The future of the American health care is known to be greatly impacted by a governmental health policy, enacted in 2010. The Patient Protection and Affordable Care Act (PPACA) is being strongly criticized by Obama's opponents, mostly as an attempt to enhance their own political value. Specifically, the ACA's opponents strengthen the controversy between people who "want a single-payer system with those individuals who want to continue the free-market system" (Lachman, 2012). Undoubtedly, one can rightfully deduce that single-payer system is greatly beneficial for general prosperity of the American society because it assures that a greater amount of people will be covered. Simultaneously, it tends to threaten basic humans rights and freedoms.

The Purpose of the Study

The purpose of this paper is to identify the main concerns of the U. S. people and current health care policies, respectively. Besides, this research paper discusses economic and ethical considerations of the ACA. Finally, it is aimed to provide relevant recommendations in accordance with the obtained and assessed insights.

The Main Goals of the ACA

To explore, discuss and evaluate the impact of this reform, it is appropriate to outline its core goals. Firstly, this health policy is aimed to provide subsidies to individuals who cannot afford medical insurance without state's financial assistance. Secondly, it obligates the U.S. citizens to purchase the insurance, in order to avoid penalty. Thirdly, small businesses (companies with more than 50 staff members) are required to obtain medical coverage for their collaborators. Fourthly, the so-called "Obamacare" supports a significant expansion of medical aid. Finally, it encourages health insurers to cover all the applicants. Noteworthy, insurance companies are engaged not to charge more "for those with a history of illness, as well as requiring community rating, guaranteed issue, non-discrimination for pre-existing conditions, and conforming to a specified benefits package" (Rice, Rosenau, Unruh, & Barnes, 2013). Undoubtedly, the dubious nature of the above-stated aspects strengthens the relevant concerns of the American citizens.

People's Attitudes and Concerns Regarding the ACA's Relevance

In particular, the adherents of the free-market system assume that single-payer health policy may decrease the quality of medical services. In addition, they prefer to have a complete freedom of health care choices, which, presumably, is limited by the ACA (American College of Emergency Physicians, 2014). What is more, the affordable health care is quite expensive to be maintained on a governmental level; therefore, the opponents of the single-payer system reveal concerns regarding its relevance and feasibility. Moreover, being raised as the representatives of the compassionate nation, Americans want their fellow citizens to enjoy the same great range of high-quality medical assistance, which resonates with the "death panel jargon" (Lachman, 2012). In particular, many individuals are afraid that the ACA would leave elderly without the proper medical aid because "ACA has a focus on physicians counseling individuals on end-of-life options" (Lachman, 2012). Without a doubt, this approach is the most ambiguous one in terms of ethics. Meanwhile, it is true that most insurance money are spent after retirement, it surely does not mean that the elderly should be imposed to consider "end-of-life options".

The Economic and Ethical Considerations of the ACA

The main strong and weak economic and ethical sides of the ACA can be identified while evaluating the suppositions revealed below. For instance, numerous individuals believe that the ACA's idea to encourage person's sense of responsibility for his/her health would lead to conflicts with the compatriots who refuse to maintain healthy lifestyle. In this case, the irresponsible people behave unethically; meanwhile, responsible citizens are in charge for the inappropriate behavior of their citizens. Simply put, they have to spend "insurance dollars" to cover the treatment of the reckless persons. In addition, many Americans adhere to the free-market health system because they do not want to pay for the services they would never consider taking. For example, due to religious, cultural or other beliefs, some people would refuse the transplants or "mechanical ventilation for person in persistent vegetative state" (Lachman, 2012). Undoubtedly, these economic and ethical issues, which the ACA begets, should be seriously addressed on a state level. Nevertheless, in a long run, this health reform presumes promising achievements. For instance, thanks to the ACA, the U. S. government expenses for medical care are expected to be significantly reduced in the near future (about $575 billion till 2019) (Sorrell, 2012). Without doubts, this expected statistics is a strong financial rationale that serves in favor of the general ACA's approach.

The Objection to the Opponents' Concerns

Critically evaluating these concerns, it is necessary to comprehend that it is the free-market system that prevents individuals from enjoying high-qualified medical assistance. The medical insurance companies must be controlled on a state level; poverty must be provided with a medical care. For example, "the PPACA provisions extending health insurance to an additional 32 million people" (American College of Emergency Physicians, 2014). Without this health reform, those citizens would have remained uncovered. Therefore, I consider the opponents' concerns to be worth attention, but, generally, irrelevant.


Taking into consideration the findings that were presented above, it is appropriate to suggest the following improvements. Firstly, it is necessary to delete (or at least reform) the aspect of "end-of-life options" from the ACA, since it is unethical. Besides, it contradicts with the general American cultural attitude of compassion. Secondly, one should consider the need to elaborate and implement the supportive clarifying programs, which would reduce the emergence of concerns and ambiguity. Thirdly, the individuals should not be penalized for refusal to purchase governmental health insurance; instead, they may be obliged to pay a double price for their medical treatment. Fourthly, to enhance the effectiveness of prevention, it is appropriate to launch the programs that would provide basic medical knowledge to all citizens. Fifthly, one's health insurance package should be agreed with a person, in order to eliminate his/her expenses on unnecessary medical services.

In a word, the Patient Protection and Affordable Care Act (PPACA) is known to beget a controversy between the adherents of a single-payer health system and their opponents who prefer to use the free-market system. Undoubtedly, the ACA has its strong and weak sides, which is clearly visible in financial and ethic concerns of the U.S. citizens. Nonetheless, in general, this health reform is greatly beneficial for the American society, since it assures a healthy and complete existence to a greater amount of people.


American College of Emergency Physicians. (2014). The ethics of health care reform: Issues in an emergency - Medicine - An information paper. Retrieved from

Lachman, V. D. (2012). Ethics, law and policy: Ethical challenges in the era of health care reform. Medsurg Nursing, 21(4), 245-248. Retrieved from al-Challenges-in-the-Era-of-Health-Care-Reform.pdf

Rice, T., Rosenau, P., Unruh, L. Y., & Barnes, A. J. (2013). United States of America: Health system review. Health Systems in Transition, 15(3), 40. European Observatory on Health Systems and Policies. Retrieved from America.pdf

Sorrell, J. (2012) Ethics: The patient protection and affordable care act: Ethical perspectives in 21st-century health care. The Online Journal of Issues in Nursing, 18(1).

Retrieved from ls/OJIN/Columns/Ethics/Patient-Protection-and-Affordable-Care-Act-Ethical- Perspectives.html

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