Obama Health Care Reform Is a Step Forward, Hopefully Toward Medicare For All

January 03, 2012

Mark Weisbrot
Dallas Morning News (TX), December 30, 2011
McClatchy-Tribune Information Services, December 29, 2011
Syracuse Post-Standard (NY), December 29, 2011
Harrisburg Patriot-News (PA), December 29, 2011
New Orleans Times-Picayune (LA), December 29, 2011
Juneau Empire (AK), December 30, 2011
Gainesville Times (FL), December 30, 2011
Glens Falls Post Star (NY), December 30, 2011
Times of India, December 31, 2011
Marshfield News Herald (WI), December 31, 2011
Fond du Lac Reporter (WI), December 31, 2011
Stevens Point Journal (WI), December 31, 2011
Wisconsin Rapids Tribune (WI), December 31, 2011
Wasau Daily Herald (WI), December 31, 2011
Sheboygan Press (WI), December 31, 2011
Oshkosh Northwestern (WI), December 31, 2011
Manitowoc Herald Times-Reporter (WI), December 31, 2011
Appleton Post-Crescent (WI), December 31, 2011
Green Bay Press-Gazette (WI), December 31, 2011
Savannah Morning News (GA), December 31, 2011
Lincoln Journal Star (NE), December 31, 2011
New Bedford Standard-Times (MA), December 31, 2011
Waterville Sentinel (ME), January 1, 2012
Kennebec Journal (ME), January 1, 2012
Arizona Daily Sun (AZ), January 1, 2012
Boulder Daily Camera (CO), January 1, 2012
Centre Daily Times (PA), January 2, 2012
Duluth News-Tribune (MN), January 2, 2012
Arizona Daily Star(AZ), January 2, 2012
Keene Sentinel (NH), January 3, 2012
Orange County Register (CA), January 3, 2012
Medford Mail-Tribune (OR), January 4, 2012
Great Falls Tribune (MT), January 4, 2012
Keene Sentinel (NH), January 4, 2012
Olympia Olympian (WA), January 5, 2012
Allentown Morning Call (PA), January 8, 2012
Kokoma Tribune (IN), January 8, 2012
Santa Barbara News-Press (CA), January 9, 2012

The United States has a terribly dysfunctional health care system, unique among the rich countries in the world in its waste and abuse of its citizens. As a nation we spend about twice as much per person as other high-income countries, and yet we have 50 million people uninsured and have worse health outcomes. This is not a result of Medicare or the nearly half of health care spending that is funded by the government, but rather the private insurance companies that dominate the system, as well as pharmaceutical companies.

The 2010 Affordable Care Act (ACA) did not provide the needed reforms that would bring us to parity with the rest of the high-income world. However, it will bring significant and noticeable improvements in the health care coverage of many Americans.

Some of this will be done by reducing or eliminating some of the worst abuses committed by private insurance companies. For example, by 2014 most insurance companies will not be allowed to discriminate against people who have a pre-existing health problem.  This is now in effect for children up to age 19. Most insurance companies are also prohibited from placing limits on the amount that they pay out for a patient’s illness over a lifetime, and the law raises and then eliminates such limits on annual spending.  The law also makes it more difficult for insurance companies to cancel a customer’s insurance after they get sick.

There are other benefits which expand coverage for those who have insurance. Parents will be allowed to keep their children on their insurance policies up to age 26. There is some reduction of prescription drug costs for Medicare patients. And in 2014, most insurance companies will also be required to cover treatment for mental health and substance abuse.

There are some loopholes and of course implementation can still be changed by future legislation. But most of these improvements can be expected to happen if the law survives.

The law will also expand health insurance coverage to an estimated 60 percent of the uninsured. This relies on a mandate for employers as well as uninsured individuals to purchase health insurance, with subsidies for low-income people. The mandate for individuals has become controversial and is also subject to legal challenges now pending at the U.S. Supreme Court.

Ironically, the reform is being attacked as having gone too far in expanding the government’s role in the health insurance system. But the real problem is that it did not go far enough. A simple expansion of Medicare to cover the non-elderly population would have achieved much more than the ACA in terms of eliminating abuses, covered all of the uninsured, and avoided the controversy over forcing people to pay money to private insurance companies. It would be affordable because it would eliminate the biggest source of waste – which comes from private insurers.  The second biggest source of waste – the monopoly pricing of pharmaceuticals – could also be drastically reduced to save hundreds of billions of dollars each year.

When Medicare and Medicaid were enacted, it was widely believed that covering the elderly and the poor were just the first steps to providing the same single-payer insurance to everyone. That it has not happened yet is a result of the corruption of our political system by powerful corporations – especially pharmaceutical and insurance companies – and a lack of political leadership. The major media have also played a supporting role in this process of keeping what Americans want and need off the political agenda. But Medicare for everyone is the future, and hopefully the ACA will end up being a step in that direction.

Support Cepr


If you value CEPR's work, support us by making a financial contribution.

Si valora el trabajo de CEPR, apóyenos haciendo una contribución financiera.

Donate Apóyanos

Keep up with our latest news