Research Paper: Why Americans Need Universal Health Care (Research Paper Sample)

Why Americans Need Universal Health Care
Name of Student
Institutional Affiliation
Why Americans Need Universal Health Care
Background
Introduced in 2009, the America’s Affordable Health Choices Act of 2009 spelled out a comprehensive overhaul of the US healthcare system. This was prompted by President Obama’s move to provide universal health care in the United States. Considered by many as the turning point in the history of American health care, the Affordable care instigated key changes within a complex, fragmented and expensive U.S healthcare system (Mukau, 2009). Presently, over 50 million Americans lack health insurance including working aged men and women and their children. In its bid to provide universal healthcare, the legislation expanded access to Medicaid which is the federal-state insurance program for low income people. It also provides subsidies to help small businesses and individuals with minimal income to purchase coverage based upon state run programs that can be compared against private plans (Feldman, 2012).
The legislation also provided coverage for older people on Medicare, promising free preventive checkup with subsidies for drug coverage. Besides, for individual purchases including the176 million American citizens with employer provider health coverage, key regulatory protections provisions are outlined in the program. Under the provisions of the legislation, it will be illegal after 2014, for private insurers to cut or avoid insuring people with serious pre-existing conditions (Vivar, 2011). Policy makers have nonetheless, presented a number of pros and cons of the health care reform which is designed provide universal health care to US citizens. The reform, nonetheless, moves beyond the subsidies and protections for ordinary citizens, seeking to correct the rising inequalities with the aim of trimming the national health care costs.
Jacobs (2012) contend that both proponents and opponents of the reform have agreed on the need of universal healthcare; nonetheless, there are deep differences on its basic structure and who over who to pay for the increased insurance costs. Due to the ascending costs of healthcare, the number of uninsured individuals, our struggling economy and high unemployment in America. The democratic majority in Washington, District of Columbia must continue to use their authority to implement health care reform legislation to promote optimal health care for all Americans and prevent medical expense bankruptcy for those who have chronic illnesses or need high cost procedures done.
The Outrageous Costs of Health Care Coverage
The overall cost of universal health coverage in the U. S. has been delineated by many policymakers as outrageous. Estimates indicate that the total cost will range between $1 trillion and $1.5 trillion. The office of the Actuary in the Center for Medicare and Medicaid 2009 estimates indicated that expansion of health insurance coverage inclusive Medicaid eligibility changes would cost an estimated $1.0 trillion by 2019 fiscal year (CMS, 2009). Estimates indicate that, by the year 2019, the uninsured would reduce from 57 million to 23 million. An estimated 18 million are to get primary Medicaid coverage due to the expansion of eligibility to all legal resident adults of the US under the 133.33 percent of the Federal Poverty Level (FPL), (CMS, 2009). An estimated 13 million of the currently uninsured population are expected to receive individual insurance coverage via an elaborate Exchange program. Majority are also expected to qualify under the Federal government’s affordability credits which provides a series of premiums and cost sharing subsidies while an estimated 40% are still expected to participate in the public insurance plan option, (CMS, 2009).
CMS (2009) further estimates that the total national health expenditure for the legislation is expected to increase by an estimated 2.7 percent by the 2019 calendar year. This would in part reflect; lower prices paid to health providers by those covered under both Medicaid and the public plan option via health insurance exchanges, lower payment for Medicare services and a greater utilization of health care services by citizens who are newly covered or those having a more complete coverage. Nonetheless, CMS (2009) acknowledges that the future impacts on health expenditures, individual decisions, insured status and employer behavior of the legislation remains highly uncertain.
Projections indicate that the universal health coverage plan will have massive fiscal impacts on both Federal expenditures and the overall health insurance coverage within the United States. CMC (2009) estimated that the scheme would cost the federal government an estimated net total of $861 billion between the years 2010 and 2019. This result from a combination total of $1, 035 billion in net costs associated with the coverage provision minus the net savings associated with reduced costs in Medicare provisions, savings from proposals to reduce the rate of growth in health spending and savings from reduced costs in Medicaid/CHIP provisions, estimated at $179 billion, $2 billion and $7 billion respectively. A large proportion (nearly half) of the net increase in federal expenditures related to coverage provisions is directly attributable to the expansion of Medicaid to cover all adults who make less than 133.33% of the FPL and all the uninsured newborns.
Under the 100-percent Federal Medical Assistance Percentage (FMAP), the federal government is expected to bear the full costs for new eligible enrollees, which explains the high costs in terms of Medicaid expansion. Additional costs would arise from affordability credits, which will be extended to low income enrollees who would opt to purchase insurance via the exchange and credits, a provision open for small employers who opts to offer insurance. Provision of affordability credits for low income enrollees and exchange and credit for small employers would cost the federal government an estimated 4672 billion and $44 billion respective year in the 2010-2019 fiscal years. However, as a measure to reduce cost expenditure, there would be penalties for employers who opt not to offer coverage and for individuals who opt to remain uninsured. The penalties within the 2009-2019 periods would total to an estimated $182 billion (Vivar, 2011).
Shouldering the Cost
Much controversy surrounds the issue of; who to actually shoulder the cost of the Universal health care. The plan proposes to tax wealthy families, earning more than $250,000 per year by reducing their charitable contributions deductions and their mortgage interest deduction. Nonetheless, families earning less than $250,000 will have their taxes cut by billions of dollars (Feldman, 2012). The cost of the health insurance will be funded by multiple revenue provisions outlined under Title IX of the Affordable Care Act. Individuals who are deemed to have not maintained acceptable coverage for themselves and their qualified children will also be subjected to an additional tax. This would be 2.5% of their modified adjusted gross income. Employers who do not comply are also expected to deal with increased taxes. Employers are expected to meet the health coverage participation requirement for every employee or otherwise, pay an additional 8% payroll tax to its employees. Employers will also be expected to make contributions to various plans of up to 72.5% of the premium of the lowest cost qualified plan. The act also proposes to surcharge individual trusts and estates with modified adjusted gross income which exceeds certain amounts. The surcharge amount would depend on varying income brackets with $350,000-$500,000, $500,001-$1 million and over $1 million paying 1%, 1.5% and 5.4% respectively. The legislation also stipulates multiple underpayment penalties to pay for the increased cost coverage (Jacobs, 2012). Emergency Rooms
Income disparities and lack of health insurance coverage have led to the inappropriate use of Emergency Rooms (ER). Today, they are being abused as clinics to treat preventive and or chronic illnesses. Americans are increasing their use of hospital Emergency Rooms (ERs) for non emergent and even routine health care programs (HHS, 2010). Data provided by the Center for Disease Control’s (CDC’s) National Center for Health Statistics (NCHS) reported that, ER use has risen by almost 20% since 1990. The increase is due to the growth in the number of uninsured Americans, although it is also as a result of reduced access to a regular source or care (Feldman, 2012). An estimated 95% of all ER visits are treated and discharged, nonetheless, Medicaid estimates that at least a third of all visits relate to nonurgent health problems. Besides, almost 20% of these visits are made by Medicaid beneficiary who account for less than 15% of American residents comparative to 12% ER visits from uninsured individual, also estimated to be 15% of the American population (HHS, 2010).
The America’s Affordable Health Choices Act of 2009 is likely to reduce the abuse of ERs for the treatment of both chronic and preventive illnesses. The program will directly increase health insurance coverage and possible, provide individual residents with a regular source of health care. Several studies have shown that, having an unconstipated source of health care, otherwise referred to as, a medical home or a ‘health care home’ directly reduces ER use significantly (HHS, 2010). This is not only for healthy patients, but also for patients who are sicker and in need of greater health care. In order to reduce ER use, initiatives that provide high quality, cost effective, preventive health care to the Medicaid is necessary. Such initiatives ought to rely on primary care providers as coordinators of the care (HHS, 2010). Having a health care home as a resul...