United States’ Health Care Reform: The Literature


Hi Guys and Happy Boxing Day to my Canadian and English friends! Today, I wanted to deal with something that concerns all Americans today and will in the future– wellness and health care. If you live in the United States, you know election years are some of the ugliest years with news media, politicians, and the general population on polar ends of the political spectrum on issues such as health care.  But, beneath it all, lies the same fear–the preservation of our nation and its people.

After President Trump’s victory with the new Tax Reform being signed into law, the next thing on his agenda is infrastructure, which you may think alludes to the conditions of “bridges, roads, and highways”, but it should go deeper than that. The infrastructure the President is referring to also includes the organizational structure or the “framework” of the welfare system after all these two go hand-in-hand. How? As the tax reform passed in 2017, so soon will the budget, and then the Congress will decide how and where to “spend the money”. One may allocate money for the physical infrastructure such as buildings and roads, and separately for the welfare systems such as health care; however, if we look at these two through a bird’s-eye view as I suggest, we need to see them as two categories under a SAME grand “America’s Welfare System”.

With healthcare being the second and THE next task on President Trump’s infrastructure agenda, I thought I give an opinion on the literature of the current healthcare system and how I think it can be further improved.

Honestly speaking, I am a little concerned about the “individual mandate” being lifted off by the new Tax plan. This means that individuals like illegal immigrants and the unemployed will not be REQUIRED to pay for their own health insurance, but would instead depend on finding a job that will provide them with complete health benefits. In my opinion, that is a BAD deal for the general population. Before I go further into this, I want to give a little background about the current healthcare plan:

What is Our Current Health Care System?

According to Wikipedia, “The (current) Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system.” 


According to Wikipedia , “By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20–24 million additional people covered during 2016. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and to major changes (expansions) to individual insurance markets. Both involved new spending, funded through a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office reports said that overall these provisions reduced the budget deficit and that repealing the Affordable Act would increase the deficit. The law also enacted a host of delivery system reforms intended to constrain healthcare costs and improve quality. After the law went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.” 

While the employer-based plans more or less stayed the same, the individual insurance markets saw the most changes. “Insurers in these markets are made to accept all applicants and charge the same rates regardless of pre-existing conditions or sex. To combat resultant insurance companies’ adverse selection (based on pre-existing conditions), the act mandates that (unemployed or illegally immigrated) individuals buy insurance and insurers cover a list of “essential health benefits”. However, this mandate was repealed starting in 2019 by the passage of the Tax Cuts and Jobs Act of 2017 (it passed last week). To help households between 100–400% of the Federal Poverty Line (what about the homeless?) afford these compulsory policies, the law provides insurance premium subsidies. Other individual market changes include health marketplaces and risk adjustment programs.

But, what happens after the “Individual Mandate” lifts in 2017?

From now on these individuals are not subject to the mandate:

  • Illegal immigrants, estimated at around 8 million—or roughly a third of the 23 million projection—are ineligible for insurance subsidies and Medicaid. They remain eligible for emergency services.
  • Eligible citizens not enrolled in Medicaid.
  • Citizens who pay the annual penalty instead of purchasing insurance, mostly younger and single.[19]
  • Citizens whose insurance coverage would cost more than 8% of household income and are exempt from the penalty.
  • Citizens who live in states that opt out of the Medicaid expansion and who qualify for neither existing Medicaid coverage nor subsidized coverage through the states’ new insurance exchanges.[20]
  • All citizens as of December 20, 2017

This means fewer people will be insured (because they are not required to get insurance) and have access to preventable health services and will have to pay for emergency services instead. Thus, President Trump’s agenda of health premiums coming down or the tackling the opioid epidemic will fall short.

What Should Happen in the Long Run?

I think we need to have a bipartisan POINTS to tackle the American Health Care System, which may seem controversial to both parties, but will help the general public at large. First of all, all American individuals, immigrants, illegal immigrants, old/young, rich/poor should be required to have insurance by the government. This is a very “democratic party” point. Then comes the point of who pays for the insurance premiums-the individuals or groups (like employers)? I think individuals should be required to pay for their own premiums, whether employed or not. This should make the laissez-faire “Republican Party” happy.

This way each individual and family get the same and equal quality of health care. Insurance companies are happy, employers are happy, and ALL individuals are happy. Please do not let the Washington lingo thrown at you confuse you because that is what they do instead of investing in improving healthcare technologies. If ALL full-time and part-time individuals pay for the premiums they can afford, then truly the health costs will come down for all and we will have a bi-partisan HEALTH CARE SYSTEM in the country.

To learn more about the current health care system, you can read it HERE. Happy Reading!

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