Ongoing Health Care Reform Debate Symptomatic of Larger Problems

The 2010 Patient Protection and Affordable Care Act sought to reform health care in America in one sweeping, comprehensive package. The legislation could not, however, put purchasing power in the hands of consumers hard hit by the recession that began late in 2008. According to figures compiled by the U.S. Centers for Medicare and Medicaid Services (CMS) and published in the journal “Health Affairs,” health care spending in the U.S. in 2010 increased only 3.9 percent. The second lowest increase in half a century.

High Unemployment Equals Lost Insurance Benefits

As unemployment hovered between 8 to 9 percent from 2009 through 2011, many Americans lost their job-based insurance benefits and could not afford private policies. As a result, more and more people put off medical care. Total health care spending in the U.S. for 2010 came to $2.54 billion (17.9 percent of the total economy), or approximately $8,402 per person.

Health care costs in the U.S. have increased almost 8 times from the 1980 level of $1, 110 per person. Many Americans who had already struggled with that upward curve for three decades lost the fight when they lost their jobs during the recession, or were forced to sharply curtail personal expenses to cover day-to-day necessities like food for their children.

Annual spending on health care in 2009 grew just 3.8 percent, the lowest rate recorded in 50 years. The miniscule 0.1 percentage point change in that level for 2010 is a clear indicator of the tight economic conditions under which Americans continue to labor more than a year later. Even given these statistics, however, per capita health spending in this country is the highest in the world.

Health Care Prime Political Point in Presidential Election

As the country moves into the 2012 presidential election season, these are the kinds of numbers that will be front and center in candidates’ remarks about the perceived success or failure of President Barack Obama’s health care reform package. Hailed by the White House as the president’s central domestic achievement, critics argue that the Affordable Care Act is actually Obama’s greatest failure and illustrates his ineffectiveness as a leader.

In March, the Supreme Court will be reviewing the constitutionality of one of the most hotly debated aspects of the Affordable Care Act, the requirement that all Americans have health coverage by 2014. Critics contend that the constitution does not give Congress the power to compel citizens to purchase any product in a free marketplace including insurance coverage. Although most Americans are compelled to buy auto insurance as a condition of holding a driver’s license, those stipulations are state, not federal laws.

High Cost of Medical Care Tied to Federal Debt and Spending

Health care reform also intersects with the ongoing acrimonious political infighting about the federal debt and deficit spending. By the second quarter of 2011, outlays for Medicare and Medicaid benefits were already up 10 percent for the year over 2010 levels, and on track to post a $90 billion hike for the year, sending the annual rate above $1 trillion for the first time.

Conservative candidates are hammering for both a repeal of key aspects of what is termed as “Obamacare” in the political jargon, as well as for a sharp decrease in “entitlement” programs like Medicare and Medicaid. Given the graying of the American population, spending increases in both programs are inevitable without legislative changes. Every day for the next 15 years, thousands of Baby Boomers will turn 65 and become eligible for both Social Security and Medicare benefits.

Additionally in 2014, the Affordable Care Act will extend coverage to some 30 million more Americans when Medicaid is to be expanded via a system of health insurance exchanges in each state. In 2011, Medicaid enrollment was up by 3.7 million as droves of Americans sought federal help when they could no longer afford private health insurance. The Obama administration, in an effort to help state governments, increased federal spending to share the Medicaid burden.

The Health Care Debate if Far from Resolved

Given the relationship between health care reform and deficit spending, President Obama will face an-ever growing challenge in defending the success of his health care reform package. In 2011, insurance premiums grew faster than benefits for the first time in approximately seven years. The price of coverage was up 8 to 9 percent on average, with some small group plans seeing even steeper hikes. Although small business owners tend to have a more intimate relationship with their employees and continue to offer insurance benefits even in hard times, many can no longer afford to keep their doors open and pay for health insurance.

Misunderstands and Rumors Complicate the Situation

Perhaps no other president in modern history has been at the center of so many swirling rumors as Barack Obama. When the Kaiser Family Foundation conducted a study in November 2011, the results indicated that the vast majority of Americans do not understand the Affordable Care Act, nor can they name its major provisions. Yet, 44 percent of those surveyed disapprove of the legislation and by extension, the president.

Outrageous claims continue to circle on the Internet, with one of the most prevalent being the so-called “death panel.” This rumor suggests that the president’s support of “end of life” counseling is actually an attempt to cut medical spending in the U.S. by killing off thousands of older Americans by denying life-extending care to them in their final years. Run the phrase “Obama death panel” through a search engine and more than 135,000,000 results are returned.

Facts Speaker Louder than Rumors

Even in the face of that kind of obviously inflammatory rumor mongering, however, there are hard facts that make the health care reform debate central to the overall feeling of frustration and decline with which American voters are struggling. Insurance is 8-9 percent more expensive and fewer Americans than ever are utilizing the services of a doctor. We are an overweight and out-of-shape nation, with a third of the population qualifying as obese. Diabetes and heart disease are on the rise, and the population is growing older.

These problems are set against a varied social backdrop. There is an ever-widening gap between the “haves” and “have-nots” in America, graphically illustrated by the Occupy protests in the summer of 2010. Government spending is out of control. The collapse of the mortgage industry and the sweeping wave of foreclosures led to a real estate crisis that left thousands of Americans homeless and starting over. And there is a widespread call for a clamp down on big business after the bailout of Wall Street failed to halt rogue behavior on the part of big business. The popularly perceived failure of health care reform is symptomatic of a larger malaise, with the common man suffering the hardships while the politicians debate.