The Patient Protection and Affordable Care Act

 By Victor Meier

Americans have paid more for health care than the citizens of all other industrialized nations and yet Americans rank among the lowest in wellness.

Here is a complete and comprehensive look at the current state of affairs regarding America’s Patient Protection and Affordable Care Act (ACA) and how it pertains to Californians. Beginning with the term entitlement, entitlement is an accounting term and it means a good or service that one is owed. The opposition’s implications have changed the vernacular of the word entitlement and used it to imply that people instead believe they are owed a particular good or service that they in turn do not deserve.

It may be cliché at this point, though it is apropos nonetheless; subsidies provided by American tax dollars to large corporations and supporting America’s Military Industrial Complex are more problematic to the economy than providing basic necessities to its citizens. America is a nation full of workers and consumers. “We are the best consumers on the planet,” says Senator Joe Manchin (D) from West Virginia.

Receiving affordable medical coverage in the world’s so-called richest nation should make sense to a capitalist economy that is completely reliant on its workers and consumers participation. Universal health care works similarly to a membership at a health club or gym. Americans pay their dues already and deserve better than what they get.

Perhaps you are one of the few who have seen their policy cancelled and subsequently increased in cost. If you are a Californian and this is the case, chances are that you were originally paying for health coverage that was subpar and therefore not worth the paper it was written on. The decision about what to charge the insured and whether or not to honor coverage is controlled by the health care provider solely. With record profits recorded by insurance companies the decisions are clearly based on a profit margin.

In other words, the status quo scenario requires one to trust a for profit company to intercede and supersede even your own doctor’s advice and prescribed health care. However, for Californians there are many affordable options available and provided by California’s health care system which is called Covered California. Covered California is America’s largest state insurance marketplace and the most successful so far.

“This (Health Care Reform) is the biggest thing that Government has tried to do in decades,” says Jacob Weisberg, Chairman-Slate, “it’s reforming a massive part of the American economy.” Health care in America makes up one sixth of the United States economy. This simply means that the health care system in America (even after the ACA) is a for profit system that is mainly concerned with its bottom line. Insurance company’s first priority is making money. Even a nonprofit organization may allocate up to 75% of its revenue for administrative costs.

The individual mandate was a compromise that was made between Democrats, insurance companies and Republicans. Insurance companies claimed this is the only way to cut individual policy costs, citing the law of supply and demand. President Obama as Democratic Candidate Obama originally opposed the individual mandate. Perhaps this is why the penalties resulting from incompliance of the law are the least strenuous of all Internal Revenue Service (IRS) punitive actions?

The individual mandate only applies to those who can afford to pay for an insurance policy. The cutoff point is households with family incomes around $95,000.00 per year. The cost of the penalty gradually increases over the next three years and is about the same cost as that of an annual health insurance policy. This stands to reason due to the fact that in this time you are guaranteed medical coverage. The mandate does provide accountability for all Americans.

Opposition to the ACA resembles cheesy black and white reenactments in late night infomercials. The reenactments where actors make the easiest daily tasks look too difficult to manage. Has this ever been you? Do you find yourself struggling to make an egg? Seriously! You don’t need some eventual plastic trash to cook and egg and you definitely don’t need to be cooking in a microwave. That’s another story though.

It is off putting to see leadership acting like there is nothing that Americans can do to work with and fix health care reform. Health care reform has been attempted unsuccessfully for sixty years already. The notion that we the people of the United States of America cannot overcome and improve the ACA is counter intuitive to the very culture that this great country was founded upon. We are a nation of innovators. Even though we’ve currently been left behind by the rest of the first world, an industrialized nation we can do universal health care better than them.

When pizza arrived in the United States, Americans said, “You know what that needs, sauce and more cheese” and we made it better. Americans wouldn’t be outdone by a little glorified Russian satellite named Sputnik that flew around the earth. Americans went to the Moon. America has given the world the Panama Canal, Assembly Lines, Hollywood, Alternating Current, The Internet, Muscle Cars, Elvis, Google, American Football, Basketball, Baseball, Jazz, Blues, Rock ‘n’ Roll, the Blue Man Group, Broadway, Alfredo Sauce, Chili, Fried Chicken, BBQ, Philly Cheese Steaks and the list goes on.

In states where Governors have cooperated with the ACA the citizens have clearly benefited the most. For example there are California, Connecticut, Vermont, Washington and look at Kentucky’s success; who knew? Ironically Kentucky is the home of one of President Obama’s and the ACA’s most staunch opponents, Senate Minority Leader (R), Mitch McConnell. Specifically, in California, Covered California is on track to meet its 2014 enrollment target.

Californians are once again taking leadership of the progressive movement in America. Each and every person in California should be proud of this fact. There were 31,000 Californians who have enrolled in the ACA during the month of October and enrollment has doubled that amount within the first two weeks of November. Universal health care is working so well here in California that there is now talk of a single payer system being introduced.

Speaker of the House of Representatives and 8^th District of Ohio Representative (R), John Boehner has gone on the record recently saying, “We have the best healthcare delivery system in the world.” This is complete denial of factual information and an injustice to his constituents. America is one of the most obese nations in the world with the highest infant mortality amongst industrialized nations, while leading the world in heart disease and drug addiction.

The overwhelming amount of nonpartisan information available on the matter speaks to the truth. “We pay more for health care in this country than most any nation on earth and we rank very poor thirty-fifth, thirty-seventh in wellness,” argues Senator Joe Manchin.

According to the Commonwealth Fund, in 2013 37% of Americans avoided recommended health care, seeing a doctor because they were sick and having prescriptions filled due to the high cost of doing so. This means that more than one in three people in America couldn’t afford their health care. The percentage in England is only 4%. Medical bills are the number one cause for bankruptcy in the United States.

So, there have been difficulties rolling out the ACA and therefore healthcare reform. Yes, the President, his administration and the Democratic Party have made mistakes implementing universal health care in America. The only way one may avoid making mistakes is to do nothing at all.

Republicans are spending a lot of time spiking the ball, working on their touchdown dances and telling progressives, “I told you so.” Meanwhile, many other issues that are paramount to the prosperity of an increasing number of Americans are being ignored and overshadowed. Issues like the removing food assistance programs from the Farm Subsidies Bill.

Many of the issues associated with the ACA would have been avoided with better political support, cooperation by the states and more importantly providing a single payer option through the government and funded with current tax revenue. Give all Americans health care and there’s no need to fill anything out.

Most economists believe that the way for health care reform will work is by providing American citizens the same health care that our representatives and senators enjoy. Health care can be easily subsidized with existing tax funds while protecting Americans from an insurance company monopoly in the process. A healthy stabilized economy mirrored by a healthy population becomes a win/win situation.

It is interesting to see the sort of party in-fighting from Democrats that has been wearing down the Republican Party. “I think Republicans now are understanding that in 2014 they have to come forward with some kind of policy alternative, so, as much as they rally against the current ACA, what’s the Republican plan, what’s the Republican proposal,” Robert Costa, National Review.

Some of the Republican leadership has suggested that Americans be provided with the opportunity to purchase insurance policies across state lines, opening more competition to drive down the price of insurance. This may or may not work. This is the beginning of an actual conversation though.

Senator Joe Manchin has been working with Republicans on a bipartisan agreement that would amendment the ACA and intend to fulfill President Obama’s promise that, “If like your insurance, you will keep it.” Manchin has expressed that, “It (substandard insurance policies) should be extended indefinitely if you already had it.”

Is the distinguished gentleman from West Virginia correct? Is he attempting to give all consumers in America an equal opportunity to be protected under the law? Or, does this provide yet another loophole for the insurance companies to use in order to offer inferior healthcare that is not worth the money paid?

Health care reform began with former Republican President, Ronald Reagan and the Emergency Medical Treatment and Active Labor Act (EMTAL) in 1986. The law requires hospitals to provide emergency treatment to anyone seeking it. This care is provided regardless of their citizenship, legal status, with or without health care coverage and whether or not they can pay. The public trust pays the bill when they can’t.

The ACA in its current incarnation was originally introduced by former Republican President Richard Nixon and former Kansas Senator (R) Bob Dole. Health care reform made its first appearance in Massachusetts under then Republican Governor Willard “Mitt” Romney. The reform that was accomplished was widely supported by conservative think tanks, organizations and has proven in time to be widely successful. This begs to reason why Republicans reject such a political accomplishment and distance themselves from its success.

Americans deserve better from their leadership. Your health should not be so closely tied to a profit margin. The American health care system is as it ever was, a for profit system. A single payer system would eliminate the “for profit” health care system entirely and place the decision making firmly in the hands of American’s beloved doctors. As it stands without the ACA, we are truly at the mercy of insurance companies and what our laws allow them to do; laws that are commonly written by the insurance companies themselves.