Mandate of the Affordable Care Act - Obamacare - Essay Example

Essay History, Human Rights and Ethics of the Individual Man the Affordable Care Act- Obamacare Public Health in 19th century The public health, in the nineteenth century, was attributed to substandard housing, whereby numerous houses were poorly constructed, and they were unhygienic and unsafe. Some of these houses were poorly ventilated while many people lived in one house leading spreading of diseases. Moreover, most of the common diseases were such as cholera, typhoid, typhus, and this led to a life expectancy of forty years for people living in these areas (The National Archives, 1). In addition, cholera had become a highly infectious disease, which was considered as a fatal intestinal disease, whereby the first outbreak was experienced on October 1831-1833, and the disease caused deaths of twenty-two thousand people (McVeigh, 1). After the revolution in 1848, there was legislation concerning the public health issue from the government, and there were laws passed and implemented for due to the purpose of protecting people from the epidemic disease (TRIPOD, 1). Public Health in 21st century During the twentieth century, the public health was attributed to decreased rates to tuberculosis cases, and the central-line related to the infections of the bloodstream. Moreover, there was earlier diagnosis of diseases such as HIV/AIDS through screening of blood in order to prevent potential transmission though transfusions (Chan, 1). There was a decrease in the number of hospitalization and death from diseases that could be prevented through vaccination, and the influence of pneumococcal conjugate, while the rotavirus vaccines became outstanding. There was smoke-free law, whereby the taxes on cigarettes were increased while FDA commenced to apply the regulatory authority over products like tobacco, thereby banning flavored cigarettes (McMichael, 101). In addition, there were restrictions on the accessibility of the youth to drugs, and there were proposals of graphic warnings on cigarette packets. A brief history of Affordable Care Act The Affordable Care Act (P.L. 111-148), which is also known as ACA, and it was signed on 23 March 2010, through the federal health reforms. There were provisions entailed in the ACA aimed at expanding the accessibility to insurance, increasing consumer protections, emphasizing on prevention, improving the quality and system performance, expansion of the health workforce and curbing health care expenses (Pound, 1). It also focuses on expanding the health insurance to insuring approximately thirty two million in private and public sector. The ACA focuses on addressing the workforce problems through provision, which entail reforms in the graduate medical education training in order to increase health profession scholarship and loan programs. This will also offer support to programs for nurses in their new care models of primary such as managing the chronic diseases through a team and medical homes, increasing the funding for community health centers. ACA focuses on National Health Service Corps, and supporting school based health center and health clinics managed by nurses. Moreover, the provisions of the ACA are aimed at addressing the increasing cost of health care services, by providing an oversight of the health insurance premiums and practices, emphasizing on preventive measures, primary care and effective treatments, and reduction of fraud and abuse. Human Rights According to the declaration of Alma Ata, health is a state of complete bodily, psychological and social well-being and nonexistence of illness, and it is a primary right. Moreover, the statement indicates that health care is a human right that sets a stage for the entire movement in public health, which is attributed to health disparities and offering ethical basis involved in health care (Hixon and Maskarinec, 1). In fact, the declaration indicates that family medicine expects to work at a system level for social justice in distribution of services. There are other issues related to the mandate of individuals concerning to health insurance whereby establishing a significant pool of healthy customers to reduce the costs of premiums. On the other hand, Scalia indicated that broccoli can be used by Americans willing to make their decisions concerning about life. He also indicated that the government exceeds constitutional limits through interference with individuals as they make their personal decisions. Nevertheless, Paul Krugman and other economists indicate that people are choosing not purchase or they are not able to afford broccoli, but this is not a reason for making it exorbitant for those who need it. Therefore, people willing to purchase the broccoli are not contributing to unavailability to those who are willing to buy it, though people are not willing to acquire insurance policy unless they are sick. There are those who need health insurance and others do not need it, but at any moment, people get ill or injured, thus leading to uninsured patients incurring costs that run to hundreds of thousand dollars. In addition, the hospital is unable to absorb the costs for financial stability, whereby the costs are shifted to those who are insured through raising the rates for all charges such as diagnostic, room and therapeutic procedures. Therefore, the health insurance companies are faced by the obligation of paying for these claims; thus, they end up increasing their premiums. Ethics In relation to ethics, there are arguments for individual mandate indicating that there is a penalty in place, whereby people play with the system, whereby they wait until they are sick or injured in order to purchase a health insurance policy. However, the insurer is expected to offer the policy that result to increased costs for the companies. In this case, it seems that individual mandate is forced to people, whereby they are expected to pay for the insurance policy by contributing to the insurance pool through their fair share (Gostin, 4). Consequently, this results to increased costs, though the individual mandate spreads the responsibility for the universal accessibility to affordable care. On the other hand, there are three ethical principles for socially beneficial health reforms that are not addressed. First, it relates to the inefficiency or creation of incentives for economical appropriation of resources, whereby there are expectations that people may spend less on luxury in order to pay for their insurance premiums. The second principle relates to the reduction of premiums, which would not reduce the cost, whereby the insurance coverage fails to address the problems of moral hazards. The third principle relates to the personal consent in relation to redistribution of wealth to the amount of cover required for people to facilitate accessibility of health care despite ability to pay. There are issues related to the controversy over the helmet law, which is an issue of paternalism, which is defined as the interference with personal freedom for their own good. In this case, the issue relates to an idea based on an example of a father who makes the decisions for their children, instead of giving them a chance to make their own decision. Therefore, the principle of paternalism relates to a wide range of laws, practice and actions, whereby physicians are expected to make decisions on behalf of the patients. This is experienced in a situation such as implementation of laws against assisted euthanasia, required retirement savings plans and other this that are aimed at protecting the interests of the people. In addition, people are being forced to acquire health care insurance, and this is against their personal freedom, whereby resulting to mixed reactions by people different levels. In fact, the legislation is expected to address more than the question of the individual being forced to acquire health insurance; thus leading to decisions of upholding two percent tax on the revenue earned by the medical companies. There is an effort to offer the intellectual property, which is considered critical for the biotechnology sector, this increasing the prospectus of insured pool, which spurs demand for the border hospital services. In conclusion, the paper has explored issues related to history, human rights and ethics of the individual mandate of the Affordable Care Act. In this case, public health in the nineteenth and twentieth century has been discussed. In the following section of the paper, a brief history of the Affordable Care Act has been discussed, and its aims are elaborated, and other section elaborates on health care as a human right, and the last section elaborates on ethics in relation to health care. Works Cited Chan Margaret. “Public health in the 21st century: optimism in the midst of unprecedented challenges”. 3 April 2007. World Health Organization. Available at: http://www.who.int/dg/speeches/2007/030407_whd2007/en/index.html [Accessed 21 November 2012] Gostin, Lawrence.” The National Individual Health Insurance Mandate: Ethics and the Constitution”. Georgetown Law: the Scholarly Commons. October 2010 http://scholarship.law.georgetown.edu/cgi/viewcontent.cgi?article=1429&context=facpub [Accessed 21 November 2012] Hixon, Allen and Maskarinec, Gregory. “The Declaration of Alma Ata on Its 30th Anniversary: Relevance for Family Medicine Today”. Family Medicine. September 2008.Available at:http://www.stfm.org/fmhub/fm2008/September/Allen585.pdf [Accessed 21 November 2012] Pound, William. “The Affordable Care Act: A Brief Summary”. National Conference of State Legislatures. March 2011. Available at: http://www.ncsl.org/portals/1/documents/health/hraca.pdf [Accessed 21 November 2012] McVeigh Daniel. An Early History of the Telephone 1664-1865. Available at: http://www.ilt.columbia.edu/projects/bluetelephone/html/health.html [Accessed 21 November 2012] McMichael Anthony. “Public health, the environment and the 21st century: a wider field of vision”. Eur J Public Health, 2008 18 (2): 101. Available at:http://eurpub.oxfordjournals.org/content/18/2/101.full [Accessed 21 November 2012] The National Archives. Public health and epidemics in the 19th century. Available at: http://www.nationalarchives.gov.uk/records/research-guides/public-health-epidemics.htm[Accessed 21 November 2012] TRIPOD. 19th Century Public Health. Available at: http://alissahubert.tripod.com/[Accessed 21 November 2012] Read More