America prides itself as a beacon of democracy the world over. But the US government’s democratic processes have come under immense strain recently, resulting in America being thrown into disarray following a shutdown of non-essential government services at midnight on September 30, 2013. One could equate Congress with a rocky marriage at present; with the bickering between parties (The House of Representatives and The Senate) causing the functioning of the household to come to a standstill. At the core of the relationship breakdown is the Patient Protection and Affordable Care Act, also known as ‘Obamacare’. Obamacare, the brainchild of Obama and the Democrats (and thus largely supported by the Senate), has faced opposition from the Republicans from the beginning. But a Supreme Court ruling in favor of the central tenets of the Act gave impetus to its scheduled implementation.
But the Republicans have not backed down in their quest to have Obamacare repealed. The US financial year end presented the Republicans with the opportunity to barricade the impending implementation, by denying Obamacare the funding required in the 2013-2014 financial year budget that it presented to Congress. The budget was essentially held hostage, with funding for Obamacare being the ransom. The House of Representatives, led by the Republicans, presented a budget that effectively dismisses Obamacare, as they believe it will be a drain on the country’s economy, while the Democrat-led Senate stood firm in their belief that Obamacare would best solve the healthcare needs of the people of America. Incidentally, one of the major phases of the rollout of the Affordable Care Act, coincided with the first day that the new financial year budget comes into effect. Despite the deadlock on a budget deal and the resulting government shutdown, the commencement of insurance exchanges and the individual mandate continued on October 1st as planned.
Insurance exchanges are federal and state run markets, meant to serve as an online resource that allows small businesses and individuals to compare and purchase insurance policies with a government subsidy where it is applicable. The exchange acts in a sense, as a government controlled broker between the purchaser and the insurance provider. While it is clear that the intention of the Act is noble and public opinion polls show that a vast majority of Americans favor numerous individual aspects of the law, there is still widespread opposition to the law overall, with a Reuters/Ipsos poll from June 2012 indicating that 56% of Americans were against it or against it in its current form. So in fairness to the Republicans, their concerns are not dissimilar to the views of the average American. The main reasons for the opposition noted in opinion polls was the fear that there would be an increase in individual healthcare spending and that government would have too much involvement in healthcare. There are also concerns that Obamacare will cost government far more than is anticipated. Further, can these new enrollees afford it, yet alone manage these health benefits? More to the point will these individuals, who have never had to be responsible for their health coverage be able to effectively manage their coverage properly and will they be able to actually afford the dollars associated with this new coverage?
The Democrats would argue that the risks associated with these fears do not outweigh the benefits this law proposes to bring to millions of Americans. For instance, the shift from paying for individual health services to paying for bundled services could positively impact on the efficiency of healthcare provision. The law also alleviates the costs of medication for pensioners and allows Americans with pre-existing health conditions to qualify for health insurance. It also makes a defined set of healthcare services accessible to millions of Americans.
However, regardless of one’s opinion on Obamacare, the political drama that has unfolded over the days past is tragic. As in any rocky marriage, the ones who suffer the most are the dependents. While the parents are arguing about how and where to spend the family budget, the rest of the household sits helplessly in the dark and goes hungry. An estimated 700,000 workers woke up on Tuesday morning to the harsh reality that they will not be getting paid until further notice. The question we should be asking then, is not whether Obamacare should be implemented or not, but how we can mend the broken relationship in Congress so that a common ground can be found. In the end, both parties are guilty of putting their own political agendas above the needs of the American public.
Bottom Line: Elected Officials “Do unto others as you would have them do to you!” In the meantime, stop focusing on “Obamacare,” start tweaking the “Patient Protection and Affordable Care Act.” Patients are waiting.
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Rebecca S. Busch, RN,