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     Persuasive Essay Example: Environmental determinism 

      Environmental determinism 

    The world has evolved, and throughout the study of geography, there have been a number of theories that have come up in a bid to explain the development of the world’s cultures and societies. One of the theories received prominence in geographic history is environmental determinist, however; it is important to note that this theory has been declining in recent decades. Environmental determinism is the belief that it is the environment which includes physical factors such as climate, and landforms that determine the pattern of societal development and patterns in human societies.

Sachs and Jared Diamond are some of the notable scholars and authors that subscribe to this school of thought and argue that the human population often looks at patterns of the environmental change, and geographical difference in order to understand trajectories of human social development. They argue that by observing the environment, it becomes possible to explain why some societies often flourish while other continues to languish in poverty or sometimes collapse altogether.

    The main argument that environmental determinism possesses is the fact that than area’s physical characteristics like climate, often have a strong impact on the psychological outlook of all its inhabitants. This, therefore, means that there are outlooks which then spread throughout a big population and consequently help in the definition of the overall behavior as well as culture of the society. One of the example given was that areas in tropics were less developed that those at higher attitudes because of the warm weather. The warm weather made it easy to survive and consequently people who lived there did not work hard in a bid to ensure their survival. Another example that is prominent is the fact that island nations often have unique cultural traits; this is because there is isolation from other continental societies.

     Origins of the theory 

    Environmental determinism goes back to the fifth century where a medical treatise written by Hippocrates. The medical treatise argued that humans are controlled by climate, and it is the climate of a place that controls behavior. Further, the Greek geographer Strabo also wrote on the subject and argued that it was climate influences that cause the existing psychological dispositions of the different races. However, it was in the 19th and early 20th century that environmental determinism took shape; it was taken up as a central theory in the discipline of geography. Evolutionary biology was instrumental in the ever rising profile of environmental determinism, however, after some time the theory started to crumble.

     Decline of theory 

    The theory lost most of its luster in the early to the mid twentieth century as most decolonization scholars launched an attack after an attack on the theory. The intellectual backlash was focused on the discipline that was closely associated with environmental determinism; geography (Van, 2008). At this time, Ivy league institutions were embarrassed with the obvious association with imperialism and racism, and it is at this point most of them dropped geography departments in mass.

The embarrassment and the shame that came with being associated with the theory meant that it was largely ignored as opposed to being buried. Therefore, this is why it can be seen that the theory has mounted a surprising comeback in recent years. Sachs, an economist at Harvard and a key advisor to the United Nations secretary-General Ban Ki-Moon, argues that the redistribution of wealth cannot resolve global inequality, this is because there exists geographical as well as unequal distribution of poverty and affluence which is a result of complex geographic and climatic dynamics which nave nothing to do with capitalist expansion and colonial conquest.

    The theory came under heavy criticism and repeated attacks that its claims were severely faulted and wrong. Some geographer completely refused to acknowledge the theory of environmental determinism but instead developed a softer notion of the theory that they referred to as environmental possibilism. Critics argued that the theory was biased, and it was intended to justify imperialism and racism (Van, 2008). The fundamental argument that was used by the proponents of environmental determinism was the fact that it was the aspects of physical geography, and particularly climate, which influenced the mindset of individuals and consequently influenced the behavior and culture of the society.

Therefore, they argued that in order to understand why some people behave the way they do, it was important for them to trace the climate that the people existed in this was why evolutionary biology was a key factor and central point in this theory (Newcomer, 1972). However, there are some scholars who pointed out that disapproval was not actually based on inaccurate findings but methodological process, which were against science. They argued that massive generalization, which were premature which came from environmental determinism.

    The most influential factor in environmental determinism is climatic determinism. Climatic determinism is also referred to as equatorial paradox. This theory states that about 70% of the economic development that exists in a country can be predicted by the distance that exists between the country and the equator. Therefore, the close a country is to the equator, the less the development in the country (Wu, 1995).

The paradox occurs in hemispheres, the north and south. For example, the northern U.S states are more developed as compared to the Southern U.S states. This is supposedly because they are closer to the equator. However, Singapore is a counter example to this argument. This is because it is located at 1.22 degrees north of the equator and currently it is one of the most prosperous countries in the world.

     One theory that gained recognition in the 19th century and early 20th century is that development is often not very necessary in tropical regions; this is supposedly because one can lie on a hammock and pick bananas. This is as opposed to the need to have a robust economy and invent agriculture in a bid to survive and prosper. This theorem, however convenient finds it difficult to be able to sufficiently explain the complex nature of the equatorial paradox (Diamond, 1998).

    Another theory in environmental determinism is the fact that tropical countries often tend to be plagued with diseases. Some of the diseases mentioned include Malaria, whose transmission is entirely dependent on a warm climate. Consequently, the tropical country’s workers often tend to be sicker, and they have a low life span. This means that they are often less productive and when it comes to time, the cooler and disease free economies experience faster economic growth as compared to the tropical countries.

    However, environmental determinism according to 21st century scholars should not just be ruled out. This is because it contains some truth in it; Africa is one of the prime examples that indeed environmental determinism affects the psychological mindset of an individual. Africa has unfavorable variables that exist from the theory of environmental determinism which has over the years led to its poor economic development. It is imperative to note that Africa’s per capita income has been on a constant decrease over the past 50 years (Diamond, 1998).

The continent has a large land mass in the tropics; however, most of the population is often concentrated in the interior. More than one fourth of the population in Africa lived in landlocked countries, and there exists a low population density when it comes to the coastal regions. Therefore, Africa as a whole, when looked from the point of view of the entire continent has a lot of ingredients that have contributed to its underdevelopment.

     For example, the continent has many small landlocked countries which often brings high transportation costs, there is little cohesiveness when it comes to governing and policies, the decent agricultural land is often patch and climate conditions often bring low rainfall as well as the increased probability of drought (Newcomer, 1972). These correlations despite not being the exact causation of the poverty that exists in Africa have a very large role to play (Wu, 1995).

There exists a very deep relationship between the poor economic growth in Africa and the massive unfavorable variables which directly or indirectly influence lack of development. Therefore, environmental determinism incorporates factors of environment in trying to explain why there is difference in development from place to place. The theory puts into focus the role of nature and geography when it comes to the distribution of growth as well as development.
      
    References 

Diamond, J. M. (1998). Guns, germs, and steel: The fates of human societies. New York: W.W. Norton & Co.
Wu, J., & Loucks, O. L. (December 01, 1995). From Balance of Nature to Hierarchical Patch Dynamics: A Paradigm Shift in Ecology. The Quarterly Review of Biology, 70, 4, 439-466.
Van, S. L. (2008). 'The Ornithorhynchus of the Western world': Environmental determinism in Eric Anderson Walker's South African history, 1911-1936. South African Historical Journal, 60, 1, 7-40.
Newcomer, P. J. (1972). The Nuer are Dinka: An essay on origins and environmental determinism. Man, 7, 5-11.




The Affordable Healthcare Act


The provision of the best healthcare services is one of the main goals of any government. Healthcare refers to prevention, management and treatment of illness and the preservation of both mental and physical health. This is done be ensuring the provision of the best medical services to all the citizens of a nation. In almost all the nations of the world, the governments strive to provide the best medical services to all citizens (Gruber, 2011). The policies enforced are aimed at ensuring that the public is kept safe from all the avoidable and unavoidable illnesses. At times, this proves to be a challenge especially in the third world nations with a larger population, languishing in poverty.

The main reason why governments all over the world strive to provide the best healthcare policies is because; the progress of a nation will proceed much faster if the larger part of the population is health. There are a couple of things that healthcare reforms try to achieve. The first being the decrease in the cost of health care to the citizens. Second, the improvement of services and quality of health care and offer more care to the citizens. The third reason is the improvement of access to healthcare by citizens. Another reason is the increase of healthcare providers that gives the citizens have a wide range of variety for selection.

The last reason for the healthcare reforms is to improve the access of the citizens to a healthcare specialist. This is very important when it comes to illnesses that can only be handled by specialists. The types of healthcare reforms differ from one nation to the other, and certain factors are put into consideration before the methods can be put in place. The most important factor is the population of a nation. For a nation with a smaller nation, it might be easier to contain the healthcare situation compared to a nation that has a very large population. The assessment of the poverty level is also very essential to the government. It aides come up with a rough figure of those who can cater for their own healthcare needs. Also, for those that struggle in poverty and need the assistance of the government. Healthcare insurance is the most common and preferred method of healthcare reforms in most nations.

The case is the same in the United States healthcare history. Healthcare reforms have been the cause of political debate in the United States ever since the 19th century. In the United States, the main issues under the healthcare reforms include; access to healthcare, right to healthcare, sustainability and equality of the healthcare system and the cost or spending of the government in healthcare. United States public-private healthcare system tops the list of expensive private healthcare systems in the world. The amount that is spent on healthcare per person is relatively expensive, and no other country matches up to these standards (United States, 2012).

Except for East Timor, the US spends a larger portion of its Gross Domestic Product on healthcare compared to all other member countries of the United Nations. Despite the spending on healthcare in the United States being higher than all other members of the United Nations, the Commonwealth Fund Report of 2008 reported that the nation ranks among the last countries in the provision of healthcare services. The report was done in comparison to the fellow developed nations.

This leaves behind two very crucial questions; How come the United States spends so much in its healthcare and still lags behind in the provision of healthcare services? What should be done to enhance that the public has access to the best healthcare services since the government is already spending too much? Truth is that the United States compared to other developed countries lags behind when it comes to infant mortality rates and life expectancy (Vivar, 2011). A large part of the population is underinsured, with the number amounting to about a quarter of the population.

Another issue is that, those insured have to incur about a quarter of their annual paychecks paying up the insurance, due to the high deductible policies. This has prompted the introduction of new reforms in the healthcare system to try and counter the poor results. In 2010, President Barrack Obama passed healthcare reform system that is popularly known as the ObamaCare. ObamaCare is the unofficial name given to the Patent Protection and Affordable Care Act that was signed on March 23, 2010. On June 28, 2010; the act was approved by the Supreme Court. Seven days later, the President also signed the Health Care and Education Reconciliation Act of 2010 on March 30.

The two acts can be termed as the progress of endless efforts of the 11th Democratic Congress in conjunction with the Obama government. The implementation of these two acts came at a time that the healthcare system in the United States was under too much pressure. The government had to come up with reforms that will transform the healthcare system (Tate, 2013). The reforms being aimed at achieving the trust of the public and retain the international image that the healthcare system had lost. This paper will focus on the Patent Protection and Affordable Care Act and the possible implications of the law.

The history of the emergence of the ObamaCare, however, is traceable to the 2008 national elections. The president put healthcare support as one of the issues he would take care f once he got into power. His plan was to provide subsidies and at the same time rejected the use of the individual mandate. After his election, President Obama in February 2009 made his intention of working with the congress to formulate a healthcare plan for the public. The formulation of the bill took about thirty one meetings before the members could agree. The main democrats behind the implementation of the act convinced the president to have the inclusion of the individual mandate.

Most people, however, do not understand the real terms behind the Obama Care and what the Act approves and condemns. The Obama Care in a much general explanation is a healthcare reform that is aimed at; reducing healthcare spending in the United States and offer all Americans access to quality and affordable healthcare services. Most people go wrong by assuming that the healthcare system is aimed at replacing the already in place private medical insurance systems like Medicare and Medicaid (Pratt, 2012). This, however, is one of the many misconceptions associated with the Affordable Care Act. The act is aims at offering affordable healthcare to all the American citizens just like its name.

The implementation of the Affordable Care Act is a significant milestone in the provision of healthcare systems. This is the largest law ever passed since the approval of Medicaid and Medicare in 1965. The Affordable Care Act includes ten titles that spread over a thousand pages, with most of the key provisions being included in the first title. The first title contains a total page count of about 140 pages. The law is divided into several parts depending on the implementation of the provisions (Turner, 2011). Some provisions became effective immediately after the act was passed into law, ninety days after the enactment, and six months after enactment. The enactments roles up in phases up to 2020, which by then all the provisions are supposed to have been implemented.

There are some main clauses that if one understands, it would be very easy for one to understand the Affordable care Act. The first is the individual mandate; under this mandate, each citizen as an individual has a part to play in ensuring the change of the healthcare system. Every individual must, therefore, find an insurance plan before 2014 or be eligible for a penalty. The employer mandate demands that employers find an insurance cover for their permanent employees by 2015. The Affordable Care Act also creates marketplaces in states for the purchase of insurance plans. These market places are an option of those that do not want to be included in the Medicare expansion.

Before people start criticizing the Affordable Care Act, people need to understand the law first. The act includes several provisions that are set to take place between the periods of 2010 to 2020. The policies that were already issued before 2010 remain in place and are protected by a grandfather clause, but this only last until 2015 (Pipes, 2010). This ensures the insurance standards are exempted from most of the reforms though there are some that touch them. There are significant reforms that are supposed to take effect as of January 1, 2014. These provisions are the main important ones in the Affordable Care Act, and that is why they are at the top list of preference.

The first provision aims at the prohibition of insurers from denying citizens insurance cover due to pre-existing conditions (CCH Incorporated, 2010). This is under the terms of guaranteed issue; therefore, an individual can sue the insurance company that denies him/her the right to insurance due to their condition. Insurers are also supposed to provide the same rates or premium price to those who may apply from the same geographical location and age. Gender or pre-existing conditions should not be used to determine the premium rates. However, there is an exclusion which allows the use of only tobacco as a pre-existing condition that can be used to determine the rates.

The Affordable Care Act requires the establishment of the minimum standards for the health insurance policies. The new standards include the ban on the power of insurance companies to let go of policy holders in case they get sick. There is also a ban on the discrimination when it comes to premium rates on factors like gender and pre-existing conditions. The new insurance policies also give children the benefit of depending on their parent’s insurance cover until they are twenty six years of age. After attaining this age, they are supposed to create their own insurance plans since at this age one is not a child anymore.

Under this rule provision, Kathleen Sebelius, the Secretary of Health came up with essential health benefits that all insurance companies have to provide. The insurance companies were, however, prohibited from issuing lifetime or annual charges on the defined essential health benefits. The defined essential health benefits include; emergency services, maternity and newborn care, hospitalization, behavioral health treatment, laboratory services, mental and substance abuse treatment, prescription drugs, chronic disease management, oral and vision care and pediatric care (Gruber, 2011). However, there are a set of the essential benefits that are meant to be covered through an insurance plan’s premium. They include; immunizations and vaccinations for children and adults, medical screening and preventive care.

There are four insurance plans; bronze, silver, gold and platinum. The four plans aim at ensuring there is an insurance plan for everybody; from those earning the lowest amount to those at the high class taking hefty salaries home. The bronze plan offers the lowest premiums while the platinum plan offers the highest premium rates. The insurance companies are expected to spend about 80%-85% of the premium amount on healthcare rather than administrative costs and profits.

Under the Affordable Care Act, every individual is expected by the government to be under an insurance plan. Therefore, if one is not covered by Medicaid, Medicare, a healthcare sponsored by the employer or public insurance system; the government makes it mandatory for individuals to look for an appropriate private insurance cover. If one does not adhere to the law, it makes them eligible to pay a penalty. The only exceptions to the penalty are that if one, they can prove that they are experiencing financial hardships and, therefore, cannot afford an insurance plan (Pratt, 2012). The other exception is if one belongs to a religious group that is exempted from this provision by the Internal Revenue Service.

If the least expensive premium rates would exceed eight percent of an individual’s income, then they are exempted from the penalties. The other group that can also be exempted are individuals who US citizens who also qualify as citizens of other nations. This would be under the provision known as the foreign earned income exclusion rule provided by the Internal Revenue Service. For those that experience financial hardships, the government can offer them subsidies that will help them find a working and suitable insurance health plan. Those who fail to pay the penalty cannot be arrested because it is not considered as a federal felony. However, the Internal Revenue Service has the power to withhold their future tax refunds.

The exchanges or marketplaces for health insurances exchanges provide the public with an open forum to view the various insurance policies, comparing the various premium rates. After selection, an individual can purchase an insurance policy with a government subsidy if this is allowed at the exchange. Every state has its own places where the marketplaces for purchase of insurance policies are held. The first exchange runs should have started on October 1, 2013 to March 31, 2014 and those that will have successfully purchased their insurance plans by December 15 can start using them by January 1, 2014. In the years that follow, the exchange rate will always open on October 15 and end on December 7.

The advantage of these exchanges is that those individuals or families that have low income have a chance to own an insurance plan. The government avails itself to offer subsidies to individuals or families that are living between 100% and 400% of the federal poverty level. However, they are only eligible for the subsidies if they purchase the insurance plan via the exchange forum (United States, 2012). For individuals or families who happen to be in the range of 133% to 150% of the poverty level, their premium costs will only consume an average of 3% to 4% of their income. Small businesses are also eligible for subsidies but under different terms.

The law also expands the eligibility of individuals and families to Medicaid; that is up to 133% of the federal poverty level and adults without dependent children or disabilities. There provision includes a five percent termed as an income disregard percentage. This rises to eligibility to Medicaid to 138% of the federal poverty level. In this provision, the enrollment to the State Children’s Health Insurance Program is simplified. This program is an affiliate of the United States Department of Health and Human Services (Washington Post Company, 2012). Its main aim is the provision of insurance cover to families with children; especially the uninsured children who belong to families that earn a modest income that does not, however, qualify for Medicaid.

The reforms in the Affordable Care Act aim at changing the method of payment involved when an individual is paying for the health services they receive. The medical reimbursements aim at encouraging the payment services in one bundle rather than individual payments paid to the individual service providers. For example, if one gets their hand fixed, the provision prefers the payment of all the services that have been offered to the patient as one bill. Rather than separately paying the physician, the nurses and then the hospital last.

For businesses that have an employee capacity exceeding fifty, there is the need of the offering of health insurance to their full time employees (Vivar, 2011). Failure to do so will lead to a business having to pay a tax penalty especially if the government has already subsidized the employees healthcare through deductions. This is referred to as the employer mandate and the provision in July 2013, was delayed for one year by President Obama. If a business has about twenty five permanent employees, the employer is eligible to tax breaks and tax credits that will ensure the employees receive health insurance. Obama Care also exempts individuals that make less than 200,000 dollars and 250,000 dollars annually for a family or a small business, from the tax levies under the law.

Through the provisions above, the law looks at accomplishing its main goal; reforming the healthcare sector and ensuring the government funds are spent in the right forum. For a very long time, the healthcare system in the United States has been a profit industry for insurance companies at the expense of the system. The system has been biased, and only those that can afford expensive insurance plans are able to access quality healthcare. Those who do not have the financial capability have no option, but to run to Medicare or Medicaid policies. This, however, has a restriction and patients can only get cover during emergency situations; not any other normal checkups. The Obama Care aims at expanding the coverage of healthcare to the bigger United States population, and providing quality medical care services (Tate, 2013).

There are various misconceptions that the public has about the Affordable Care Act. First being that every individual has to shop for a health insurance policy using the marketplace even if one has a job that has benefits. However, this is not the case because most employees have insurance cover at their place of work. This means that such employees do not need to purchase an insurance policy at the new marketplace. However, if one is not covered under the employer’s insurance policy, there are two options. One is to purchase an insurance policy at the market place, one that goes along with an individual’s income. The second is to be incorporated in the insurance policy being offered by the employer. This is a provision that is provided for by the Affordable Care Act (Pipes, 2010).

The second misconception is that if one purchases an insurance policy at the marketplace they end up paying the full amount. An average of abut forty eight million United States citizens will need to purchase insurance policies or enroll at Medicaid. Almost 40% of the uninsured people will qualify for federal subsidies. The federal subsidies will reduce the amount payable for the purchase of an insurance policy. The expansion of Medicaid will also ensure that those uninsured qualify for the benefits under the policy. The Medicaid expansion is, however, only accessible to individual who earn less than $15,900 and families of four earning less than $32,500.

The best part of those getting the opportunity to the expansion of the Medicaid is that; for the first three years, the government will cater for the full enrollment cost. Anyone who does not have an insurance plan already in place at this time of the year is at risk. As of 2014, anyone who does not have an insurance plan will pay a penalty. The penalty is ninety five dollars or one percent of an individual’s income which will amount to a larger amount. So if an individual takes home an average of $75,000 annually, the amount they should be ready to part with $750.

There is, however, a group of people that will remain uninsured even after the passing of the penalty next year. The first group is the over eight million illegal immigrants living in the United States. This group is ineligible to subsidies and Medicaid and also exempted from the health insurance mandate. The immigrants are, however, eligible for emergency services in case of emergency situations (Turner, 2011). The other group is citizens who decide not to be enrolled to Medicaid despite being eligible for enrollment. There is also the larger percentage of single and young Americans, who prefer paying the annual penalty rather than signing up for an insurance policy. The last group who will remain uninsured are the citizens who live in states; that have taken up the decision not to engage in the Medicaid expansion.

The impact of the Obama Care in the healthcare system, in the United States, can be termed as tremendous ever since the Act was enacted into law. The biggest impact has been felt by the insurance companies that have had their activities monitored and regulated. This is done to ensure the public receive what they deserve. This has seen the creation of provisions that ensure that even those living below the federal poverty level are able to have an insurance policy at hand. This is despite the common trend that has been there in the past. The insurance policies have only been available to those who can pay expensive premiums in the past.

The other groups of people that will also suffer under the Obama Care are the seniors. The seniors have for a long time had an upper advantage and enjoyed the Medicare advantage. Medicare is the most common private healthcare options that are preferred by the rich and well off. Obama Care seeks to end this and the law comes along with very expensive charges to the program (CCH Incorporated, 2010). The tax increases affect the high earners and larger businesses compared to the low income earners. There are also tax credits aimed at subsidizing the cost of low income earners and small businesses to purchase an insurance claim. The increased cost of taxes for the high earners is used to cater for the tax credits used on the low income earners. This leaves behind the question whether the Affordable Care Act is out to burden the high income earners.

Another group that will gravely be affected by the Affordable Care Act is the drug companies. This is due to the creation of new taxes that will affect the drug companies and medical device makers. The new taxes for drug companies amounting to 27 billion dollars while the medical device makers having to cough 20 million dollars in tax. Physicians have not also been spared, and there are new reporting requirements and regulations imposed on them. This will make healthcare services expensive and difficult to access especially for seniors. This makes it seem like the law was aimed at favoring the low income earners at the expense of putting oppressive tendencies to the high income earners.

The increase in taxes brought about by the Affordable Care Act also affects the taxpayers in a very significant way. In the period of 2010 to 2019, the estimated cost that taxpayers ought to incur is 503 billion US dollars. The tax hikes in the law will, in fact, increase raise the taxes payable by the middle income earners. This will end up being a violation of something that the President’s Obama government had sworn not to violate. The delays by the President and the congress have shown that there is reluctance in the government to pass these taxes. This goes a big way to prove that the fear that the taxes might force the nation into increasing the deficit. This again will be a break of another promise that the President’s government had made (Coulter, 2012).

These tax hikes will end up reducing employment, suppressing the wages and slow economic growth. The loss in employment is projected to affect mainly the middle and low income earners. This is because their small incomes cannot sustain their needs and also pay up the increased tax rates. This puts into jeopardy the effectiveness of the Affordable Care Act. Calculations show that, in the long run, the law may end up causing more problems than benefits. There are some negative implications already being felt by various sectors in the economy. There is also the fear that the law may not be in existence for the time it was stipulated.

Since the amendment of the Affordable Care Act, several companies have already or are projecting to incur higher tax costs as of next year. An example is the Delta Air Lines, which projects that its healthcare costs will rise to about 100 million US dollars from next year. In the first year of the passing of the Obama Care, the Caterpillar Incorporation also projected a similar increase in 100 million dollars of its healthcare costs (Turner, 2011). The SeaWorld Company used to have most of their part time employees work up to 32 hours per week. However, the company has been forced to reduce this to 28 hours per week.

This is because the Obama Care only allows the company to offer insurance cover if the threshold does not exceed 30 hours. This has greatly affected the company considering that about 80% of the company employees are either part time or seasonal. The Smith and Nephew, a British Company, informed its workers in Massachusetts and Tennessee that they would be laid off. The nearly 100 workers would be laid off in an aim of containing the costs that the company has to take up due to the tax on medical devices. Hospitals have not also been spared by the negative effects that have resulted due to the implementation of the Obama Care.

The Cleveland Clinic in Ohio happens to be one of the world’s best known hospitals. In September, the hospital management made a press statement that it was considering reducing the number of employees in the facility. It would also reduce its annual six percent of its annual six billion budget. This is to have the ability to pay up the cost that associated with the Obama Care. The Clinic is the largest in Ohio and also a very large employer attaining the second position with forty four thousand employees. The Orlando Health Hospital also announced the cutting down of about four hundred jobs. The areas of those said to lose their jobs ranges from the administrative sector to the children’s sector.

The different state government and institutions have also not been spared. In the township of Middleton, New Jersey, the working hours of twenty five part-time employees, have been cut down (Pipes, 2010). In its defense, the authority of the town claims that if they do not reduce the working hours, the expensive cost of insurance will be passed to the public. In the state of Virginia, the general Assemble accepted the Governor’s, Bob McDonnell, decision to cut down the working hours of the part-time workers to 29 hours per week. The director of Brevard County, Florida, announced that the larger group of over 300 part time employees would have their working hours slashed. The part-time employees would now have to work for less than 30 hours to avoid the about 10,000 US Dollars expected to be paid per employee in the health insurance policies.

There are already numerous complaints from the public against the implementation of the Affordable Care Act. This is especially from the middle and low class society who fear the implications of the law. President Obama had made a promise that the implementation of the Obama Care would not affect those earning below 250,000 US Dollars. This might end up not to be the case, however, since the increase in taxes may end up affecting the middle and low class. This might not be direct, but the effect will surely be passed on them eventually breaking a promise the president’s government promised not to break. The effect of the law is even being felt by the government institutions and state government which raises very many questions about the future of the Obama Care.

The Obama Care does not seem like it will sustain the test of time after President Obama’s term ends. This is because of the negative impacts that have associated the act ever since its enactment. Though the act is a transformation of the healthcare system, there are various negative aspects that have come with the law that the government had not anticipated. The government might be forced to change some few aspects of the law to enable gain the approval of the public (Ross, 2013). The earlier the government can do this, the better before it becomes too late. The changes should try and reverse the measures that have been taken by the state and other institutions in the reduction of working hours for the temporary workers.

The new imposed taxes are another issue that should be considered for change and amendment. This is especially the increase in taxes in the drug companies and medical care services providers. An increase in taxes to the two groups is being shifted to the public and, therefore, an increase in taxes that the public has to pay. A change in these tax increases would save the American economy of sinking into a great deficit. This would also save the public the amount of 503 billion US dollars expected to be incurred in taxes by the year 2020. The low and middle class will also be saved from unemployment in the move. This seems as the only way the government can regain the public approval when it comes to the Affordable Care Act.

The law might end up losing the trust of the public and risk being vetted out if no change is done. President Barrack Obama should be keen to make sure the changes in the law keep the promises that he made to the public who elected. Otherwise, he will end up leaving a very bad legacy when his term expires. That of a president who could not keep his promises like other past presidents. The history books will obviously portray a picture of him as a failed leader. Therefore, the Affordable Care Act should have some of its provisions changed. This is to ensure the law brings out the best of the healthcare system to all the American citizens without discrimination and oppression of some (Pipes, 2013).

The Affordable Care Act has faced a lot of political disapproval since the first stages of the formulation of the law. This is because of the century old rivalry known to be between the two major political parties in the United States; the Democrats and the Republicans. The republicans were against the implementation of the individual mandate in the bill. The republican senators who had actively been included in the formulation of the bill started claiming it as unconstitutional due to the inclusion of the individual mandate. This is because, in his campaigns president, Obama had promised not to include the individual mandate in the bill. To the republicans, the view that every American must purchase an insurance policy was conservative thinking.

The Affordable Care Act also faced a lot of oppositions from various lobby groups in its stages of creation and implementation. These are the same groups that led boycotts against the healthcare reforms proposed back in 1993. They were now backed by the advocates who also viewed the Obama Care as unconstitutional. Over the August 2009 summer recess, several movements held organized debates and demonstrations. In the debates, the members were asked their consideration about the Obama Care and the bigger percentage of them were against the bill. The movements even went a step ahead to threaten members of the congress who were advocating the Affordable Care Act. On November 7, 2009, the House of Representatives passed the Affordable Care Act on a vote of 220-215, and it was, therefore, passed to the senate.

In the senate, the case was not different, and the bill erupted many debates. The senate was, however, a little more effective, and it changed and modified some of the clauses that were under the bill. The struggle to keep the bill was, however, replication of what had happened in the House of Representatives. The battle between the Democrats and the Republicans was far from over with every side trying to pull as much as they could. The Democrats, however, emerged successful after a vote count of 60-39 on December 24, 2009. This, however, did not prove to be the end of the battle between those advocating the law and those against it (Pipes, 2010).

Even after the implementation of the Affordable Care Act, there have been several groups that are still trying to bring the law down. The act has even eluded an international outcry from International Activists Groups and the media. Most condemning the Obama government for passing a law that does not fulfill what it promises. The main concern being that the low and middle income earners that the Obama Care seems to have their interests will end up suffering more (Torinus, 2013). The President’s government is under too much pressure not only from the international community but also from within the government. The congress has to figure out ways to contain these complaints from all over or face the consequences which might be severe.

In the government, there have also been various attempts to bring the law down since its implementation. This shows that the leaders who vetted for the law in the first place do not approve of it just a few years later. This raises the credibility of the success of the Affordable Care Act when it is completely implemented. The fall out points out the fear of the failure of the Obama Care, and the possible consequences that the Americans will have to bear. Such measures go along to show that this law is not here to stay. If at all, its existence is being jeopardized by the same people who created it, this means that, in the near future, the law will be completely faced out and forgotten (Ross, 2013).

The Affordable Care Act has had to face several unsuccessful repeal efforts by the Republicans. The 111th, 112th and 113th congress houses have all come down very strongly when it comes to the Affordable Care Act. In 2011, the republicans passed a repeal motion against the Affordable Care Act which they won on a vote count of 254-189. A Supreme Court ruling last year, however, proved the Affordable Care Act as constitutional. After the court ruling, the Republicans held another vote to repeal the law on July. The House of Representatives had 239 votes of the Republicans which included five votes from the Democrats. This was the 31st repeal attempt by the republicans, but their efforts deemed useless after the re-election of Obama in 2012 with the larger Democrats consisting the majority of the senate.

In conclusion, the Obama Care is a very good idea and a major milestone in the American Healthcare reforms history. The genesis of the act being the provision of better health care services even to those who earn middle or low incomes. The act also aims at the abolition of some bad practices that the insurance companies have including; dropping off their members when they fall ill due to pre-existing conditions and the discrimination due to gender (Gruber, 2011). The law, however, in its full implementation might cause some unexpected results. These results include; increase in the national deficit, increase in tax rates, loss of employment and wages and a lag in the development of the American Economy (Pipes, 2013). Therefore, the government needs to jump swiftly in action and change the clauses that will bring the negative effects. Though, it is proven to be impossible to come up with a perfect bill, the act should have many benefits and few unavoidable bad outcomes (Torinus, 2013).

References

CCH Incorporated., & Wolters Kluwer (Firm). (2010). Law, explanation and analysis of the Patient Protection and Affordable Care Act: Including Reconciliation Act impact. Chicago, IL: Wolters Kluwer Law & Business.
Coulter, A. (2012). Mugged: Racial Demagoguery from the Seventies to Obama. S.l.: Penguin Group US.
Gruber, J., & Newquist, H. P. (2011). Health care reform: What it is, why it's necessary, how it works. New York: Hill and Wang.
Pipes, S. (2013). The cure for Obamacare. New York: Encounter Books.
Pipes, S. (2010). The truth about Obamacare. Washington, DC: Regnery Pub.
Pratt, L. L. (2012). Let's fix medicare, replace medicaid, and repealthe affordable care act: Here is why and how. Bloomington, Ind: AuthorHouse.
Ross, B. M. C., & Ross, B. M. C. (2013). Beating Obamacare: Your handbook for surviving the new health care law. Washington, D.C: Regnery Pub.
Tate, N. J. (2013). Obamacare survival guide.
Torinus, J. (2013). Opt Out on Obamacare, Opt Into the Private Health Care Revolution. New York: BenBella Books, Inc.
Turner, G.-M. (2011). Why Obamacare is wrong for America: How the new health care law drives up costs, puts government in charge of your decisions, and threatens your constitutional rights. New York: Broadside.
United States. (2012). Examining the impact of Obamacare on job creators and the economy: Hearing before the Committee on Oversight and Government Reform, House of Representatives, One Hundred Twelfth Congress, second session, July 10, 2012. Washington: U.S. G.P.O.
Vivar, L. M. (2011). Obama's health care reform 2010: From change to concession?. S.l.: GRIN Verlag.
Washington Post Company. (2010). Landmark: The inside story of America's new health-care law and what it means for us all. New York: PublicAffairs.





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