As health care has finally begun to expand over the past few months, fewer Americans are now without health insurance.
“It could be [on] the order of nine or 10 million in the past year or two. The big trend is that there are fewer uninsured,” Daniel Polsky, executive director of Penn’s Leonard Davis Institute of Health Economics, said.
Polsky is one of many Penn professionals who interact directly with health policy and the legislation that has come out of the Obama administration.
The Affordable Care Act, also known as Obamacare, was passed and implemented in 2010. Although the rate of increasing health care costs has been declining over the past five or six years, only recently have more people obtained insurance.
Perelman School of Medicine professor Jennifer Ruger explained that the government has interacted a lot with the academic community, especially those who do research in health policy.
“The Obama administration is reaching out to academics to provide their research in relation to health policy issues that the Obamacare law is addressing,” she said.
Ruger wrote a paper titled “The Moral Foundations of Health Insurance,” which the government used to defend the Affordable Care Act after it was being contested by the Supreme Court and multiple states.
“What health insurance is doing for people is providing good conditions for health and providing them with a sense of security that is important for people’s well being,” Ruger said. “Avoiding the anxiety and risk of becoming ill ... [and] not having the ability to pay for health care that one needs is really part of what insurance is helping to address in supporting peoples’ health and security.”
While Ruger focuses on the moral and ethical issues surrounding health insurance, Polsky is currently researching the bigger question of whether primary care providers “have sufficient capacity to handle the potential increase in demand in care that may result from health care expansion.”
Polsky worked in conjunction with Karen Rose, a doctor in emergency medicine at Presbyterian Medical Center, to conduct a survey of over 13,000 physicians to see whether they could sufficiently accommodate patients.
“We posed as a patient, and we asked if we could schedule an appointment ... Half the time we had Medicare and half the time we had private insurance,” Polsky said. “Eighty-five percent of the time you could get an appointment if you had private insurance.”
Although there have been challenges in patients getting appointments in the era of Obamacare, Polsky explained that they believe these challenges have always been present and that a change is unlikely to occur.
Wharton professor Mark Pauly researched the desirability of the individual mandate, the requirement that a person obtain health insurance or pay a tax penalty. His work on this concept was picked up by the first Bush administration and its influence has carried over into current policy. Pauly has also researched how people get health insurance through their jobs and how insurance payments vary with income levels.
“In the current arrangement, we overcharge high-risk people, mostly young people, and this is a less desirable way to help out high-risk people because it drives them to try and avoid being insured, which is contrary to the most important purpose of the legislation,” he said.
Although some Penn professors have worked closely with health care issues relevant to Obamacare, they are not necessarily wholly in support of the legislation.
“A system that was less fragmented and didn’t have five different styles of insurance to fill all the holes would be better,” Polsky said.
“I’m a cheerleader for the goal of reducing the number of people who are uninsured ... but I’m not a cheerleader for Obamacare,” Pauly added.
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