Introduction
Over the past several decades prior to the Affordable Care Act (ACA), America had disproportionately increased health care spending, although there had been no tangible reasons in terms of improved quality of services. The cost of insurance per employee had almost doubled, and a significant part of the population remained uninsured. The insurance market provided by employers had been extremely monopolized, which impeded labor mobility and created an environment where discrimination is possible. To address all these issues, ACA was passed, which provided a transparent set of available coverage choices. There are various levels of coverage defined by the ACA, including Bronze, Silver, Gold, and Platinum. There is also a catastrophic plan for specific circumstances and certain age group.
A Bronze plan is targeted at people who are generally healthy because it is the cheapest of metal plans and features high deductibles and copays. Bronze level coverage will pay for 60 percent of the full cost of medical services (Patient Protection and Affordable Care Act, 2010). A Silver plan is suitable for those who want to pay a little more because there is more routine care needed. Seventy percent of all costs will be covered under this plan (Patient Protection and Affordable Care Act, 2010).
Gold level plans have high monthly premiums but low deductibles. It is suitable for those who visit health care facilities more often. All Gold level plans must pay for 80 percent of the total cost (Patient Protection and Affordable Care Act, 2010). A Platinum plan provides benefits equivalent to 90 percent of the full price (Patient Protection and Affordable Care Act, 2010). It has the highest monthly premium but the lowest deductibles. A Catastrophic plan covers all preventive services and additional three primary care visits per year before requiring the first deductible to be met (Patient Protection and Affordable Care Act, 2010). It is cheaper than the previous four coverage levels, but not everybody can qualify for this plan.
Health Care Reform Challenges
There are firm distinctions in how people approach health care reform. These differences in views have been fueling both political and informal debates for many years, posing a hindrance to prospective laws and acts. Among the specific factors making health care reform difficult are the lack of clear vision, prioritization between costs and access, debates over whether the government should take full control, political partisanship, and economic self-interest of critical stakeholders.
The lack of a national vision on health care will always result in contradicting proposals. While many politicians would support a system where everybody would benefit, the discussion will still have no uniform shape because there is no enforced national idea that would hold all propositions consistent (Giaimo, 2016). There are also endless debates on whether the country must care for every individual despite the costs, whether it must leverage the expenses and the number and quality of services, or whether it should prioritize money savings (Giaimo, 2016). The country must be able to choose between access and costs. The ones concerned with budgets may object to reforms that require excessive amounts of expenditures.
The third reason is concerned with the debate over the government’s involvement in health care. The reality embodies the cooperation between private firms and lawmakers. The dominance of the free market, however, is evident because the lack of responsibility on the government’s behalf led to the system’s failure to serve the population (Giaimo, 2016). Political initiatives are in stagnation due to government passiveness. Political partisanship is another reason because the parties tend to focus on competing ideologies rather than concentrating on shared values and goals (Giaimo, 2016). This competition results in debates that never conclude with reasonable decisions.
The last reason is about the financial interests of various people that have a voice in the discussions. Health care reform is expensive, and someone will have to pay for it, be it the government or private companies. People that may potentially lose profit because of reforms will always oppose them and use Special Interest Groups (SIGs) to promote their interests in the political arena.
References
Giaimo, S. (2016). Reforming health care in the United States, Germany, and South Africa: comparative perspectives on health. London, UK: Palgrave Macmillan.
Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010).