Affordable Care Act is a statute signed into a law by Barack Obama on March, 23 2010. This act which is also known as Obamacare is a part of a health care reform which among other things will change and regulate requirements for employers’ group insurance plans as well as private health plans and public health programs. There are a lot of pros and cons to this reform and a lot of aspects of the act are being misinterpreted or misunderstood. Although this reform was designed with the best intents, certain aspects of it seem to be questionable.
One of the aspects that raises the most disputes among the political leaders is the funding issue associated with the implementation of this act. In order to finance the new program 500 billion dollars were taken out from Medicare funds to be set aside to fund Obamacare. So that this reform can be better evaluated, it is important to understand all the perspectives of the reform, and evaluate who will benefit from it in a short and in a long run.
Aside from political dispute, one of the important perspectives of this reform is the regular people who will be affected by it, including both employers and employees, and their concerns that this reform is raising. Employers are feeling anxious of being forced into providing health coverage to their employees and extra economic costs that they will be forced to face in order to do so. Some business owners are even worried of their overall ability to stay in business if they experience extra expenses.
Employees are worried about the costs that they will carry, as they will be forced to cover part of the costs associated with mandatory health coverage, and what will remain of their paychecks in order to be able to provide for their families. And the last major category at stake is doctors and health care providers themselves who are wondering what will happen when additional 32 million Americans get medical insurance, and who will be treating them as the resources available to provide medical help these days are already limited.
In this analysis I will try to utilize different ethical approaches and philosophical theories that will help better understand pros and cons of this reform, as well as the positions taken by our political leaders in regards to it. At the end, I will conclude with my own understanding of this reform and consequences that I see it will lead to. In my opinion, one of the most commonly used ethical theories is utilitarian theory. I will use this theory to identify the ethical and economical questions raised by this reform.
According to utilitarian theory, the decision is considered ethical if it does greatest good to the greatest number of people. But in order to determine the amount of people affected positively or negatively, it is important to identify all the stakeholders of that decision. We already identified several groups that will be affected by Affordable Care Act, such as employers, employees and their families, doctors and other healthcare providers, but also we need to include regular taxpayers as funding of Obamacare might affect them too.
What is also important to understand, is the difference between the benefits that this program will give now against the consequences of the same program that can be experienced in the future. Let’s take a look at the White House prospective and the perspective of the opposition in both short and long runs. By enforcing this act, legislators believe that the advantages of this reform outweigh the cost. Medicare spending continues to go up year after year.
The health care bill tries to identify ways to save money, and so the $500 billion figure comes from the difference over 10 years between anticipated Medicare spending and the changes the law makes to reduce spending. “Reducing the deficit by $143 billion over the next ten years, and by $1. 2 trillion more over the following decade; reining in waste, fraud and abuse, paying for quality over quantity of care.
Failure to enact reform would have meant continued double digit premium increases—some as high as 60%, arbitrary loss of coverage, and huge increases in the national deficit”, states Nancy Pelosi. In accordance with the new law among greatest advantages would be an opportunity for the young adults to stay under their parents plans until they are 26 years old; private insurance companies will be required to justify increases in premiums and will be prohibited from refusing coverage based on pre-existing medical conditions.
Additionally, in accordance with a new legislature lifetime limits or caps on total benefits that can be paid out to the beneficiaries will be prohibited. And lastly, employers will benefit as they will be provided with larger tax credits for providing health insurance coverage to the employees. In other words, this reform will benefit all those who currently do not have health coverage by providing them with one, and will benefit the ones who are currently covered by employer’s group or private plans by imposing stricter regulations on the nsurance companies. On the other hand, the opposition argues that this reform will hurt more than it will benefit.
“Senior citizens get this more than any other segment of our population, because they know in Obamacare the president of the United States took away $500 billion — a half-trillion dollars — out of Medicare, shifted it to Obamacare to pay for younger people. And it’s senior citizens who have the most to lose in Obamacare,” argues Rep. Michele Bachmann (R-Minn. Paul Ryan also argues that this law relies on 10 years of tax increases to pay for six years of new spending, and that it is also damaging to job creation and economic growth as it encourages employers to drop coverage and let employees enroll into a government-controlled programs. So what seems to be working in a short run will lead to major problems in the future as the funds taken out from Medicare will reduce short term costs and out of pocket medical costs for everybody, but it will be not enough time to rebuild the budget for the future cost, which will ultimately can cause the whole system to collapse.
After carefully analyzing both positions in regards to Affordable Care Act, it is hard to define if there is a solution that will satisfy both legislators and its opposition. It looks that there is no “Golden Middle” at this point in time, and it is obvious that more work needs to be done by the White House to make the new law work. From utilitarian perspective, the new act will definitely benefit the majority of people in the short run, as the stakeholders under the new law are all the citizens of the US.
However, in the long run the same law can hurt the same amount of people unless the government will find a way to ensure that current program will lead to savings in the future that will prevent the whole system from collapsing. The benefits of the new law cannot be argued right now as the law does benefit everybody currently covered or uncovered by the health plans. But until uncertainty about the future of the law is completely eliminated, it is hard to say if taking out $50 billion a year from Medicare funds is justifiable.
Another interesting perspective to analyze is the position that was taken by representatives of libertarian party after Supreme Court upheld Obamacare constitutional on June 28, 2012. “Libertarianism, in the strict sense, is the moral view that agents initially fully own themselves and have certain moral powers to acquire property rights in external things. Libertarianism is sometimes identified with the principle that each agent has a right to maximum equal empirical negative liberty, where empirical negative liberty is the absence of forcible interference from other agents when one attempts to do things. Today’s definition of libertarianism is a little bit different. Today libertarianism is simply defined as belief in liberty. Libertarians fight for peaceful world where each person is free to pursue his own dreams, and has rights to decide as he pleases as long as it does not harm anybody else. Libertarians believe in and strive for everybody’s individual and political freedom. After Supreme Court’s recent ruling on Obamacare was announced, number of libertarian candidates commented on the decision.
According to libertarian presidential nominee Gary Johnson, Supreme Court’s ruling cannot be considered constitutional, as it violates the principles of freedom and liberty, as upholding Obamacare forces US citizens to buy something just because they exist and live in this country. He also states that the whole idea of government trying to control and manage the quality of life of its citizens is wrong in nature. Another libertarian Andrew Ian Dodge argues that this ruling also violates individual freedom and liberty by giving the government power to penalize people by increasing taxes.
After analyzing different political positions in regards to Affordable Care Act, and economic and ethical considerations that politicians are using in support of their views, it is hard to take a side. Even though one thing stays clear, in order to support any argument our political leaders tend to influence moral values and beliefs that majority of people have in common. They are all trying to appeal to our core values. There are basic needs that every human being has. We all want for ourselves and our families to feel safe and secure, to have a home and to have enough food.
So we tend to reject everything that can jeopardize these basic needs. In regards to Obamacare, there are too many uncertainties left, so it is very hard to find ultimate decision that can please everybody. Everybody prioritizes these core values differently, and depending what dominates, leads to a different decision. I don’t think there is a right or wrong answer about Affordable Care Act. Everybody sees it differently depending on his owns values or beliefs. I truly believe that present government is trying to do its best to make sure that health care will be available for everybody, but only time will show if he ways they are using and decisions they are making to accomplish this goal will work the best.
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