring down the labour costs by around 4% according to economist Alec Philips of Goldman Sachs’ analysis. Jobs will immediately be created and this will spur the economic growth in a special way by putting money in more American pockets (Trumbull 2010).
Illegal immigration into America is a problem that does not only compromise security but also threatens the American health sector. The 8% illegal immigrants left out of the health care system is a huge number that must be addressed. There are a range of solutions that include the controversial amnesty to illegal immigrants already in the country so that they can come out of hiding and receive health and other services, crackdown and subsequent deportation to help reduce the population of uninsured residents as well as providing absolute security at the boarders especially that with Mexico which the major path for illegal immigrants. A difficult decission must be made to help save the American people who are at risk of living with neighbours without any form of healthcare. My recommendation will be amnesty but with the kind of political debate around this issue, it is difficult to come up with an all inclusive solution.
It has been seen that healthcare mangement cannot be left at the total mercy of the private sector that is driven by annual growth in profit figures (McNeal & Gloria 2010). This is evidenced by the failure in the American system which has over the years been in the hands of privare companies. It is for this that a lesson from the French system that incorporates a mix of both government and private sector partcipation. The french system is voted the best in the world by world health organization and in as much as its far from perfect it works and there are high indicators of customer satisfaction to the system. Government and private centre particpation expands population covered with health care. The statutory framework put in place under the PPACA goes along way in taming private companies but there is need to further broaden Medicare which is a partial program to cover the entire population in the long run. This can be done without neccesarily leaving out the private health providers who take care of the supplementary health insurance market (Rodwin & Victor 2003).
The PPACA is hailed as a beautiful piece of legislation but it must be questioned is America can in all honesty afford it. Provisional figures show that trillions of dollars are required for its implementation and with the growing foreign debt, can America truly afford this health care system? To answer this question there is need to look beyond the dollar figures into the value of human life which is worth much more than the trillions necessary for full implementation. (Trumbull 2010). The Act will bring back sanity into the American health care system, a virtue that has been missing for many years.