Controversy always surrounds change. Healthcare is this kind of controversial topic where people refuse to accept changes, even though changes must be made. Obamacare details many changes, how they will be made, and whom they will affect. As with any bill, there are pros and cons that exist as the bill helps many, but makes some a little worse off. Taking into account the pros that include the minimum benefits package and expansion of Medicare coverage as well as the cons that include rising costs to government and a shortage of doctors, I would vote against the bill.
Obamacare is an extensive bill that completely transforms the healthcare system. The main part of the bill is the individual mandate that requires all citizens and legal immigrants to have health care coverage. If individuals do not have health insurance by 2014 there is a monetary penalty. In order to allow many Americans to obtain coverage, it outlines a major change in insurance practice in that companies are no longer allowed to deny individuals health insurance because of pre-existing conditions; individuals are able to buy into health insurance at anytime.
Obamacare expands Medicaid for those who cannot afford health insurance; the expansion will supply more than 17 million more Americans with health insurance than before the bill. People who are employed can fulfill this health insurance requirement by enrolling in their employer’s plan. Health insurance must be provided through employers if the company has 10 or more employees. Small businesses will be subsidized so that they can afford to provide insurance.
People without insurance through their employer will be able to buy plans through health insurance exchanges, where most will qualify for subsidies, greatly reducing the premiums. Exchanges are run by the state or non-profit organizations and require that all insurance companies offer certain plans that make it easier for Americans to determine the differences between companies and plans so they can choose one that is best for them. The cost of implementing the changes the bill puts forth will be paid for through budget cuts and taxes.
Though the bill provides many individuals with the opportunity to have health insurance, taxes and budget cuts will not be enough to sustain it (MacGillis 2010, 85-92). Within Obamacare there is a minimum benefits package that outlines the benefits that I believe every American has a right to. The package allows for equality under health insurance and allows those who are less well off to be able to have access to the benefits even if their coverage is minimal.
The package includes: “ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitative services and devices, laboratory services, preventative care and wellness care, chronic disease management, and pediatric services (including vision and dental care). ” The federal government outlines the services that must be included in the exchanges to make sure everyone has the minimum coverage. The government also makes sure that individuals are not being taken advantage of by profit seeking insurance companies.
Even though the government controls the plans there is still competition between the companies because of the other benefits that the insurance companies may offer in addition to those that are required. Without competition the insurance companies would take advantage of the consumers and charge higher prices solely to make a profit. The minimum benefits package helps all Americans not only receive better benefits, but also easily compare insurance plans (Whitman 2010, 32-34). Along with the minimum benefits package Obamacare addresses the problem of spotty prescription drug coverage found in Medicare.
Currently, there is a gap in coverage when the beneficiary consumes between $2,250 and $5,100 worth of prescription drugs a year. Many people do not realize that they have fallen into this donut hole until they are required to pay for the full amount of their drugs, but are unable to (Dorgan, 2006). The new policy will make the insurance companies pay for 75 percent of the drug expenses and leave the consumer to pay 25 percent. However, when the drug expenses reach the catastrophic threshold of more than $5,100, then the insurance Medicare will pay for 95 percent of the drug costs.
The government has already started to try and close this gap by subsidizing those who fall into the donut hole. Each year they will slowly increase the subsidy until the consumer only has to pay 25 percent. By addressing the donut hole that has occurred in the current health coverage Americans will be better off and no longer face drug expenses that they are unable to pay (Goldstein 2010, 113-121). However, the major changes come with huge monetary costs. Even with huge increases in taxes the government will not be able to pay for it. Obamacare requires all b
usinesses to provide insurance; if the business chooses not to they must pay a penalty. The quantity of the penalty is less than the cost of insurance; so many businesses opt out of providing insurance plans. If employees do not receive insurance through their workplace, they must buy insurance plans on the exchanges. The plans provided on the exchanges are heavily subsidized in order to make sure that they are affordable for the average American. When more Americans buy from the exchanges the government must provide more subsidized plans, creating a huge expense for the government.
Since the penalty for the businesses is so low, the government is unable to directly use that money to completely subsidize the insurance exchanges and instead must use money from the federal fund, further increasing our deficit. Moreover, another problem Obamacare faces with increasing costs is that more benefits can be added to the minimum benefits package as Congress sees fit. With the addition of more benefits the package and coverage for individuals will become more expensive and those expenses will fall directly on the government.
The government will continue to add benefits making it more and more expensive to insure. Overall, the rising costs of providing more benefits and the costs of subsidizing the exchanges are far too great to sustain and therefore make Obamacare implausible (United States, 2013). Another problem Obamacare faces is how all of the newly insured individuals will be able to receive care. Currently, America faces a shortage of physicians; this insufficient amount of physicians is projected to worsen as Medicare expansion almost doubles the strain of physicians with the passing of the new bill.
Obamacare takes into account the need to increase the amount of doctors with changes to health-care delivery and improved prevention. However, these increases will not be enough. The U. S. will face a shortage of more than 125,000 physicians in the next 15 years; however, only 27,000 new doctors are trained a year, and each year many more doctors retire (Feldman 2011, 113). Massachusetts already has put in place a health care reform that increases the number of people insured. However, they have already noticed the effect this increase in insured citizens has on the amount of doctor’s needed to treat the increased amount of patients.
“A survey of Massachusetts’s physicians displayed that almost 40% of family practitioners and 56% of internists reported that they were not accepting new patients” (Feldman 2011, 115). Before the implementation of this new reform, Massachusetts’s practitioners and internists were able to accept any new patients that were applying. This is not only a problem for primary care doctors, but also specialty doctors. Current healthcare statistics reveal that a doctor sees on average 38 patients a day.
That is, a patient every seven minutes of an eight-hour day. This data does not even include the time doctors spend returning calls, entering data, and speaking to consultants. With the new expansion in health insurance there will not be enough time in the day for physicians to see all of their patients. The new expansion of coverage will lead to patients scheduling more appointments because they no longer have to pay for them. They will schedule appointments for a common cold or simply for just something to do and someone to talk to.
In order for Obamacare to successfully work there must be more doctors or a more efficient way of dealing with the increased number of patients (Feldman 2011, 113-122). The positives of Obamacare, the minimum benefits package and more prescription coverage, do not outweigh the negatives, which include rising costs and a shortage of doctors. The cons are huge factors that must be addressed in order for Obamacare to be successful. If we are unable to pay for the treatments or even to provide the proper medical professionals to treat the increase in patients, then the basic goal of the bill cannot be achieved.
Overall, I believe that though Obamacare is addressing a desperate need within our society, the method by which it attempts to implement reform is not realistic, and in fact will create more harm to society than good. Instead of implementing Obamacare, I would vote against the bill and believe that the President and Legislature should go back to the drawing board and figure out how to insure all citizens can have insurance without increasing our federal deficit and overwhelming our healthcare system.
