Introduction
The Affordable Care Act (ACA), also known as Obamacare, set about reforming the health care system in America so as to enable more people to obtain access to health care. The ACA arrived with a number of strengths and weaknesses. Altogether, the Act affected patients’ access to and quality of health care. It also impacted the cost of health care in the system. This system will discuss the ACA’s strengths and weaknesses while describing its impact on health care in America. It will also provide a discussion of how I would change and improve our current health care system from the standpoint of access, quality and cost.
Strengths and Weaknesses
While the ACA’s biggest supposed strength is the 20 million people who obtained health coverage as a result of the Act, one of the ACA’s main weaknesses is the fact that it has done little to reduce the bureaucratic red tape that causes problems for providers, facilities, and health care workers in various ways. The “competitive grants for regionalized systems for emergency care response” (ACA, 2010, Sec. 1204, 124 STAT., p. 518) that were instituted by the ACA to ensure that federal dollars went to places where they were going to be used most effectively sounds good on paper—but the reality is that Accountable Care Organizations (ACOs) that have emerged as a result have placed restrictive conditions on many providers, which in the end harms patients (Alpert, 2013.). EMS workers, for instance, must adhere to new rules that determine where they take patients, as some facilities will not accept them because of ACA and ACO restrictions that stem from the patient’s history and the facilities’ history in treating that patient. So while the 20 million newly covered patients is touted as a strength of the ACA, the reality is that there are conditions that apply. Eckstein (2013) summarizes the problem succinctly when he states that “government-provided health insurance rates of reimbursement do not lend themselves to a successful business model, especially one in which lives are on the line” (p. 2068).
Other strengths of the ACA included its goal of eliminating “lifetime and annual limits on insurance coverage” while ensuring that health care providers would offer patients “preventive services” to help stave off health...
100). The ACA was also meant to guarantee greater “access to health insurance for individuals with preexisting medical issues,” and compel states to have the necessary “flexibility to establish health care programs for low income non-Medicaid eligible clients” (Jacobson-Vann, 2011, p. 100). In short, the ACA’s intentions were its main strengths, but the reality of the situation has revealed the ACA’s weaknesses: ideals do not necessarily translate into good or effective policies.
The real weaknesses of the ACA were that its policies were undermined by the very essence of subsidization that sits at its core: by subsidizing health care, the ACA continues the escalation of the cost of care. While the ACA was meant to increase preventive medicine, the fact that it continues to subsidize treatments has ensured that treatments are what get implemented the most—since treatments rather than prevention are what bring in the profits (Goldhill, 2009). In other words, if the ACA really intended to make health care affordable, it would have done the one thing that alone could reduce costs—that is, get government out of health care; i.e., end subsidization.
The big strength that the ACA was able to tout—its granting of access to care to 20 million people—did not really address the issue of quality or cost. In fact, by guaranteeing that access, it actually diminished the likelihood of both quality and cost being efficient. Thus, its main strength is also actually its biggest weakness and the one thing that has doomed the ACA from the outset.
How I Would Improve the Current Health Care System
Access to care was the main selling point of the ACA. It was important to people because so many millions of individuals in the U.S. cannot afford health care. They either rely on government subsidized programs like Medicaid and Medicare or they purchase health insurance (either individually or through their job). When the ACA helped millions to gain coverage, it was heralded as a great success. However, the ACA continued subsidizing treatments that, as Goldhill (2009) has pointed out, are oftentimes unnecessary and costly (paid for, of course, by tax payers). By incentivizing health care providers to treat patients with lab tests, interventions, pharmaceuticals (that commonly…
