The Individual Mandate Provision
Following the passage of the Obamacare Act, many people still appear to be equally divided with 42 percent in support of it, 42 percent against it, as well as 16 percent not decided (Davidson 13). Probably there is no provision in the act that generates more resentment and opposition than that of the individual mandate. This specific provision that was to be effected by 2014 requires that all the Americans who do not obtain health insurance from those who employ them to buy health insurance or else pay a yearly tax penalty. Therefore, it is significant to evaluate the appropriateness of this individual mandate provision in the promotion of both personal as well as social responsibility.
The individual mandate is amongst the well-known but least-comprehended constituent of the Affordable Care Act. In this Act, every person must have access to health insurance under the ObamaCare health care reform legislation. It operates under the shared payment responsibilities of individuals in the U.S. Emmanuel assert “The law exempts different groups from getting a cover from this law†(15). For instance, immigrants who are not documented are exempted since they cannot even utilize the insurance exchanges in the purchase of a cover. The penalty for the individuals who do not buy health insurance for at least three months is that they will be obligated to pay the IRS money that accrue every uninsured month from their federal income tax. The individual mandate is effected through the deduction of the unpaid penalty from one’s tax refund.
Reactions in opposition to this provision have been so strong to an extent where immediately after the legislation was passed, lawsuits were filed by 13 different states in challenge of the constitutionality of the requirements. From that time, there are other states which have joined into these lawsuits, totaling to 26 states (Emanuel 112). There are more than 41 state laws considering legislation that would limit, change, or contest federal actions that are related to this Act, together with a single payer provision as well as mandates to buy insurance. According to Thompson (78), there are five courts that have ruled on the Acts’ constitutionality, where three supported it whereas two of them were against it.
The philosophical foundation of the Affordable Care Act disregards the influence that individuals possess to have an impact on their individual health trajectory (Kolstad and Amanda 87). In addition, it forces Americans to acknowledge their lasting duties as patients in a health care system that many individuals do not want to be part of. The ObamaCare Act efficiently scrapes out the idea of personal responsibility as well as mastery of lasting wellness from the quest of actual health. The ObamaCare Act, as it is socially referred to as, is expected to impose a lot of penalties on individuals who do not purchase expensive health insurance. According to the provision in the Obamacare, there are millions of American citizens who will be targeted. The Act is set to cause havoc as well as harm to many Americans soon. The Act is not a program that is “voluntary†(Thompson 24).
The question on the appropriateness of the Affordable Care Act lies in the legality that the mandate places on its constitutionality. The implication is that Commerce Clause of the Constitution of the U.S. bestows the Congress with the capacity to call for individuals to take part in a profit-making activity, that is, buy health insurance, which is in opposition to their will, in addition to its seeming violation on the states' rights. According to Kolstad and Amanda, “From this standpoint, there are people who present an argument classifying the mandate as ineffective, inefficient as well as unenforceable†(113). However, perhaps above other things, the individual mandate is perceived as an attack on individual freedom. The invasion of individual liberty provides limitation to the federal government through sovereignty as well as individual choice, and values that are central to the American experience. The provision that is found in the mandate appears to touch matters that are very profound within the American psyche. As a result, the appropriateness of the ObamaCare policy in the promotion of personal as well as social responsibility, at its heart also presents a moral matter.
The individual mandate, although imposed by the government, can assist in fostering as well as recognizing the values that are profoundly rooted in the culture of the U.S. and the tradition of the Judeo-Christian (Siegel 44). The individual mandate might not be the most excellent or perfect instrument towards the attainment of the reforms that ought to take place within the health care sector, but, nevertheless, perceived from an ethical standpoint, it appears to echo with the principle of our culture along with the considerable good for every American as well as American society.
Whereas the consequences of the individual mandate are very significant drivers, the most significant drivers are probably naturally ethical. The individual mandate assists in the promotion of justice (that is, as fair distribution of a very important social good). Secondly, it promotes unity (that is, the sense that all individuals are in this situation together and should be of help to one another during the times of need) (Lazarus 43). In addition, the individual mandate facilitates the common good (that is, the thriving of every member in the society as well as the society as a whole).
In addition, the individual mandate is helpful in protecting insurance companies from adverse selection, i.e. the uneven enrollment in insurance arrangements of individuals who have higher than the average risks in terms of health. Individuals who suppose that they will require health insurance at some point will characteristically buy it in case they can be able to afford it. However, this implies that the insurance pool consists of high-risk persons who may be very expensive to the insurance companies. Additionally, adverse selection can result into high premiums being charged by the insurance companies. The prohibition of such kind of practices by the Affordable Care Act, together with the requirement for insurance companies to keep on covering children under the policy of their parents until the age of 26, could strain the insurance industry. Essentially, the individual mandate is effective through conversion of the uninsured into health insurance policy holders is funding of health care for individuals who are sick.
According to Siegel, when the individual mandate obliges the 17 million individuals who opt-out to purchase insurance, the do not just become health insurance consumers, but they as well become financiers of the health care for other people†(45). There is a tendency that most of the people might pay premiums, which are higher than what they will actually consume in terms of care. Therefore, some parts of the premiums contributed by these people will be utilized in paying medical expenses incurred by other people. However, for a majority of the individuals, their investment in the care sector might pay off when the fall sick and use more health care in comparison to the amount they pay in terms of premiums. Ethical considerations once more take part in a significant role here.
As one moves ahead to ahead to ethical considerations, it is important to recognize centrality’s autonomy. Nevertheless, in opposition to what is frequently illustrated, the autonomy principle is an eligible value in the bioethics of the Americans. The major text that is applied in bioethics courses recognizes that this principle as it should be comprehended "is not extremely individualistic (thus abandoning individuals’ social nature as well as the consequence of individual choices on others), not extremely placing emphasis on reason (in that way disregarding the emotions). Correspondingly, the limits of the individual mandate principle have been discussed, asserting "autonomy provides persons with a moral liberation from the influence of pre-existing rules, roles, as well as relationships. All these are inherited and are enforced obligations. However, they inquire "can individuals who are so liberated disregard the moral relationships that continue to be fundamental for the human good?
Therefore, even though arguments are presented by others arguing that the autonomy principle is not in support of the individual mandate, there are others who uphold that the individual mandate principle itself should be put into a bigger perspective of relevant values. Most fascinatingly, nonetheless, is the prospect that a richer comprehension of the spectrum of the values held by the American public provides substantial support towards the individual mandate.
The regulations that are provided in the Affordable Care Act are allowed to work as a result of the individual mandate, that is, the requirement to either purchase insurance or else pay a penalty, as well as the limits set on open enrollment, which in its absence, healthy individuals may avoid insuring themselves up to when they fall sick. During such incidents, the insurer may be forced to raise the premiums they charge so as to meet the expense of the remaining population. The nonexistence of the individual Mandate provision would have possibly resulted into a malfunction of the exchanges. In opposition, the insertion of the mandate raises the size in addition to the diversity of the population that is insured, expanding the risk pool so as to spread the insurance cost in a manner that is sustainable.
Siegel states “Prior to the effecting of the Affordable Care Act, the health system was entirely voluntary†(90). This is because people were not required to buy health insurance, although most employers offered it. Individuals would only buy health insurance only when he/she can pay for, in the confidence that one can derive benefits from it. Since most Americans are in opposition to a single payer system, and given that there was a lot of antagonism to a public option, the initiative to reform the health care system is broadly built on the present structures of the U.S. health care system, inclusive of the private insurance companies.
The ObamaCare Acts’ individual mandate provision is an appropriate policy in the promotion of per both personal as well as social responsibility. According to Kolstad and Amanda (13), there is a considerable number of Americans, roughly 50 million individuals who do not have health insurance policies. These individuals can be categorized into two main groups- individuals who cannot be able to afford it, as well as those who can afford it, but choose to place their resources into other uses.
Amongst the individuals who cannot afford to buy health insurance, are the individuals who are poor. This group of individuals is presented with the task of choosing between health insurance along with other necessities such as food, shelter, or education. The latter group are both well-off and healthy and to not perceive the necessity of purchasing a health policy. As a result, they opt not to purchase. According to Kolstad and Amanda, “this group, which voluntarily opts out might believe that insurance costs are more than the benefits derived from them†(49). In addition, there is a group of persons who opt not to use their resources on purchasing health insurance, thinking that if they fall ill, they will be given care although they are not insured. By so doing, these persons transfer the costs of treatment to other individuals. In this situation, it is the social order that assumes the costs that are approximated to amount to $49 billion annually (Lazarus 12).
Considering the above realities, health reform that is founded on private insurance corporations as well as health insurance system that is entirely voluntary, the individual mandate found in the ObamaCare Act is beneficial in attaining two key goals. Firstly, it encourages a key objective that is found in the reform initiative, that is, universal coverage (Davidson 46). By means of requiring each American citizen to have health insurance, about 32 million more U.S. citizens shall receive a health cover. Apparently, this will assist both the individuals as well as communities in several ways, (including; better health, as well as increased productivity), will lessen the insurance costs for all and cut down the costs of health care organizations.
There are significantly more issues at stake in the requirement regarding an individual Mandate in the ObamaCare Act than the attainment of a universal coverage as well as maintenance of stability in the market for health insurance. However, a refutation of the individual mandate simply because it invades on individual liberty would appear as reinforcing a false impression of American individualism as well as weakening a sense of responsibility towards oneself, in addition towards fellow citizens. This would imply a neglecting a single side of the actual equation, failing to remember that Americans are not only persons with the liberty to choose, but are as well societal members who are urged to embrace the common good.
On the basis of arguments that have been discussed above, it is evident that the individual mandate provision that is found in the Affordable Care Act is indeed an appropriate policy in the promotion of both personal as well as social responsibilities. This is true because it facilitates both the society and the individual to be responsible for their health. The individual mandate promotes personal responsibility by making sure that all persons are accountable for their health and that they do not overburden others when they fall ill. Individuals in the American become personally responsible for their health through the payment of premiums to the insurance companies that may be utilized in off-setting medical fees during one’s sickness. The Act promotes social responsibility The individual mandate requests that Americans ought to stand in each others' shoes in order to be aware of a common plight as well as to facilitate the creation of security for every person in opposition to the costs related to poor health. As a result, Americans have the responsibilities to both oneself, as well as to take part in the shaping of the society in order for other citizens may profit as well as flourish.
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