Is Obamacare Working? The Affordable Care Act Five Years Later
In which
John Green pauses, five years after the
Affordable Care Act was signed into law, to consider what we know so far about the law's effectiveness and repercussions. I also look at health care in the
United States more generally, and the limited scope of the Affordable Care Act relative to the size of the overall health care system in the
U.S.
I got a ton of help from
Aaron Carroll, who hosts the great
Health Care Triage https://www.youtube.com/user/thehealthcaretriage, but any errors are my fault and mine alone.
SOURCES:
More than 17% of
US GDP goes to health care expenses:
http://en.wikipedia.org/wiki/Health_care_in_the_United_States
The U.S. spends way more on health care than any other country: http://www-tc.pbs.org/prod-media/newshour/photos/
2012/10/02/US_spends_much_more_on_health_than_what_might_be_expected_1_slideshow
.jpg
And yet our healthcare outcomes are not generally better (and are in many cases worse): http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror
44 (or maybe 46) million
Americans were uninsured in 2009: http://www.pbs.org/healthcarecrisis/uninsured
.html
This
NYT article assessing the
ACA is excellent: http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html#/
Understanding pre-existing condition exclusions: http://kff.org/health-reform/fact-sheet/health-insurance-market-reforms-pre-existing-condition/
Medical debt is the biggest cause of U.S. bankruptcy: http://www.cnbc.com/id/100840148
Employer-based insurance distorts the labor market in the United States: https://www.bostonfed.org/economic/conf/conf50/conf50e
.pdf
Both the access and the cost savings parts of the Affordable Care Act are discussed really well at this wikipedia page: http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
We are nowhere close to a path to health care spending stability: https://www.cbo.gov/publication/45471
But the uninsurance rate has dropped dramatically: http://www.gallup.com/poll/180425/uninsured-rate-sinks
.aspx
And more than 12 million people have gotten insurance through the health care exchanges set up by Obamacare: http://acasignups.net/
The rollout of healthcare.gov was a disaster: http://en.wikipedia.org/wiki/HealthCare.gov
Insurance premiums rising more slowly than before exchanges: http://kff.org/health-reform/issue-brief/analysis-of-2015-premium-changes-in-the-affordable-care-acts-health-insurance-marketplaces/
More insurance companies are participating in the exchanges this year than last year: http://www.wsj.com/articles/u-s-states-to-get-more-insurers-under-affordable-care-act-1411495473
The law is costing less than expected: http://www.nytimes.com/
2015/03/10/us/politics/budget-office-again-reduces-its-estimate-on-cost-of-the-affordable-care-act.html
Is the law actually improving health? It seems so at least for young adults and also for colonscopy screening rates, but much is still unknown: http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html#/
Many are still uninsured and underinsurance is a huge problem: http://www.nytimes.com/2014/12/02/upshot/underinsurance-remains-big-problem-under-obama-health-law.html
(
Don't get mad at me for linking a lot to the
New York Times; they do way more data analysis and reporting on this stuff than anyone else
I've come across)
Britons live longer and healthier lives than Americans despite being pretty similar lifestyle-wise: http://www.ncbi
.nlm.nih.gov/books/NBK62373/
Our health care spending will sink us in the long-run, but if anything the situation was worse before the ACA: https://www.cbo.gov/publication/45471
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