I think the biggest challenge that health care reformers have faced in the past has simply been the fact that a significant portion of the population does not understand the health care system. For better or worse, it seems that health related issues have usually been overlooked or brushed over by politicians and the American public in favor of other topics, such as war, politics, or the economy. I know for me personally, I have never really been concerned with health care issues and until recently really had no idea of how the health system worked. Aside from children who have parents who work in the health care system or have experienced being in the health care system a lot, most children never really get taught about the American health care system the same way they are taught about financial literacy or American civics. As a result, most people don’t really have any exposure to health care unless they get really sick. A study from the National Academy of Sciences found that half of Americans were not aware of the health care exchanges set up by the Affordable Care Act and that forty percent were unable to accurately explain what a “deductible” was. Perhaps unsurprisingly, those of lower income tended to have less understanding of the health care system than those of higher income, making it even more challenging for reformers. Without knowledge of how an existing system works, it is very difficult to reform that system.
My understanding of the history of American health care is limited since I am only 17, but I consider the Affordable Care Act to be the biggest failure in US health care reform. Contradictory to its name, the Affordable Care Act has actually caused the price of health insurance premiums to increase for most people. One year after its passage, costs of premiums increased 9% on average, and four years after its passage, costs had gone up 59% on individual plans. In addition, the ACA has been unable to convince many uninsured people to sign up for health care. A study in 2014 found that only a quarter of people who purchased an Obamacare plan were uninsured the year before. In addition, half of uninsured respondents said that affordability was their main reason for not purchasing insurance. Lastly, the Affordable Care Act has caused many health insurers to lose considerable amounts of money and withdraw from many states. As a result, people in Alabama, Alaska, Oklahoma, and other states will only have one option for health care next year.
Unlike the Affordable Care Act, I consider the State Children’s Health Insurance Program to be a success and a demonstration of the effectiveness of incremental change rather than massive overhaul. After ten years under SCHIP, the percentage of children uninsured fell greatly, even as the number of uninsured people grew. Perhaps rather than pushing for huge changes at once, health care reform could look for specific areas to target and improve on gradually.