October 02, 2014
Obamacare: The Bigger Picture
Be Well

Obamacare: The Bigger Picture

by David Tuller, DrPH  |  

One thing we can say for certain now: After several years of drama and fierce debate, Obamacare is finally in place. That means that, as of January 1, two million more people have health insurance and therefore access to better health care.

Moreover, as of January 1, no insurance company can reject someone because of a pre-existing condition, such as diabetes, cancer or heart disease. As of January 1, no insurance company can charge women more for coverage than men just because they’re women, or sick people more than healthy people just because they’re sick. As of January 1, no insurance company can sell plans with arbitrary annual and lifetime caps in coverage.

These elements of Obamacare—or, more accurately, the Affordable Care Act—are all common-sense changes that those of all political persuasions should be able to applaud. While the loudest opposition to the act has obviously arisen on the right end of the spectrum, the new system is obviously not the health care reform the left would have wanted either. As Michael Moore recently noted in the New York Times, many progressives favored a single-payer plan as the only viable approach. They observed the catastrophic October rollout of Obamacare’s health care exchanges with horror and a grim sense of “I-told-you-so.”

Certainly the infrastructure required for the Affordable Care Act is extremely complex, with too many moving parts—all designed to ensure that private health insurance companies retain their key role in the health care marketplace, even though their record of demonstrating sensitivity to the needs of policy-holders is highly questionable.

The new law constrains insurers from many of the most abusive tactics they have used in the past to deny people’s claims and increase corporate profits. But it remains to be seen whether the economics of the new system will actually work as intended, and whether enough young, healthy people will ultimately sign up for the plans to make them financially viable.

Even with the drawbacks and uncertainties, the Affordable Care Act is a landmark step in the American experiment: a declaration of every citizen’s right to obtain adequate health care. Other industrialized countries long ago extended such promises to their populations, even if implementation has often been flawed. That the U.S. has lagged so far behind is shameful; that we have now embarked on this new path represents a victory to savor, however briefly.