JCHS IPE 300

The Affordable Care Act is granted hundreds of millions of dollars to address many issues. While the provisions ranges are varied, they aim to address specific needs of the health care workforce and care delivery system. A large portion of the population will soon be requiring more health care services because the older population has increased significantly. While health care services requirements will be increasing, health care professionals will be decreasing because they will be retiring. Without new professionals coming into the workforce, shortages will intensify. While health care professionals are required, many younger generations want to have a balance between their work life and home life (Public Sector, 2010). Without a schedule to accommodate their needs, it is less likely they will accept a job that is too demanding.

Public Sector Consultants Inc. (November, 2010). Assessing the impact of health reform on the health care work force. Michigan Health Council. (p. 5-7). Retrieved from: http://www.mhc.org/file_archive/CHP_Health_Reform_Workforce_FINAL_Nov_2010_1.pdf

Although there are some great points here about the benefits to American individuals regarding their long-term health and eventual financial savings, it’s the immediate increase in cost to the taxpayers that is of concern. Blendon, et al (2006) state that surveys show there is an overall dissatisfaction with the American view of the health care system (p. 627). Americans are concerned with the payments they will be required to make due to health care reform. Payments for insurance premiums, co-pays, deductibles, and costs of services and products, are all of concern (p. 632). Americans blame insurance and drug companies for the rising costs of health care. These individuals do not see their own habits as the cause (p. 636). Studies show that the uninsured are generally dissatisfied with the health care they receive (p. 638). This may indicate that they are blaming the system, not their own habits. Many Americans feel that there are ways to reduce the cost of health care, such as tax deductibles and tax credits for businesses that provide insurance to their employees. Government programs for low-income services could be expanded. These ideas are preferred over a single government plan (p. 641). Americans do not want more out-of-pocket costs. The insured individuals are likely to take shortcuts to avoid co-pays. The uninsured are likely to opt out of insurance because the penalty tax may be less than the financial cost of insurance, or the requirement to clean up their health habits.

Reference

Blendon, R., Brodie, M., Benson, J., Altman, D., & Buhr, T. (December 1, 2006). American’s views of health care costs, access, and quality. Mllbank Quarterly. 84(4). 623-657.

When talking about how universal health care will allow more access to health care to more Americans, it seems that the focus is on the coverage and lower costs of health care related to patients. Focus should be on how long it takes to get care. In other countries with some form of Universal health care surgeries can take months before they are performed, in fact , there are “legions of stories reported by the newspapers of people who have died while waiting for surgery” (Thomas, 2012). If access to health care leads to longer waits times, then many illnesses will be prolonged and/or worsened before proper care is administered. Preventive health care is a great incentive, but what if the flu season is over before the shot can be administered?

Thomas, C. (2012). Foxnews.com. Retrieved from Health Care: http://www.foxnews.com/opinion/2012/06/21/what-uk-national-health-care-mess-tells- us-about-obamacare/

I believe that physicians should be against the health care reform for the simple reason that it has put many citizens in the position of not being able to afford health care. Therefore, people are not able to get adequate treatment from physicians because they cannot afford it. Health care reform is in a way forcing physicians to lower their care that their patients receive because of the high cost of health care that patients cannot always pay.

Whelan, P. (2011, May). Doctors debate universal health care: pros and cons from the experts. Retrieved from http://familydoctormag.com/doctors-office/194-doctors-debate-universal-health-care-pros-and-cons-from-the-experts.html

There are various validating reasons why tax payers are against the universal health care plan. Tax payers are already disgruntled after having to pay state and federal taxes each year, so when it comes to health care taxes a great deal of people quite simply do not have sufficient income to pay health care taxes. The current health care system is full of taxes and tax increases that affect many individuals. Over the years the health care system has continued to grow in complexity and cost. This increase in cost has become a giant burden on tax payers. According to research done by ProCon, “46.3 million people in the US were uninsured in 2008 according to the US Census Bureau.” This is directly related to the fact that insurance costs and healthcare taxes have increased in the past years and are continuing in that pattern. According to Healthcare Payer News, “Employers can expect to see an 8.5 percent increase in healthcare taxes in 2012, a slight increase from the 8 percent increase expected this year …” This trend means that healthcare cost will continue to grow more rapidly than individual wages. This will greatly affect those tax payers in middle and lower class. Statistics have reported that “starting in 2014, virtually every legal resident of the U.S. will be required to carry health insurance or face a tax penalty.” (Alonso, 2012) It is obvious to see that the health care system is not benefiting tax paying citizens.

Alonso, R. (2012). Health care tax penalty to hit nearly 6 million uninsured people. Huff post business, Retrieved from http://www.huffingtonpost.com/2012/09/19/health-care-tax-penalty_n_1898005.html

DeNavas-Walt, C, Proctor, B, & Smith, J. (2009, September). Income, poverty, and health insurance coverage in the united states: 2008. Retrieved from http://healthcare.procon.org/sourcefiles/CensusBureau_IncomePovertyHealthInsuranceCov2008.pdf

Pizzi, R. (2011, May 18). Pwc forecasts 8.5 percent increase in healthcare costs for employers in 2012. Retrieved from http://www.healthcarepayernews.com/content/pwc-forecasts-85-percent-increase-healthcare-costs-employers-2012

Physicians should be against a universal health care plan. The government couldn’t handle Medicare and Medicaid on a smaller scale. Physicians have a difficult time receiving reimbursements from the government which has “forced many doctors to stop treating Medicare patients altogether” (Ipsum, 2009). A CER (Comparative Effectiveness Research) council is being created to analyze cost effectiveness of types of medical care, which will “influence doctor’s decisions” possibly resulting in non-reimbursement for care; giving doctor’s “little incentive to provide better quality of care” (Ipsum, 2009). Doctors will make less money for more work prompting President Obama to warn “physicians will have to tighten their belts” (Ipsum, 2009). With increased workload and reduced salary physicians should be against Universal Healthcare.

Ipsum, C. (2009). Good Sense Politics. Retrieved from Why are so many doctors against Universal healthcare?: http://goodsensepolitics.blogspot.com/2009/03/why-are-so-many-doctors-against.html

Taxpayer

As taxpayers, we are very concerned with the proposals put forth concerning healthcare reform. We already sacrifice too much of our income to the state and federal governments in the form of taxes. How can the government think they can provide affordable health insurance to all American citizens without assessing taxes to those who can “afford” to pay them? And why should we allow government to control our choices regarding healthcare?

The state of Massachusetts imposed a requirement for all residents of that state to carry health insurance, beginning in April, 2006. According to Steinbrook (2008), subsidies are available for those qualifying for a financial hardship, determined by tax returns. Those without health insurance must pay a penalty tax. In 2008, this amount was $912 per individual, annually. Approximately 10% of the state’s residents do not file tax returns. Therefore, they are not contributing to the funding of this type of universal healthcare. More importantly, they are not partaking in the plan’s ultimate goal to improve overall health and preventative medicine (Steinbrook, 2008).

Tanner (2009) explains that residents in Massachusetts are required to purchase health insurance on their own, if it is not provided by their employer. He states that this system has failed. Healthcare costs are still rising and not everyone is insured. This plan has exceeded its projected budget and will likely continue to do so. No doubt this financial burden will be passed on to the taxpayers. There have been proposals for additional tax hikes for individuals, as well as taxes being assessed to businesses that do not provide insurance for their employees (Tanner, 2009).

The idea of government regulating choices of this type has been unpopular historically. This is especially true when a tax increase is part of the plan. Mongan & Lee (2005) state that attempts to create a healthcare reform have been made repeatedly since 1974 when President Nixon proposed a plan. President Carter in 1979, and President Clinton in 1994 also made efforts to create a type of healthcare reform. Their attempts never got far. The plans were said to be too complex. In all three cases, a high concern was that taxes would have to be raised to support the financial burden of the plan (Mongan & Lee, 2005).

Gapenski & Pink (2010) offer a chronological breakdown of the current proposal for healthcare reform. Some tax provisions will become effective as of January 1, 2014, as follows:

1. Tax credits will be offered to small businesses that have fewer than 25 employees and provide healthcare benefits for them

2. A $2000 per employee tax penalty will be imposed on employers with more than 50 employees that do not offer health insurance to their full-time workers.

3. An annual penalty of $95, or up to 1% of income, whichever is greater, will be imposed on individuals who do not secure insurance; this penalty will increase to $695, or 2.5% of income, by 2016. This limit will be the individual limit; families will have a limit of $2085. Exemptions to the penalty in cases of financial hardship or religious beliefs will be permitted.

(Gapenski & Pink, 2010).

For the average taxpayer, the idea of yet another tax to pay is not a desirable one. There is also the issue of employers being assessed fees if they do not provide health insurance to their employees. A likely argument would be that this cost would have to be extended to the customers of that business.

The article, Tax Penalty to Hit 6-Million, suggests that some individuals believe by staying uninsured and paying the penalty, they may actually be saving money and coming out ahead of the game (Tax Penalty to Hit 6-Million, n.d.).

Clearly, healthcare reform is not working in Massachusetts and, even more unlikely, is the idea that the plan can work nationally without a major increase in the amount of taxes American citizens are required to pay. We believe we have the right to make our own decisions regarding our health and the healthcare we may or may not seek. There is no room for government mandates that will in-turn punish the individuals and businesses of this country by assessing taxes to carry the financial burden.

References

Gapenski, L., Pink, G. (2011). Understanding healthcare financial management. (6th ed.). Healthcare Reform Update. Health Administration Press. Retrieved from http://acheweb.ache.org/pubs/HAP_Companion/Gapenski%206th/HEALTHCARE%20REFORM%20PRIMER-clean.pdf.

Mongan, J., Lee, T. (March 24, 2005). Do we really want broad access to health care? The New England Journal of Medicine. 352(12). 1260-1263.

Steinbrook, R. (June 26, 2008). Health care reform in Massachusetts: Expanding coverage, escalating costs. The New England Journal of Medicine. 358. 2757-2760. Retrieved from http://www.nejm.org/doi/full/10.1056/nejmp0804277.

Tanner, M. (June 9, 2009). Massachusetts miracle or Massachusetts miserable: What the failure of the "massachusetts model" tells us about health care reform. CATO Institute Briefing Papers. 112.

Tax penalty to hit 6-million who don’t buy health insurance by 2016. Retrieved from http://www.insurancejournal.com/news/national/2012/09/24/264067.htm?print.