NURS 6050 week 1 Presidential Agendas

Affordable health care remains a hot topic in American society. This topic has sparked discussions from ordinary citizen’s dining tables to the corridors of political power. The ordinary citizen is concerned about the affordability of their health care. Over the years, there have been various initiatives by the different presidents to improve the American citizen’s affordability issues. This issue has been a significant campaign topic for the past presidents and has helped some get re-elected for a second term. NURS 6050 week 1 Presidential Agendas

In 2004 President Bush gave the State of The Union speech, where he stated his intentions for affordable health care (Holahan & Cook, 2004). Bush’s idea was to provide more power to the American people to invest in their health care upfront. This will, in turn, increase their deductible Health Savings Account (HSA), which will help people save money upfront in case of an illness. This helped solve the problem of out-of-pocket health care costs during a time of crisis. It also allowed the consumers to choose their health care providers.

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During the Obama presidency, the “Affordable Care Act (ACA)” was signed into effect by 2010. The Obama administration made been uninsured unlawful, thereby decreasing the numbers of uninsured population (Uberoi et al., 2016). They created the health care marketplace that made health care accessible and made provision for children up to 26 years old to stay under their parent’s coverage (Uberoi et al., 2016).  As a result, the Affordable Care Act uninsured rate declined by 43%, from 16% in 2010 to 9.1% in 2015 (Obama, 2016). Also, between 2 to 3 million young people benefited from been added to their parent’s insurance (Uberoi et al., 2016).

President Trump’s bill for the American Health Care Act (AHAC) passed the house of Representatives in 2017 (Congress, 2017) but did not pass in Senate.  In the effort to repeal the previous health care Act (ACA), the Trump Administration provided some changes:  to create a tax credit to people who qualify, gave power to the state to have control over some aspect of the marketplace, and removed the insurance mandate policies.

Health care impacts everybody: young, old, rich, or poor, and that is why it is an extremely critical part of politics. Everyone should have the right to adequate health care. Given some of these different health care reforms’ successes and failures, I would study how other countries with affordable and decent health care got to where they are. I will put the population as the primary focus, thereby sharing the burden of cost with individuals and preventing insurance companies’ cost monopolization. Health care will be centralized and federally controlled so that everybody will have an equal opportunity to coverage and adequate health care. NURS 6050 week 1 Presidential Agendas

References:

Congress Budget office (2017). The American health care act, incorporating managers

amendments 4, 5, 24-25.

https://www.cbo.gov/publication/52516

Holahan, J., & Cook A. (2006). Changes in economic conditions and health insurance coverage, 2000-

2004. Health Affairs.

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.498 (accessed 6 Feb 2006).

Obama, B. (2016). United states health reform: Progress to date and next step. JAMA 316: 524-

532

Uberoi, N., Finegold, K., & Gee, E. (2016). Health insurance coverage and the affordable act

2010-2016. Washington, DC department of health and human services office of the

assistant secretary for planning and evaluation. http://resource.nlm.nih.gov/101701796

sample response

As you and several articles have stated, the want and need for affordable heath care has been a hot topic for a number of years in the world of politics. Former president George W Bush tried to make great changes within our health care policy, although some of his ideas may not have worked as plan. The HSA program as you mentioned was a great idea for it assisted with the problem of the out-of-pocket costs as you said, but it was helpful that it is a tax-deductible deposit (Reinhardt, 2006). When you think about it though, the FSA funds are removed prior to our 401k/retirement funds are removed, making us decrease the average amount of retirement funds we put away, so individuals should be educated to put and extra percentage or two away per paycheck to cover this deduction. Otherwise, people may have to work longer, before they can afford to retire. NURS 6050 week 1 Presidential Agendas

As you stated several pros of the Affordable Care Act, I also wanted to mention that it was a great change for our ‘at the time’ health care policy, because it also allowed Americans/individuals that had preexisting comorbidities’ to not be denied health care coverage, like they have in the past (Melillo, 2019). Though, some employers would decrease some of their employee’s hours so they would not have to supply their works healthcare, which in my opinion is not right (Melillo, 2019). That is something I can see we both agree with, everyone should have the right to adequate health care, and should not be punished if they do have coverage.

Reference

Melillo, G. (2020, June 25). Trump administration, republican attorneys general ask supreme court to repeal ACA. The American Journal of Managed Care. https://www.ajmc.com/view/republican-attorneys-general-file-briefs-to-repeal-aca

Reinhardt U. (2006). President Bush’s proposals for healthcare reform. BMJ (Clinical research ed.), 332(7537), 314–315. https://doi.org/10.1136/bmj.332.7537.314

Discussion: Presidential Agendas

By Day 3 of Week 1

By Day 6 of Week 1

sample post 2

Topic that rises to the presidential level.

Reforming healthcare insurance has been a feat for many previous presidents in American history. Within the past two decades our country has experienced great change with federal involvement in healthcare insurance. This is a problematic topic that arises to the federal level because too often do American citizens go without the proper health care they need due to a lack of accessible quality health insurance. NURS 6050 week 1 Presidential Agendas

George W. Bush

With the intentions of providing healthcare insurance for a larger population within the United States, former President George Bush narrowed his focus on healthcare insurance to reforming medicare. This medicare expansion included the addition of preventative care coverage in hopes for early detection and prevention of illness or disease (The White House, n.d.).

Barack Obama

Former President Barack Obama spent a vast majority of his time in office completely revamping the american healthcare system by implementing the Affordable Care Act (ACA) also known as Obamacare. Part of former President Obama’s agenda was to enact a healthcare insurance plan that would benefit the entire United States’ population unbiased to socioeconomic status. Similar to former President Bush’s medicare expansion, the ACA also provided coverage for pre-existing conditions (Affordable Care Act, 2010). The Affordable Care Act extended healthcare coverage for unmarried dependents to 26 years old, allowing young adults to focus on career building or educational growth (Affordable Care Act, 2010). NURS 6050 week 1 Presidential Agendas

Donald Trump

During his term in office, former President Donald Trump attempted to implement the American Health Care Act (AHCA). Part of former President Donald Trump’s agenda was to reform the Affordable Care Act put into place by his predecessor. A few noteworthy amendments made to the Affordable Care Act during Trump’s presidency include an executive order  “increasing flexibility to States and cooperate with them in implementing healthcare programs” (Exec. Order. No. 13765, 2017). A second change put into place by the former president was the reversal of individual mandates for health insurance put into place by the ACA. (Exec. Order. No. 13765, 2017).

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What would you do differently?

Although I do agree with many healthcare insurance policies put into action by our former presidents; there are a few things I would have done differently. I’m a firm believer that primary preventive care is one of the most important phases of healthcare. Former President Trump’s executive order allowing for states to have the ability to waive out of covering preventative care was a misjudgment. I would have also kept the individual mandate intact. The requirements for healthcare coverage or the penalty for not acquiring coverage provided support for the financial risk pools of individual or small healthcare insurers (Wilson & Philips, 2017). With former President Trump eliminating the penalty for a lack of health care coverage, insurance companies were faced with larger, unrealistic monetary demands. NURS 6050 week 1 Presidential Agendas

References

Affordable Care Act. Pub. L. No. 111-148, § 2711, 124 Stat. 124 (2010).

Exec. Order. No. 13765. 82 Fed. Reg. 14 (January 24, 2017).

Reinhardt, U. (2006a, February 11). President Bush’s proposals for healthcare reform. National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1363898/

The White House. (n.d.). President Bush Strengthened America’s Health Care System. Retrieved March 1, 2021, from https://georgewbush-whitehouse.archives.gov/infocus/bushrecord/factsheets/healthcare.html

Wilson, C. E. Philips, M. S. (2017, August). Repealing the Affordable Care Act Essential Health Benefits: Threats and Obstacles. National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508159/

sample post 3

Access to Mental Health Care

An issue that presidents have noted and tried to manage is mental health concerns. Access to mental health care remains a concern for people in the United States (US). It is a concern addressed at federal and state levels with different laws made to ensure better access. President Bush established a new Commission regarding mental illness called the New Freedom Commission on Mental Health (Hogan, 2003). This commission created goals at the federal and state level, which have positively impacted access to care for people with a mental disease (Hogan, 2003). The goals included new requirements for evidence-based research in mental illness treatment and required states to have formal plans in place for better access and mental health care per Hogan (2003). President Obama passed the Affordable Care Act (ACA) during his presidency, which increased insurance coverage for low to middle-income Americans (Leonard, 2016). The increase in coverage ensured more Americans could afford health care and decreased difficulty accessing mental health care (Leonard, 2016). Leonard (2016) reported the increased coverage reduced the cost of medications for people with mental illness. President Trump tried to cut funding for mental health care in the US (Moritz-Rabson, 2019). NURS 6050 week 1 Presidential Agendas  His administration allowed states to impose Medicaid coverage requirements, such as employment, making it harder for people with mental illness (Moritz-Rabson, 2019). President Trump also strengthened short-term limited-duration plans which do not include coverage for mental illness, which negated ACA’s changes to Medicaid per Moritz-Rabson (2019).

 Access to appropriate care remains a concern. If I were to respond to this concern, I would work closely with leaders within mental healthcare, providers, and different organizations that work closely with people with mental illness. It is essential to have the most accurate understanding of current concerns. Without working with people currently working in this healthcare area, it will be hard to determine solutions. Presidents Bush and Obama made great strides by increasing healthcare access through increased insurance and equating mental disease like any physical disease deserving proper treatment (Leonard, 2016; Hogan, 2003). Both Presidents identified issues regarding the number of providers available. Part of my plan would be to prepare a better financial plan to entice providers into working in mental health. Advanced practice registered nurses (APRNs) continue to bridge the healthcare gap for underserved communities and rural areas; APRNs must be included in the plan with equal treatment as medical providers. NURS 6050 week 1 Presidential Agendas

References

Hogan, M. F. (2003).  The President’s New Freedom Commission: recommendations to transform mental health care in America.  Psychiatric Services 54(11), pp. 1467-1474.  https:// psychiatryonline.org

Leonard, K. (2016).  Here’s what Obamacare did for mental health.  US News.  https://www.usnews.com/news/articles/2016-05-04/heres-what-obamacare-did-for-mental-health

Moritz-Rabson, D. (2019).  Trump has tried to slash funds for mental health care despite post-shooting rhetoric.  News Week.  https://ww.newsweek.com/trump-has-tried-to-slash-funds-for-mental-health-care-despite-post-shooting-rhetoric-1452907 NURS 6050 week 1 Presidential Agendas