Life, Liberty and the Pursuit of Health Care

The Patient Protection and Affordable Care Act (ACA) was enacted by the United States Congress in 2010 to guarantee basic health insurance to all citizens.  People who object to the ACA ,aka Obama Care, dislike or even fear government involvement in medical care; they consider it interference, control, or even nationalization of the United States healthcare system.

I think many people, even physicians, don’t realize or forget, how involved the government already is in healthcare. As far back as the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system has evolved into the current military health care system which covers service members and the Veterans’ Administration system for veterans.

a Veterans Administration clinic
a Veterans Administration clinic (photo by blogger)
American soldiers serving in Afghanistan
American soldiers serving in Afghanistan

This year marks the 50th anniversary of two other government healthcare programs- Medicare and Medicaid. The Journal of the American Medical Association, JAMA, devotes its entire issue this week to them,the ACA and the implications for the future of healthcare in the United States.

Medicaid provides insurance coverage for adults and children who are unemployed or low income.  

Medicare covers disabled children and adults  and persons 65 years and older.

The numbers are rather staggering.

  • Together these programs cover at least 30% of Americans.
  • Together they comprise 25% of all federal spending.
  • Together they pay 40% of total U.S. health care spending.

An infographic from the Kaiser Family Foundation and JAMA explains this further.

Disabled children and adults may qualify for Medicare.
Disabled children and adults may qualify for Medicare.
Children may be eligible for Medicaid if their families cannot obtain health insurance for them.
Children may be eligible for Medicaid if their families cannot obtain health insurance for them.

You may not be eligible for either of these programs now, but chances are eventually you or someone close to you will.

  • Anyone can become disabled from a serious illness or freak accident.
  • You or your spouse may lose your job and your employer sponsored health insurance.
  • Your child may have a disability that will prevent them from working when they grow up.
  • We may all live long enough to qualify for Medicare on the basis of age alone.  Your parents or grandparents are near or already at Medicare age.
Senior adults age 65 and older use Medicare.
Senior adults age 65 and older use Medicare.

It’s important to understand how Medicare works, since it’s not automatic; even if you qualify, you need to sign up to be covered (with a few exceptions). The rules are summarized here. Or consider an easy to understand book here. 

photos courtesy of volunteer photographers at Pixabay

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