Health care reform has long been an issue within the United States given the necessity for quality health care and insurance needed to survive in the modern world. However, while the intension of health care reform is for the benefit of all Americans, positions regarding such idea remains heavily contested even at the present time due to the beneficiaries of such reform and the impact it would have in the health care industry. On the one hand, there might be an increase on taxes to pay for those who do not have their own insurances and cause health care to increase in costs. On the other hand, this would save countless of Americans who have no capacity to pay for quality health care benefits. With the introduction of policies such as the Affordable Health Care Act of 2010 (or also known as the Affordable Care Act, the US health care system has now transformed to expand its capacity to provide quality health care for all those who need it.
Health care reform has long been an issue since the 1930s due to the increasing calls of civil society groups and labor associations to improve health care services that would be affordable with their current wages. According to Mason, Leavitt, and Chaffee (2013) Presidents Franklin D. Roosevelt, Harry Truman and John F. Kennedy had tried to create a National Health Insurance system as a response to these calls, but the opposition from the Republicans, Southern Democrats, the American Medical Association, and the private health care insurance providers. Under Lyndon B. Johnson’s tenure in 1960, he managed to create the Social Security Act amendments of 1965 that would establish Medicaid and Medicare to create affordable health care programs for the public. However, the succeeding administrations of Presidents Richard Nixon, Jimmy Carter and Bill Clinton did not continue the amendments and left health care back into debate. Recently, the debate has been revived due to the lack of improvements on health care especially for the US population and the increasing costs of health care services and insurance. Although the country is lauded with the most advanced and expensive health care system in the world, it had already exceeded the mortality rate set for developed nations who have the capacity to prevent these deaths and the lowest for health quality measures for maternal and child mortality. As of 2009, the American Journal of Public Health estimated that almost 45,000 people have died in the country due to the lack of health insurance and access to health care. The US Census supported the study and reported almost 49.9 million Americans who are not insured, increasing drastically due to the decline in employer-based health insurances. If government action is not done in any way to improve health care, mortality rates and uninsured Americans would continue to increase .
However, there are several advantages and disadvantages of health care reform should it be applied to the United States. As far as the advantages are concerned, Coady, Clements and Gupta () indicated that health care reform would benefit all those who are not qualified under the Medicaid or Medicare, which includes children and dependents. Having healthcare reform would also enable people would pre-existing health problems originally denied of service by the government or private insurance companies due to the fees attached to their corresponding health problems. Expanded coverage would also be the advantage of health care reform as it would cover children and those normally not included in healthcare. With free or affordable health care programs, reform would provide financial relief for families and allow families to have insurance security for their families and select appropriate plans that would be suitable for the family. However, some argue that health care reform is complicated as it would only contradict the universal insurance coverage needs of the people due to resources for sustaining these coverage and political and social education for the people. Health inequalities would also be a problem for health care reform because of the health quality of people that is affected by socioeconomic factors like income, education and occupation and cannot easily be defined by the health care sector. Finally, cost is also a crucial argument for many because of the increasing costs attached to health spending and quality .
As far as the Affordable Health Care Act of 2010 or the Affordable Care Act of 2010, its inception, according to Barr (), was after the inauguration of President Barack Obama and immediately worked with the Congress to discuss health care reform. The Congress was given the liberty to decide on the reform legislation and was given five separate committees to discuss the draft: 2 from the Senate and 3 from the House of Representatives. It was agreed by the committees that in order to expand health care insurance coverage, it would require all residents to carry health insurance while requiring all employers to offer insurance. Massachusetts had earlier promoted the same reform a few years earlier, but in the case of country-wide reform, the politicians had been worried as to the acquisition of coverage. Senator Max Baucus (D-Montana) proposed the creation of public health insurances similar to Medicare, which would be held by the federal government. The Republicans immediately disagreed with the public insurance decision such as Senator John Cornyn (R-Texas) and Senator Charles Grassley (R-Iowa). To them and their party, this would only spell increasing government control over health care which should not be under the government. The debate continued between the Democrats and the Republicans and in order to stop this impasse between the two parties, President Obama addressed the two houses and stressed three things for reform: expanding health insurance to those who cannot afford it, constraining the rising cost of health care in the country, and improve or expand coverage for those with terminal and chronic illnesses. In response to the decree, the Congress submitted their version of the act on November 7 and the Senate followed on December 24. Budget reconciliation was raised in the meetings of both houses to discuss such as the Consolidated Omnibus Budget Reconciliation Act. Obama had also convened summit meetings with leaders of both Democrats and Republicans to discuss the problems of health care and the possible compromises that can be done. Eventually, the houses have approved the health reform bill and Obama signed it into law on March 23, 2010 and was known as the Affordable Health Care Act of 2010 or the Affordable Care Act of 2010 .
The ACA has several provisions that would enable the improvement of patient and physician experience and to sustain health care reform. According to Abrams, Nuzum, Mika and Lawlor (2011), the ACA would enable the augmentation of funds and incentives to clinicians who are under Medicare and Medicaid to ensure the stability of the workforce and to grant more patients quality health care service. This would ensure the reduction of expenses and disparities when it comes to receiving cheap health care. Bonuses would also be given to improve health care services and reduce the fees attached to service of physicians. Patients themselves would be given bonuses if they obtain preventive care services as it would remove deductibles and taxes for important medical treatment tests such as cancer screening, mammograms and blood-pressure. Beneficiaries of the ACA would also be given affordable health care options, especially for low-income patients. ACA also would provide medical services at home to ensure they can reach patients with chronic health ailments and to also reduce the cost for these patients for travel. Research and state health development is also supported by the ACA to ensure that doctors and health practitioners are capable of answering the calls of its patients and reduce expenditure for the government. Funds of almost $11 billion dollars would be provided in the span of five years to improve training, residency programs and loans for practitioners in order to ensure they would be able to give quality service to the people. However, there are still concerns as to the access of health care for patients because of the lack of health practitioners in the country and the competitive market physicians would have to endure under the ACA. Experts also argue regarding the Payment System that would be incorporated by the ACA to pay for heavy operations considering the lack of financial support for American health practitioners as compared to their peers. .
With health risks steadily becoming severe and dangerous for all people, the necessity for quality health care is crucial to protect families and lives in the process. As far as the ACA is concerned, its intentions, although still untested and questioned, is actually very important in this day and age because it is difficult to find quality health care that is cheap and affordable. In a personal extent, the ACA is needed because not all people have the capacity to get health care and even they should be provided such liberties considering that some of them power the country in their own way. The ACA is also important because if the health care system of the country remains restricted to a selected few and its development remains at its traditional state, there is a possibility that mortality rates would increase especially for illnesses that is easy to prevent.
Abrams, Melinda, et al. Realizing Health Reform's Potential: How the Affordable Care Act will Strengthen Primary Care and Benefit Patients, Providers and Payers. Publication. New York: Commonwealth Fund, 2011. Print.
Barr, Donald. Introduction to U.S. Health Policy: The Organization, Financing and Delivery of Health Care in America. Baltimore: Johns Hopkins University Press, 2011. Print.
Coady, David, Benedict Clements and Sanjeev Gupta. The Economics of Public Health Care Reform in Advanced and Emerging Economies. Washington, D.C.: International Monetary Fund Publications, 2012. Print.
Mason, Diana, Judith Leavitt and Mary Chaffee. Policy and Politics in Nursing and Healthcare. St Louis: Elsevier Health Sciences, 2013. Print.