Reply to two discussion board post

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Healthcare, and the opinions of billions is a constant uproar in the United States, especially after the
Affordable Care Act came into play, aka Obama Care. After reviewing Case study 3 in our textbook,
“International Comparisons: Where Else Might We Have Gone?”, there are several different comparisons
of the United States healthcare system and other international countries healthcare and policies.
“Employment-Based Health Insurance is the core of Japan’s health system, and it continues to produce
the best health outcomes of any of the systems mentioned here” (McLaughlin & McLaughlin, p.85).
When the ACA came into play, our healthcare system, was still with error before it ever came into effect.
“In 2008, the US healthcare system was historically considered to be lagging behind its global peers in
terms of efficiency and coverage” (Irigoyen, 2017). Obama, when enacting the policy in 2010, had
intentions to increase the number of Americans with coverage and improving access to care. In some
ways, I think the President tried to incorporate experiences from other countries, and in some areas
compared to the U.K. he was successful. “In the subcategories, the U.S. ranks higher on preventative care,
and is strong on waiting times for specialist care” (Davis, Stremikis, Squires & Schoen, 2014). Overall,
the U.S. is still extremely behind compared to other well-developed countries and have been hurt by the
ACA.
After I reviewed this study further, I believe that the President could have analyzed Canada,
Australia, and Germany for ideas that could have influenced the U.S. Although, several things and ideas
in these various countries are reoccurring currently within the U.S, some are not. “Healthcare is provided
to all. Often it is through a patchwork of public and private funds, but every effort is made to have
everyone in the system” (McLaughlin & McLaughlin, p.86). A lot of the things that are in the ACA,
could have been bounced off of the set ways that other countries policies are in place. Even with few
ideas being current with other countries, such as the idea of Universal Healthcare, the U.S costs are the
most expensive.
There is no 100% right way to healthcare, where it can please every single person, but I do think
that there is room for improvement on the current healthcare policy. With saying that, there are countries
that have much more effective ways of handling healthcare policies, with much lower overall costs.
“Many U.S. hospitals, and health systems are dedicated to improving the process of care to achieve better
safety and quality, but the U.S. can also learn from innovations in other countries” (Davis, Stremikis,
Squires & Schoen, 2014). With real effort, I believe there can be a reform to this that better suits the
entire country.
References
Davis, K., Stremikis, K., Squires, D., & Schoen, C. (2014). Mirror, Mirror on the Wall, 2014 Update:
How the U.S. Health Care System Compares Internationally. Retrieved from
http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror
Irigoyen, C. (2017). The Affordable Care Act in the US (Obamacare). Retrieved from
https://www.centreforpublicimpact.org/case-study/affordable-care-act-us-obamacare/.
McLaughlin, C. P., & McLaughlin, C. D. (2015). Health policy analysis: An interdisciplinary
approach (2nd ed.). Burlington, MA: Jones & Bartlett Learning
I think the crafting of the Affordable Care Act relied a great deal on the experiences in other
countries a great deal. One of the key goals of the Affordable Care Act is universal health care
coverage. A number of themes recur in the systems of the various countries in the case study we
read. (McLaughlin, McLaughlin 2015) I think we all would prefer to have everyone be able to
have health coverage. The debate is over how to achieve that. One way the ACA has attempted
to achieve universal coverage is by instituting an employer and induvial coverage mandate.
Germany has a health coverage mandate, but like the United States, has one of the largest
percentages of GDP devoted to health care. It doesn’t appear that insurance mandates have been
able to lower health care spending.
Another way the ACA has attempted to achieve universal coverage is by expanding Medicaid
and Medicare coverage. The qualifying percent of income above the Federal Poverty Level was
raised in attempt to qualify more people under Medicaid. Australia also has a national health care
system called Medicare which is financed through taxation. (McLaughlin, McLaughlin 2015)
Australia’s Medicare system is not the same as the Medicare system her in America though.
Australia’s Medicare system was established to support government hospitals, medical care, and
prescription drugs for the indigent. In America, Medicare was established to cover the elderly.
Canada’s policies seem influential to the creation of the ACA. It appears to me the ACA is
aiming for health care policies the most resemble Canada’s current system. Universal health
coverage managed by the government, but still allow for private insurance. The ACA is
attempting to finance universal coverage through payroll taxes and insurance mandates in the
form of tax penalties for those that don’t participate. Canada uses payroll and income taxes to
finance their health care system, although they do not mandate coverage. Canada’s system has
lots of issues with it. It’s not fiscally sound. What Canada has dutifully maintained for decades is
a disease care system that is reactive, not proactive. (Ducharme, 2016) Canada is also facing ever
increasing health care costs just like America. Their system isn’t working either.
Japan relies on employment based health insurance and they continue to have the best health
outcomes of any of the systems in this case study. McLaughlin, McLaughlin 2015) For those
unemployed or retired in Japan also has a national health insurance program financed with
national and local taxes. America seems to have similarities to Japans system. Many people here
in America have health insurance through their employer and those that can’t afford it, are retired
or unemployed use the marketplace for subsidized coverage.
The ultimate impact of the ACA has yet to be determined. Josh Archambault surmises the overall
impact of the ACA on the labor market and economy will be much worse than the CBO
projected. (Auerbach, 2014) We need to continue to rely on the experiences of other countries
and our experiences as well so we can ultimately come up with a system that affords everyone
accessible, affordable, quality health care. We have a long way to go.
References
Auerbach, David, (2014), Assessing the true impact of the ACA: revisiting the CBO’s initial
predictions, American Journal of Law & Medicine Vol 40.2-3, pg. 231, retrieved
by http://www.aslme.org; http://www.allenpress.com
Ducharme, Jim, (2016), Health Care in Canada—Where? When? From Whom?, CJME: Journal
of the Canadian Association of Emergency Physicians, Vol18, Iss 2, pg 133-135
McLaughlin, Curtis P., McLaughlin, Craig D., Health Policy Analysis, An Interdisciplinary
Approach,Burlington MA: 01803 Jones & Bartlett Learning

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