Obamacare Won’t Solve Our Public Health Problems: Look at Romneycare



To judge mandatory health care successful by observing the number of people insured sounds great superficially, but to understand the reason for implementing mandatory health care in the first place, one must look to other measures to understand whether such reform is effective.  Looking at how many people are insured after forcing them enroll in health insurance and saying that a program is effective because so many people have enrolled is so blatantly obvious – there almost is no need to examine that, unless the product is so awful people would rather pay a fine than enroll. Even in the case where health care is excruciatingly hard to get, (we’re looking at you healthcare.gov) people will still want it for a variety of reasons, one of which is obvious – fines suck.

However, what is the point of mandatory health insurance. Why is the government and people who know better than everyone else forcing the general populace to have health insurance? Their main goal is to increase people’s longevity, stave off mortality and they believe that people with health insurance will be better equipped to deal with life’s illnesses and diseases. According to the proponents of mandatory health care, diseases will be found earlier, people will be more likely to access preventative care and society overall will live longer.

Therefore, to understand whether or not mandatory health care is effective, one shouldn’t examine enrollment rates. It tells nothing about the distal outcome, the outcome the health care reform hopes to improve. Instead, we need to look at mortality, rates of illness and whether people do indeed more frequently access preventative care resources. How can we do that? After all, Obamacare is in its infancy. Barely anyone has enrolled, let alone feel the benefits of such a great social project!

Though Obamacare is in its infancy, one needs not to look in far away lands to gleam evidence supporting or weakening universal healthcare. One only needs to look at Massachusetts. As governor, Romney created a health care program, the same program Obamacare is modeled after. The program was praised, hailed as a success. How did these people measure Romneycare’s success? The number of people enrolled.

What happens when you look at Massachusetts’s mortality rate? Not surprising, Massachusetts’s mortality rate has gone down. It must be Romneycare! What a miraculous social program! Let’s say Romneycare’s effects can be observed starting in 2007, one year after it was enacted. Although the data demonstrates that mortality rates have gone down since 2007, the same data also shows the mortality rate has gone down since 2000 and has been doing so steadily every year, for 7 years before Romney care. Furthermore, the data does not seem to show a significant difference in decreased deaths pre- and post-2007.

Although the overall mortality rate has only decreased somewhat, surely specific illnesses have decreased drastically. It is unfair to lump all deaths together! One aspect of Obamacare, as is with Romneycare, is to decrease preventative diseases through preventative measures, which would be better accessed by those with insurance. A good measure of this may be cancer. Cancer is fast spreading but easily missed and only through frequent check-ups can one catch it. Thus, it could be used as a measure of how successful mandatory health care is as improving the outcome of preventative illnesses.

It does not fare well. Deaths from cancer have been steadily decreasing before 2007 and have since decreased at the same rate. What about specific cancers? Deaths from lung, colorectal and prostate cancer all have similar rates in the 2000-2010-time range. Sadly, deaths from breast cancer have actually increased since 2007. Deaths from other cancers, such as bladder, uterine and ovarian cancer have also gone up since 2007. If more women than ever in Massachusetts are insured, then why are they not able to identify and treat the cancers in time? It may be that the number of deaths from these types of cancers is not statistically significant, that is, they are not a drastic increase from pre-2007. However, it also means the number of deaths have no decreased, which is interesting, considering how mandatory health care should decrease these types of deaths.

Infant mortality rates have also increased since 2000. As technology, especially medical technology has improved, it is surprising to see that infant mortality, for Whites and Blacks (thus, not a problem for a specific race) have increased since 2000, 3.8 per 1000 to 4.1 per 1000 and 5.2 per 1000 to 7.1 per 1000 deaths for Whites and Blacks respectively. Why hasn’t better access to cheaper healthcare lowered infant mortality? Shouldn’t expectant mothers have better access to the necessary medical treatments, especially with more people enrolled with health insurance?

Is mandatory insurance the best way to go about increasing life expectancy? Is there possibly another way, a better, more effective way of disseminating medical care and medical knowledge and awareness to people to decrease mortality?

Perhaps, through better health education in high school or stronger public health campaigns about preventing illnesses and getting more frequent check-ups. These methods have research and empirical data backing their effectiveness, whereas Romneycare and Obamacare do not. Other ways of improving preventative care include stressing a medical model that focuses more on preventing diseases instead of merely treating them once they surface. These means may be better at improving life expectancy and attack lack of knowledge and treatment possibilities at the source rather than as a Band-Aid. Universal health care may work. However, with other external factors at work, Obamacare, as Romneycare has shown, may not work the way its implementers expect it to. Instead, it may need larger problems facing public health to be fixed before it can even approach success.

These are questions and problems that daunt Obamacare. After all, if the health care reform policy Obamacare is based on is unable to reduce the mortality rate, what good is it? The whole point of forcing people to do something, to deny their liberty to say no, is because it is better for them. Though I disagree people should be forced to do something, even if it is for “their own good”, at least it betters their lives. Romneycare was forced onto people and hasn’t even be demonstrated to be effective and it has been hailed as a great social program. If Romneycare isn’t able to do what it’s supposed to, how is Obamacare supposed to, especially when, in its early stages of implementation, it has been clumsily put together?

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