Moral Obligation and Social Rationality of Government: The Affordable Care Act

Outline

Introduction
Discussion

Significance of the work

Opinion
Conclusion

Moral Obligation and Social Rationality of Government: The Affordable Care Act

Introduction

The Affordable Care Act (ACA) has elicited mixed reactions from the people of America. The act was proposed on March 2012 and waits approval by the congress. The act seeks to ensure that the 15 percent-uninsured people in America access affordable care. The health case will be subsidized through government-imposed mandate to ensure low costs and improve the health care. The social obligation of government is morally imperative and consistent with section 1 and article 8 of the U.S constitution. Opposition of the act based on individual ethic is morally, economically and socially irrational.

Discussion

The debate on ACA has been centered on the terms “moral obligation” and “social rationality”. Those opposed to the act claim that they are not supposed to be coerced to take insurance cover (Okeke, 2011, p. 4). They argue that moral obligation is an individual obligation and it is one’s judgment that guides one to do right or wrong. Therefore, they should be left to choose to take cover or not. Few people, approximately 15% without the cover, should not make the government coerce them to help the poor by contributing to the kitty. They believe that every person should take an initiative to take insurance cover. On the other hand, social rationality is built on the premise of taking care of all the people welfare to ensure that problems of health care are resolved (Kaebnick, 2012, p. 2). The proponents of this act base their argument on that provision of quality health care to all people of America is a right and a responsibility of the government to provide facilitation of achieving this right.

The ACA act contains provisions that will ensure that health care provided is of high quality and accessible to all Americans. Furthermore, the healthcare services will be more consumers friendly. The government will ensure that the number of people with access to the health care increases. For instance, 46 million people who lack insurance cover will be insured, and will therefore be guaranteed to access affordable and quality medical cover (Okeke, 2011, p. 6). With coming into effect of the act, the number of people in America with access to insurance cover is expected to increase from the current 85% to 94% in the initial stages. Under the act, no insurance company will be allowed to cancel any policy in case a person gets sick. The doughnut gap will be closed as adults will be able to access drugs at reduced prices.

The act has a saving program, which will require the insured to deposit funds at the beginning of the years, and the funds will be used to meet the health expenses (Davis & Stremikis, 2011, p. 1201). In case expense is withdrawn from any other fund, the rate of taxes will increase from 10 to 20 percent beginning from 2016. Adults will be charged medical expense fees in excess of 10 percent up from 7.5 percent. The older people above 65 years will be charged lower taxes compared to the younger generation (Okeke, 2011, p. 4). Policy analysts are worried and contend that the aged who incur higher medical care and have higher income will pay less compared to the young people. This creates some inequalities as those with less pay higher taxes compared to those with higher income (Okeke, 2011, p. 4). The blame of insurance companies for charging higher costs of health will be resolved under the ACA provisions. Insurers will be obliged to spend 80 percent of their premium dollars on medical care services and on its quality improvement initiatives to avoid overspending on marketing activities, overhead, and salary to CEO and profits (Jacobson, 2011, p. 934).

The provisions are aimed at ensuring that the insurers do not charge excessive rates and improve affordability to the health services. This exorbitant profit by the insurance company is evident from the high profits they reap. For instance, in 2009, top five profit insurance companies got 12 million U.S dollars, which was an increase of 56 percent from the previous year (Collins, 2012, p. 1). High profits are paid to CEOs while many Americans over 45000 die from preventable diseases yearly because of inability to access to the proper health care.

Under the act, all Americans will gain accessibility to medical care and those who will fail to get cover will be fined. This is aimed at ensuring that all people gain access to good healthcare. Some people are opposed to the act because it will affect the poor, who may not have the capability to pay the premium making them to be penalized. This therefore raises questions of moral obligation whether it is right or wrong for people to be forced to pay premiums. Individuals will be expected to spend less that 9000-2100 dollars U.S in premiums under the act (Okeke, 2011, p. 4). By 2014, all people are required to be insured and failure to which they will be expected to pay a penalty of 95 U.S dollars.

Current insurance systems that are handled by government such as Medicare, Medicaid and Children Health Insurance programs provide good services. However, there is optimism that when the act comes to effect, services will be improved further. The act requires the government to run insurance market place using oversight boards that will have to evaluate the kind of treatment offered and will define essential benefits required to be offered by insurance plans. The provision of the ACA concerning individual mandate requires that all people acquire insurance cover by 2014, and aspires to make more people eligible for Medicaid. However, 12 states and small business administration have expressed dissatisfaction on the penalty issue for those who fail to meet the condition (Okeke, 2011, p. 12). They contend it is against constitutional sovereignty as it imposes a burden to them. Those who will not be taxed because they are covered by others will be obliged to pay the penalties in threefold beginning 2014 of 750 US dollar per year under the individual responsibility requirement (Koh, H. et al. 2010, p. 1296). Exceptions are also provided for those who have financial hardships, incarcerated, those with low income that is below the commerce department poverty line, religious objection and Americans Indian. Those who fail to pay the penalty will not result to criminal liability. The mandate requires that all uninsured people purchase insurance cover to afford healthcare services.

Significance of the work

The work is of great importance because it has provided the readers with an opportunity to get acquaintance with the ACA act. The author has elaborated on the moral obligation as well as the social rationality of the act. The act will ensure that all American people access to medical health at affordable rates as well as quality health care.

Opinion

I am in agreement with most points raised in the article. The fact that many Americans are covered by the act, it is also in good order that the 15 percent who are uninsured get access to affordable health care. Every individual has the right to good medical care. The increase in preventable death in America will be solved once the act is passed. However, I am also worried about some of the provisions in the act especially those that seem to be vague like the consequences for those who fail to pay the penalty. There is no clear provision that can be relied to give direction on the actions that will be taken for those who break provisions of the act.

Conclusion

The provision of the ACA will impact positively on the health care provision, but the proponent who proposed the reform should know that the act is not the panacea to reduce all the health inequalities and disparities. It will require collaboration and participation of all stakeholders to ensure that there is innovation to address political and socio-economic disparities among the population. The act should be passed and allowed to mature because it will save many uninsured Americans. The government decision of enacting the act is therefore morally and socially imperative. The time and the resources that were invested in the process are exorbitant and therefore, it is an act or social rationally and moral obligation for the government to provide insurance to millions of its citizens who cannot afford it.

I agree that if passed, the act will promote high standards of health among the U.S people. The act has various provisions that may tend to confuse at some point but the clear thing about the act is that it will help to improve the health standards of all Americans. I believe that every citizen has a constitutional right to access to good healthcare. All citizens should therefore support the act to realize its advantages.

References

Collins, S. (2012). The Income Divide in Health Care: How the Affordable Care Act Will Help Restore Fairness to the U.S. Health System. The Commonwealth Fund

Davis K., & Stremikis, K. (2011). How the Affordable Care Act will strengthen the nation’s primary care foundation, Journal Of General Internal Medicine [J Gen Intern Med], 26 (10): 1201-3.

Jacobson, P. (2011). Physicians, the Affordable Care Act, and primary care: disruptive change or business as usual?, Journal Of General Internal Medicine [J Gen Intern Med], 26 (8): 934-7

Kaebnick, G. (2012). The ACA decision: law and philosophy, The Hastings Center Report [Hastings Cent Rep], 42 (5): 2

Koh, H. et al. K. (2010). Promoting Prevention through the Affordable Care Act, New England Journal of Medicine, 363 (14): 1296-1299.

Okeke,T. (2011). Moral Obligation and social responsibility of government: The Affordable Care Act, Forum on Public Policy: 1-27.