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health mandates

i wrote this argument paper a few weeks ago during the last exam in my english class. we weren’t supposed to save a copy of it, but i was too happy with what i was able to come up with that i tried to find a way to save it through my online blackboard account. so to somehow make sense of my semi-illegal saving of this essay, i’m posting it here. bakit ba ako naman nagsulat ah?!

btw, i got all the A’s that i needed. now that my first sem is over, i have 7 semesters left until i finish nursing school. if only i can wake up one morning and all these studying are over and done with – wishful thinking.


The Need for Health Mandates.

The recent passing of the Patient Protection and Affordable Care Act (HR 3590) and Health Care and Education Reconciliation Act (HR 4827) have been both praised and criticized. Among the many programs that will take effect through these laws are the individual and group mandates on getting health insurance coverage. Supporters of these health mandates argue that their inclusion is crucial in achieving the reform that US seeks and without it this shared responsibility, lasting reform is not possible (Health Care Mandates, 2009). This paper aims to provide support to this claim by showing how the inclusion of the health mandates help solve the many problems of the current health care system.

Studies show that the largest group of uninsured Americans consist of young, healthy people who choose not to get covered (Health Care Mandates, 2009). Together with this group are the workers of businesses who choose not to cover their employees. In the event that these groups of uninsured individuals get sick, they do not have the capability to pay their bills. Someone else then, the insured or the government, picks up the tab; causing the overall health care cost to rise (Health Care Mandates, 2009). Mandating everyone to pay into the system while they are healthy helps create an economically fair set-up. Also, implementation of the health mandates forces the government and the private insurance companies to manage health care costs. High cost will “infuriate constituents who are being forced to buy something they can’t afford”, requiring Congress to “get serious about holding costs” down (Klein, 2010,1). The current voluntary insurance system has not provided enough incentives for insurers to efficiently manage costs. Linda Blumberg, in her article published in the New England Journal of Medicine notes, that “the most expensive 5% of the population accounts for half of the aggregate health care spending, and the bottom 50% of spenders only account for 3% … the gains insurers get from avoiding the sick outweighs any possible gains from managing their care” (Blumberg, 2009). Blumberg also states that, “mandate will tend to bring healthier people and those with higher income into the system at a relatively low incremental cost … with added benefit of government financing”, addressing the benefits in terms of cost for the healthy and the wealthy (Blumberg, 2009).

In a voluntary system, companies “compete to avoid the sickest people and sign up the healthiest people” (Klein, 2009). Removing this un-humanitarian kind of competition while enabling the right kind (which is, drive down cost), helps create a better quality of health care in the US. Without coverage, individuals who are sick either get sicker or they end up filing for bankruptcy. Forcing insurers to cover them prevents this downward spiral. The only way to allow insurers to be financially viable while requiring them to cover these group of people is the inclusion of the health mandates. Also in the current system, government resources of approximately $43 billion in 2008, are allocated for minimal health care service for the uninsured (Blumberg, 2009). Blumberg states that, “care provided this way does not amount to continuous, comprehensive care for the uninsured…” (Blumberg, 2009). Washington Post blogger Ezra Klein also relates a story when he was left uninsured for months because of a computer error. He claims that these incidences will be prevented with the health mandates in place because it will force both employers and individuals to “make sure the paperwork is in order” (Health Care Mandates, 2009).

The enforcement of the health mandates allows the US to be one big step closer to the ideal, which is, universal health insurance coverage. Statistical projections by the Congressional Budget Office (CBO) show that, “between 6 million to 7 million people who would not be covered by under the current law will be covered …” through the employer mandate (CBO, 2009). A study on the impact of the health reform bills by the Rural Policy Research Institute declares that because of the reform, the number of uninsured will decrease from 50 million to 21 million (Mueller, 2009). Ezra Klein notes that the, “uninsured category has gone from the second largest to the absolute smallest” (Klein, 2010, 2). Reducing the number of uninsured by insuring the sick, those with preexisting conditions, and employees of businesses who used to deny coverage, will not be economically viable without the health mandates in place.

Driving down and managing health care costs, insuring the sick and those with preexisting conditions, and decreasing the growing number of uninsured individuals are  just a few of the most critical problems in the current US health care system. The data presented is plain and evident that without the health mandates, health care reform will not be doable and sustainable. Alternatives to achieving the much-needed changes without the health mandates are extensive subsidies that US government cannot afford,  increase in revenue by insurers through higher premiums, or through higher taxes that a majority of Americans do not need more of.  The health mandates, then, are indispensable to the fulfillment of the essence of health care reform. To oppose it would automatically mean continuity of the current health care system; a system which has been repeatedly proven to be inadequate, unacceptable, and inhumane.
Blumberg, Linda and John Colahan. “The Individual Mandate – An Affordable and Fair Approach to Achieving Universal Health Care Coverage”. The New England Journal of Medicine. Vol 361, p6-7. [http://content.nejm.org/cgi/content/full/361/1/6]. 02 July 2009. (25 April 2010).

Health Care Mandates. “Issues & Controversies”. Facts on File News Services, 16 Oct 2009. [http://dll.umaine.edu/ble/U.S.%20HCweb.pdf] (15 Feb 2010).
Klein, Ezra. “How Health Care Reform Reduces the Deficit in 5 Not-So-Easy Steps”. Newsweek Web Exclusive. 21 Mar 2010. [http://www.newsweek.com/id/235246]. (25 April 2010).

Klein, Ezra. “Who Is Left Uninsured?” Washington Post. 22 Mar 2010. [http://voices.washingtonpost/ezra-klein/2010/03/who_is_left_uninsured_by_the_h.html]. (25 April 2010).

Mueller, Keith. “The Impact of patient Protection and Affordable Health Care Act on Covered Person”. Rural Policy Research Institute. 29 December 2009. [http://www.rwfg.org/files/research/53234.pdf]. (25 April 2010).

United States Congressional Budget Office (CBO). “An estimate of the budgetary effects of the reconciliation proposal; in combination with the effects of HR 3590 and the Patient Protection and Affordable Care Act (PPACA)”. [http://www.cbo.give/ftpdocs/113xx/doc11379/Manager’sAmmendmenttoReconcilliationProposal.pdf]. 20 Mar 2010. (23 Apr 2010)

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