Just a reminder, we discussed in class that my 2nd aspect incorporated the future of the medical field, so the "3rd aspect" is really in the 2nd and the conclusion because the conclusion will mainly encompass the future of the medical field.
By Allen Kukovich, former Democratic State Senator
Positives of the Affordable Health Care Act - Most of the large positive impacts will be phased in throughout this year and primarily in 2014 when the insurance exchanges are mandated to begin. This means that a majority of the estimated 40 million+ Americans without health care will be covered. ( In PA. estimates are between 482,000 to 683,000 people will get coverage) Nationally, the law will provide approximately one billion dollars in refunds to businesses and individuals. Much of this is accomplished by cutting unwarranted subsidies to provider companies. ( It has been estimated that this is already saving money in Medicare and added 8 years to the solvency of the Medicare Trust Fund.) For decades health costs have increased by 10% or more annually. Since the Act, it’s been below 4% for the first time in 50 years. Immediate benefits of the law include insurance industry reforms that prohibit insurers from denying coverage due to preexisting conditions and stops them from unfairly creating lifetime limits on care. It prohibits insurers from charging expensive copays for medical services considered to be preventive. This has already helped young children get immunizations and hearing tests and has helped identify autism and mental health issues in young children. The law allows young adults to remain on a parent’s health insurance plan until age 26 which has already helped thousands. In a broader sense the law is important because all of our global economic competitors have some form of a national health care system which has historically put the U.S. at a disadvantage. In a moral sense we have an obligation as a society to ensure that all our citizens have access to basic health care.
Negatives of the Affordable Care Act – Being created out of a contentious compromise, it is criticized by some on the right as government interference and criticized by some on the left as not going far enough. ( For example, since it is not a law that mandates universal coverage, not everyone will be covered.) Since it is the first major change to our health care system in over 50 years, implementation will be difficult. Federal regulations are not yet complete, so there is a lack of certainty in how states should proceed. The exchanges which implement the law can be created by a state, left to the federal government or operate as a partnership of both. Some see this as creating confusion. ( However, some see this as a positive, in that it allows states to adapt according to its unique needs rather than a “one size fits all” approach. The law mandates businesses to either cover their employees or pay into a national fund. A “business” is defined to be a company with more than 50 employees. A criticism is that this may prevent some small companies from creating more jobs. Although the law has already started to save money in the health care industry, it will increase some health coverage costs for individual businesses.
How will it affect the medical field? The first major issue is whether the state accepts Medicaid expansion under the law. Most states in our part of the country have, but not PA. yet. When a state accepts the expansion, more of its citzens get health care and the federal government picks up 100% of the costs through 2016 and 90% thereafter. Hospitals will benefit because in PA hospitals absorb almost 1 billion a year in unreimbursed costs. This law will help make up for the uninsured costs that people too poor to have health care but not poor enough to receive Medicaid cost hospitals. In 2014, when many people will start receiving care, an issue will arise regarding whether we have enough doctors to meet the new demands on the system. PA already has shortages of certain medical specialists in rural and more isolated, poorer parts of the state. The law puts an emphasis on preventive care, which hopefully will move our country from a health system focused on sickness to one that promotes wellness.
How will it affect the economy? Some elements of the business community think it will increase costs of doing business. I think, from my personal experience with the Chidren’s Health Care Program (CHIP), when more people have access to preventative care, money is saved and cost shift to large purchasers of insurance of millions of dollars is prevented. Eventually the business community will benefit. Families USA and the Pennsylvania Health Access Network recently put out a report estimating that it would bring 41,200 jobs and $5.1 billion in increased economic activity to the state. If PA accepts Medicaid expansion, a Kaiser Foundation study estimates the Federal Government will provide another $17 to $20 billion to the state over the next 6 years. The PA Hospital Association says the hospitals’ financial stability will improve and access to care for all patients will be preserved.
How will it affect the job market in the medical field? Initially the country will have to address a shortage of primary care doctors. The law contains many provisions that should help relieve this problem. It provides money to increase the number of medical residents, nurse practitioners and physician assistants trained in primary care. It’s estimated this will create more than 1,700 new primary care providers by 2015.
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