MIAMI (CBS4) – Next Tuesday millions of uninsured Americans will have access to health insurance.

With the start of the new year, having health insurance will be mandatory under the Affordable Care Act.

In this, the second installment of CBS4’s Healthcare 101 series, David Sutta takes a look at the impact that the ACA will have on healthcare.

Simply put the movement to insure all Americans is founded in money. Healthcare has gotten so expensive that without doing something it would (some would argue has) be unattainable.

In 2012 the United States spent nearly 18% of our money on healthcare. That’s the most on the planet, twice what is spent in the United Kingdom and Japan. In fact Americans spend more on healthcare than food and housing combined.


There are number of reasons but including the fact we are living longer, technological innovations are costly and demand for services is increasing.

At the same time some would argue statistically we do not necessarily have the best healthcare in the world.

We’re 33rd in the world for life expectancy. Nearly 70% of Americans are overweight which is contributing to skyrocketing rates of diabetes and cancer. A study done in 2005 found the United States has the highest rate of medical mistakes in the world.

The ACA is an attempt to rein in costs and hopefully improve healthcare. Many in the medical community are skeptical.

Dr. Olveen Carrasquillo with the University of Miami’s Miller School of Medicine told CBS4 “I think the major concern is you are going to have a lot more people being insured and whether we can meet that demand with the existing physicians supply.”

Doctors are not only expecting a rush of new patients, but existing patients are expected to come in more often. Co-pays for preventative checkups are being eliminated.

Which brings us back to where we started – money.

“There are some doctors that are very concerned how will this pay? Will our pay go down? That’s one concern. Other doctors are concerned that this means that the federal government is going to have more rules, more regulations,” Dr. Carrasquillo said.

Overall the medical community is concerned about the unknowns. Change is always difficult, especially when it affects your income.

Dr. Carrasquillo believes whatever happens, they’ll likely adapt.

“When Medicare got implemented in 1965 a lot of doctors were extremely concerned. It was a new change. It was big and many doctors were very opposed to it. Within two years they saw much more number of patients, increased revenue and they all were extremely happy and they said ‘Why did we fight this? This has been very good for us’,” said Dr. Carrasquillo.

Time will tell if this is history repeating itself. Already we know there are not enough nurses in the pipeline. For years we have had a shortage of nurses. This is expected to grow that problem. Who knows – maybe our insurance problems will help solve those job problems.

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