Today the Supreme Court of the Unites States of American handed down a momentous decision, to uphold the constitutionality of the Patient Protection and Affordable Care Act (PPACA). Of course this will continue to be debated. Already the Republicans, including Mitt Romney, have vowed to overturn it, and continue to fight it at every juncture.
Let's not lose sight of
what the PPACA, which was dubbed Obamacare by the Republicans, provides for all
Americans. It increases healthcare
coverage for pre-existing conditions and won't allow insurance companies to
deny coverage based on pre-existing conditions. This allows 30 million more Americans
to get coverage. Researchers from
Harvard Medical School say that the lack of coverage can be linked to about
45,000 deaths per year in the United States. That
is more than die of breast cancer. You don't
see Republicans trying to prevent breast cancer research.
More than 3 million Americans under the age of 26 will be allowed to stay on their parent's healthcare plan. Think about this; we weigh our youth down with incredible debt from the first day they start college. Most carry this debt with them for many years after college, and many never get from under it. Why burden them further by dropping their coverage just when they need it the most? We should be doing more to help students. It's no wonder we have dropped to 14th in reading, 17th in science, and 25 in math. We have our priorities all wrong.
More than 80 million Americans now have access to preventative care, such as vaccinations and cancer screenings. This vast increase in preventive care can't help but result in healthier Americans, fewer deaths, and ultimately lower healthcare costs. Insurers can no longer cap the total dollar amount of care you receive over a lifetime. They also can no longer cancel your coverage because of an honest mistake on your application.
Women have historically made less than men, and continue
to today, however, they pay more for healthcare coverage. Beginning next year this will no longer be
allowed. They can no longer deny
coverage for "pre-existing conditions" such as, pregnancy, having had
a C-section, or having been a victim of domestic violence. 45 million women will now have access to
mammograms, cervical cancer screenings, pre and post natal care, flu shots,
regular well-baby, well-child and well-woman visits, domestic violence
screening, and contraceptives.
For the first time ever, health insurers are required to use 80% of the money that they collect from individuals and 85% for large group insurers, and apply that towards actual healthcare rather than to add to their profit margin. If they are found to be in violation of this new rule they are required to send their customers a rebate check. This will stop some of the most egregious abuses by healthcare companies. This year alone $1.3 billion will be returned to consumers and businesses.
The average American, over the age of 65, will save an about
$650 per year. These are our
grandmothers and grandfathers. Don't forget, you too will be that age one
day. Last year $4.1 billion of our tax
dollars was recovered due to healthcare fraud prosecutions.
These are just the highlights; they are many more provisions that benefit us all. How could Republicans fight so hard to prevent this law? Is it because they think it is forcing religious intuitions to provide contraceptives against their beliefs? Is it because of the individual mandate? Or is it because they believe it will drastically increase healthcare costs? Let's look at the validity of each of these points.
Researchers at the Institute of Medicine conclude that contraceptives are medically necessary "to ensure women's health and well-being". Churches and houses are worship are exempt from providing contraceptives, but all employers and education institutions must comply. A compromise was proposed, by President Obama, which would require insurers to provide contraceptives directly so that religious organization would not have to do so. Of course this was not good enough for Republicans. What I find shocking, besides the obvious disregard for the health of women, is that their stance, in effect, is forcing their beliefs on all Americans. What if they aren't a member of your faith? That doesn't matter because they believe that God doesn't want you to use contraceptives, so they believe they know what's best for you. This is supposed to be a free country, if a woman shares these beliefs then she can choose not to use contraceptives. In fact, about 99% of women actually use contraceptives. They clearly don't share these beliefs, yet the church is fine with forcing them to do so. How is telling people what they can and can't do with their bodies not tyranny? As people are fond of saying, "What would Jesus do?"
The individual mandate requires all Americans, whose income is above the poverty line, to purchase insurance. If the coverage would cost more than 8% of your income then you are not required to purchase it. For those that don't meet these requirements they are required to pay, at most, a penalty of $625 or 2.5% of your income, whichever is higher. What happens to you if you don't get coverage and don't pay the penalty? Absolutely nothing, you cannot be criminally prosecuted, and the IRS cannot levy further penalties or leans against you. The reason we have the mandate is to make sure everyone pays their fair share, and to keep insurance premiums low.
The irony is that the individual mandate has
traditionally been supported by Republicans. Mitt Romney signed a law in his home state of
Massachusetts that included an individual mandate. For years Newt Gingrich supported the mandate
wholeheartedly. Of course, once he and
Romney ran for president they quickly reversed their opinion. What is their opposition to mandate? That it is unconstitutional? Well the Supreme
Court just concluded that it is not. How
could we deny Americans all of these life saving benefits just because a few
people that can afford to pay the penalty don't want to?
In March The Congressional Budget Office (CBO), and the Joint Committee on Taxation, revised its estimates of the costs of the law. The CBO is a non-partisan federal agency that provides economic data to Congress, and both parties regularly use their estimates. They project that over the next 10 years the law will cost about $1.1 trillion, which is actually $50 billion less than last year's projections. Since 2001 US healthcare costs have risen steadily. In 2010 healthcare the US spent more per capita ($8,632), and more as a percentage of GPD (17.9%), than any other country, however, our healthcare system is 37th out of 191 countries. While Republicans focus on these costs, they completely ignore the fact that, with all of these cost savings measures, new revenues, and elimination of waste and fraud, the CBO estimates the net effect of the law is to decrease overall healthcare costs, while improving the quality of patient care.
Some argue that, "access to healthcare" doesn't actually mean they will receive healthcare. They say that this will result in long lines and waiting lists. So what if it does? Providing millions of Americans access to healthcare, by providing them insurance coverage, is far better than leaving them to die. Regardless of wait times this helps save lives, increases the life expectancy of Americans ,for which we are currently ranked 50th, slows and ultimately reduces exploding healthcare costs, and is the right thing to do. At one of the recent Republican primary debates, they actually cheered when Ron Paul suggested that someone without insurance should be allowed to die. How can people that claim to love this country care so little about the lives of its citizens?
Of course this law is not perfect, but it is the most progress we have ever made towards universal healthcare, and is a stepping stone to a single payer system, in which insurance companies would not be able to reap huge profits at the expense of our health. In our current system there are literally tens of thousands of different healthcare organizations, all of which collect administrative costs that trump the costs of patients care. We should be getting excited about the fact that our government is taking steps to help us live healthier lives rather than fighting progress every step of the way.
With the exception of Mexico, Turkey, and the US, all OECD countries, which is comprised of 34 of the world's leading industrialized nations, have managed to provide universal coverage for at least 98% of their populations by 1990. Why do we fail where other countries have succeeded? It is because the Republican Party opposes the very concept that government should use our tax dollars to help Americans get insurance coverage. Healthy Americans are happy Americans, and happy Americans are more productive, as well as better equipped to compete in a global economy in which we are quickly lagging behind. Today's Supreme Court decision is a win for every American whether Republicans admit it or not.