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Alex Pinto

When the Affordable Care Act was first introduced, there was a lot of debate over
whether America should have a universal health care system or if it should keep its
privatized version. The intentions of the Affordable Care Act are simple: supply the
population of the United States with affordable high quality care. However, the reality of
achieving those goals under this law is much more farfetched than one may realize. It is
possible to achieve those goals by other more accepted ideas, however the Affordable
Care Act is much more complicated than necessary and actually creates more problems
than it solves. These problems include but are not limited to: worse delivery and quality
of health care, larger expenses on behalf of the taxpayer and the government, and large
inefficiencies created by over complicated bureaucracies.
Under the Affordable Care Act, studies show that expenses for health care would
increase significantly. This law is based on a communal payment system similar to
many socialist countries. Everybody who chooses to pay into the system rather than
pay the fine receives its benefits. The problem is that not everybody is willing to pay the
premiums and may choose the less expensive fine rather than the health care. The
system is largely dependent on millennials to sign up for health care (Perez). This is so
that they will pay into it in order to pay for the elderly citizens who need more care and
thus more money (Perez). However, historically, millennials have not purchased health
care, and a national poll taken by Harvards Institute of Politics of 18-29 year olds shows
that less than one third of millennials plan to enroll and would rather pay the cheaper
fine (Perez). This is very bad news for the future of the Affordable Care Act and more
importantly, this nation. If there are not enough millennials to pay into the system then
there will not be enough money to offset those who use it which will result in higher
premiums than expected. In addition to this idea, which has been coined The Death
Spiral by many economists, a socialized healthcare system destroys competition
among health care providers for lower rates (Glen).
Studies have shown that people will be less likely to find cheaper health care if
most of it is being paid by the government through the communal system described
above (Glen). People are usually encouraged to look for cheaper options when the
payments affect them directly (Glen). Therefore there will be less competition driving
lower cost which is typical in a capitalist society. In addition to less competition,

Alex Pinto
everybody has to pay for the same coverage plan according to the Affordable Care Act
(Ross). This means there will be millions of people paying for services they do not need
creating an inefficient use of money (Ross). For example, a regular working man will
have to pay for the same coverage as a stuntman. When it comes to the Affordable
Care Act, cost does not necessarily mean higher quality coverage either.
The delivery of care is expected to worsen under the Affordable Care Act. Many
countries that have similar health care systems have very long wait times due to the
inefficiencies in the system (Thind). Canada, which has a population the size of
California and thus should be easier to control, suffers terribly due to long wait times
(Thind). It takes an average of 53 days (8 weeks) from referral to see a specialist
(Thind). This report does not include the wait time to see a general practitioner in order
to receive a referral for a specialist, nor the wait time from a specialist consultation to
actual treatment. However, putting wait times aside, the quality of care is not much
better. It is not uncommon to see patients being treated with unorthodox or unproven
methods such as IMRT and proton beam for early prostate cancer, CT and MRI
angiograms, Epogen for chemotherapy induced anemia, Erbitux and Avastin for
colorectal cancer, and drug-eluting stents for coronary artery disease (Emanuel). These
less effective and possibly dangerous methods are a result of increasing expenditures
due to the reasons described in the last two paragraphs about expenses. In addition,
the government subsidizes the loss of health care providers which means that these
unpopular and ineffective methods will not be driven out by competition like in a
privatized system (Glen). In a privatized system, ineffective or inefficient systems are
replaced so that an organization keeps a competitive edge (Glen).
The Affordable Care Act is filled with inefficiencies that will not be replaced
because there is little or no incentive to spend the time and energy to do so. Many
people do not realize how vastly complicated health care is. When health care was
privatized, insurance companies would have people called actuaries whose entire job
was to figure out the payment plan based on a persons needs and risk. In addition,
insurance companies would have multiple coverage models to fit the specific needs of
an individual. In the Affordable Care Act, there is only one coverage model with 4
payment plans (Frantz). This is because the government is not able to create thousands

Alex Pinto
of coverage models with thousands of payment methods under it to address the large
range of needs for 318 million people (Frantz). With privatized health care, one could
find a coverage model and payment plan that would deliver the most cost effective
method, but under the Affordable Care Act, the result is inefficiency in both payment and
Inefficiencies are also caused by the intricate bureaucracies involved with the
different areas of the system (Ross). It is comparable to trusting the DMV with health
care information. By the time salaries are paid, meetings are held, paperwork is done,
and documents are signed, more time and energy will have been spent on these
endeavors rather than the task at hand (Ross). One example of Bureaucratic
disorganization can be seen in Florida (Big Jump In Number Of Immigrants Losing
Health Law Coverage). The Affordable Care Act says that legal U.S. citizens are
eligible for health care (Big Jump In Number Of Immigrants Losing Health Law
Coverage). However, in determining eligibility in Florida, 400,000 legal U.S. citizens lost
their coverage due to disorganization on part of the government (Big Jump In Number
Of Immigrants Losing Health Law Coverage).
Many people point to other countries such as Sweden or Denmark when
considering whether America should have a socialized health care system. It is difficult
to make a comparison to either of those countries due to large differences in population
and military expenditures (central intelligence agency). Sweden and Denmark have a
population of 9 million people and 5 million people respectively, which is not much when
compared to the United States with a population of 300 million people (central
intelligence agency). A smaller population makes it easier to implement and control any
type of social program. Sweden has a military expenditure of $71,307 compared to that
of the United States which is 5.75 billion dollars (central intelligence agency). If a
country spends more on its military it will have less to spend on social programs. Even
with these advantages, both Sweden and Denmark still have problems with their health
care systems. Sweden, for example, is trying to decrease its wait times but it struggling
to meet its goals due to certain inefficiencies in the system (Reyers).
The Affordable Care Act seeks to benefit the entire population of the United
States by providing socialized health care, but success under this system is very

Alex Pinto
unlikely considering the faults. In order to meet these goals, congress should repeal the
Affordable Care Act and replace it with a privatized version that can be improved upon.
A major reason for creating the Affordable Care Act was because there was a large
portion of the United States that was uninsured, but this is no reason to replace the
privatized system. It is possible to implement government sponsored ideas using a
privatized platform without trying to start over with a complicated socialist health care
system. For example, my bill proposes to give tax benefits to health organizations that
give health care to poor or elderly people who can not pay for their own health
insurance. In addition to tax benefits, my bill also proposes that the government gives
single use vouchers, or single use checks limited to health care, to those who need it.
These single use vouchers will be based on ones financial situation and other relevant
factors such as family size. This way there will still be competition among health care
organizations to offer the best and least expensive care while also supplying health
insurance to those who need it.

Works Cited
Reyers, A., comp. Measuring and Comparing WAITING LISTS A Study in Four
European Countries (2004): 6. HOPE, 18 Apr. 2004. Web. 25 Oct. 2015.

Alex Pinto
Central Intelligence Agency. Central Intelligence Agency, n.d. Web. 25 Oct. 2015.
United States. Department of Defense. Comptroller. NATIONAL DEFENSE BUDGET
ESTIMATES FOR FY 2015. N.p.: n.p., n.d. Print.
Thind, Amardeep, Moira Stewart, Douglas Manuel, Tom Freeman, Amanda Terry, Vijaya
Chevendra, Heather Maddocks, and Neil Marshall. "What Are Wait Times to See a
Specialist? An Analysis of 26,942 Referrals in Southwestern Ontario." Healthcare Policy.
Longwoods Publishing, n.d. Web. 26 Oct. 2015.
"Big Jump In Number Of Immigrants Losing Health Law Coverage." Big Jump In
Number Of Immigrants Losing Health Law Coverage. Associated Press, n.d. Web. 19
Oct. 2015.
Emanuel, Ezekiel J. "Project MUSE." Project MUSE. N.p., n.d. Web. 18 Oct. 2015.
Perez, Esten. "Unlikely to Enroll, Majority of Millennials Believe Costs Will Rise and
Quality of Care Will Fall Under New Health Care Law, Harvard IOP Poll Finds." Harvard
Kennedy School -. N.p., n.d. Web. 11 Jan. 2014. <>
Frantz, Douglas. "Read the Law." N.p., 26 Aug. 2015. Web. 28 Oct. 2015.
Ross, Betsy McCaughey, and Betsy McCaughey Ross. Beating Obamacare: Your
Handbook for Surviving the New Health Care Law. Washington, D.C.: Regnery Pub.,
2013. Print.
Glen, Kelly V. "A Lack of Incentive." Hands Off Health Care. N.p.: n.p., n.d. N. pag. Print