Policy and Advocacy for Improving Population Health Essay
Policy and Advocacy for Improving Population Health Essay
The presidential agendas have been fundamental in American politics as they portray the candidate’s potential and leadership in reforms that affect different sectors within the American communities. As such, one of the most recognizable agendas has been the healthcare reforms which translates to legislation that will make the healthcare more affordable and accessible to the millions of Americans. In this regard, most presidents have in the recent past made efforts in bringing on the agendas on covering those with pre-existing conditions. This paper aims at comparing the agendas and forming analysis of the current and two previous administrations on the way they have handled the matter on health insurance coverage for those with pre-existing conditions. Policy and Advocacy for Improving Population Health Essay.
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Agenda Comparison Grid, Fact Sheet and Talking Points Brief
Part 1: Agenda Comparison Grid
Identify the Population Health concern you selected.
Health insurance coverage of pre-existing medical conditions
Describe the Population Health concern you selected and the factors that contribute to it. Over the years, the health agenda has emerged as one of the elements that has shaped the American politics, especially when it comes to the presidential election. As such, the health agendas have been varying with different administration coming up with a unique strategy to address the underlying health issues. One most common agenda has been the insurance coverage for people with pre-existing medical conditions. Pre-existing medical conditions are health issues one has before the date that new health coverage starts. Most health insurance companies have in the past either refused to cover, charged extra money or subjected people to waiting period when it comes to those seeking the insurance cover, and are having pre-existing conditions (Glied & Jackson, 2017). This thus limits the affordability and access to healthcare denying millions of Americans their basic right to access healthcare at an affordable rate.
Administration (President Name) President Trump President Obama President Bush
Describe the administrative agenda focus related to this issue for the current and two previous presidents. President Trump’s administrative agenda in regard to health insurance for the pre-existing conditions has been to cover all the pre-existing conditions with an aim to increase cover and make healthcare affordable to over 100 million Americans who have pre-existing medical conditions.
Although the Trump administration has been criticizing the Affordable Care Act (ACA) introduced by the Obama administration, the Trumps agenda on covering the pre-existing conditions has been similar with that of ACA where there has been a push for the insurance companies to cover anyone regardless of their pre-existing conditions (Glied & Jackson, 2017).
President Obama has been hailed as the first American president to take the bold step and advocate for the overall insurance coverage regardless of the pre-existing conditions. As such, in his first term, Obama inherited the Pre-existing Condition Insurance Plan (PCIP) which ended on April 30, 2014 as it was replaced by the Affordable Care Act (ACA) commonly referred to as Obamacare. The PCIP was a special provision for those people who were denied coverage by the insurance companies and had been uninsured for a period of six months or more. The ACA mandated insurance companies to cover individuals regardless of their pre-existing conditions and has been in existence since 2014.
President Bush’s agenda to cover those with pre-existing conditions was pushed through what was commonly referred to as the Pre-existing Condition Insurance Plan (PCIP). The PCIP program was introduced to offer those who were not eligible for private health plans due to pre-existing conditions a chance to be covered and access healthcare just as the rest of the patients. Although this was a good idea, it was seen as a segregation for those who were having pre-existing conditions in that they were supposed to pay more and being subjected to various access conditions compared to the rest of the patients.
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue. Trump’s administration financial strategy on health care plans has been aimed at reducing the current spending on health which will see an increased saving in the federal funding for health-related matters. The current proposed budget for the FY2021 on federal health agencies such as CDC, CMS, NIH and other major health care agencies stands at $94.5billion, which is a 10% reduction from what was allocated to the same agencies in FY2020. Although the cuts in spending will have an impact on the overall government spending, this is seen as a negative move as some of the programs aimed at assisting the vulnerable population, especially those with pre-existing conditions.
Since Obama took office in 2008, the healthcare budget has been rising rapidly hitting 20% of the total budget allocation by 2018. $630Billion was allocated for the reform implementation in the healthcare sector for the next 10 years from 2009. This was largely aimed at reforms that would see an everyone coverage, including those with pre-existing conditions. Over the years, the Obama administration spent over 6 Billion each year for funding the NIH to expand research on the most pre-existing conditions that were common with patients such as the cancer disease. Bush administration concentrated more on tax reforms that would see more people afford the insurance, especially those that were subjected to the Pre-existing Condition Insurance Plan (PCIP) program.
Most of the people that were unfavored with the insurance companies were the war veterans as most would have pre-existing conditions and therefore the Bush administration committed a $1billion fund to cater for the war veterans starting 2007 with the establishment of 22 network sites and clinic support teams to cater for the veterans (Kelley et al., 2019).
Explain how each of the presidential administrations approached the issue.
The Trump administration aims at lowering the healthcare insurance premiums, as well as bringing a federal requirement that all insurance companies are in a position to cover everyone. Apart from lowering the coverage premiums, the administration is also aiming at reforms that will bring the cost of prescription drugs down as this will greatly assist the patient with pre-existing conditions to continue accessing and affording the drugs as most of them are regular users based on the conditions that they suffer from (Adepoju et al., 2015).
The administration also aims at protecting the veterans and providing them with world-class healthcare and services.
The Obama administration aimed at bringing reform to the healthcare sector with an aim of not leaving anyone out of the coverage regardless of the pre-existing conditions (Glied & Jackson, 2017). By doing so, the administration pushed for the insurance company antitrust reforms to make the companies accountable in the delivery of health-related insurance services and to eliminate discriminatory elements for those with pre-existing conditions.
The administration also sort to abolish the Pre-existing Condition Insurance Plan (PCIP) and replace it with the Affordable Care Act (Obamacare) which was to ensure that everyone got covered. The Bush administration established a number of reforms to the healthcare sector with an aim of bringing everyone on board. Although the administration did not push for the insurance companies to cover everyone, it did provide a package for those with pre-existing conditions and were denied coverage by the insurance companies. This was under the Pre-existing Condition Insurance Plan (PCIP) program. On top of that, the administration also introduced tax-free Health Savings Accounts (HSAs) to entice more people into joining the coverage for their healthcare needs. On the other hand, there was an increased funding at the National Institutes of Health (NIH) to cater for the advancement of research, especially on common conditions that were registered with the patients.
Part 2: Agenda Comparison Grid Analysis
Administration (President Name) President Trump President Obama President Bush
Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
All the below agencies will be key in the advancing services to the patients with pre-existing conditions, especially when it comes to the health insurance. They are; The insurance companies, the NIH, the Centers for Medicare and Medicaid Services (CMS), the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), as well as the American Medical Association (AMA)
All the below agencies will be key in the advancing services to the patients with pre-existing conditions, especially when it comes to the health insurance. They are; The insurance companies, the NIH, the Centers for Medicare and Medicaid Services (CMS), the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), as well as the American Medical Association (AMA)
All the below agencies will be key in the advancing services to the patients with pre-existing conditions, especially when it comes to the health insurance. They are; The insurance companies, the NIH, the Centers for Medicare and Medicaid Services (CMS), the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), as well as the American Medical Association (AMA)
How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there? With the advancement in reforms that was aimed at aligning with the ACA, the Trump administration should not look on how to eliminate the ACA but on ways that they can incorporate reforms that will strengthen the existing healthcare system. One such move is to negotiate with the insurance companies to cover everyone regardless of their pre-existing conditions (Glied & Jackson, 2017). The Obama administration was best placed having inherited a system that was somehow discriminatory on the patients with pre-existing conditions. As such, the agenda for accessible and affordable insurance to cater for this vulnerable group was essential to bring everyone on board as it was the broad aim with the introduction of the ACA (Hall & Moore, 2008). Although the push for ‘everyone coverage’ has not borne the fruits up to now, it was essential at the time to bring all stakeholders on board, especially the insurance companies to see the best way forward to implement the reforms (Adepoju et al., 2015). The Bush administration made an effort of introducing a special package for those who were denied coverage by the insurance companies. In a broader way, this was not a solution to the root cause as the patient with pre-existing conditions continued to suffer under the hands of a responsible government (Adepoju et al., 2015). To push the agenda, one had to proof that a large portion of the Americans were underinsured or uninsured and at the same time most of the people had pre-existing conditions. With this fact, most private companies denied this population the much-needed coverage, which deteriorated the efforts of achieving a universal coverage.
Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents? Health Resources and Services Administration (HRSA), Veteran Associations, Human rights groups, the federal and state governments, as well as American Medical Association (AMA)
Health Resources and Services Administration (HRSA), Veteran Associations, Human rights groups, the federal and state governments, as well as American Medical Association (AMA)
Health Resources and Services Administration (HRSA), Veteran Associations, Human rights groups, the federal and state governments, as well as American Medical Association (AMA) Policy and Advocacy for Improving Population Health Essay.
Part 3: Narrative with The Facts
With more than 100 million people in America, having a pre-existing medical condition, it is important that the government realizes the importance of insurance coverage for everyone regardless of their pre-existing conditions. With the current and previous administration having pushed for the reforms to realize the goal of universal coverage, it is important for the government of the day to put the words into action by consulting widely and as well, push for the legislation that will ensure the intended reforms are in line with the existing laws and are recognizable before the law (Adepoju et al., 2015). With such move, the insurance companies will have no choice but to comply, enabling millions of Americans to access and afford healthcare services even when they have pre-existing conditions.
The agenda to cover those with pre-existing conditions should be implemented with caution to achieve the long-term sustainability, especially with the insurance companies (Fontenot, 2015). This will be greatly informed by the nurse’s involvement in the agenda setting where the professional views contribution can be of great importance in the negotiation, methodology and implications for the setting and presentation of the reform agenda in the overall aim of covering those with pre-existing conditions.
Conclusion
In a recap, the health insurance cover for those with pre-existing conditions in the US still remain unresolved and there lacks a clear guidance through a legislation which can be a solution to the whole menace which has been witnessed over the years. With the budget allocation on health surpassing 20% of the total government spending, there should not be a reason for discrimination in terms of access or affordability when it comes to healthcare. The responsibility of a government is to make sure that the reforms that are aimed at improving the health status of its people get proper legal backing for a smooth process of implementation. As such, the US government should push for legislation in order to place everyone on board in terms of coverage, especially those who have suffered most under the pre-existing conditions that they hold.
References
Adepoju, O. E., Preston, M. A., & Gonzales, G. (2015). Health care disparities in the post-affordable care act era. American Journal of Public
Health, 105, S665-S667.
Fontenot, Sarah F, BSN,J.D., C.S.P. (2015). WHERE IS THE ‘AFFORDABLE’ IN THE AFFORDABLE CARE ACT? Physician Leadership
Journal, 2(4), 50-52.
Glied, S., PhD., & Jackson, A., B.A. (2017). The future of the affordable care act and insurance coverage. American Journal of Public Health,
107(4), 538-540. doi:http://dx.doi.org/10.2105/AJPH.2017.303665
Hall, J. P., & Moore, J. M. (2008). Does high-risk pool coverage meet the needs of people at risk for disability? The journal of health care
organization, provision, and financing. Inquiry, 45(3), 340-52.
Kelley, A. T., Tipirneni, Renuka,M.D., M.Sc., & Levy, H., PhD. (2019). Changes in veterans’ coverage and access to care following the
affordable care act, 2011–2017. American Journal of Public Health, 109(9), 1233-1235. doi:http://dx.doi.org/10.2105/AJPH.2019.305160
Plein, L. C. (2010). FEDERALISM, INTERGOVERNMENTAL RELATIONS, AND THE CHALLENGE OF THE MEDICALLY
UNINSURABLE: A RETROSPECTIVE ON HIGH RISK POOLS IN THE STATES. Journal of Health and Human Services Administration, 33(2), 135-57.
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NURS 6050 Module 1 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief
It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.
Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.
As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.
In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.
To Prepare:
- Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
- Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
- Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
- Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.
The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)
Part 1: Agenda Comparison Grid
Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:
- Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
- Describe the administrative agenda focus related to the issue you selected.
- Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
- Explain how each of the presidential administrations approached the issue.
Part 2: Agenda Comparison Grid Analysis
Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:
- Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
- How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
- Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
Part 3: Fact Sheet or Talking Points Brief
Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following: Policy and Advocacy for Improving Population Health Essay.
- Summarize why this healthcare issue is important and should be included in the agenda for legislation.
