The Patient Protection and Affordable Care Act (ACA) of 2010 was a landmark piece of legislation that brought about numerous changes to the U.S. healthcare system. Three key provisions of this act are expanding Medicaid eligibility, providing subsidies for those buying insurance on marketplaces, and prohibiting insurers from denying coverage based on preexisting conditions (Ruzek et al., 2020).
Of these three provisions, I feel the prohibition against denying coverage due to preexisting conditions has had the most significant impact on the US population. Prior to this provision being put in place, many individuals with chronic health conditions were unable to obtain health insurance due to their medical history (Kaiser Family Foundation 2018). This caused many people with costly diseases like cancer or diabetes – who needed ongoing care – to be left in a financially precarious situation since they could not receive financial help through private insurance plans. By eliminating this practice, millions more have been able secure access to quality care while also reducing skyrocketing out-of-pocket costs associated with treating serious illnesses (Lichtenberg & Fung 2019). Therefore, by protecting individuals with pre-existing health issues from discrimination while simultaneously increasing access to affordable healthcare services, the ACA has created an environment where all citizens can enjoy greater peace of mind when it comes managing their own health concerns.
is leads to question of what qualifies to be a combatant, and whether it is lawful to kill each other as combatants. Combatants are people who are involved directly or indirectly with the war and it is lawful to kill ‘to shelter the innocent from harm…punish evildoers (Begby et al (2006b), Page 290).However, as mentioned above civilian cannot be harmed, showing combatants as the only legitimate targets, another condition of jus in bello, as ‘we may not use the sword against those who have not harmed us (Begby et al (2006b), Page 314).’ In addition, Frowe suggested combatants must be identified as combatants, to avoid the presence of guerrilla warfare which can end up in a higher death count, for example, the Vietnam War. Moreover, he argued they must be part of the army, bear arms and apply to the rules of jus in bello. (Frowe (2011), Page 101-3). This suggests Frowe seeks a fair, just war between two participants avoiding non-combatant deaths, but wouldn’t this lead to higher death rate for combatants, as both sides have relatively equal chance to win since both use similar tactics? Nevertheless, arguably Frowe will argue that combatant can lawfully kill each other, showing this is just, which is also supported by Vittola, who states: ‘it is lawful to draw the sword and use it against malefactors (Begby et al (2006b), Page 309).’
In addition, Vittola expresses the extent of military tactics used, but never reaches a conclusion whether it’s lawful or not to proceed these actions, as he constantly found a middle ground, where it can be lawful to do such things but never always (Begby et al (2006b), Page 326-31). This is supported by Frowe, who measures the legitimate tactics according to proportionality and military necessity. It depends on the magnitude of how much damage done to one another, in order to judge the actions after a war. For example, one cannot simply nuke the terrorist groups throughout the middle-east, because it is not only proportional, it will damage the whole population, an unintended consequence. More importantly, the soldiers must have the right intention in what they are going to achieve, sacrificing the costs to their actions. For example: if soldiers want to execute all prisoners of war, they must do it for the right intention and for a just cause, proportional to the harm done to them. This is supported by Vittola: ‘not always lawful to execute all combatants…we must take account… scale of the injury inflicted by the enemy.’ This is further supported by Frowe approach, which
