It’s been almost a decade since the Patient Protection and Affordable Care Act was signed into law in the United States. Commonly referred to as Obamacare or the ACA, its passage marked the most ambitious and significant chapter in American healthcare reform. The new law provided patients with new protections while putting an end to the ability of health insurance companies to deny coverage due to preexisting conditions. It redesigned many aspects of the healthcare industry with the aim to lower costs, and ultimately expanded the number of Americans covered by health insurance.
Despite the significant improvements made possible by Obamacare becoming law, the push for further reform to American healthcare remains a popular rallying cry for politicians, policymakers, and talking heads. Virtually every major candidate vying to become the Democratic Party nominee for president in 2020 has a plan for further changes to the healthcare system. This is because, while far better than what existed beforehand, the state of American healthcare post-ACA still presents many challenges and obstacles for average Americans.
The most apparent issue still facing most Americans when it comes to healthcare are the costs involved. Even with insurance, many individuals find themselves paying significant sums of money out-of-pocket for medical treatment. Co-pays, deductibles, and other costs that are not covered by insurance must be paid by the individual. It’s not uncommon for someone with health insurance to apply for a medical loan or pay into a medical savings account to ensure they can afford the treatment they need. These out-of-pocket costs range from a few hundred dollars to tens of thousands. These financial hardships create plenty of opportunities to further reform the U.S. healthcare system.
Another area of the existing American healthcare system which will require reform in the future is the rising costs of treatment. As medical science becomes more advanced, it becomes more expensive. Procedures and medications which go up in price cause insurance companies to raise their rates. If the current trend continues, healthcare will become an overwhelming living expense for average Americans. New laws to better control costs will need to be passed in order to prevent this from happening.
While many people point to for-profit healthcare as an incentive mechanism for encouraging doctors and other medical professionals to provide the best treatment possible, the unfortunate reality is that it serves to hinder that outcome. If a physician earns more money by ordering more tests, pushing for more treatment, and prescribing more medication it creates a situation where unnecessary costs are incurred by insurers and ultimately individuals. Another avenue of American healthcare reform would involve doctors being paid based on patient outcomes; the more patients they help to get healthier, the more money they make. This change would help to lower costs and create a more substantial link between personal financial success and the betterment of patients.
To accomplish all of these potential reforms to American healthcare, the U.S. will need to embrace a single-payer system. This means creating a system where private health insurance is a luxury option for those able and willing to afford it, while everyone else participates in a nationalized insurance program by default. The National Health Service available to citizens of the United Kingdom is an example of this sort of system. However, such a system remains controversial to many Americans who prefer to have more of a say in their insurance provider and who also have a natural distrust of government playing a role in healthcare.
For post-ACA healthcare reform to happen, Americans will have to come to some sort of compromise. But truth be told, Obamacare was an act of compromise. At some point, one side will have to give way to the other.