We have all mentioned in this week and prior weeks discussion that cost of care is not always affordable whether you do or do not have insurance. In thinking about the implementation of the ACA, if insurance coverage was not obtained then financial penalty ensued. So basically (in my area) if you couldn’t afford to pay, you payed, to the tune of up to $285.00 per family in 2014, $325.00 in 2015, and $2085.00 in 2016-2018 (Eibner & Nowak, 2018). How did that make sense? After 2018, the financial penalty mandate was eliminated due to the Tax Cut and Jobs Act of 2017. Per the Congressional Budget office, this mandate elimination is estimated to reduce health care coverage by 3-6 million between 2019-2021 and increase the premiums on the individual market by approximately 10 percent (Eibner & Nowak, 2018). Meaning others payed to make up for the loss in penalty payments. The proposed plan of 2020 by President Trump is looking to allow pre-existing conditions to be a consideration for companies again, which will lead to yet higher premiums and higher rates of uninsured. All seems confusing with much back-and-forth.
Rising health care costs due to new technology, prescription drug costs rising, rise in chronic disease, and high administrative costs are no secret. Cost management needs to come from all angles. Yet it seems no one financially benefiting wants to take the hit. Fifty- nine percent of physician in the U.S. state they are aware their patients have difficulty paying for care services (Laff, 2015). Yet, according to Laff (2015) salary report, “salaries for family physicians rose 10 percent between 2014 and 2015, the fifth highest rate of increase for any specialty.” I would venture to say that it would be a rarity to find a worker in the medical field that would say they feel they are overpaid and willing to take a pay cut to help reduce medical costs and allow more to be insured.
With this class making me more aware of the issues and proposed plans, it surely makes me wonder if resolution is even a possibility, or if the gap will just widen as each new plan that gets put into place just gets overturned by the next in office and more people get lost in the mix. 

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