Leave a comment

Health Care Reform: Is It Really Working?

Vanilla Ice famously once said “Stop, Collaborate and Listen” in his 1989 song “Ice Ice Baby.” To the same token, we all can agree that we do not do enough of collaborating and listening when it comes to the issue of health care reform: it is a complex topic with no easy fix and one which has become divided on party lines.

In the 2008 U.S. presidential election, health care reform was a major topic of discussion. And after his inauguration, President Obama announced to a joint session of Congress in February 2009 his intent to work with Congress to construct a plan for health care reform. In turn, the Patient Protection and Affordable Care Act, or commonly known as “Obamacare,” was signed into law on March 23, 2010.

Since its inception, more than eight million people have enrolled in private health insurance under Obamacare for 2014, with the state of Vermont having the highest percentage of enrollment and the state of Iowa the lowest. However, this is less than one-third of the number of people who could have signed up. Using data from the Census Bureau and the Department of Health and Human Services, the Kaiser Family Foundation estimates 28.6 million U.S. residents were eligible to buy health insurance via the exchange, compared to the eight million who did.

A large number of these enrollees were those in greatest need; they had pre-existing conditions that shut them out of the pre-Obamacare market. Furthermore, 85 percent of the eight million people who enrolled received tax credits that reduced their monthly premiums. With all this being said, you might be wondering what effect Obamacare will have on the economy. According to a 2010 Center for American Progress report, up to four million jobs will be created by Obamacare over the next 10 years. Obamacare reduces the cost of health care, making it cheaper for businesses to hire. The law is expected to create between 250,000 and 400,000 jobs a year and likely will help create more than 200,000 manufacturing and 900,000 in the service sector by 2016. In addition, proponents of Obamacare say it will be cheaper for employers to provide health care to employees.

According to David Browdin of the American Sustainable Business Council, each car sold by GM contains $1,200 in health care costs for the company workers. Thanks to Obamacare, small businesses are already receiving tax credits written into the law to help insure their employees. Reading the above, one might think Obamacare is progressing well. However, it has it’s fair share of misses.

It is important to understand that under the Affordable Care Act, one can buy five different types of plans on exchanges: Catastrophic, Bronze, Silver, Gold and Platinum. The higher-tier plans have lower deductibles and co-pays but higher premiums. McKinsey, a multinational management consulting firm, released its latest analysis of preliminary rate filings for 2015. Among other things, McKinsey looked at the premium of the lowest-priced Silver plan in 2015 and compared that to the premium of the lowest-priced Silver plan in 2014. This comparison is useful because Obamacare’s insurance subsidies are geared to the cost of Silver plans and because 65 percent of those selecting plans this past year chose Silver plans. McKinsey found that the premium of the lowest-priced Silver plan increased by an average of 8 percent in 2015. Speaking of the cost to create the official Obamacare website, healthcare.gov, Bloomberg Government Analysis estimates that the website alone cost $2.1 billion and counting. That amount of money could pay for tens of thousands of people to be insured for life with premium plans. In addition, Obamacare health-insurance policies limit your choice of doctors as well as your choice of hospitals. For example, several major cancer treatment centers are excluded.

In conclusion, Obamacare has its pros and cons but it remains to be seen whether it really is a solution to the complex problem of reforming health care. In a recent poll conducted November 2014, just 37 percent approved of the Affordable Care Act, 1 percentage point less than the previous low recorded in January 2014. Time will tell what happens in the years to come.

Hormuz Nicolwala Hormuz Nicolwala (5 Posts)

Editor Emeritus: Former Medical Student Editor (2013-2015)

Texas A&M Health Science Center College of Medicine

I am currently a first-year pediatric resident at the Children's Hospital of West Virginia. I received my MD degree from Texas A&M Health Science Center in 2014. I love medical writing!