01Why Study Public Finance（课件）- 《财政与金融》同步教学（人民大学·第五版）

Finance and Finance 1 of 38 1 1.1 The Four Questions of Public Finance 1.2 Why Study Public Finance? Facts on Government in the United States and Around the World 1.3 Why Study Public Finance Now? Policy Debates over Social Security, Health Care, and Education 1.4 Conclusion Why Study Public Finance? 1 Heather Luea and Dan Sacks P R E P A R E D B Y 1 of 38 2 Introduction: The Affordable Care Act 1.1 On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act, commonly known as the ACA. Under the ACA, the government was projected to spend nearly $1 trillion on public health insurance and subsidies to private health insurance coverage between 2010 and 2019. This spending would be offset by spending reductions on existing public insurance programs and new taxes on the medical sector and the wealthy. As a result of the ACA, insurance companies can no longer discriminate against sick patients, and individuals who can afford health insurance must purchase it or pay a penalty. In addition, dozens of new initiatives are being undertaken in an attempt to control runaway health care spending in the United States of 38 3 Introduction: The Affordable Care Act 1.1 Despite its passage, the ACA continues to be debated ferociously in Congress, in the states, and in campaigns at all levels of government. Supporters argue that the bill corrects failed insurance markets, reduces the economic burden on the uninsured, and moves to control health care costs in the long run. Opponents of the legislation viewed the ACA as an unwarranted expansion of government power into the health care sector—and an enormous expansion of government spending at a time of record deficits. The controversies over the proper role of the government in dealing with health care coverage and costs raise the fundamental questions addressed by the branch of economics known as public finance. of 38 4 The Four Questions of Public Finance 1.1 Public finance: