History of Healthcare Reform
Healthcare reform has been a topic of discussion for years now. Opinions about the Affordable Care Act Problems and Solutions has always been discussed as healthcare providers, citizens, private organizations etc all try to understand the requirement, how it works, and how it can benefit the different stakeholders of the healthcare industry. The affordable care act is not the first huge legislation that the healthcare industry has faced.
In 1965, the Medicare and Medicaid law was passed which was part of the Great Society Legislation and it was passed by President Lyndon B. Johnson. And then, in 1966 the Consolidated Omnibus Budget Reconciliation Act (COBRA) and the Health Insurance Portability and Accountability Act (HIPAA) was passed. These legislations provided health insurance protection for some employees when they leave their jobs and this legislation is still ongoing today. And the in 2010, the affordable care act was passed by President Barack Obama and it was called OBAMACARE and since it has been passed, additional rules, regulations, and changes have been made to the bill to further expand it. The affordable care act includes:
- The Affordable Health Care for America Act
- The Patient Protection Act,
- The healthcare-related sections of-
- The Health Care and Education Reconciliation Act
- The Student Aid and Fiscal Responsibility Act
Medicare and Medicaid
The Medicare and Medicaid bill was passed as two part program. Part A covered hospital insurance and Part B covered medical insurance. Not everyone is eligible for Medicare and Medicaid but the government every now and then makes changes to open up eligibility to more people. An example of this was in 1972 where Medicare and Medicaid were expanded to include older citizens who are disabled.Medicare and Medicaid were also expanded to include added services. Some services of Medicare and Medicaid
Medicare and Medicaid are unlimited home health visits for up to standard and approved nursing homes.
Medicare and Medicaid have also been expanded to include low-income families, pregnant women, people requiring long-term care and people with disabilities. Medicare and Medicaid can also be tailored meet specific needs and this is what most states have done in the past. They tailor Medicare and Medicaid to meet the specific needs of its residents.
Affordable Care Act Problems
Loss of Health Insurance
After the Affordable Care Act was passed, many people (up to 5 million) lost their employment-based health insurance because many companies and business found it a cheaper option to pay the penalties of not providing their employees with insurance than actually providing their employees with insurance. This led to the individuals having to purchase their own health insurance plans separately.
In addition, there were millions of people who relied on private health insurance plans. And at the same time, some private health insurance companies had to cancel plans of their customers because they did not reach the requirements put in place by the government.
These changes and dynamics discussed above and many other reasons thus led to the cost of private insurance care to rise. Another reason is that many people now had access to healthcare they previously did not like preventive care which increased the demand for healthcare. As with the laws of demand and supply in economics, this increase in demand led to a rise in cost.
The Affordable care act could not tax as many people, who defaulted in their insurance purchase, as it could because of various tax exemptions loopholes. At the same time, many people chose to pay the tax fees than actually purchase health insurance coverage.
There was an increase in the tax rate for income tax. The Affordable Care Act raised the tax rate by 1% for 1 million individuals with incomes above $200,000. It didn’t stop them. The income tax for couples filing joint tax returns was also raised for those with joint income higher than $200,000
A medical device tax imposed on medical device manufacturers was put into place in 2013 but in the last two years, the tax has been suspended. This tax affected employment because of the high cost discouraged these manufacturers from doing more hiring.
Pharmaceutical companies are taxed up to $84 billion dollars fees. This could lead to a rise in drug costs if the pharmaceutical companies decide to pass the burden of these taxes over to consumers. However, the problem with rising drug costs has little to do with this and more to do with the increasingly exploitative pharmaceutical companies. For example, the price of insulin has seen a steady rise in the past few years for no justifiable reason other than the Pharmaceutical companies can do whatever they want.
Lack of Access to Care
The increased accessibility of care by many people who previously could not afford care will lead to a surge in demand. This could present a problem as there is no matching surge in the supply of care. Hospitals might face problems of having too many patients with too few doctors, nurses, and health workers to oversee them. And the government is doing nothing to fix this supply problem. This will lead to patients being put in a vulnerable position as doctors would have to ration their care and higher paying patients will be given priority of care over lower paying patients.
In addition, some doctors might opt for concierge care or some other type of private practice in order to take the pressure off from working in the public sector and this will mean even fewer doctors to go around for the general population.