Barack Obama kept a campaign promise when he signed the healthcare reform law in March 2010.
The days of health insurance as a workplace perk for Americans with decent jobs were ending, he said – the gap being closed between haves and have-nots.
Insurance companies would now accept all customers, by law.
President Obama said: “Once this reform is implemented, health insurance exchanges will be created, a competitive marketplace where uninsured people and small businesses will finally be able to purchase affordable quality insurance. They will be able to be part of a big pool and get the same good deal that members of Congress get.”
The Patient Protection and Affordable Care Act (PPACA) sought to extend coverage to 30 million Americans till this point excluded by their circumstances, whose needs were ignored.
The total US population is 310 million, of whom 50 million are not insured for their health. Obama’s plan regulates, standardises, gives incentives and subsidises.
Insurers under the law could not turn people away based on pre-existing conditions, or discriminate unfairly on the basis of age or gender.
Supporters argue that having many uninsured Americans is bad for the whole of paying society, and that expanding coverage to everyone will not only lower costs but deliver better quality.
Primary care physician Basim Khan said: “Without health insurance, they put off getting care. They are not able to get care, they go to the emergency room and it costs them thousands and thousands of dollars to get care, so I see them on the flip side when they’ve suffered a bad consequence, when they’ve had a stroke and they are not able to walk. So we end up spending more, they’ve lost their means to make a living and we still end up providing them care, but a lot of the time it’s just too late.”
Many Americans do not want to be ordered to pay for something, as the PPACA effectively does. It says individuals must maintain minimal essential health insurance coverage if they do not have an employer’s or government-sponsored plan. Obama’s solution was to impose fines for non-compliance.
A protester said: “We want health care reform, do not misinterpret my message: we want private market solutions.”
The Republican Party presidential candidate, Mitt Romney, has promised he would turn back “Obamacare”, although he brought in a similar scheme when he was Massachusetts governor. Current spending on health care is an immense strain on resources, with statistics compilers saying it surpassed 15-17% of US GDP in 2008, the highest in the world.