Is affordable healthcare affordable? Is it profitable?
No market-based health care system would measure its success in what truly matters — the health, longevity or quality of life of its patients. Rather, the purpose of such a system is to provide people with as much healthcare treatment as they can afford and to make money doing so.
Therefore, the only way to measure the true success of ObamaCare is to see whether enough money is being made.
ObamaCare, rightfully known as the “Patient Protection and Affordable Care Act (ACA),” was passed into law on March 23, 2010. A primary goal was supposedly to provide coverage for Americans who were neither eligible for Medicaid or Medicare nor could afford private insurance.
Today, more Americans do, in fact, have health care insurance now than before the ACA was passed. But the program is far from perfect.
Affordability or lack thereof
Patients complain of low coverage, restricted networks and high premiums. Many small businesses and individuals do not qualify for subsidies but cannot afford to pay full costs, leaving some still uninsured. High deductibles are another major complaint.
Bill, a 53-year-old widower and single parent summed up what many ObamaCare recipients are feeling when he said, “Sure, I have health insurance, but I can’t afford to use it.”
Doctors find themselves having less time to spend with each patient and difficulty providing them with the care they need. Regulatory issues are extremely burdensome and difficult to accommodate. Some are even calling for socialized medicine, despite the implications. A few have even suggested that ObamaCare was designed to usher in socialized medicine to the U.S.
The insurance companies are not happy, either. Consumer Operated and Oriented Plan (CO-OP) Programs offered insurance plans at a lower cost than private insurers under a federal grant and loan program written into the ACA. Now, 17 of the original 23 CO-OPs have closed as a result of too few young and healthy people and too many old or sick people signing up, which created a costly imbalance. The remaining six CO-OPs are struggling. Struggling even more are the enrollees of the closed programs, but at least new legislation (H.R. 954 and S. 3311) will protect enrollees from having to pay fines for being uninsured.
Although about 30 percent of insurance companies were able to profit in 2014, many reportedly required and apparently received a lot of help from the taxpayers. Bailing out these insurance companies is yet another big problem.
In 2014 alone, 175 insurers were due compensation estimated to be in the billions of dollars. Big bailouts apparently came from a taxpayer-funded budget from the Department of Health and Human Services or a so-called Treasury Department Judgment Fund. According to a recent letter from the Government Accountability Office, billions, in fact, have been paid to ObamaCare plans.
Another program, called “risk corridor,” promises insurers a fund in which those with low costs pay in and those with high costs pay out, so it works out evenly. If it doesn’t work out evenly, insurance companies may sue to receive compensation through “the Treasury Department Judgment Fund,” which is creating further controversy.
Neither bailout option sounds sustainable, or even legal for that matter. A better approach might be to pinpoint what exactly is broken in the system and to take steps toward fixing it.
Whether the ACA is good or bad depends on one’s perspective. Individual stories about how the ACA has impacted American families illustrate the fact that there is no one-size-fits-all solution. Small business owners, working class families, the young, the old and the disabled all seem to continue to struggle. Once again, the bottom line appears to be money. Nothing personal, I’m sure – just business.
The problem is that health care by its very nature is extremely personal. Maybe our market-based business model simply doesn’t fit when it comes to health care. Maybe compassion, altruism and social responsibility need to play larger roles. After all, how can anyone put a price tag on a human life?
The Hippocratic Oath for entering the field of medicine is basically a solemn vow to avoid inflicting harm or injustice on patients. The oath basically contracts the health care provider to treat all patients like family members. How have we been doing since the oath was written?
On the bright side, the ACA has had some positive effects. For example, people with pre-existing conditions have been able to obtain coverage without being charged more than others. Also, parity for mental health services ensures that mental health care is reimbursed at the same rate as that for other medical problems. Free and low-cost preventive services have also been added. As Election Day draws near, legislation to amend or repeal the ACA tops headlines. Perhaps now is the time for Americans to speak up about what kind of health care system they want for themselves and future generations.
Dana Connolly, Ph.D., is a senior staff writer for Sovereign Health, a Joint Commission-accredited behavioral health treatment provider with locations throughout the United States. She earned her Ph.D. in research and theory development from New York University and has decades of experience in clinical care, medical research and health education. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org, visit us at SovHealth.com, Facebook and LinkedIn, or follow us on Twitter.
The views expressed by contributors are their own and not the views of The Hill.