Essays, poems and Stories of an African-American

Monday, 24 October 2016

Obamacare! America's Goose that lays the golden eggs

Obamacare! America's Goose that lays the golden eggs, I dare say President Donald Trump will be happier if the goose was taken care of.

Employers and Employees should be equally invested in the tenets of Obamacare because it's spirit positions squarely responsibilities of everyone when it comes to quality long life. It is through reconciling ourselves with that fact that such issues like obesity as an emerging event of the 21st Century America will be tackled comprehensively.
Cackling Geese: Google Images
According to the Affordable Care Act (Obamacare), it is perfectly legal for employers to assess their employees as much as 30% of the cost of provided health benefit (insurance) coverage, if the employee doesn’t meet certain wellness goals (established by the Department of Health and Human Services) which include weight and/or body mass index (BMI). When, the employee engages in obesity management therapy this effort should be rewarded by coverage. This should not be seen as paying into social programs but as an act of addressing risk for protracted sickness and hence wage loss (Shi. L & Singh D.A. 2015). This approach increases self care and engagement in early and timely diagnosis for any likely adverse effects (Marieb E.N.2015). This is a motivation and it establishes an incentive for people to work toward long-term health goals. There are some assumptions I am making here: obesity affects performance at work and self esteem so employees and employers are invested in addressing it; universal coverage is part of American value for life, liberty and pursuance of happiness; employers pay for employees’ coverage has social-wide dividends; concepts like individual or limited benefits, shared responsibility and minimum essential coverage are apparent; and penalties of not having insurance coverage exist to encourage participation in healthy lifestyles. Also in this essay, I write a bit more emphatically on obesity and its significance as a social, clinical and medical factor. As well as the fact that indirectly, Obamacare is shining a brighter light on significance of prevention and community participation in addressing chronic illnesses. 

The Affordable Care Act (ObamaCare) is a law mandating medical coverage benefits for individual and families. One such benefit is that an employer is able to pay at a very low cost for an employee’s insurance coverage. The other benefit is that this establishes grounds for a basic and minimum essential coverage. This minimum essential coverage includes all government, job based insurance and most Private Insurance. A minimum essential coverage means any major medical insurance on or off the marketplace, whether it is a public program, or through work you typically have minimum essential coverage.

ObamaCare’s individual mandate requires that most Americans obtain and maintain health insurance, or an exemption, each month or pay a tax penalty. A penalty deters one from not fulfilling the duty to be covered. The individual mandate went into effect at the beginning of January 2014 and continues each year. The penalty for not having coverage is paid for using one’s Federal Income Tax Returns for each full month one or a family member doesn’t have health insurance or an exemption and is based on one’s Modified Adjusted Gross Income (MAGI).The annual fee for not having insurance in 2016 is $695 per adult and $347.50 per child (up to $2,085 for a family), or it’s 2.5% of your household income above the tax return filing threshold for your filing status – whichever is greater. It is important to note that one pays 1/12 of the total fee for each full month in which a family member went without coverage or an exemption. 

An individual should be aware of the concept of limited benefits and the areas where this individual has to pay using their own cash. Minimum essential coverage does not include coverage providing only limited benefits, such as coverage only for vision care or dental care, and Medicaid covering only certain benefits such as family planning, workers’ compensation, or disability policies. The following types of health insurance are not minimum essential coverage:

Short Term Health Plans
Fixed Benefit Health Plans
Supplemental Medicare like Part D and Medigap
Some Medicaid covering only certain benefits
Vision only, Dental only, and limited benefit plans
Grandfathered Plans (one will avoid the fee, but won’t get the new rights and protections)

Obesity is a medical condition in which excess body fat has accumulated to the point that it has an adverse effect on health and may shorten one’s life expectancy. This has social, clinical and medical implications (Battle U.C. 2009). Employees will have to be provided time off work for medical reasons. Livelihoods may in turn be affected with reduced or loss of incomes. Obesity is an epidemic in U.S., it is associated to significant morbidity, mortality for and risk fact for hypertension, type 2 diabetes, coronary disease and stroke (Gordis L. 2014). Where obesity lurks, so does diabetes. (1) in three (3) people may develop diabetes in the next 40 years; diabetes is a debilitating disease, a cause for blindness, kidney failure, limb amputation and a leading cause of death in U.S. 35.7% of adults 20-years-old and above are obese. They are 20% over their ideal body weight. One third of children and adolescents are either overweight or obese. In 2012 alone, it cost $245 billion for the U.S. to provide medical care and attendant care for people diagnosed with obesity related conditions (Judson, K., & Harrison, C.2016). Prevention measures and management of obesity to stop worse events are increasingly calling for the wider participation by many stakeholders. Participation by more stakeholders, establishes interventions that reduce overall incidence and prevalence by affecting frequency distributions in entire populations (Turnock 2015); the range of settings include multilevel response to social, behavioral and environmental influences (Edberg M. 2015); it creates social capital, resources, norms, values and institutional policies affecting energy balance and weight status (Coreil J. 2010). 
Battle U.C. 2009. Essentials of Public Health Biology; A Guide to the Study of Pathophysiology. Jones & Bartlett Learning. Burlington, MA. 

Coreil J. 2010. Social and Behavioral Foundations of Public Health. Sage Publications, Inc. Thousand Oaks, CA

David Hogberg. 2014. 14 Ways Obamacare Is Still A Disaster (That You Won’t Learn From Vox). Retrieved from:, Retrieved on October 24th 2016.

Edberg M. 2015. Essentials of Health Behavior; Social and Behavioral Theory in Public Health. Jones & Bartlett Learning. Burlington, MA. 

Gordis L. 2014. Epidemiology. Elsevier Saunders. Philadelphia, PA.

Judson, K., & Harrison, C. (2016). Law and ethics for the health professions. (7th ed.). New York: McGraw-Hill. 

Marieb. E.N. 2015. Essentials of Human Anatomy and Physiology. Pearson. Boston, MA.

Minimum Essential Coverage. Retrieved from: Retrieved on October 24th 2016. 

ObamaCare Individual Mandate. Retrieved from: Retrieved on October 24th 2016.

10 Things You Get Now That Obamacare Survived. Retrieved from: Retrieved on October 24th 2016. 

Shi. L & Singh D.A. 2015. Delivering HealthCare in America; A Systems Approach. Jones & Bartlett Learning. Burlington MA. 

Turnock J.B. 2015. Essentials of Public Health. Jones & Bartlett Learning. Burlington MA.