The Patient Protection and Affordable Care Act is a bill passed into law by the U.S. president Barrack Obama in the year 2010 (Goodson, 2010). This act is normally referred to as Obamacare. The act collectively with the Health Care and Education Reconciliation Act symbolizes the most important government development and regulatory revamp in the U.S. healthcare system for the last 50 years. The act mandates all insurance companies to provide medical insurance cover to all claimants regardless of their social background, sex, race, or ethnicity. This paper seeks to specify the top 3 issues of the U.S. health care system, identify the aspects of this act that are directed at the issues, evaluate to what extent the act will improve each of them, and suggest any unintended consequences of the act related to the issues identified.
Top three issues of the U.S. health care system
Currently, the top three issues of the U.S. healthcare system are reduced access, reduced quality, and increased costs. The U.S. health care system has continuously been faced by several challenges. By the time the government stopped its heavy-handed managed care in the 1990s, the cost of health care services had rose sharply as the number of uninsured individuals increased. Before The Patient Protection and Affordable Care Act was passed into law in the year 2010, the number of uninsured individuals was estimated to be more than 46 million (Goodson, 2010). Equally, during this period new medical technologies, pharmaceuticals, and workforce were in great demand. As the country’s life expectancy continues to increase, its population will continue to age leading to more chronic health issues. In the year 2006, the U.S. healthcare system was reported to be among the most costly system in the world. According to these reports, the U.S. government spent over $2 trillion in health care expenditure during the same year. These figures are disturbing since the above expenditure represents 16% of the country’s gross domestic product.
Although there have been reports indicating an increase in some realized health care access, it is worrying to note that inpatient hospital use has been declining for the past 20 years. Similarly, the reports indicate that there has been a decline in the number of individuals covered under the private insurance programs. In addition, equity of access to health insurance has not been achieved. A larger percentage of minority community populations are uninsured as compared to the majority community populations. On the other hand, healthcare cost has increased tremendously becoming one of the most expensive health care systems in the world. With these challenges, hospitals are under tight pressure to control the health care cost. Through this, the quality of health care services might be compromised.
Aspects of the ACA that are directed at these issues
The act is primarily aimed at increasing the number of Americans under medical insurance cover and decreasing the cost of health care services (Goodson, 2010). In the act, several mechanisms have been outlined on how to meet the above goals. These mechanisms are mandates, tax credits, and subsidies. Within a period of 10 years, this act will ensure that every American has access to quality and affordable health care services. Through the title Quality, Affordable Health Care for All Americans, the act is determined to transform the American health insurance programs through shared responsibility to ensure that all individuals get access to quality, accessible health care insurance services.
Through these initiatives, discriminatory practices that exist currently in the system will be abolished. Alternatively, through the title Improving the Quality and Efficiency of Health Care the quality of and efficiency of the U.S. medical health system will be enhanced. Through this initiative, appropriate investments will be put in place to improve the quality of the current health care services. Similarly, through the title Revenue Provisions the cost of access health care services will be reduced significantly. Eventually, all these programs will reduce the healthcare expenditure and reduce the deficit. It is estimated that once the program is fully implemented it will cover health care needs for more 94% of Americans within the stipulated bill of $900 billion.
Unintended consequences of the Act related to the issues identified
With the passage of this act, every individual adult was required to purchase a health insurance cover to afford quality and accessible health care services. Failing to do so would result in penalties. Although the act will eventually enhance universal health care, it should be noted that it infringes on individual sovereignty. Individual sovereignty is infringed when a person is forced to purchase the insurance cover contrary to his or her wishes.
Another unintended consequence that would result from these initiatives aimed at offering quality and accessible health care services is reduction in employment for less skilled laborers. Through its subsidies, this act will result in reduction of financial rewards associated with working for long hours. These rewards will be phased out with family unit incomes. Under this act, as individuals work for more money they lose more subsidies. Eventually, individuals will have to decide on whether to increase their family unit income through better jobs or working for long hours.
Goodson, J. (2010). Patient Protection and Affordable Care Act: Responsible Reform for the Middle Class Journal , 12, 1.