Patient Protection and Affordable Care Act Debate

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22nd Mar 2019 Health Reference this

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Patient Protection and Affordable Care Act should continue

When people heard the news that the first patient with the Ebola virus arrived in Dallas, they were frightened by not only panic about the Ebola virus itself but also by fear that someone in the early stage of infection might not see the doctor because of the enormous cost of health care. In March 2010, President Barack Obama signed into the law the Patient Protection and Affordable Care Act (PPACA) or obamacare. It is the United States’ first health care reform since legalization of Medicare in 1965. Provisions of PPACA include that, in brief, all Americans should buy health insurance from the Health Insurance Marketplace in their state. Another provision states that the federal government should support insurance exchange’s financing (“Patient Protection and Affordable Care Act (PPACA)”). PPACA needs to continue because through the implementation of this Act, people with pre-existing conditions as well as a lot of uninsured people can be aided, and the budget for Medicare can be reduced at any time.

Although there are many opposing views on PPACA, the implementation of PPACA has to be supported because of its clear advantages. For example, imagine that there are a man with type I diabetes, which developed when he was young. To manage type I diabetes, periodical injections of insulin are needed. This means that he needs to visit the doctor to get insulin throughout his life. The cost of insulin depends on insurance coverage. If he tries to apply for insurance in this situation, the insurance company will decline his application due to he has a pre-existing condition. The reason why he is worried about this problem is that he is an American. Fareed Zakaria reports that other countries, such as Switzerland or Taiwan, support their people’s universal insurance independently of pre-existing conditions (22). This is possible because the government, not private insurers, provides the coverage (22). Before PPACA came to the front, Americans had to be anxious about the United States’ terrible health care support system. To address this issue, PPACA prohibits that insurance companies deny an application on account of applicants’ pre-existing conditions (“Patient Protection and Affordable Care Act (PPACA)”). Also, another benefit of the program is that the uninsured Americans can be aided by expansion of PPACA. With the implementation of PPACA, they can have opportunities to get medical service when they require it. According to the article written by Leonard Zwelling, for example, 28 percentages of adults, about 6 million people, in Texas are currently uninsured and about 3 million uninsured Texans can get coverage by the implementation of PPACA (13). In addition, because the budget cuts for Medicare are possible if the states’ finances are endangered PPACS should continue. One of key facts that the Obama administration provide PPACA includes current Medicare and has a plan to expand it with states’ cooperation. Uninsured adults do not have as much political leverage as wealthier insured citizen who can contribute to political campaign. Therefore, the securing of the budget for Medicare can be threatened easily when there is pressure to cut the budget. “Already, there are calls for curbing the law’s subsidies that will help the uninsured buy coverage as part of a bipartisan budget deal-an extraordinarily bad idea, given the limited scope of those subsidies.” Clearly, PPACA is required to protect and expand Medicare. / reference: Oberlander, Jonathan, The New England Journal of Medicine.

The debating on the implementation of PPACA continues even though PPACA has already begun implementation. Young Americans oppose the implementation of PPACA because they already have health insurance, and they might spend more money if the federal government and states try to expand health insurance. The Institute of Politics of Harvard University questioned “2089 citizens aged 18 to 29: 56% of those 18 to 24 disapproved of the President’s job performance; 53% of those 25 to 29 disapproved; and 47% maintain they would recall President Barack Obama if that were possible” (Emord, Jonathan W. “YOUNG AMERICANS TO OBAMACARE: NOT INTERESTED” USA Today, February 2014. 16). They argue that PPACA is primarily attractive to those who have been uninsured in the past and who suffer from chronic or acute and costly diseases. It is likely that only those individuals will sign up for the program. Most of interviewees have already health insurance. They think that PPACA’s benefits will not affect them because they are already insured by some other way. Instead, those polled might think that they will have to pay the money that allows expanding health insurance through PPACA. Also, because PPACA does not target a specific population, money might be wasted in the allocation of funds in the federal governmental budget for PPACA’s implementation. In his article “The Future or Obamacare”, Jonathan Oberlander argues that there is no “clear programmatic identity: unlike Medicare and Social Security, PPACA does not have a well-defined population of beneficiaries, and its benefits are diffuse.” (Oberlander, Jonathan. “The Future of Obamacare”, The NEW ENGLAND JOURNAL of MEDICINE (2012). Furthermore, Texas and 15 other states assert that PPACA, with expansion of Medicare, should be reconsidered because it will raise state expenses. (Zwelling, Leonard. “Obamacare: Why Should We Care?” Journal of Oncology Practice Vol .10, Issue 1 (2014). This is the most difficult, prolonged assault, which the federal government and states should overcome for continuous implementation of PPACA. In spite of these opposing opinions, PPACA should continue to go to the fore. First of all, nobody can assure that they will have enough insurance when they will need health care. In 1963, Kenneth J. Arrow wrote, “UNCERTAINTY AND THE WELFARE ECONOMICS OR MEDICAL CARE”. In his article, Kenneth J. Arrow contended that health care industry could be explained with “uncertainty in the incidence of disease”. Namely, the reason why young Americans oppose PPACA implies that young Americans are literally young. Current situation can change suddenly; the insurance is for risk and uncertainty. Reference : Kenneth J. Arrow, “UNCERTAINTY AND THE WELFARE ECONOMICS OF MEDICAL CARE”, The American Economic Review, Vol LIII December 1963 Number 5 941-973. Moreover, PPACA’s targeting to the universal population of the US is not a weak point, but a strong one. There are other countries with universal access and universal insurance such as Switzerland and Taiwan. Their types of insurance are similar to Medicare supplied by their government instead of being supply by private insurance companies. Surprisingly, while the United States spends 17% of its GDP on health care, Switzerland and Taiwan spends 11% and 7% respectively, of their GDP on it. Because PPACA is not completely enacted Act yet, addressing concerns over budget waste and discussing solutions are necessary to make PPACA move forward Reference: Zakaria, Fareed, Time magazine, 3/26/2012. Last but not least, the Federal government, not each state, will support the expansion of PPACA at a 100% level until 2017, a bit less later, then at 90% indefinitely after 2022(Zwelling, Leonard 12). For example, in Texas, for every $1 the state spends on health care for the poor, the US government matches $9 dollars. This effectively means that, during the first 10 years of the program in Texas (current Medicare program plus expansion) the federal government would increase payments to the Texas health care system by nearly $90 billion, whereas the state of Texas’s share would be $15.6 billion. However, there are no specific plans after 10 years. More patchworks should be added in many holes of PPACA for its sustainable implementation.

PPACA is not perfect yet, but its direction is right. Because PPACA can aid people with pre-existing conditions or uninsured people and can support Medicare, which may be endangered. The opponents argue that they have already health insurance, money might be wasted, or state expenses will be increased. PPACA, supported by the federal government, however, can guarantee people’s future health insurance. In the process of the implementation, although waste of the budget can occur, and PPACA does not have enough time to be revised, it can be getting better with continuous debating with many opposing views. Therefore, PPACA needs to go on in spite of several opposing opinions.

Works cited

Arrow, Kenneth J. “UNCERTAINTY AND THE WELFARE ECONOMICS OF MEDICAL CARE” The American Economic Review LIII (1963): 941-973. Academic Search Complete. Web. 16 Oct 2014.

Emord, Jonathan W. “YOUNG AMERICANS TO OBAMACARE: NOT INTERESTED.” USA TODAY Feb. 2014: 16. Print

“Health Care that Works for Americans.” the White House PRESIDENT BARACK OBAMA. The government of the United States of America, 2014. Web. 28 Oct. 2014

Levy, Michael. “Patient Protection and Affordable Care Act (PPACA).” ENCYCLOPAEDIA BRITANNICA. Encyclopaedia Britannica, Inc., 2014. Web. 16 Oct. 2014

Oberlander, Jonathan. “The Future of Obamacare.” New England Journal of Medicine 367.23 (2012): 2165-2167. Academic Search Complete. Web. 16 Oct 2014.

Zakaria, Fareed. “Health Insurance Is for Everyone.” Time 26 Mar. 2012: 22-23. Print.

Zwelling, Leonard, and Hagop M. Kantarjian. “Obamacare: Why Should We Care?” JOURNAL OF ONCOLOGY PRACTICE 10.1 (2013): 12-14. Academic Search Complete. Web. 16 Oct 2014.

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