Obtain an article from the New York Times, either the Science Times on Tuesday or
another New York Times article from the last six months. The topic could be on a science
innovation that impacts patient care or an article about what is happening with the
Accountable Care Act (ACA otherwise known as Obamacare).
Synopsis
In the article on the New York Times by Paul Krugman, Obamacare is facing a serious
challenge due to the inability of the supporting private insurance firms to offer their support. The
THE ACCOUNTABLE CARE ACT 2
anticipated intake of the insurance cover by the Americans has overwhelmed the private
insurance companies supporting Obamacare and thus a significant challenge to Obamacare. This
article presents the challenge with the Accountable Care Act despite there being many benefits
and positive stories about the scheme (Krugman, 2016).
Three major points of the article
Despite the successes of Obamacare (Accountable Care Act), a political challenge looms.
The election year in progress offers a significant challenge to the Accountable Care Act because
the president’s legacy is tarnished by the Republican candidates as well as the party. This is why
the fact that companies such as Aetna pulling out will definitely be a blow to Mr. Obama and his
successor at the Democratic party candidature; Hillary Clinton.
The article brings out the success of Obamacare despite very high skeptics on the care
program. The Obamacare scheme was expected to be very expensive and taxing on the American
citizens but instead; this has not been the case. The scheme has operated for more than two years
and indeed, more than 20 million Americans have benefited from the scheme. This was
unprecedented.
There seems to be a deliberate scheme to frustrate the Accountable Care Act. Many states
have alternative care programs aside from the expanded Medicaid and indeed, will likely not
support the program when major donors pull out. Instead of making it affordable for the
Americans to afford care, they are hiking the cost of insurance as a response to Americans
pulling out of Obamacare.
Impact to nursing career
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The article points out that the health care sector should often consider the cost of
healthcare with regard to the duty of care. The article on Obamacare has led to the provision of
quality services at affordable costs. Obamacare may not have solved all of America’s problems
but it did bring about major hospital reforms (Oberlander, 2012). Regardless, the challenges with
Obamacare may lead to a backlog of patient record processing especially with regard to
payments.
References
Krugman, P. (2016, August 19). Obamacare Hits a Bump. The New York Times.
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Oberlander, J. (2012). The future of Obamacare. New England Journal of Medicine, 367(23),
2165-2167.
Supporters of the Affordable Care Act gathered outside the Supreme Court in 2015. Credit Doug
Mills/The New York Times
More than two and a half years have gone by since the Affordable Care Act, a.k.a. Obamacare,
went fully into effect. Most of the news about health reform since then has been good, defying
the dire predictions of right-wing doomsayers. But this week has brought some genuine bad
news: The giant insurer Aetna announced that it would be pulling out of many of the
“exchanges,” the special insurance markets the law established.
This doesn’t mean that the reform is about to collapse. But some real problems are cropping up.
They’re problems that would be relatively easy to fix in a normal political system, one in which
parties can compromise to make government work. But they won’t get resolved if we elect a
clueless president (although he’d turn to terrific people, the best people, for advice, believe me.
Not.). And they’ll be difficult to resolve even with a knowledgeable, competent president if she
faces scorched-earth opposition from a hostile Congress.
The story so far: Since Obamacare took full effect in January 2014, two things have happened.
First, the percentage of Americans who are uninsured has dropped sharply. Second, the growth
of health costs has slowed sharply, so that the law is costing both consumers and taxpayers less
than expected.
Meanwhile, the bad things that were supposed to happen didn’t. Health reform didn’t cause the
budget deficit to soar; it didn’t kill private-sector jobs, which have actually grown more rapidly
since Obamacare went into effect than at any time since the 1990s. Evidence also is growing that
the law has meant a significant improvement in both health and financial security for millions,
probably tens of millions, of Americans.
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So what’s the problem?
Well, Obamacare is a system that relies on private insurance companies to provide much of its
expanded coverage (not all, because expanded Medicaid is also a big part of the system). And
many of these private insurers are now finding themselves losing money, because previously
uninsured Americans who are signing up turn out to have been sicker and more in need of costly
care than we realized.
Some insurers are responding by hiking premiums, which were initially set well below what the
law’s framers expected. And some insurers are simply pulling out of the system.
In Aetna’s case there’s reason to believe that there was also another factor: vindictiveness on the
part of the insurer after antitrust authorities turned down a proposed merger. That’s an important
story, but not central to the broader issue of health reform.
So how bad is the problem?
Much of the new system is doing pretty well — not just the Medicaid expansion, but also private
insurer-based exchanges in big states that are trying to make the law work, California in
particular. The bad news mainly hits states that have small populations and/or have governments
hostile to reform, where the exit of insurers may leave markets without adequate competition.
That’s not the whole country, but it would be a significant setback.
But it would be quite easy to fix the system. It seems clear that subsidies for purchasing
insurance, and in some cases for insurers themselves, should be somewhat bigger — an
affordable proposition given that the program so far has come in under budget, and easily
justified now that we know just how badly many of our fellow citizens needed coverage. There
should also be a reinforced effort to ensure that healthy Americans buy insurance, as the law
requires, rather than them waiting until they get sick. Such measures would go a long way
toward getting things back on track.
Beyond all that, what about the public option?
The idea of allowing the government to offer a health plan directly to families was blocked in
2010 because private insurers didn’t want to face the competition. But if those insurers aren’t
actually interested in providing insurance, why not let the government step in (as Hillary Clinton
is in fact proposing)?
The trouble, of course, is Congress: If Republicans control one or both houses, it’s all too likely
that they’ll do what they do best — try to sabotage a Democratic president through lack of
cooperation. Unless it’s such a wave election that Democrats take the House, or at least can
claim an overwhelming mandate, the obvious fixes for health reform will be off the table.
That said, there may still be room for action at the executive level. And I’m hearing suggestions
that states may be able to offer their own public options; if these proved successful, they might
gradually become the norm.
However this plays out, it’s important to realize that as far as anyone can tell, there’s nothing
wrong with Obamacare that couldn’t be fairly easily fixed with a bit of bipartisan cooperation.
The only thing that makes this hard is the blocking power of politicians who want reform to fail.
Read my blog, The Conscience of a Liberal, and follow me on Twitter, @PaulKrugman.
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A version of this op-ed appears in print on August 19, 2016, on page A23 of the New York
edition with the headline: Obamacare Hits a Bump. Today’s Paper|Subscribe