The Affordable Care Act and major health care reform challenges in America

National Health Care Reform

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On March 23, 2010, President Barrack Obama signed into law the first piece of major health care legislation in decades.

This follows a long uphill battle that both sides went through, where a series of initiatives were proposed over the years. Yet, none were never fully enacted out of the possible fears surrounding what they could do to: competition, the overall quality of care and costs. As time went by the overall levels of health for millions of Americans would become worse, as the number of uninsured continued to increase.

Then, when you consider the fact that a large portion of the population is becoming older and more people are suffering from preventable diseases such: diabetes, obesity and hypertension, only made the situation worse. This is because treating these different conditions requires more use of health care services and prescriptions drugs. As a result, the constant decline in the overall levels of health of most Americans has led to number of different comments about the current state of the U.S. health care system. A good example of this can be seen with comments made by Novartis CEO Daniel Vasella where he said, "The United States has an aging society. With increasing age, the frequency of certain diseases is increasing significantly. Take osteoporosis, heart disease, dementia, cancer. The other development is that the prevalence of obesity is continuing to increase. That is linked to a number of degenerative diseases. Of those, diabetes is the most important, with 21 million suffering from it. All of that has a consequence. One aspect is better patient education and better nutrition. People continue to eat as they did during the times when they were working in the fields. Secondly, we should look at how to give incentives to people to avoid disease-prone behaviors such as smoking, alcohol consumption and being overweight. If you look into the health care system itself, at data management, information systems and information technology, it is not very progressive. There is no shared database. The last point I would make is liabilities. In the health care system, for doctors, hospitals and pharmaceutical companies, you have huge liabilities that have lots of indirect costs, from insurance costs to the over testing of patients. That costs over $100 billion a year."

This is significant because it shows how the U.S. health care system has been facing a number of challenges that have not been addressed over the years. As a result, the recently passed health care legislation is attempting to address these issues. To fully understand how the bill is addressing these challenges requires that you examine: the history, the proposal, the process, the politics involved and the political ramifications. Together, these different elements will provide the greatest insights on the various challenges in reforming the system.

History

The history of health care reform dates back as far as 1935, when President Roosevelt wanted to impose a semi-universal health system that would provide coverage to everyone. Once Truman became President, he would support similar proposals, yet there was never the support or political will to bring about these changes. As opposition to reforming the system was facing significant challenges. Then, in 1993 President Clinton proposed a form of universal coverage for millions of American. Like with other attempts to reform the system, the opposition was so strong that the bill was never able to leave the different committees. As a result, the system based on private care would continue to take its affect on the nation, as insurance companies would seek to maximize their profits. This is accomplished by raising premiums and disqualifying those who have the most health problems from receiving coverage, by claiming that these people have pre-existing conditions.

The Proposal

The Obama Administration used a different approach for reforming health care. Where, they would set the general agenda, but have the various members of Congress make the difficult decisions. This would cause two different bills to emerge out of both Houses, with a merger of the two into one bill. The House version would have the federal government serve as another provider of insurance to those who can not afford it, while increasing the amounts of regulation of the industry. The bill originally envisioned by Senate did not have this version of universal health coverage. However, after intense negotiations with the White House and the House leadership, this option was added. As a result, the final proposal would have the desired amounts of regulation and offer some type of universal coverage to American citizens.

The Path from President Obama to Congress into Law

Like what was stated previously, President Obama would set the broad agenda of health care reform. He would then have the Congressional leaders figure out the details. Once this was accomplished, the White House was forced to make series of compromises, to ensure that there were sufficient votes in passing the legislation. A good example of this is when the President would sign an executive order, stating that funds from the new health care legislation will not be used to pay for abortions. This is significant, because it shows how once the legislation was created, the President would engage in tactics to bring others on board to ensure passage of the legislation.

Political Fallout

The political fall out from the proposed legislation is facing major challenges in the courts. Where, a number of different business groups and Governors are challenging the legislation because they feel that the law is overstepping the powers of the federal government. At the heart of the challenge, will be a stipulation in the bill that requires everyone to purchase health insurance from private insurers or the federal government. The Justice Department is challenging this argument, saying that you can not claim that this is a violation of the Constitution, when this provision of the bill will not take effect until 2014. This is significant, because it shows how the proposed legislation will have a series of legal challenges that could go all the way to the U.S. Supreme Court.

Clearly, the recently passed health care legislation highlights the overall challenges that were faced in reforming the health care system. This important, because it underscores why it has been so difficult in bringing about effective reforms, based on the overall scope of power of the federal government and the capitalist system. As a result, the differences on these two issues have been the major hurdles standing in way of effectively reforming the system.