Obamacare is the colloquial name of what officially is known as The Patient Protection and Affordable Care Act, or the Affordable Care Act. Saying that the introduction of Obamacare was a critical change is an understatement: today, it is recognized as the single most significant regulatory overhaul since Medicare and Medicaid in 1965. Obama’s healthcare reform is often compared to that developed by Hillary Clinton, the so-called Hillarycare. However, Obamacare proved to be far more successful due to the insurance industry reform, expansion of coverage, and the “triple aim” of improved access, improved outcomes, and reduced costs of care. This paper discusses Obamacare in more detail and describes the main stakeholders of the policy: their motives, influence, and interrelationships.
The malfunctioning, inefficient system that American health care has come to be motivated the need for Obamacare Facts speak for themselves: in 2009, one of the leading healthcare institutions in the US, the Institute of Medicine recognized the system as inherently faulty. In their annual report, the organization stated that the government wasted around one-third, or $750 billion (Leimbigler & Lammert, 2016).
The main expenses were unnecessary services, high administrative costs, fraud, and other issues. On top of that, the Institute of Medicine showed that as many as 75,000 people died due to the decreased access to health care and poor services; otherwise, they could have been alive to this day (Leimbigler & Lammert, 2016). Smith, President and CEO of the California HealthCare Foundation and chairman of the panel, said that the system in its current state posed an imminent threat to Americans’ health and economic security (Center, Woods, Manchikanti & Purdue Pharma, 2017). To sum up, the healthcare system lagged in its capacity to accommodate patients, meet their needs, and ensure better outcomes.
The most significant change enabled by the promulgation of Obamacare was the provision of medical insurance coverage to a great number of uninsured Americans. The main objective of the new policy was to protect citizens from rising healthcare costs. Before the Affordable Care Act, insurance companies could freely refuse services to people with pre-existing conditions. As a result, citizens with such a health status would live without taking preventive measures for years, afraid of an expensive emergency to befall them and their budget.
The accessibility ensured by Obamacare allowed patients with pre-existing conditions to afford preventive care, which reduced the number of hospital visits and set back the rise of healthcare costs (Lanford & Quadagno, 2016). Obama’s government introduced new tax policies and penalties: an increase in taxation for those making more than $200,000 a year. It also obliged business owners to provide insurance to at least 95% of full-time employees. These measures made sure that insurance companies had the resources to serve patients with pre-existing conditions.
The formulation and promulgation of Obamacare included numerous stakeholders, including but not limited to the following:
- The federal and state government plays an important role: it regulates and finances the healthcare system. Its interest in the passage of Obamacare was motivated by the economic inefficiency of the existing healthcare system and poor health outcomes for American citizens;
- Health insurers help citizens pay for healthcare services by combining the risk of increased costs for a large number of people and allowing them or their employers to pay a premium calculated in accordance with the average price. Health insurers did express dissatisfaction with the new policy in the making because the inclusion of patients with pre-existing conditions implied higher expenses;
- Political parties provide a platform for a public debate on an important issue; each of them has its own rhetoric;
- The Supreme Court upholds the constitutionality of the new policy;
- The general public expresses its concerns with the current situation and wishes for better healthcare policies.
Probably, the stakeholders with the most contrasting, incompatible positions on the opposite sides of the broad spectrum of opinions were the two main US political parties: Democrats and Republicans. Democrats in the US were in favor of a rather socialized solution for systemic healthcare issues, which could be achieved in the form of Medicare expansion and a single-payer system. Republicans, on the other hand, thought it was more reasonable to keep the system personal or employer-based (Béland, Rocco, & Waddan, 2015).
To this day, Republicans are fighting against the expansion of medical services. Interestingly enough, even in the Republican-controlled, conservative states, the majority of the residents support Obamacare; yet, Republicans insist on its repeal (Béland, Rocco, & Waddan, 2015). The two stakeholders are likely to continue having conflicts on the grounds of healthcare solutions.
The continuing debate around health care in the United States is indicative of persistent problems in the practice of medicine, its cost, and quality. Over the last few decades, the North American country has seen several attempts to introduce a comprehensive healthcare policy that would address the issues, with the latest being Obamacare. Obamacare sought to achieve better accessibility for all patients, especially those with pre-existing conditions that were often deprived of preventive care.
The policy had numerous stakeholders, including federal and state governments, health insurers, political parties and leaders, the National Republican Congressional Committee, the Supreme Court, and the general public. The two most vocal stakeholders were Democrats and Republicans, with the former supporting a single-payer system and the latter disapproving of the more socialized approach.
Béland, D., Rocco, P., & Waddan, A. (2015). Polarized stakeholders and institutional vulnerabilities: The enduring politics of the Patient Protection and Affordable Care Act. Clinical Therapeutics, 37(4), 720-726.
Center, H., Woods, C. A., Manchikanti, L., & Purdue Pharma, L. P. (2017). A critical analysis of Obamacare: Affordable care or insurance for many and coverage for few. Pain Physician, 20, 111-138.
Lanford, D., & Quadagno, J. (2016). Implementing ObamaCare: The politics of medicaid expansion under the affordable care act of 2010. Sociological Perspectives, 59(3), 619-639.
Leimbigler, B., & Lammert, C. (2016). Why health care reform now? Strategic framing and the passage of Obamacare. Social Policy & Administration, 50(4), 467-481.