Why Obamacare falls short of Universal Healthcare coverage? Will Universal Healthcare coverage be an answer to all US healthcare problems? On March 23, 2010, President Barack Obama signed the Patient Protection and
Affordable Care Act, or more commonly known as Affordable Care Act (ACA), or “Obamacare”
into law. It is the most significant overhaul of the United States healthcare system since the
passage of Medicaid and Medicare back in 1965. With The Supreme Court's decision to uphold the Patient Protection and Affordable Care Act may correctly be viewed as a milestone on the path to universal coverage, especially considering the 46 million uninsured persons who would have lost the opportunity to obtain coverage if the court had overturned the entire law, or may be not? So, the first year of enrollment is almost over. Let`s assess remaining challenges and impact of the new law, and understand if Obamacare reform really can be considered a start for future universal healthcare. According to CMS data in 2012 the United States of America spent more than 2.8 trillion dollars on its healthcare system. This spending meant that, in 2012, health-care expense per capita was substantially higher in the USA than in any other country. Despite such spending on health care, many United States’ residents had no health insurance and several combined measures of health quality and outcomes recorded in the USA were poorer than the corresponding data from other high-income countries. Immediately before the implementation of the key elements of the ACA in 2014, according to CDC website data 18% of residents younger than 65 years lacked any form of health insurance. As uninsured residents have relatively poor access to the offices of private physicians, they frequently seek care from so-called safety-net providers – such as community centers and the outpatient or emergency departments of hospitals.
Compared with their counterparts in other high-income countries, patients in the USA are much more likely to refuse medications and to skip care – especially preventive care –because of costs. Gaps in health coverage, problems with access to health care and unhealthy lifestyles are thought to contribute to the many disappointingly poor health outcomes recorded in the USA. It is a result of many factors. These factors include poverty, a lack of universal health coverage, a general lack of focus on primary care and public health, high rates of accidents, violence and teenage pregnancy, and poor health behaviors – e.g. poor diets and an overreliance on automobiles for travel, and that lead to obesity and lack of fitness. The USA is currently the only high income country without nearly universal health- care coverage. Attempts to achieve universal health coverage have been made since the 1940s. During World War I universal health care was labeled by government-commissioned documents as “German socialist insurance.” That labeling killed support for it very quickly. After World War II it was known as “socialist insurance.” Again, public support waned. The plight for universal health care has always been difficult in the United States, therefore apart from the development of Medicare and Medicaid, which provides coverage for the poor, near- poor residents, including children, pregnant women, parents, seniors and individuals with disabilities in 1965 – little progress had been made before the implementation of the ACA. In 2012, two years before implementation of the ACA’s major provisions, 56% of residents younger than 65 years had health-care coverage via their employers. Six percent purchased private individual health insurance, and about 21% relied on Medicaid. In general, individually-purchased private health insurance policies are very expensive because they are not subsidized by employers. Due to