Present American Healthcare System Is in Need of Reform

Healthcare Reform

The subject of healthcare reform set the country ablaze last year, proving to be one of the most contentious issues that has swept through American political discourse in recent decades. One reason that healthcare reform might have proven to be such a contentious issue -- bringing out the worst and shrillest elements of the American public -- was that healthcare is one of the most important issues in the lives of many and even most Americans (Christensen and Jason, 2009).

All of us will face serious illness at some point in our lives, whether our own or that of a loved one. The fact that so many Americans do not have any healthcare at all or have very limited access to healthcare makes the issue a personal one, and this alone should have made it central to the public discourse. However, while the above was no doubt the case for some people, for many others the debate over healthcare became an excuse for their anger at the Obama Administration, at the fact that an African-American had become president, at the fact that a wide range of groups felt disenfranchised by everything from climate change (an idea that many who rejected healthcare reform also rejected), to the changing requirements of the workplace, to the recession.

Although it would have been hard to tell by listening to many of the loudest voices in the debate over healthcare reform (which died down about a year ago when Congress passed and the president signed), there are a number of positive results that will occur if the Democratic healthcare bill survives court challenges (the bill was in fact just taken up by the U.S. Supreme Court today). The law would allow for every American to get healthcare. For the first time, healthcare for the majority of Americans would not be associated with their employer but simply with their status as individuals and as human beings (http://www.healthreform.gov/index1.html).

The current recession has made abundantly clear the limitations and perils of making healthcare available almost exclusively through jobs. As more and more Americans have lost their jobs, they also lost their health insurance. Just as they lost their salaries, in other words, they were also faced with the possibility of catastrophic health costs. This had a ripple effect beyond the potential tragedy to each individual family. As people lost their health insurance, they began to wait until they were so sick that they had a health emergency and sought healthcare through the emergency department of a hospital.

Hospitals are required to treat patients facing an emergency. However, when they treat patients with serious illnesses or injuries without insurance are treated in hospitals, those hospitals lose money, which can lead to hospitals closing down their emergency departments or even their entire operations. This reduces the quality of healthcare available to the rest of the community (http://www.healthreform.gov/index1.html).

The other major improvement in the lives of many people that will come about as the healthcare law goes into effect over time is that insurance companies cannot drop individuals who are diagnosed with serious diseases or refuse to insure them to begin with. Many individuals currently find themselves effectively uninsurable: The only private insurance that they can afford would cost them more than their entire salary (Reid 119). A related benefit of the healthcare reform bill is that insurance companies can no longer place a cap on lifetime health benefits. For those who have suffered a serious illness when they were young or who have high long-standing costs associated with a chronic condition, the prohibition of this cap will be of substantial benefit.

Finally, increased competition in the insurance industry is likely over time to bring down insurance costs for everyone (Mahar, 2006).

However, balanced against these substantial benefits, there are drawbacks to the new healthcare law. It is important to distinguish actual and actual potential drawbacks of the bill from the outrageous claims made by many of the opponents of the bill, such as their claims that the law would establish "death panels" to determine who would receive medical care and those who would be allowed to die.

Among the real drawbacks to the law are that it could cost as much as $100 billion per year. (The actual costs of enacting this law are the subject of a great deal of debate and cannot be clearly predicted.) Individuals will be required either to have health insurance (either by paying for it through a private insurance company or through a government program such as Medicare) or will have to pay a fine (http://www.healthreform.gov/index1.html). This is referred to as the "individual mandate" of the law and is one of the aspects of it that caused the loudest objections.

Those who argued against the bill when it was being debated argued that this individual mandate was an intolerable infringement on personal liberty. The Obama Administration argued that the bill could not become law without it, because without the additional revenue brought in by a large number of new customers, insurance companies could not afford to keep providing coverage for those who are sick.