The Patient Protection and Affordable Care Act (ACA) has left many Americans questioning what health care reform means for their future. With the Supreme Court ruling that the ACA is constitutional last month, reform will undoubtedly move forward. The 1,900-page bill is far from accessible to the average American and its basic tenets are not always accurately portrayed in the mainstream media. Luckily, economist Jonathan Gruber has come to the rescue.
While the MIT professor may not look like your average comic book superhero in his suit and spectacles, in his graphic novel, “Health Care Reform: What it is. Why it’s Necessary. How it Works.,” Gruber saves the day, clearly and concisely explaining the ACA as well as the impact it will have on individual Americans. As the novel’s two-dimensional narrator, Gruber explains why health care reform came into existence and how it works. Co-authored with HP Newquist and illustrated by Nathan Schreiber, the graphic novel makes one of the most complex and hotly debated political issues in recent years commonsensical and—surprisingly—even entertaining.
From the moment President Obama signed the bill into law in 2010, widespread misinformation left Americans confused. As one of the architects of the Massachusetts health care overhaul initiative of 2006 and a consultant to the Obama administration and Congress during the crafting of the federal plan, Gruber thought it important to clearly explain the ACA to the public.
He explains how heath care reform works by following four imaginary citizens, each dealing with the health care system. One character has employer-provided insurance; another Medicare; a third has self-purchased coverage; and the fourth is uninsured. By comparing what happens to each individual after they suffer a heart attack and survive, Gruber explains the outcome under the current system, as well as after reforms take full effect.
Under the current system, the insured would indirectly pay for the uninsured and all would likely have to deal with future denial of care for a preexisting condition—most of which would be negated by the ACA.
The majority of Americans receive health insurance from their employer or the government, through its Medicare and Medicaid plans. For these Americans, their existing insurance works reasonably well. Premiums may be rising faster than is desirable, but otherwise, these individuals are generally well insured against medical catastrophes. On the other hand, individuals who rely on insurance purchased on their own in the “non-group” market face a marketplace where coverage is expensive and unreliable. Because the majority of Americans haven’t struggled to buying insurance themselves, there has been a general lack of appreciation for a law that will fix these problems.
Gruber also explains the major elements of the law including the individual mandate—the law that requires uninsured individuals to purchase insurance. He outlines how the mandate helps to tackle the enormous task of controlling health costs. In the book, Gruber presents a double headed monster—rising costs and a growing number of uninsured individuals—to be at the core of the problem.
He writes, “As costs rise, more people—many younger and, for the moment, in good health—are opting to live without insurance. And because fewer healthy people are buying insurance, the rates go up for everyone.” Therefore, the individual mandate not only helps to tame the beast, but is critical in expanding coverage without excluding those with preexisting medical conditions.