There was much discussion, concern and even furor leading up to the passage of the “The Patient Protection and Affordable Care Act”, and even now the rancor has turned toward its repeal. This piece of legislation has stirred passionate debate and shouting matches over the meaning of freedom in the United States, the direction of the country in its acceptance of social welfare, and the limits of authority granted the Federal government in the U.S. Constitution. In all of this, you might hear inferences or plainly made statements that the recent healthcare reform legislation results in a takeover of the U.S. healthcare system by the Federal government.
However, a read through the summaries of the legislation that you can easily find online prove that this is not a government takeover of the private medical insurance system in place today. In fact, setting aside all the philosophical and constitutional discussion, the healthcare reform legislation should strengthen and make the private sector managed healthcare industry even more profitable.
Here is why. A key reason for the legislation that was recently passed is to achieve near universal healthcare coverage for Americans and for that coverage to be affordable and not out of reach for most Americans. And the legislation did not pass with a publicly funded healthcare plan to do this – in other words, no “Medicare for all” or “public option” resulted from the bill that passed. Universal healthcare coverage in the “The Patient Protection and Affordable Care Act” is to be done within the private healthcare system in the United States and this is why you see in the legislation a brute force reconciliation of two aspects that are usually not reconcilable when trying to provide universal coverage with a private sector insurance or managed care system.
What is reconciled, albeit in a forced manner, is the concept of a for-profit medical insurance system covering everyone without going broke. To provide healthcare coverage for sicker members in a population without running out of money for everyone in a private system, you have to make sure that all of the population participates in the system. This especially means that the healthy members of the population participate, even if these members do not require any medical services at all. The brute force solution to this by the recent bill from Congress is that in 2014, all but the poorest of Americans will be required to purchase a healthcare plan, regardless if they have that option through their employer or not. If you can get healthcare coverage at work, great. If you can’t, you have to enter the individual insurance market and purchase a healthcare plan.
So, the real issue that has some Americans upset is the U.S. Federal government mandating that Americans purchase healthcare, regardless if they want it or feel they need it, and the unanswered question as to whether the Constitution extends this authority to the Federal government or not.
The question of the U.S. Federal government taking over the American healthcare system is answered in the bill itself – it did not.