We’re hearing a lot about the 22 million people who may lose their health insurance if the Affordable Care Act is repealed. But there’s another less publicized issue that could play out if the ACA is gutted: States could lose critical funding for public-health efforts like responding to outbreaks, vaccination programs, and anti-smoking and anti-obesity campaigns.
Not every state will be impacted in the same way. Some of the preventive-health funding is population-based and some of it is grant based, though the Trust for America’s Health said the biggest states tend to be hardest hit because they have more municipalities that can receive grants.
Removing the funding will mean less money for responses to outbreaks, less money to fight the opioid epidemic, less money to fight superbugs in hospitals, and less money for vaccination programs. It’ll also mean more scrambling for cash at already cash-strapped public health offices. “The indirect impact of the ACA repeal,” Auerbach added, “is that the funding has to come from somewhere else.”
When public health works, it’s often invisible. When we have mosquito-control programs that prevent Zika from spreading, it’s a non-story. When we aren’t poisoned by our food, it’s a non-story. It’s also more difficult to talk about the benefits of public health: They tend to be long term, slow to show up, and affect entire populations instead of individuals. "Public health has little news value — saving statistical lives doesn't make for good human-interest stories or photo ops," Hemenway writes.
In Trump’s healthcare reform position statement, he said, “The best social program has always been a job — and taking care of our economy will go a long way towards reducing our dependence on public health programs.” It’s not clear how job creation would stop an Ebola outbreak, or control tobacco, or test people for STDs. But we will soon find out.
9 comments:
In regards to the repeal of the ACA, it is a very delicate situation: at the same time insurance companies felt obliged to withdrawal from it, premiums have gone sky high, making it impossible for the +20 million people to make the best use of the program. Some have opted in not relying on it, being subject to count on luck of nothing happening to them or their families or being able to somehow afford for whatever the cost may be. Trump and his affiliates have being extremely against the ACA, especially on the terms of being a financial burden on companies and businesses.
In addition, Trump has not yet clearly suggested an alternative to Obamacare, bringing even more concern to the population. Also, given his nominations to political positions (the most controversial being that of the Secretary of Education, Betsy DeVos, who never had any experience with million dollar loans nor managing such an immense quantity of money), it just leaves the people even more hopeless. It will be an interesting year for the country and its economy. As for us, we are left with the option of waiting and see where his administration leads us.
The problem with this situation is that for years the abolition of the Affordable Care Act has been at the forefront of the political agenda. Now that the Republicans have the control that they require, they seem to have no alternatives. It's interesting that recently Obamacare has begun to work like its' designed to and there has still never been an effort to repair it, just repeal it. This political division has lead to an ideology that seems to focus on partisanship rather than policy outcomes. The Affordable Healthcare Act is a perfect example of this. People on both sides of the political spectrum have been shown to support or reject Obamacare/The Affordable Care Act more or less just depending on the name it was given in the question appraising it. They are the same exact thing, however, people prefer the one that's terminology aligns with their political affiliation.
Listening to the Republican party leaders (other than Trump) talk about the Affordable Care Act, it is unclear of their exact plan for replacement. They emphasize that those with healthcare currently will not lose it and they highlight the aspects of the ACA that they will keep, such as allowing young adults to stay on their parents healthcare plans until the age of 26 and maintaining the fact that one cannot be denied healthcare due to a preexisting condition. However, they have been noticeably vague when it comes to specific plans.
In a previous class I read a book that talked a lot about what to do beyond the ACA. The US already spends excessive amounts on healthcare, and the returns are diminishing. Rather than completely overhauling the system, we need to focus on preventative measures. While it's great that someone having a heart attack can go into a hospital and receive treatment, focusing on policies that would have prevented that heart attack in the first place would be more cost efficient in the long run. Its time for us to expand our understanding of healthcare.
It seems that there is an unclear future for the ACA. Many representatives from different political parties are for and against it. Like Caroline said, I believe the best action forward is to reform the act and have more policies that focus on preventing diseases instead of spending money on technology to cure diseases. Being more proactive would make our healthcare system much more efficient.
The talk of replacing Medicaid funding with Block Grants of each state is something that doesn't sound like a viable alternative to the ACA. These replacement funds are likely to dwarf the previous support provided by the federal government. I find this frustrating because many social polices that provide support for underserved populations are better from an economic standpoint too.
I also share your perspective Greyson. I find that it's one thing to have criticisms of ACA but it's another thing to want to do away with it completely. If a viable alternative is presented then I believe its a realistic discussion, however I don't imagine stripping the ACA without any real replacement is illogical.
I agree with the common consensus that the ACA should not be repealed without a dedicated replacement plan in place. Partisan political rhetorics have certainly not helped the health care "situation" in the United States. Given how long it took the United States to finally implement something remotely resembling universal health care, I do not think that an alternative can be figured out in time without putting the lives of millions of people in jeopardy.
The iron triangle of health care has trade-offs between "quality" "affordability" and "accessibility." Although countries like Canada and the UK have somewhat universal health care plans, people are often bogged down with long wait times and other inconveniences. It will certainly take the United States some time before they can find a good balance.
ACA is far from perfect, but reforms would clearly be the better choice rather than having to re-implement a whole new health care plan that has not even been discussed yet.
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