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Student Perspective: Nicole and Kingsley

January 30, 2016

As our January pharmacy externs, Kingsley from Cedarville University and Nicole from Ohio Northern University were able to witness not only the Health Partners culture, but also the busiest month of Affordable Care Act (ACA) health insurance sign-ups.  As an addition to all their regular duties and perspective assignment, the students this month were tasked to answer the question, “Is ACA the answer to our healthcare woes in this country, and does everyone get the same care?” Please take a moment to read their responses in our latest edition of Perspective:

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Nicole

Health care in the United States is the farthest thing from simple. We have such a large, diverse population that it is very hard to reform it in a way that bests suits everyone. Some countries have mandated universal health care, which simplifies and equalizes care among each and every citizen.  This would seem promising in the United States, but the idea is much more complicated than it appears.  President Barack Obama’s Affordable Care Act was designed to increase more Americans’ access to health care, improve the quality of care and regulate the overall health care industry.  This reform has made millions of Americans eligible for Medicaid that was not previously accepted and has opened the Market Place to individuals unable to receive federal insurance or private insurance from their employers.

So the question becomes, “With the new health care reform, are we all receiving the same care?” Although, more Americans are able to get access to health insurance it does not mean everyone is receiving the same care for the same price. Private insurance premiums have increased for some individuals since the passing of the Affordable Care Act with no increases in annual income.  While others have benefitted from the Medicaid expansion and are now receiving essentially free health care.  Some deductibles are outweighing the individual’s wages, so even if they are “covered” they cannot afford the health care. The increase in availability of insurance through the Market Place seemed promising, but affordability is still the real issue among Americans.

Another issue that needs to be addressed in the reform is the fact that every physician and pharmacy does not accept each insurance plan that has become available on the Market Place.  For example, a gentleman came into Health Partners Free Clinic looking for assistance with applying for health coverage using healthcare.gov.  He was close but did not meet Medicaid requirements. Looking at his possible plan options, the cheapest option for him was a plan that his primary care physician that he has seen for many, many years did not accept. In order to use that plan, he would have to find another doctor to take over his needs or pay a monthly premium of ~$100 more in another plan to keep his same doctor. Continuity of care is a very important aspect in achieving positive patient outcomes and overall better care.  Switching providers allows for opportunities of miscommunication and errors in patient plans. There have been many walk-in patients who were forced to come into the Clinic because they could not find a doctor that took their insurance. What is the benefit of having insurance coverage if you have no physician to address your health problems to?

The Affordable Care Act has incorporated positive components to our health care system, but, I feel, have not addressed the concept of equal care for all Americans. It has taken years to see Obama’s proposed reform come into play, so changes to improve this inequality of care are unfortunately in the distant future.

Kingsley

I think we have not come close to reforming health care for all to receive the same care. The Patient Protection and Affordable Care Act aims to decrease the proportion of the population who are uninsured. These aims are to be achieved through Medicaid expansion, insurance market reforms, and the creation of subsidized insurance and health insurance exchanges.  With all these expanded coverage options, is health care comprehensive and equal for all?

The answer is NO. Health care reform has only decreased the proportion of uninsured and increased the proportion insured by making it affordable but not comprehensive. The term affordable is relative when it comes to the general population. Insurance premiums are outweighing wages in the poor and underserved populations.

After spending a month at Health Partners, I realized healthcare reform does not provide a comprehensive insurance coverage. Doctors do not accept some of the insurance plans offered in the health care reform system. I saw a lot of people who have health insurance come into the free clinic to see a doctor because doctors are unwilling to take their insurance plan. Premiums are also pricey; to have an insurance plan that most doctors take, it means patients would have to choose a plan with a higher deductible.  Given that not everyone can afford a higher deductible, the poor and underserved are faced with no choice but to choose a plan that fits their household budget. If doctors are not accepting all the insurance plans offered in the health care reform, then health care reform does not provide a comprehensive insurance coverage and everyone is not receiving the same care.