FROLITICKS

Well it’s finally here, much to the consternation of the Republican Party and half of the American population according to recent polls! As of the first of October, the Affordable Care Act (ACA) went into effect and the uninsured multitudes were invited to go on-line or in person to seek out an appropriate health insurance plan. However, the continuing debate is anything but over. Article after article continues to explore the pros and cons of this new healthcare initiative. Critics see it as being too costly for middle class families, forcing many small and medium-sized businesses to lay off workers, being overly complex or hurting the quality of healthcare in the U.S.

On top of which, a Supreme Court’s ruling on the healthcare law last year, while upholding it, allowed states to choose whether to expand Medicaid, the government’s medical insurance program for the poor. As a result, some claim that millions of poor people will be left uncovered by the ACA. They live in states, mainly found in the South, largely controlled by Republicans who to date have declined to participate in a vast expansion of Medicaid. About 60 percent of the country’s uninsured working poor are in those states, many of whom are Black or Hispanic. They are now among the eight million Americans believed to be impoverished, uninsured and ineligible for help.

Regardless of the implementation of Obamacare, the fact is that according to a recent study by the Commonwealth Fund, a private healthcare foundation, almost half of working Americans between the ages of 19 and 64 currently have no insurance or are under-insured. Other recent studies concluded that more than 65 percent of personal bankruptcies in the U.S. are due to healthcare costs. Compared to other member nations of the Organization for Economic Cooperation and Development who have universal government-run healthcare programs, Americans are paying a lot more for healthcare and getting a lot less value for services provided. Furthermore, it pays to be rich in the U.S. in order to have access to quality health care. Lack of regulations essentially allows hospitals to charge whatever they like. According to a database of hospital medical charges, there are huge disparities for pretty well every medical procedure everywhere in the United States. Sticker prices are shockingly inflated and the differences are in many cases astronomical. In 2005, the average cost of a day in a hospital was anywhere from $1,629 (for for-profit hospitals) to $2,025 (for nonprofit hospitals). For cancer patients, the average cost was $3,000 a day.

Dependent upon the private insurance sector in U.S., an important reason for the high healthcare costs is that prices for healthcare goods and services are negotiated between individual health insurers and physicians, hospitals or drug companies. On top of which fees in the private healthcare sector have been jealously guarded trade secrets among insurers and providers of healthcare. In other countries, prices either are set by government or negotiated between associations of insurers and providers of care, on a regional, state or national basis. In Canada, healthcare costs are regulated by provincial healthcare agencies, in consultation with hospital and physician representatives.

One of the major problems with Obamacare is its complexity and general coverage. Indeed, polls indicated that most of the uninsured Americans didn’t know that the health insurance exchanges or marketplaces had opened on October 1rst. It is there that persons who don’t have coverage through their employers can shop for insurance and compare prices and benefits. Incredibly, failure to secure health insurance can end up in one being penalized by the government. Starting in 2014, almost every legal resident of the U.S. will be required to carry health insurance or face a tax penalty, with exemptions for financial hardship, religious objections and certain other circumstances.

All of this is complicated and even confusing. However, it appears to be the best that the current administration can do at this time under difficult circumstances. It certainly isn’t the end all and be all to healthcare reform, and is often portrayed as a stop-gap measure to at least insure the estimated 30 to 40 million Americans that had no health insurance what-so-ever.

Still, here we have former members of the Tea Party holding the Republican Party hostage in a senseless act to delay the ACA’s implementation and its subsequent funding, three years after the Act was passed by Congress. Oh, let’s just shutdown the government and blame the President for not willing to compromise and proceeding with “socialized medicine”! Compromise on what? As in Canada, the healthcare debate will go on for years to come, especially given an aging population and ever increasing healthcare costs. Politicians in both countries will have plenty of future opportunities to bicker over the numbers and options, public or private, short-term or long-term. Bandages aren’t enough when only major surgery may be required.