While America has the most expensive health care system in the world, Americans do not live longer or have better health than people in most other developed countries. The Affordable Care Act (ACA) contains reforms that address quality of care, cost control and access to services for millions of Americans.
There are a lot of factors that contribute to the poor health care outcomes in the U.S. compared to other countries. Costs and access to doctors and medicine are significant, but not the only influences.
The United States health care system is unique in that it is the only country in the civilized world that is controlled by private or publicly traded corporations that sell health insurance policies and prescription medicines for profit. It is also the only county in the industrialized world that does not provide health care for all its citizens.
Everything from prescriptions to medical procedures to diagnostic testing is essentially controlled by the companies that sell health insurance policies. Even Medicare and Medicaid, which are government-run programs, have limits on what insurance will pay for and what it will not. If an injury or illness is not a covered expense the patient is not likely to receive treatment, even if it is deemed necessary by their doctor.
Because the primary goal of insurance and pharmaceutical companies is profit as opposed to actual health care, access to medical services are often reserved for those who can afford costly premiums for individual policies, or groups plans offered at shared costs by employers.
Access to Health Care
In the United States, as many as 45,000 people die each year because they do not have access to affordable health insurance, according to a Harvard Medical School research study.
Some of the ways the ACA addresses issues of access is by making health insurance more affordable. It does this through a combination of cost control measures, competitive purchasing marketplaces, no-cost preventive care screenings, and by creating minimum required standards for coverage.
Beginning on October 1, 2013, consumers will be able to shop at open marketplaces, also referred to as health insurance exchanges, for the best policies at competitive prices.
Many lower-income Americans will be able to get a government subsidy to help pay for their health insurance policy.
In states that choose to participate in the Medicaid expansion of the ACA, lower-income consumers may qualify for government sponsored health insurance at little to no costs to them.
Health Care Costs
Health care costs in the United States have soared ten-fold since the 1980s, driven in large part by America’s profit-based system. According to the Centers for Medicare & Medicaid Services, health insurance premiums have risen 131 percent since 1999.
In 2012 alone, the top pharmaceutical companies had nearly $85 billion in profits, representing only part of America’s $880 billion profit-based health care industry. The ACA addresses run-away premium costs by requiring insurance companies to justify future rate increases beyond the desire to increase profits through a “rate review” process.
Additional efforts to make health care more affordable and accessible to Americans are included in the Patient’s Bill of Rights, which establishes benefits for all consumers whether they buy insurance from an Affordable Care Act marketplace, or have health insurance from their employer. You can read more about the rights afforded by the ACA on HealthCare.gov.
Maryann Tobin is an award-winning writer based in Tampa, Florida. She has appeared on the History Channel’s ‘DECODED’ series, and her investigative reporting on animal welfare issues led to a WTSP 10 News Investigators report. Her work can be found on Examiner.com.