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I am about to finish my MSW and in one of our Social Policy Classes we prepared different arguments for the following options:

(1). Keep and adjust as needed the Affordable Care Act;

I think that, at best, keeping and adjusting as needed the Affordable Care Act would be a temporary solution for what I believe needs a deeper shift in paradigm. After reviewing the materials for this module, it was eye-opening to realize that perhaps, the reasons the Affordable Care Act could not efficiently deliver affordable health care to every American citizen are related to deeply rooted problems such as high health care costs/high profit and the power of government regulations. Historically, liberty, self-government, individualism, and the free market are some of the strongest values and beliefs that might have also played a role in the outcomes of the Affordable Care Act.

For instance, many Americans would not accept the government choosing or limiting their health insurance choices; many insurers fled because they did not want to be part of a “strict” government-run market in which they “could not make a profit”; many large employers found it outrageous to be mandated to provide health coverage to employees or have to face an IRS penalty; last but not least, the costs of health care remained exorbitant due to the high profits (laissez-faire) health care industry. In other words, instead of a health care system, the United State has a health care market, which makes offering affordable health care extremely challenging.

Keeping and adjusting the ACA goes beyond amending and enforcing rules.  In order to successfully establish universal health care, the government would have to intervene not only in how insurance companies operate and how consumers choose health coverage but also and perhaps most importantly in taking the profit out of the health care industry. That, in turn, would mean a shift in paradigm for Americans, in which it would be OK to have the government regulate welfare domains such as the health care system without losing its laissez-faire economic approach.

(2). Based on the alternatives to ACA in the materials you consulted for this assignment – propose a viable NEW health care policy.

Proposing a viable new health care policy also means taking the profit out of the health care through government price regulations, offering public/government-run hospitals and specialty care, and expanding federally qualified community health care centers so that they can attend to the needs of larger populations when it comes to primary and preventive care. In other words, the welfare state (societal health care needs, and other domains)  should be regulated by the government- not with the objective of profit making. Considering that choice is an important factor for consumers, when planning for health care coverage, they would still be able to choose between using the government-run health care system and having zero copayments and premiums (even though there is some waiting time, no system will be perfect); being employed by a company that offers private health care;  or paying the exorbitant premium prices charged by private insurance companies. Finally, due to culture, values, and beliefs, I believe that key factors for offering universal health care in the United States are related to the extent to which the government can or will regulate prices and to the extent that the population and businesses will accept government intervention. Any health care policy that proposes universal health care to American citizens will have to first address the way individuals and businesses see the world.

(a). Identify two core questions that will frame your ethical decision-making within the argument you prepared;

1) Will universal health care policies hurt American’s values and beliefs ( e.g. liberty, self-government, individualism, and opportunity)?

2) Will the universal health care policy be under the auspices of the social justice approach?

(b) Justify your course of action based on these questions.

When reflecting about keeping and adjusting the ACA or proposing a new health care policy, two main factors crossed my mind. First,  American’s values and beliefs and second, the need for equitable and accessible health care coverage for every American. I believe that establishing universal health care in the U.S. would be a long process not only because of structural modifications but also adaptation of a belief system. There has to be a grey area, in which American’s values are not hurt and health care equality can be achieved. There must be a grey area in which public health can be regulated and economic affairs can remain in laissez-faire mode.