In the United States, health care is a widely debated topic that has many puzzled over the proper implementation of what is the most effective practice for helping the majority of the population. This means that under the Obama administration, a new healthcare policy was put into place in order to accomplish several goals regarding fair, affordable healthcare options. These methods have been scrutinized and compared to other healthcare methods, such as single payer, that are currently in use in other well-functioning countries like Canada.
Under the Affordable Care Act (ACA), or otherwise known as Obamacare, the main premise is to expand coverage to millions of United States citizens by requiring all to purchase private insurance plans. The ACA also sets out to lower the cost of healthcare for all in an attempt to equalize the industry for all socioeconomic, racial, and gender backgrounds. For Obamacare to accomplish these set goals, there are three main provisions: expansion of Medicaid, online insurance exchanges, and an individual mandate. The expansion of Medicaid covers more individuals under a specific income level that don’t have the aims of purchasing their own healthcare. The use of online insurance exchanges allows citizens to search online and further compare rates, policies, and more. The individual mandate requires that all citizens must have some sort of health insurance, whether it’s Medicare/Medicaid, or a private insurance company. What these three provisions aim for is to gain coverage for a substantially greater population, as well as cover more individuals with pre-existing conditions that other insurance companies would not previously insure. There are also no more annual limits, thus insurance companies cover expensive crisis and treatments, instead of the patient. Obamacare’s system to expand coverage and lower costs are substantially admired by those who feel that it’s the government’s job to provide citizens with the necessities of existence like – clean water, shelter, physical security, and healthcare.
Although Obamacare’s intentions are aimed in the right direction, there are still many needs that are not addressed. One of these needs includes the gap in healthcare coverage for many people in the system. Although there’s a wide expansion of people receiving coverage that could previously not afford it, there are also approximately 30 million people remaining uninsured. Not only are there missed people, but within this system, there are many cost issues that coincide with treatments and care facilities. The insurance companies will continue to eliminate freedom within their policies, keep networks small, as well as limit and deny healthcare to some patients. Insurers also have the ability to increase costs paid by buyers, including co-pays, deductibles, and other costs that must be paid out of pocket upon arrival to the appointment. Although the public would like to blame the doctors and nurses treating them for their lack of care, the medical staff are not the root of the problem. The problem lies in the poorly designed medical institutions that promote failing structures and poor incentives.
Obamacare is aimed towards long-term aid, however, there are other healthcare options that have been illustrated as better ideas towards fixing the needs for healthcare and rising costs. One of these systems is called Single Payer, or otherwise known as “Medicare for all.” In this system, there is a single public organization that covers all financing for healthcare in the United States. Within this system, all citizens of the U.S. would be insured and covered for all medical services. These services range from primary care, hospital visits, preventative care, long-term care, to even mental health and dental care. To attain this funding, unlike Obamacare, the system would be funded through new taxes that everyone is responsible for paying. Implementing this system would then save citizens’ money due to the elimination of premiums, deductibles, and co-pays. The people in this system would also gain the right to choose their own doctors and physicians, a right that is currently stifled under ACA due to private insurances “out of coverage” policies.
Just like in any system, there are also flaws in the Single Payer method as well. One of the major complaints about single payer healthcare is the extensive waiting lists for medical appointments and procedures. Because all citizens are covered, there’s an unmet need for the amount of care that is available to each person. In other countries where this policy is put into effect, there’s a process that many people undergo that lasts weeks, and even months, wherein the U.S., citizens could receive the procedure a week later than the initial referral. Stemming from the problem of significantly longer wait times, there is a worsening of treatment outcomes of serious diseases from the inconvenience of waiting. Delaying the availability of treatments and medicines has been seen as a detriment to the outcome of the received treatment. Not only are the treatments less successful, the time spent waiting is not only a huge inconvenience but also painful for those waiting and suffering. Another aspect of single payer that citizens are against, is the increase of taxes associated with covering all Americans.
Even though there are concerns for single payer, there are also associated benefits as well. Countering the concern of long wait times, and waiting lists, there’s also an availability of primary care physicians that most American’s don’t see currently due to copays and restrictions. By gaining the ability to see a primary care physician as frequently as necessary, there is a common bond shared between the patient and the doctor. This could lead to the detection of diseases earlier, as well as preventative care needs to be met sooner as opposed to later. Also, by gaining this relationship between patient and physicians, there will be more listening to the patients’ problems to fix them long-term, rather than simply writing a prescription to mask the problem. This hand-in-hand works to fix the ongoing financial struggle citizens anticipate facing if taxes are increased. There would be an adverse effect. Because there are no co-pays, deductibles, and premiums, there’s more of an opportunity to receive necessary care earlier and avoid complicated emergency surgeries later. For example, if an American is at risk for a disease like cardiovascular disease, seeing a primary care physician more frequently would lessen their risk of trauma later. This patient at risk might not have had sufficient funds to afford a co-pay to see a primary care physician regularly for check-ups, thus leading to their condition worsening to needing emergency care. This then ends up costing the patient and private insurance companies much more than if they would have just gone in sooner and more frequently.
As many political individuals come and go, they all have their own opinions regarding the unmet need for policy and healthcare measures for U.S. citizens. Even with implemented programs like ACA, and expansions of Medicare, there has still not seen a substantial increase. The power struggle between allowing the government to control healthcare, and the individual’s needs for healthcare will still be ongoing, however, there are many strides forward that can advocate the needs for Americans trying to make ends meet.