|Thinking About Health|
|Written by Trudy Lieberman, Rural Health News Service|
The Coming of Obamacare: What it Means for You
The Affordable Care Act formally makes its debut on Oct. 1 when its central feature, the state shopping exchanges and accompanying government subsidies to help low- and moderate-income people, opens for business.
Just how will this new act affect you? First, it’s important to understand what the Affordable Care Act is not. Contrary to what many politicians and others have claimed, it is not socialized medicine, and it is not government-run health care. It’s not even a national health insurance system like Medicare or the health systems in other countries.
Delivery of health care in the U.S. is mostly private with doctors still being paid fees for their services by insurance companies or government payers like Medicare. With the exception of a handful of county or municipally-funded facilities, hospitals are privately run. While they may be nominally not-for-profit businesses and receive certain tax advantages, they increasingly concentrate on the bottom line. In effect, there’s not much difference between for-profit and not-for-profit facilities.
At its core, the Affordable Care Act calls for improvements in existing American health insurance arrangements. That arrangement can loosely be thought of as a kind of public/private partnership with Medicare available for those 65 and older and some disabled people, Medicaid for people with very low incomes, and the commercial market with for-profit and not-for-profit insurance companies selling to everyone else.
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