Yet those who trumpet such gains while scratching their heads at the law’s
relative unpopularity are missing the crux of the problem: despite President Obama’s reforms, the health-care system continues to fail much of the nation.
One example: in Canada, physicians and hospitals are free when you use them. In the United States, co-payments and deductibles for such care (which
average $7,474 for a family marketplace silver plan) often rations medical care by economic status. Studies have shown that those with inadequate insurance avoid
going to the EReven when they need it, delay care when in the
throes of a heart attack, and face financial strain and
sometimes bankruptcy when sickness strikes. Such injustices preceded the ACA, but because the law failed to fix them, it is blamed — fairly or unfairly — for their persistence.
More recently, Obama signed the
21st Century Cures Act into law, which among other things incrementally
reduced the rigor of the Food and Drug Administration’s drug approval process. These provisions were tantamount to a generous handout to the pharmaceutical industry, which had
lobbied heavily for the bill. Not surprisingly, it also did precisely nothing about sky-high
drug costs.
This is a decidedly mixed legacy. The gains of the ACA are evident: indeed, for some of those who gained coverage, it was lifesaving. Its shortcomings, however, are equally evident: some twenty-eight million uninsured, persistently high cost-sharing, inequalities in access, uncontrolled drug prices, and so forth.
