Pros of Obamacare: Preventive Care
One of the key objectives set by the Affordable Care Act was the promotion and support of preventive healthcare. Today, preventive medicine is recognized as the most sustainable approach as regular checkups and timely measures avert an aggravation or a serious health emergency. Among the advantages of preventive healthcare is increasing the lifespan of citizens and helping them enjoy an active life. Extended insurance coverage means that patients can prevent an acute condition from turning into a chronic one as well as having to take care of large medical bills or bankruptcy. For those who already suffer from a chronic condition, treatment has been made easier by the promulgation of the Affordable Care Act.
The National Conference of State Legislatures (2014) writes that since 2014, citizens are entitled to 63 distinct preventive services that must be covered without an additional payment on the person’s part, co-insurance, or a deductible. Some of the examples of such services include colorectal Cancer screening for adults over 50, type 2 diabetes screening for adults with hypertension, and diet counseling for adults at risk for developing a chronic condition. As seen from the examples, the ACA encourages the early diagnosis of quite serious diseases to avoid future hospitalization and increased healthcare expenses.
A day in a hospital may cost from $2,000 to $20,000, and many citizens are unprepared for dealing with a bill this large. They may not be aware of exactly what is the maximum implied by their current insurance plan. If patients are unable to cover the bills, they can file bankruptcy, to which the hospital responds by declaring a loss and passing the bill to someone else. Between 2010 and 2016, Obamacare decreased the number of bankruptcy filings from 1.5 million to 780,000.
Cons of Obamacare: Distribution of Resources
One of the greatest issues that occur when devising a healthcare strategy is the distribution of resources. Among other goals, Obamacare sought to be a universal policy that would keep the number of uninsured citizens down and offer advantages to each demographic. Today, the Affordable Care Act is often criticized for not exactly reaching young people. As of now, millennials constitute less than 30% of all the people enrolled in Medicare and Medicaid, which, of course, is far from ideal. The Centers for Medicare & Medicaid Services report that the total of all consumers under the age of 30-35 was 8,746,642 with an average premium of $621.
Furthermore, for the last four years since its peak in 2016, the enrollment rate has been on a steady decrease. Such unpopularity of the healthcare policy with the millennials may be indicative of several problems inherent to its stipulations and realization.
First and foremost, Obamacare might have still not be able to resolve one of the biggest problems with the American healthcare system: its affordability. Moore (2018) writes that in 2017, the average deductible for individuals whose employers provided them with medical insurance was $1,221, which is significant compared to $303 in 2006. Besides, extending coverage for all enrollees means more taxes for everyone else – the fact that may also be making the millennials especially wary of the legislation. Lastly, Obamacare did not help mitigate the health insurance market instability that frightens many younger Americans and impedes their decision-making.
Response to “Pros of Obamacare: Preventive Care”
Preventive care is indeed a reasonable approach to medicine that spares millions of people suffering and undesirable expenses down the line. It is true that regular checkups instead of neglecting a condition may avert critical amounts of money in medical bills. Yet, this effect might be mitigated by other not-so-obvious expenses that are well indicative of the fact that Obamacare might not have lived up to its initial ambitions.
Firstly, preventive care was supposed to lead to decreased use of emergency room services whose cost was also diminished as part of the new policy. The opposite happened: Nikpay et al. (2017) suggest that after the promulgation of the Affordable Care Act, Oregon and Massachusetts started to visit emergency rooms more often. People do not always choose to go to the emergency room because they cannot afford an actual appointment: they do so because it is more convenient.
Another aspect of the Affordable Care Act that might be rather dubious is its promotion of workplace wellness programs. Jones, Molitor, and Reif (2019) explain that this part of the policy was supposed to be non-discriminatory and rewarding to those employees that make healthy choices and show better health outcomes. In reality, however, according to the researchers, the realization of the plan proved to be punitive and unfair toward unhealthy employees. They were not receiving financial incentives and had to bear greater costs, despite often being from underprivileged socioeconomic backgrounds. In summation, the cost efficiency of preventive services covered by medical insurance plans might as well be nothing more than a myth that both politicians and citizens choose to believe in.
Response to “Cons of Obamacare: Distribution of Resources”
The fact that Obamacare is not exactly popular with the younger generation may not be reflective of its inherent faultiness. First and foremost, young people might be reluctant to enroll in the program because they do not see exactly how it could provide any value to them. One look at the list of preventive care services can demonstrate that many of the conditions that Obamacare helps to diagnose early on are age-related. Since it is senior citizens that are more susceptible to such conditions as hypertension, heart failure, and colon cancer, young people may not see these services as necessary.
As for affordability, it would not be correct to compare and contrast expenses in 2006 and 2017 because they do not take into account many factors such as inflation and average income growth. Another reasonable note on the affordability of Obamacare would be that the millennials themselves are making life choices that deprive them of the opportunity to become financially stable early in life. More young people than ever enroll in college programs and graduate with an average debt as large as $37,000 (Friedman, 2020). Sociologists describe the phenomenon of the “Odyssey years” that describe a significant gap between college graduation and maturation.
The new generation tends to search for themselves, make career transitions, and gain new experiences before settling down. These decisions may postpone financial growth and prevent individuals from spending money on healthcare.
Lastly, the low enrolment rate may be explained by the poor medical literacy of the new generation. TransUnion (2017) Healthcare Millennial study shows that more than half (57%) of millennials have a very faint idea of basic healthcare out-of-pocket expenses as well as co-insurance, co-pays, and deductibles. 40% do not understand how medical insurance works and what benefits they are entitled to. In summation, better literacy and awareness might change the situation and make Obamacare more attractive for this demographic cohort.
References
Centers for Medicare & Medicaid Services. (2018). Health insurance exchanges 2018 open enrollment period final report. Web.
Friedman, Z. (2020). Student loan debt statistics in 2020: A record $1.6 trillion. Web.
Jones, D., Molitor, D., & Reif, J. (2019). What do workplace wellness programs do? Evidence from the Illinois workplace wellness study. The Quarterly Journal of Economics, 134(4), 1747-1791.
Moore, S. (2018). 8 reasons to still hate Obamacare. Web.
National Conference of State Legislatures. (2014). Preventive services covered under the Affordable Care Act. Web.
Nikpay, S., Freedman, S., Levy, H., & Buchmueller, T. (2017). Effect of the Affordable Care Act Medicaid expansion on emergency department visits: Evidence from state-level emergency department databases. Annals of Emergency Medicine, 70(2), 215-225.
TransUnion. (2017). Lack of knowledge and changing healthcare landscape impacting millennial payments. Web.