This post is somewhat of a response to “Rousseau’s Health Care Plan.” In this November 22nd post, while talking about the new plan Obama healthcare plan, the poster would not offer his opinion on the plan because he stated that he “[didn’t] know enough about it to criticize it one way or another.” The general public has many misconceptions about the Patient Protection and Affordable Care Act (aka ObamaCare). In fact, most of us don’t know much of anything about the new plan, we just hear what others say about it. So, before I offer analysis of it, I want to quickly share some of the main points of the plan that is on track to be in place by 2014:
1) The Individual Mandate – This requires everyone in the USA to have health insurance or face a penalty if they don’t. These penalties will increase by year starting with a $95 penalty in 2014 and increasing to a $695 or 2.5% of an individual’s income by 2016.
2) Employer Contribution- This penalizes companies that have over 50 workers and don’t provide health insurance (at least $2,000), but exempts them from paying a penalty for the first 30 workers. There are also tax credits that will be given to small business employers (<25 workers with average wage <$50,000) as incentive for them to buy health insurance for their employees.
3) Insurance Reform- There are several changes in regards to insurance. After 2014, insurance companies will no longer be able to prevent people with pre-existing conditions from obtaining health insurance, as they do today. On top of this, there will no longer be any lifetime or annual caps or rescission. Also, government will be able to regulate insurance rate increases and unfair practices. Finally, insurance companies will be required to spend 80-85% of the premiums they receive on health care.
4) Insurance Exchanges- Individuals without work-based health insurance will be able to purchase plans through State Level exchanges. These plans are private plans without any public option. There will be different packages that offer differ amounts of coverage at different costs. These exchanges will be online, similar to the format of websites such as Expedia. The goal of the government is to make this plans much less than they currently cost.
5) Medicaid Expansion- More people will be covered by Medicaid. The Federal government will cover the costs of these newly eligible members through 2017. Then, the costs will gradually go to the states.
6) Medicare Changes- There will no longer be the Part D Doughnut hole by 2020.
7) Financing- The cost of Medicare will increase. There will also be penalties for individuals who are uninsured and employers who do not buy insurance for their employees. Also, the "excess" payments to Medicare Advantage Programs (HMOs) will be eliminated. Reform will take hold with malpractice as well. The goal of this is to lessen the amount of unnecessary examinations/tests done on patients.
8)Prevention and Public Health – More funds will be given to prevention programs such as tobacco cessation programs and obesity programs. These programs will result in fewer medical visits for many.
9) Workforce – With so many more people insured, there will be an increased need for doctors and nurses. This health care plan will provide funding for practitioners as incentives to increase the number of doctors, specifically primary care physicians.
Dr. Lichtenstein of U of M – Powerpoint on ACA
Many people are distraught with this new plan, claiming that is takes away our freedom by forcing people to do something: buy health insurance. Most people already have health insurance, but Obamacare will force about 45 million uninsured Americans to buy health insurance. Currently, there are several lawsuits filed in which different groups are deeming that forcing people to buy health insurance is unconstitutional. We have done things like this in the past, however. Consider that we require everyone to have accidental car insurance. Isn’t this the same as making everyone get health insurance? Why are many people upset with this new plan when it presents fair and equal opportunity for all to obtain medical care? The people who took risks by not obtaining health insurance before, went to the doctors much less and were generally less healthy than those who had health insurance. Now, by making these people obtain health insurance, their doctor visit numbers should increase and their health should improve.
As Amartya Sen puts it, “freedom and equality are in tension with one another.” I think this is the conflict of interest when it comes to peoples’ differing views on Obamacare. Some people want to maintain their freedom while others want greater equality. Can we have both with a health insurance system? With the previous system in place, people felt greater freedom knowing that they did not have to buy health insurance if they did not want to. With this decree requiring everyone to have health insurance, people feel as if this previous freedom was taken away. However, Obamacare now promotes more equality in terms of health insurance and health care coverage. With everyone soon to have health insurance, it will be much easier for about 45 million people to go to the doctors. Do you want to give up a little freedom for greater equality in health insurance and health care coverage?
Requiring all to obtain health insurance brings up the procedural concept of freedom in the form of a libertarian question: when do we have the right to choose to give up our freedom? Making everyone in the USA get health insurance should theoretically result in a much healthier society. Should we choose to give up our freedom to abstain from buying health insurance? Did we already choose to give up our freedom of not buying health insurance by voting President Obama into office?
Images on this post were taken from: http://mslawllp.com/blog/wp-content/uploads/2010/03/PPACA.bmp http://thf_media.s3.amazonaws.com/infographics/2010/obamacare_in_pictures_SC/special_obamacare_in_pictures12_2160.jpg http://irrelevantaxiom.files.wordpress.com/2010/09/freedom-and-equality.jpg