Lacking access to data that would help individuals and employers understand the pricing forces behind the various coverage plans, the body politic continues to show skepticism about whether the ACA can control costs.
News reports continue to emphasize its high costs (forgetting earlier cost increases) and it is difficult to measure the impact of the ACA’s various successes, such as improving coverage for young adults , or the increased availability of care outside a traditional hospital setting (e.g. There simply is not enough information yet to judge the net cost increases after tax credits for small businesses, or discounts for prescriptions for seniors, or the ability of the system to protect against fraud, or savings from the efficiencies required by better coding procedures.
The ACA was drawn from Republican plans that had been put forward during an early attempt at a more comprehensive reform during the Clinton administration.
It was to use a model that rejected a single payer national health insurance plan (like Canada) in favor of a combination of employer plans provided by private insurers and Medicare and Medicaid.
Take the example of “qualified” health plans requiring coverage for birth control.
This coverage mandate has been portrayed as an unnecessary and costly example of government intrusion into one’s own health care, which is ironic considering that the intrusion is exactly in the opposite direction—imposing outside values on a women’s health care choices.Of course, private employer insurance plans would continue to provide coverage and subsidized insurance exchanges by private insurers at the state level for individuals were supposed to be the final piece of the coverage puzzle. model (though still in the process of rolling out each of its provisions) has yet to uniformly deliver the savings in health care costs, at least as a percentage of GDP, that either the German or the Canadian systems have delivered.This model (a version of which is used by Germany) intended to use competitive market forces to help bring quality and service through contracting with private insurers and thereby avoid some of the perceived pitfalls of national single payer systems. Despite its apparent success in states like Arkansas and Kentucky, general political sentiment seems to favor its repeal.(Why no outrage from the religious community over required coverage for Viagra?) Lost work days, mental health care and eventual child care difficulties that would result from unwanted or unplanned pregnancies are not costs easily measured, with ripple effects that may even increase the number of abortions and other family planning costs.This result comes despite deep divisions in the religious community over abortion and the importance of religious doctrines that require kindness to strangers (i.e. What emerges is, as Armstrong notes, the predictable reaction to secularism—regardless of the facts, the religious right sees government programs as efforts by the elite, for the elite, that restrict religious devotion and purity.Thus, the movement to repeal the ACA may be founded on the perception that it disrespects religious communities.Why has health care in the US been such a challenge to fix?Perhaps it is because there is a religious, even anti-secular reasoning to those who are resisting its reform.In response, religious communities continue their march towards fundamentalism and resistance even where it is self-destructive.The question is whether the new head of the DHHS will make the same mistakes, but in the other direction.