The future of the Affordable Care Act or Obamacare is in question. Republicans seem set on overturning this law that requires Americans to buy private health insurance. The irony is that Obamacare was first conceived back in 1989 by the Heritage Foundation, a conservative think tank, and later supported by many GOP leaders in the early 1990s when they were opposing Hillarycare. Here’s a short list of just some of those GOP supporters – President George H. W. Bush, Vice President Dan Quayle, Newt Gingrich, Bob Dole, Arlen Specter, Orrin Hatch. Back then Republicans were of the opinion that individuals had the responsibility to buy insurance for themselves so that they weren’t a burden to others in society. The Heritage Foundation’s health system idea gained so much support from Republican Governor Mitt Romney of Massachusetts that it became the foundation for his Romneycare, which was signed into law in 2006 and has made the cost of healthcare in Massachusetts more expensive than in any other state.
Here’s what the Heritage Foundation plan, Romneycare and Obamacare all have in common: the requirement that everyone have private insurance or pay a fine, which the Heritage Foundation called a ‘Health Care Social Contract’; the establishment of a consumer led and market driven health insurance exchange where people can go to find the best insurance policy; subsidies for low income earners to help them buy their own insurance. Since the introduction of Obamacare the likes of Newt Gingrich, Mitt Romney and Orrin Hatch have been loud vocal opponents of it and have called for its repeal. Considering how much they previously supported the Heritage Foundation plan, their opposition to Obamacare is nothing more than a crystal clear example of partisan politics at play.      
Now that we have looked at a bit of the history leading up to Obamacare, and the hypocrisy of some very influential Republicans, let’s look at what this health system does and does not do for the American people.
In addition to the controversial requirement that people must buy health insurance or pay a penalty tax, that there is a competitive marketplace for private insurance and that those on lower incomes are subsidised, one of the biggest changes to the previous health system in America, and one that just about everyone would agree has been a very good change overall, is that no one can be denied health insurance. This has meant that many Americans who were not able to get insurance due to pre-existing conditions such as cancer, diabetes, asthma, mental illness, heart disease, epilepsy and pregnancy (yes, even pregnancy) have been able to purchase a private insurance plan. As at least one in four Americans is considered to have a pre-existing condition, if this one part of Obamacare were to be repealed, the Kaiser Family Foundation estimates that 52 million people could lose their health insurance. Fortunately for those who could be denied health insurance, it appears that even many Republicans do not want this part of the Affordable Care Act to be overturned.
Obamacare has also given grants to states to enable them to expand Medicaid to the poor and those on a low-income, though nearly half of all states, mostly Republican led, have refused these grants. It’s allowed young adults up to the age of 26 years to stay on their parents’ insurance plan, provided preventative care checks at no additional cost, required employers with 50 or more employees to provide health insurance for their employees, and enabled those on Medicare to pay less than full price for their prescriptions.
To help pay for this, Obamacare has also increased taxes for individuals earning over $200,000 per year and couples earning over $250,000 per year, something the Trump Administration would very much like to change.
Despite the fact that many more people now have health insurance than before Obamacare was enacted and Obamacare has been a lifeline for many, approximately 29 million people remain un-insured and close to 30,000 Americans die each year because they cannot afford medical treatment. Additionally, healthcare costs have soared and the average family now pays $18,142 per year for their insurance plan. On top of this other costs have been rising too e.g., the deductible cost paid by the average worker now amounts to $1,221 and the cost of prescription medication continues to rise. I find it very telling that an EpiPen in the US costs $300, while that same EpiPen in New Zealand, which is not covered under the government prescription drug scheme, costs NZ$120 or approximately US$86. 
All the while that the American people have been paying more and more for health insurance, medical care and medication, even Republicans admit that the insurance companies have been laughing all the way to the bank. In a debate with Bernie Sanders, Ted Cruz discussed how the 10 largest insurers have seen their profits double since 2008. In 2015 the profit of these 10 companies amounted to $15 billion. Not only are the insurers charging their customers more, they are also raking in billions of dollars through government subsidies. When those on middle to lower incomes cannot afford to pay for their insurance or out of pocket expenses, the government assists them through either tax credits or subsidies. This money then makes its way back to the private insurance companies, so it’s really just a form of corporate welfare.  
Based upon the failings of Obamacare, the Republican argument is that any sort of government health initiative is bad and costly, but Obamacare is a private healthcare system with some government regulations. It was written by corporate lobbyists for the benefit of the private insurance industry. How else could they be making such record profits by charging the highest premiums and deductibles yet offering fewer services, while at the same time getting handed billion of dollars by the federal government? Even though health insurance premiums doubled when George W. Bush was president, one hears very little talk of this. The point is, healthcare costs were going up well before Obamacare came into effect. In fact they have been increasing steadily since the 1960s. Back then healthcare costs were only about 5% of GDP, whereas today they amount to over 20% of GDP. No one really knows what the Trump Administration will come up with to replace Obamacare, but it is pretty evident from what’s been said so far that they will try to fully privatise healthcare. From what we’ve seen from Obamacare, this will only further increase costs, as private systems are driven by one thing alone, profit, not health.
Unfortunately, the Obama Administration silenced those who were fighting for evidence based healthcare reform. Had those who have knowledge of how public healthcare systems work in the rest of the industrialised world been allowed to speak, rather than the thousands of corporate lobbyists, lawmakers would have heard how these single payer healthcare systems are not only more efficient and far less costly, but they also cover just about everyone. 
This is a subject that touches me personally. One of the reasons we left the United States was because we could not afford private health insurance. When living there we always dreaded what might happen if one of us landed up in hospital, as we couldn’t figure out how we would pay the bill and we didn’t want to be like the tens of thousands of Americans who have to file for bankruptcy every year due to unpaid medical bills. Coming to New Zealand has meant that we have a government run health plan. Is it perfect? No it’s not, and the efforts of recent conservative governments to try to privatise the system by cutting funding are not helping. But this said, it is far better than what is in the States. Here’s a rough overview of how the public health system works for us here in New Zealand. Doctor’s visits are free for those under 6, cost about $32 for those 6 to 18, and about $45 for adults up to retirement age when the fees are lowered. The poor and those on a low income pay less. If one is injured in an accident, treatment is covered for free, and if one is hospitalised that too is free. Prescriptions bought in bulk and subsidised by the government are $5 each, and other prescription medication tends to cost far less than what it costs in the States as my example of the EpiPen above proves. In fact, there was an American lady sitting in the waiting room at our doctor’s office a few months back who was remarking about how affordable her prescription medication is here compared with the States. She only paid $5 for the same prescription that cost her over $100 in the US and she has private health insurance. I’ve also spoken with a number of American doctors who’ve moved here. They say that though far less money is spent on medical care in New Zealand, the patient outcomes are the same as in the States. This is due to the fact that fewer unnecessary procedures are carried out and there is far less bureaucracy. All this goes to prove that government run systems are more efficient, less costly and still provide good care to citizens.
In the States one quarter to one third of all medical costs come from administration fees and a further 25% from carrying out unnecessary procedures. Both of these are aimed at getting more money from patients for the benefit of the private health sector, not for the purpose of helping the sick or those in need. 
The facts are these, Obamacare is better than what was in place before it came into effect in the sense that more people have received medical care and there are no longer any lifetime limits, however, it has many faults. Repealing and replacing it with a fully privatised system would be a major step in the wrong direction. This said, Democrats must stop trying to fight for a failed system that puts profits before people. If the Democratic Party is going to be true to the American people and actually represent them and not the health industry, then they are going to have to stand up to not only Trump and his cronies, but also the corporate lobbyists. If the Democratic Party refuses to do this, which I believe it will, it will be a failed party that the people must no longer support. The pharmaceutical companies and the insurance companies have far too much power in the States and everyone else pays for their greed. Americans deserve better. They deserve to have access to good and affordable healthcare and this must be seen as a human right, and not left up to the whims of the free market.