[Editor’s note: This article was originally hosted on MyFamilyDoctorMag.com, our sister site.
It’s now featured here as part of our new general-health section.]

Pros and Cons of Obamacare

by Leigh Ann Otte

In 2009, we asked two doctors to debate the pros and cons of President Barack Obama’s health-care plan. Back then, the plan was an idea. Now, it’s a law, the Affordable Care Act. (Opponents derisively call it Obamacare.)

Some of the details of Obama’s health-care plan have changed since 2009, but the overall goals remain similar. For example, as planned back then, insurance companies will soon not be allowed to deny coverage to people with pre-existing conditions. And small businesses now get a tax credit to help them provide health insurance.

You can see more highlights of the current Affordable Care Act at Obama’s website. (Of course, given the source, they’re highlighted with a positive spin.)

Rules of Engagement

We invited each participant to write an argument, then read the opponent’s argument and write a rebuttal. Neither was allowed to read the other’s initial argument before writing his own, and neither could read the other’s response before rebutting.

We asked our debators, if the United States does adopt a universal health-care plan, is Obama’s headed in the right direction? Here’s their take.

You can share your opinion in the comments section below the debate.

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Pro argument: “The Obama health-care plan is headed in a positive direction.”

Patrick Whelan, M.D, Ph.D., practicing rheumatologist and director of Catholic Democrats, “a national non-profit organization of concerned Catholics.”

The Obama health-care plan is headed in a positive direction by all historic indicators.

It began with February’s expansion [2009] of the State Children’s Health Insurance Program after years of failure, providing insurance to millions of additional vulnerable children. Then, the passage of the economic stimulus bill helped states maintain current levels of care for their poorest citizens. Now, a new secretary, Gov. Kathleen Sebelius, with a dedicated commitment to the common good has been nominated. [Sebelius was sworn in as health secretary in 2009.]

The administration has undertaken a summit [in 2009] at the White House to explore all the possibilities, with four particularly key objectives.

The first is finding ways to insure every American. At a time of foreclosures and job losses, the last worry anyone needs is whether they can get thoughtful care with appropriate follow-up if an emergency befalls them. Current law provides for continued insurance under COBRA if a job is lost, but this is incredibly expensive for families—particularly if someone has no job. But SCHIP expansion aside, more than 40 million people still have no insurance.

A second objective has been transparency, so the remarkably expensive enterprise of medical care doesn’t become a new pork barrel of inefficiency. This leads to the third goal: cost efficiency.

Tremendous efficiencies are possible because they are currently being achieved by our economic competitors around the world. Increased health-care efficiencies were probably the leading engine for the economic expansion during the 1990s. The United States currently has the developed world’s most inefficient system, costing more than twice as much as other systems while performing poorly on many health indices.

The Survival Doctor's Guides to Burns and Wounds, by @James HubbardThus, a fourth goal is heightened quality, like that supported by the significantly expanded medical research in the stimulus bill. Better health, after all, is a goal shared by everyone, and Obama has moved us a giant step closer by forcefully articulating these four objectives.


Con argument: “President Barack Obama’s health-care plan at best is not reform at all.”

President Barack Obama’s health-care plan at best is not reform at all, and at worst will expand the poorest performing segments of our health-care system and further erode what little choice currently exists at the individual patient and provider level.

“Universal health-care coverage,” according to the president’s plan, would be largely driven by enrollment in public programs, such as Medicaid and SCHIP, in which the government sets benefit levels and provider reimbursement rates. Being nominally “covered” in a public health insurance program is of little value if prohibitively low reimbursement rates and administrative hassles prevent physicians from accepting you as a patient.