Affordable healthcare should not be a privilege, it should be a right

By Wilson Noah Mazile

Jimmy Kimmel did an experiment on his late night talk show in which he interviewed
random Americans in Los Angeles and asked them a simply question. If they prefer Obamacare
or the Affordable Care Act? They responded saying that the Affordable Care sounds like a great
plan while Obamacare was considered un-American, (Huffingtonpost.com). It was funny
which is what Kimmel was trying to convey, but there was something more to this experiment
than just making public policy funny. Kimmel was trying to show America that there are
millions of Americans who do not even know that Obamacare and the Affordable Care Act are
the same exact bill. CNBC reported that 46% of Americans oppose Obamacare while 37%
oppose the Affordable Care Act. Republicans and critics of President Barack Obama have
labeled the Affordable Care Act Obamacare in attempt to defame the meaning of its mission
(cnbc.com). Republicans want Americans to believe that the law makes healthcare more
expensive for families, makes rich and middle class pay for the healthcare of the poor, and
deducts jobs from the healthcare industry. Their primary mission in stopping this law is keeping
the massive unknown wealth that lies in the pharmaceutical industry from the knowledge of the
American public. In 2010, President Barack Obama set forth the bill to Congress to make
healthcare more affordable to every American citizen because he believes it is every Americans
right to afford quality healthcare. The job of our politicians is to make civil rights legislation like
the Affordable Care Act. They are tasked in continuing to improve this country and upholding
the values that this country stands on. This means ratifying the Affordable Care Act into the 28th
Amendment.

What was Healthcare like before Obama?

During his presidency, George W. Bush achieved very little with healthcare reform
passing his Medicare prescription-drug benefit plan in 2003. The Bush Administration formed
the National Economic Council who created the bill to equalize the tax distribution of
employer/employees health insurance, without raising the governments budget deficit. This bill
was the only successful piece of legislation that George Bush was able to pass during his
presidency.
George Bushs Affordable Choices Initiative
During his 2007 State of Union Address he also proposed the Affordable Choices
Initiative a health care reform bill that was set to revolutionize the American health care system.
The proposal sought to eliminate the unlimited tax break for employer-sponsored insurance, by
replacing it with standardized discounts on the first $7,500 of employees or $15,000 family plan
for both employed and unemployed Americans (5). They theorized that the tax-deduction revenue
would grow with US CPI inflation (5). The Bush plan wanted to establish a new consumer-driven
health plan market that would make individuals save their money. They believed it was the most
economically efficient use of an individuals maximal amount of deductions to be put into a taxadvantaged medical savings accounts called Health Savings Accounts. They wanted to devolve
federal spending into states who would work to expand coverage to uninsured Americans. The
proposal also planned to shift the DSH Disproportionate share hospital underpayments away
from hospitals and into uninsured individuals.

Infographic 1: Graph measuring the potential deficit of Bushs proposal

In December of 2007, the Stock Market was hit with the Great Recession that happened
due to failing the housing market and over 20 million people losing their jobs. Democrats had no
incentives in compromising the bill, given the high probability that a Democratic President
would be elected in 2008. The Bush administration before the Great Recession believed that the
tax deductions would grow at the rate of inflation, so long as tax exclusion of employersponsored health insurance was not regulated. What went wrong with Bushs plan was the fact
that the economy was in really bad shape. The proposal was also missing the key element of
universal coverage in healthcare reform. Though they had intentions of expanding healthcare
coverage to more Americans, universal coverage was the keystone piece to solving the problem
of creating affordable healthcare for everyone.
Another key initiative they wanted to stress was capping the employer tax exclusion,
which would have the negative effects of raising taxes. By adding federal health spending to a
citizens income for tax purposes, the plan would lead millions to receiving higher tax ranges.

The 2010 Affordable Care Act called for tax-exclusion reform to be combined with a reduction
in overall tax expenditures on uninsured Americans, which is a better plan because it would not
higher taxes.
Why Bush failed to reform US healthcare?
Bush plan would shift health insurance into an individual market for health insurance,
which would make healthcare plans more expensive with fewer benefits than the employersponsored insurance. There are also distortions like the employer tax exclusion and other federal
regulations in market that will constraint a new for health insurance. Bushs plan was marketoriented reform which raises the question of whether his plan would help Americans get health
insurance or, help health insurance companies become big corporations. His plan called for a
consumer-driven market that paired high-deductible insurance with his defined health savings
account. And because they believed that tax deductions were parallel to the countrys inflation,
Americans were going to be hit with rising health costs. The rate of Inflation from December
2007-December 2008 went from 0.5% to -1.03%, which proves how detrimental it would have
been to Americans if the bill passed Congress during the recession.

Infographic 2: Graph of the US Inflation rate from 2001-2012

Overall, under President Bush healthcare was becoming the central problem of the
country. Though he proposed a bill to Congress that would completely revolutionize the
healthcare system; he ran out of time in 2007 with the huge crash of the stock market heading
into the 2008 Presidential election year. A market-based healthcare bill was not looking popular
among Americans who were suffering from this recession. The Great Recession of 2008 was
very powerful, it called for Americans to change their government completely to Democrat. And
because of the Democrats none partisan support of Bushs Affordable Health Care Initiative the
bill failed passing through Congress.

What does the Affordable Care Act do?

The Affordable Care Act was created and enacted to achieve the ultimate goal of
universal coverage for all Americans. The only way this could be done was by nationalizing
healthcare into a system that would work all American citizens. The Affordable Care Act
expands the quality, affordability, and accessibility of both public and private health insurance
coverage. It also focuses on reducing the costs of healthcare through the mechanisms of
mandates, subsidies, and insurance exchanges (2). The law grants guaranteed issue to all
applicants meaning that undeniable coverage must be given by insurance companies. Companies
are prohibited from applicants denying coverage to individuals on the basis of pre-existing
conditions, gender, or geographical location (7). While also mandating that all American citizens
get covered by an employer-sponsored health insurance, Medicaid, Medicare or other
public/private insurance programs, or face paying a penalty (6). The law puts in place a standard
healthcare insurance market where insurance companies can compete to offer patrons the best
rates that are affordable to a majority of Americans (7). The law establishes subsidies in which

individuals or families making 100% to as much 400% of the poverty line will receive federal
subsides through health insurance exchange to help people with low incomes pay for their
insurance (6). The law establishes health insurance exchanges that operates in comparing policies
and rates for individuals and small businesses in any state purchasing insurance. Low-income
individuals and families whose incomes are between 100% and 400% of the federal poverty level
will receive federal subsidies (6). The law expands Medicaid eligibility to include individuals and
families with incomes up to 133% of the federal poverty level, regardless of disabilities or
dependent children. The Medicare payment system has restructured Medicare reimbursements
from payment for individual services to bundled payments (7). The law also establishes the
employer mandate for small/big businesses to offer healthcare insurance to their full-time
workers, or face a tax penalty by the government through tax deductions (8).
How are Americans benefiting now?
As of the end of 2013, The Center for American Progress released a report discovering
that expected premiums on the insurance exchanges are reducing the governments budget deficit
by $300 billion dollars. When the law passed back to 2010, it was projected to reduce the deficit
by $109 billion (10). The New York Times analyzed the first full year impact of the Affordable
Care Act as of the end of 2014. They found that over 20 million people acquired healthcare
insurance. 85% of those qualified for federal subsidies to help pay the premiums. The percentage
of uninsured Americans dropped 5% to 13.4% as of the end of 2014 (1).

Infographic 3: Graph projecting the Net Budgetary Effects of the Affordable Care Act

Why the Affordable Care should turn into an amendment?

Obamacare facts also list out other benefits that the new healthcare reform has on
Americans. Obamacare facts also list out benefits like adding the marketplace idea that Bushs
plan had in mind but making less business oriented and more consumer competitive. The
Insurance Exchanges causes insurance to compete with each other to give the most appealing
plans, which include better benefits, rights and protections. Benefits like emergency health care,
hospitalization, prescription drugs, and maternity care. And in 2015 major medical plans are
expected to provide plans that do not exceed $6,600 on individual spending and $13,200 for any
family plan, and eligibility for Medicare expands to 26 states especially people in the 138% of
the federal poverty line. Individuals also have the right to quickly appeal any health insurance

company decision, children can stay on their parents plan until 26, and free preventive
treatments and screenings for cancer (7).
A person is bound to get a car accident at least once in their lives which is why federal
laws requires individuals to have vehicle insurance. That goes the same way for healthcare. For
so all this country has had a problem with providing healthcare stability to all Americans who
need it. The 27 Amendments today and especially the 10 Bill of Rights are laws that protect and
defend us every day. The job of our government should be to provide it citizens with the basic
needs to survive and prosper. The bill establishes that affordable healthcare insurance is a right
that Americans have in this country. There are many reasons why many Republicans and critics
of the bill say that it is unconstitutional. But there is a compelling unknown reason that has
Republicans worried. There are new reforms to the healthcare industry, which is the most
dangerous fact for Republicans and pharmaceutical companies who see a massive loss in profits
from this healthcare bill.
The reality of Republicans and pharmaceutical corporations?
In 2004, Dr. Marcia Angell a profound Professor at Harvard Medical School and Editorin-Chief of The New England Journal of Medicine, wrote The Truth About The Drug
Companies: How They Deceive Us and What to Do About It. It was a research text exposing
some outrageous facts about the pharmaceutical industry. She presents the facts of how these
companies have become business corporations marketing their products for profits instead of
research. She discovered that the American public spend about $200 billion on prescription drugs
every year due to high-raising drug prices (4). These corporations argue that the revenue made off
of the drugs fund the research and development of discovering cures and treatments for the most

challenging diseases, but Angell proves that these profits are not going to research, but rather to
marketing and commercial efforts that get more Americans to buy their drugs. It is also a fact
that these pharmaceutical companies spend a lot of money lobbying to government bodies like
the FDA and Congress. According to Angells research made in 2002 the pharmaceutical
industry's trade association had about 675 employed lobbyists which included 26 members of
Congress costing about $91 million (4). This is a reason why many Republicans have outright
outlawed the Affordable Care Act because it cuts the loopholes that these drug companies have
benefited from. Plus the lobbyists and Congressmen who support them lose out on the large
shares of those profits.
On page 18, Angell talks how under both the Clinton and Bush Administrations there
were bills in Congress that were set to close some of import loopholes that companies went
through in manufacturing their drugs, But the bill required the secretary of health and human
services to certify that the practice would not pose any "added risk" to the public, and secretaries
in both the Clinton and Bush administrations, under pressure from the industry, refused to do
that, which proves how much power the industries has in the business market (Angell 18).

Infographic 4: Source: Cegedim Strategic Data, 2012 U.S. Pharmaceutical Company Promotion Spending (2013).

Angell goes as far to claim that these drugs are becoming less effective due the fact that
the profits have been cut on funding the research and discovery, and more on the
commercialization, massive spending, and lobbying strategies to make them the most profit. This
argument has become evident to me personally attending Pennsylvania State University where
the university has established a student-philanthropy fundraiser called THON which has raised
about $140 million to fund research and development of a cure for pediatric cancer since 1976.
The Federal National Institutes of Health reported that the government has funded about $4.9
billion since 2007 (3). Yet, a cure or revolutionizing method of treatment has been discovered.
Inclusion, the Affordable Care establishes the basis of how healthcare reform ought to be
in America. Just like people have the right to free public education, affording housing, and even
car insurance, there should be a right for Americans to be able to afford a health care plan that
will work for them. The bill sets back other suppressors like pharmaceutical companies and
Republican lobbyists that have benefited from privatized and loose-market healthcare system in
the past until this bill exposed that truth. Time for change in US healthcare has come. It is an
Americans right to affordable healthcare not a privilege. Ratifying the bill to an amendment is
the next step ensuring that healthcare reform will no longer to be a continuous problem of this
nation. Republicans make these arguments that this bill will make healthcare more expensive,
makes the middle class pay for the healthcare of the poor, and limits jobs, but there is an interest
that Republicans once had that is being threatened by this new bill. No longer will families be
paying high premiums and medicine prices, everyone has a coverage that fits their income, and
the overarching mission of this law is to make healthcare affordable to every American.

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Endpoints
1. "Is the Affordable Care Act Helping or Hurting?" (October 27, 2014). The New York
Times. April 9, 2015.
2. Blumenthal D, Collins SR (2014). "Health care coverage under the Affordable Care Act-a progress report.". N Engl J Med 371 (3): 27581. April 9, 2015
3. Brill, Steven. (September 9, 2014) COLUMN-How much money is raised and spent in
fighting cancer?. Reuters. April 9, 2015.
4. Angell, Marcia. The Truth About The Drug Companies: How They Deceive Us And
What To Do About It. Reprint, revised. Random House Trade Paperbacks, 2005.
ISBN: 0375760946, 9780375760945. April 9, 2015
5. Roy, Avik. (April 20, 2012.) How George W. Bush Would Have
Replaced Obamacare. Forbes. April 9, 2015
6. "Explaining Health Care Reform: Questions About Health Insurance Subsidies". Kaiser
Family Foundation. July 1, 2012. April 9, 2015.
7. U.S. Department of Health and Human Services (June 28, 2010). "Patient Protection
and Affordable Care Act; Requirements for Group Health Plans and Health Insurance
Issuers Under the Patient Protection and Affordable Care Act Relating to Preexisting
Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections;
Final Rule and Proposed Rule". Federal Register 75 (123): 3718737241. April 9, 2015.
8. "Explaining Health Care Reform: What is Employer "Pay-or-Play" Requirement?".
Kaiser Family Foundation. May 1, 2009. April 9, 2015.
9. About the Law. Healthcare.gov. April 9, 2015.
10. Bowen, Robert. (October 26, 2013). Lower Obamacare premiums cutting deficit by
$300 billion dollars. Examiner.com. April 9, 2015.
11. Liesman, Steve. (September 26, 2013). What's in a name? Lots when it comes to
Obamacare/ACA. April 9, 2015.
12. Luippold, Ross. (September 1, 2013). Jimmy Kimmel Asks Pedestrians If They Prefer
Obamacare Or The Affordable Care Act. The Huffington Post. April 9, 2015.
13. Infographic 1: Roy, Avik (April 20, 2012). How George W. Bush Would Have
Replaced Obamacare. April 9, 2015
14. Infographic 2: Inflation United States 2008. Inflation.eu Worldwide Inflation Data.
April 9, 2015.
15. Infographic 3: Office of the Press Secretary (April 17, 2014). FACT SHEET:
Affordable Care Act by the Numbers- Health Care Cost Growth Is Lowest In Decades.
The White House.gov. April 9, 2015.
16. Infographic 4: Melecki, Sarah (July 11th, 2014). Struggling with high drug costs,
senior questions marketing expenses. Consumers Union. April 9, 2015.

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