Health Care in America the Great Debate

by jmarti83 (student)

Jason Martinez Martinez p. #1

English 102

Slaughter

7-10-12

Health Care in America, the Incurable Debate

This week the U.S. Supreme Court will decide the fate of the Affordable Health Act (ACA) or parts of it but that verdict will act to accelerate the already heated debate rather than end it. Whatever the verdict, the fight will continue for both sides of the issue. On one side the Democrats who are against it because it didn’t go far enough and on the other, Republicans who are against it because it went way too far. At the heart of the debate lies a fundamental difference between political ideologies. Democrats consider it society’s collective duty to ensure all citizens have access to health care and that the cost should not be a barrier to care. Republicans, strictly ideologically speaking, believe in a free market system and individual responsibility, that only those who provide for themselves deserve to have coverage. Due to the popularity of many ACA provisions, however, Republican leaders are calling for a “repeal and replace” strategy to allow for popular segments to remain such as allowing children to stay on their parent’s insurance plan until age 26. The topic of health care provokes high emotions for both sides. One contends that it is immoral that the country does not have universal health care like all other industrialized nations while the other believes with the ACA, Obama is taking the country down a dark path to socialism the likes of Stalin’s Russia.

The aspect of the health care debate that often fails to be mentioned alongside the rhetoric and outrage is the actual provisions of the law. According to the Congressional Budget Office 33 million of the poorest Americans will be covered but not right away. This phase-in plan lasts 10 years. Small businesses are reimbursed only half of their contribution to employee health

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insurance. It makes prescriptions more affordable for seniors and ends insurance company abuses such as discrimination against pre-existing conditions, capping payouts and dropping policyholders due to illness among others. The ACA is projected to cost about $1 trillion the first decade and cut the deficit by about $1 trillion the second decade, again, according the CBO. (Klein 1). Republicans question the figures but can pretty much live with the rest or watered-down versions of it. The individual mandate is at the heart of the debate. It is this part that sent the law to the High Court and, depending on which side characterizes it, as an infringement on liberty or a fair and necessary part of the legislation.

This is a preview of the whole essay

The individual mandate, which legally obliges all who can afford it to buy health care insurance based on a sliding income scale, was conceived during the 1990’s version of the health care debate. First Lady Hillary Clinton was tasked with the issue of health care reform in an attempt to design a bill that would cover more people while lowering costs. During this controversial, highly partisan debate the Republicans demanded that individual responsibility was written into the law and favored the individual mandate. Democrats hesitated at first but relented in an effort to pass something, even a much smaller version than they initially envisioned. Fast-forward 15 years and the Tea Party Republicans have made the mandate a centerpiece of their argument against reforming the overly costly system. They claim the ACA is a “government takeover of health care.” (Goozner 1). Republicans also claim the mandate is unconstitutional. They argue states have the authority but not the federal government. That’s why people can be forced to carry auto insurance. It’s a state requirement. Democrats might say they didn’t take that position when they conceived it themselves just a few years ago and point to the Interstate Commerce Clause as legal justification for the mandate. Americans’ opinion of the mandate has changed along party lines, of course, since the 90’s. About 60 percent of all Americans oppose it, 80 percent Republicans. A

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majority of Democrats, close to 60 percent, are in favor of the individual mandate. The two parties essentially traded viewpoints on this issue during the past decade or so.

To pay for the ACA, the government will charge an excise tax on high-end insurance policies some refer to as “Cadillac plans.” Families with investment income of more than a quarter-million per year will be taxed 3.8 percent on income that exceeds that amount. In addition, a 10 percent tax on tanning salons will be imposed. The Medicare Payroll Tax will include unearned income as well as earned. About half a billion dollars in Medicare savings would also help pay for the law. (Jackson, Nolan 3). Republicans have created their argument to combat this provision as cutting Medicare to seniors to provide health care for those who won’t get a job and pay for their own insurance. The law proposes to save half a trillion dollars by cutting waste and fraud within the Medicare system, a proposal used as a centerpiece of John McCain’s 2008 run for the presidency and a proposal widely applauded by Republicans just four years ago. During the campaign, Democrats cautioned against Medicare cuts McCain was suggesting, that it might affect senior’s access to health care and now it’s the Republicans turn. These Medicare cost savings are a must to make the Affordable Health Care Plan affordable enough to be implemented without raising the National Debt. “Repealing the $500 billion in savings in Medicare that are in the bill, which reformers insist is the nation’s best hope for making the program more cost-effective while providing better care, would leave a gaping hole in the budget that would have to be filled with either alternative cost efficiencies or the total elimination of the expansion of coverage.” (Goozner 2).

Most Americans, 55 percent, oppose the ACA as a whole while 45 percent do not want it repealed. Though the majority of Americans opposes the law they want to keep many of the major aspects of it too. That statement seems counterintuitive yet this opinion highlights the vast

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complexities of this issue. If not for the individual mandate most would approve of the health care reform law. More than eight in ten, including Republicans, support stopping insurance companies from refusing coverage to people afflicted with pre-existing conditions. More than 60 percent like the provision allowing children to remain on their parents’ policy until age 26. Nearly three-quarters of Americans favor requiring large companies to provide insurance coverage for their employees. “Republicans have won the argument with independents and that’s really been the reason that we see the majority of the public opposing it” (Zengerle 1). It’s doubtful that if the Supreme Court strikes down only the individual mandate Republicans and Democrats will work together to keep what people like while addressing the added cost issue.

Republicans and Democrats can agree on one thing. Neither fully supports the ACA as written. Republicans don’t care for the individual mandate or cutting waste from Medicare, at least not anymore. They also believe it to be a governmental overreach of power and claim it’s “socialized medicine.” Democrats argue that the Republicans have a flawed characterization of the ACA saying they wanted socialized medicine similar to what people in other nations receive in the first place but the law as they deem fit doesn’t come close to providing it.

The “government option” part of the bill was taken out as it was being crafted. That provision would have covered about 10 percent of the country but the final bill didn’t include it. Had it done so the ACA would have been about 10 percent socialized. However, Democrats are still in favor of this imperfect health care reform law because it’s better than nothing. Jason Martinez

The ACA is a product of a century long legislative effort to control the costs of health care while enhancing the health and welfare of Americans. According to the Kaiser Family Foundation Health Care the U.S. spent more than $2.5 trillion on health care in 2010, more than10 times the

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amount spent in 1980. In human costs, about 50 million are not insured and millions more underinsured. Health care bills are one of the main reasons people lose their homes to foreclosure. Somewhat surprisingly, a recent poll discovered “a good portion of the opposition to the health care law is because Americans want more reform, not less of it.” (Zengerle 2). Democrats certainly want a more comprehensive law but so do about one-third of Independent voters and Republicans as well. While about 70 percent of Republicans want very little of it, the rest feel it doesn’t go far enough to fix the broken health care system. Among independents, about two-thirds oppose much of it but one-third wanted more. Democrats are evenly split. “If you add the people that oppose it because they think it doesn’t go far enough, you get a majority of Americans, so it doesn’t mean that health care reform is dead.” (Zengerle 2011).

Health care reform is literally a life and death issue both for people and the economy. The present system, prior to the full implementation of the ACA, is costing citizens their health and contributing to the National Debt. Something must be done. If not the ACA then what? If the country is waiting on Republicans to fix the system they have a long wait. Health care is not their priority as evidenced by the previous administrations complete failure to address the topic at all. It is difficult for Washington to tackle a complex issue such as health care and seldom politically advantageous. The Democrats tried but failed during the 1990’s and have tried again, each time struggling to pass a bill against a determined and organized campaign to defeat it, a campaign of obvious lies and propaganda, the “death panels” to kill your grandmother misinformation for example. Because of this scare tactic and others, health care reform so essential to people and the nation may again go down in defeat, perpetuating the only option of waiting for another Democratic administration to try yet another time.

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Works Cited

Jackson, Jill and Nolen, John. “Health Care Reform Bill Summary: A Look at What's in the Bill.” CBS News March 21, 2010 Web. June 27, 2012 < http://www.cbsnews.com/8301-503544_162-20000846-503544.html>

Klein, Ezra. “11 facts about the Affordable Care Act.” The Washington Post June 24, 2012. Web. June 27, 2012 <http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/06/24/11-facts-about-the-affordable-care-act/>

Goozner, Merrill. “Republicans Throw the Gauntlet on Health Care Reform.” The Fiscal Times November 8, 2010. Web. June 27, 2012 <http://www.thefiscaltimes.com/Articles/2010/11/08/Republicans-Set-on-Defunding-Health-Bill.aspx#page1>

Zengerle, Patricia. “Most Americans Oppose Health Care Law But Like Provisions: Reuters Poll.” Huffington Post June 24, 2012. Web. June 27, 2012

Oberlander, Dr. Jonathan. "Great Expectations — The Obama Administration and Health Care Reform." The New England Journal of Medicine 323rd ser. 360.321 (2009): 321-23. Nejm.org. 22 Jan. 2009. Web. 29 June 2012. <http://www.nejm.org/doi/full/10.1056/NEJMp0809584>.