For people to receive the required health services, the government must remain committed to solve health problems. Irrespective of the political stance, the government should examine people’s health problems in detail and commit the necessary resources to solve them. The issue of health care access has been there for a long time. Lack of access or the failure to afford insurance coverage has been a leading cause, and governments have responded to the issue differently. This comparison grid compares the Bush, Obama, and Trump administrations’ efforts to enhance access by promoting insurance coverage through Medicare and other people-centered programs.

Findings show that religious engagement among students declines during college, but their spirituality shows substantial growth. “Students become more caring, more tolerant, more connected with others, and more actively engaged in a spiritual quest.” (“Cultivating the Spirit – Spirituality in Higher Education”) The authors also found that spiritual growth enhances other outcomes, such as academic performance, psychological well-being, leadership development, and satisfaction with college. The study also identified a number of college activities that contribute to students’ spiritual growth. Some of these–study abroad, interdisciplinary studies, and service learning–appear to be effective because they expose students to new and diverse people, cultures, and ideas. Spiritual development is also enhanced if students engage in “inner work” through activities such as meditation or self-reflection, or if their professors actively encourage them to explore questions of meaning and purpose. (“Cultivating the Spirit – Spirituality in Higher (Alexander W, 2010)”). By raising public awareness of the key role that spirituality plays in student learning and development, by alerting academic administrators, faculty, and curriculum committees to the importance of spiritual development, and by identifying strategies for enhancing that development, this work encourages institutions to give greater priority to these spiritual aspects of students’ educational and professional development

Assignment Agenda Comparison Grid and Fact Sheet or Talking Points Brief NURS 6050

Identify the Population Health concern you selected.	Tobacco Use
Describe the Population Health concern you selected and the factors that contribute to it.	Smoking is deeply related to the health condition for individuals and the public Cigarette smoking has been linked to about 90 percent of all cases of lung cancer, and tobacco is the leading cause of preventable death in the United States Secondhand smoke can affect the health of children and adults Early exposure to e-cigarette use for the adolescent has unknown effects on the health and can cause severe respiratory distress
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.	The Trump Administration keeps the stance of pro-business and anti-regulation approach to control tobacco uses	The Obama administration created new powers for the Food and Drug Administration to regulate tobacco products, offering significant new tools to combat preventable diseases The administration had strong evidences showing that increasing the tobacco tax is one of the best ways to reduce smoking and other tobacco use, particularly among children	A bill to grant the US Food and Drug Administration (FDA) regulatory authority over tobacco products was the central element of federal tobacco control efforts during the Bush administration
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.	$4.8 trillion budget proposal for creating new agency under US department of Health and Human Services for only one mission on tobacco and e-cigarettes President Trump signed the bill raising the legal age to buy tobacco to 21 The Trump administration announced a ban on most flavored e-cigarette pods	President proposed to increase federal cigarette tax by 94 cents per pack, $95.1 billion in over 10 years, and similarly to other tobacco products to fund early childhood education	The Bush administration rejected smoking and health expert’s proposal to increase the federal cigarette tax by $2 per package to fund a comprehensive cessation initiative
Explain how each of the presidential administrations approached the issue.	The Trump administration tries to build new governmental authority to control tobacco use and e-cigarette products with strong regulations	The Tobacco Control Act, signed into law by President Obama in 2009, gave the FDA regulatory authority over tobacco products, creating the Center for Tobacco Products and funding regulation efforts through fees on tobacco companies. In 2016, the FDA expanded its authority to all tobacco products — including e-cigarettes.	The administration had no significant proposals to reduce tobacco use

Narrative with the Facts

For populations to grow and live healthily, access to health care services should be guaranteed. People should have health care facilities close to their residences, and health services should be affordable. Approaches that enhance access, such as telehealth, should be adopted as much as possible. Various administrations in the United States have approached this issue differently. Their focus differs depending on political backgrounds and agendas, resources, and philosophies. The main issues that different governments explore include insurance coverage as one of the key components of access besides timeliness of care and health services availability (Office of Disease Prevention and Health Promotion, 2020). Governments’ agenda also depends on sponsors and the problems facing the populace.

The three governments have prioritized affordable health as an area of priority, and successors should make it a priority too. Donald Trump’s focus can be lauded because of tax deductions and policies promoting health savings. Considering that access limitations should be minimal as possible, doing away with denials for people with preexisting conditions as long as they have continuous coverage helped expand access. Barack Obama’s implementation of the Affordable Care Act needs recognition too. George Bush expanded private plans in Medicare. In each case, the administration focuses on improving access by ensuring that people can afford health services.

Conclusion

Problems such as high cost of care and inadequate or absence of insurance coverage have limited health care access to many populations. The low availability of health services and lack of culturally competent care amplify the problem further. Due to financial burdens, among other access problems, different administrations devise different interventions to ensure that Americans can access health. Focus on

insurance coverage has been prioritized by Trump, Obama, and Bush administrations. The idea is to make people more insured to ensure that they are not denied health services due to lack of coverage. Insurance coverage and expansion programs ensure that people can receive health services at their usual places of care. It is a method of preventing delays that governments should support as much as possible.

References

Christensen, J., & Nedelman, M. (2020, February 10). Trump budget plan could push tobacco oversight out of the FDA. Retrieved February 25, 2020, from https://www.cnn.com/2020/02/10/health/tobacco-regulation-fda-trump/index.html

Corr, W. V (2003, March 1). Administration Disappoints in Rejecting Proposal to Increase Federal Cigarette Tax and Fund Smoking Cessation Initiative. Retrieved February 25, 2020, from https://www.tobaccofreekids.org/press-releases/id_0609Liss, S. M. (2015, February 2). Congress Should Back President Obama’s Tobacco Tax Plan – It Will Protect Kids, Save Lives and Cut Health Care Costs. Retrieved February 25, 2020, from https://www.tobaccofreekids.org/press-releases/2015_02_02_taxThe White House President Barack Obama. (2009, June 22). Fact sheet and expected attendees for today’s Rose Garden bill signing. Retrieved February 25, 2020, from https://obamawhitehouse.archives.gov/the-press-office/fact-sheet-and-expected-attendees-todays-rose-garden-bill-signing

Healthcare may appear to you to be a national topic of debate among political leaders for as long as you can remember.

Healthcare has been a policy issue and a source of contention not only recently, but since the administration of the second President of the United States, John Adams. In 1798, Adams signed legislation requiring sailors to set aside 20 cents per month of their pay to cover medical expenses. This was the first major piece of healthcare legislation in the United States, and the topic of healthcare has been woven into presidential agendas and political debates ever since.

Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief NURS 6050

As a healthcare professional, you may be asked to provide expertise, guidance, and/or opinions on healthcare issues that are being debated for inclusion in new policy. You may also be involved in the development of new organizational policies and responses to legislative changes. For all of these reasons, you should be prepared to discuss national healthcare issues that are making headlines.

Part 3: Narrative

Veterans are at risk of complex conditions and are vulnerable to service-related conditions such as mental illnesses. Despite veterans having served the country on overseas missions, they encounter challenges accessing affordable and quality healthcare. Veterans’ healthcare is an issue that has reached the presidential level, and the current and former presidents have signed laws to improve healthcare access and mental health services for this population (Hester, 2017). Improving access and quality of healthcare to veterans is important because this population experiences substance use disorders, mental health disorders, post-traumatic stress, chronic pain, amputations, and traumatic brain injury at disproportionate rates compared to their non-veteran counterparts (Oster et al., 2017). Besides, a large fraction of veterans commits suicide secondary to mental health issues.

It is crucial that the national and state governments enact laws that increase access to affordable healthcare to reduce morbidity and mortality rates associated with these conditions. For instance, laws on mental health can be legislated, requiring that the federal government fund mental health services for veterans in both public and private facilities (Oster et al., 2017). Legislations can also be enacted that require the federal government to fund medical expenses for veterans who develop work-related disorders.

The nurse has a major role in setting healthcare agendas since nurses are involved in direct patient care and are significantly affected by health policies. Nurses can significantly influence healthcare policies through their daily healthcare delivery role. Since nurses understand the issue affecting healthcare delivery and the best ways to address them, they can best advise policymakers on laws that can improve healthcare systems and increase access to healthcare services (Milstead & Short, 2019). Besides, the nurse has a role in agenda-setting of proposing strategies that will benefit the communities based on their comprehensive understanding and specialization in particular areas of health care.

Conclusion

Therefore, veterans suffer from various complex issues ranging from mental matters to physical conditions. As such, it becomes the responsibility of the government of the day to ensure that their welfares are well addressed. The administrations of President’s Bush, Obama and Trump adopted various policies to mitigate the suffering of the veterans.

References

Duhaney, T. (2020). How veteran utilization of the Veterans Health Administration could impact privatization. Public Policy & Aging Report, 30(1), 29-35.https://doi.org/10.1093/ppar/prz032

Hester, R. D. (2017). Lack of access to mental health services contributing to the high suicide rates among veterans. International journal of mental health systems, 11, 47. https://doi.org/10.1186/s13033-017-0154-2

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Oster, C., Morello, A., Venning, A., Redpath, P., & Lawn, S. (2017). The health and wellbeing needs of veterans: a rapid review. BMC psychiatry, 17(1), 1-14. https://doi.org/10.1186/s12888-017-1547-0

Sisk, R. (2018). Trump signs a $55 billion bill to replace VA Choice Program. Military. Com, 6.

The White House. (2009, January 12). The Bush record – Fact sheet: The Bush administration has provided unprecedented support for our veterans. Welcome to the White House. https://georgewbush-whitehouse.archives.gov/infocus/bushrecord/factsheets/veterans.html

Agenda Comparison Grid Template Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2 Part 1: Agenda Comparison Grid Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas. You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment. Specify the Population Health issue you chose. As a professional nurse specialized in substance abuse dependency, I have chosen to concentrate exclusively on the population suffering from Opioid addiction and dependence. Describe the identified Population Health problem and the contributing variables. According to the National Institute on Drug Abuse, over 130 Americans die annually from an opioid overdose. Based on these facts, we may conclude that this issue does not discriminate against any race, socioeconomic status/class, gender, or religion. The annual cost of treatment, healthcare, costs associated with criminal participation, and addiction treatment exceeds $78 billion. (NIH, 2019). The Centers for Disease Control and Prevention report that the epidemic emerged in the 1990s.

This began with over prescribing, which led to abuse and addiction. This has resulted in the current opioid crisis. (CDC, 2018) Administration (President Name) (Current President) President Trump (Previous President) President Obama (Previous President) President Bush Describe the administrative agenda focus related to this issue for the current and two previous presidents. Under the Trump administrations’ agenda, the agenda focus is currently sterner on opioid abusers and are well equipped with better and more advanced measures on fishing out culprits engaged in these acts. There are more strategic checks and balances that have been put in place under the current administration to limit the influx of illegal drug trafficking into the country. There are also very tight security protocols and measures on the boarders of the country which is aimed at reducing the number of people affected with opioid abuse and dependency. (WhiteHouse.gov) The Obama administrations’ agenda one of the primary focus was to develop special treatment protocols for individuals suffering from opioid abuse and dependency issues and on creating incentives to ensure that there are more thorough measures in place for regulating opioid prescription by medical practitioners and dispensing means from pharmacies. Monitoring of opioid use and events located at neighborhood law enforcement stations for the return of excess drugs that have been supplied illegally within the system. Community drug dispensaries are accepting of these kinds of take back drives to support drug rehabilitation in chronic abusers addicted to drugs. (WhiteHouse.gov) The Bush administrations’ agenda focused on the prevention of the crises in opioid abuse even before it commenced, the provisions of more drug rehabilitation centers and infiltrating the opioid lack market system. (WhiteHouse.gov) Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

An estimated $13 million in October 2019 was apportioned to incentives created specifically to fund the police task force in a bid to eradicate the impact of drug trafficking. A total of 12 states across 13 counties that have battled most with the impact that opioid abuse and addiction have impacted. (WhiteHouse.gov) An outline of the proposals released from the White Trump’s budget will also seek $21 billion to put toward infrastructure spending and $23 billion toward border security, including his infamous border wall. (WhiteHouse.gov) Under the Obama administration, there was a separate budget created for the 2016 fiscal year to the total sum of $27.6 billion with was a 4.7% increment compared to the year before (2017). These funds were generated to develop resources and manpower from the federal level under this administration to tackle drug trafficking in the country. Proactive measures were implemented to combat the tragic impact of the prevalent opioid crisis via The National Heroin Initiative (NHI) by focusing primarily on areas within the community that are opioid-laden. They targeted the center of the illegal opioid supply with more advanced investigative approaches by law enforcement agencies which was a huge preventative method.

During The Bush era in administration, his regime, in 2003 there was an estimated total allocation of $19.2 billion raised to fund law enforcement efforts in the battle against opioid trafficking and all other criminal activities associated with drug abuse. Border patrol was also one of the primary areas that this administration focused on to reduce the supply of illegal opioids on an international scale. An allocation of $2.3 billion was set aside for this purpose and an estimated $3.8 billion was allocated to rehabilitation treatments for individuals in our society that have struggled with opioid dependency. In conclusion this administration allocated another $10 million in fostering initiatives for a program that supported the people that were most affected by opioid addiction which was The Drug-Free Communities Support Program. (WhiteHouse.gov) Explain how each of the presidential administrations approached the issue. The Trump Administration took on the approach of spreading awareness and education the teens and adolescents in our society by partnering The Truth Initiative and Ad Council, which was a campaign initiated to teach them on how to prevent and reduce opioid abuse and addiction. It was very comprehensive in helping young adults understand the dangers associated with addiction as well as how effective they could be in curbing the spread of this problem in various communities. This ad was designed to get the attention of the younger population in the society as it successfully has over 1.4 billion views in total when it aired. This administration declared the current opioid addiction issue a nationwide public health emergency, which has brought so much more attention to this crisis.

This prompted and inspired people to become more active in the fight against opioid abuse and dependency. More intense measures were taken at the boarders to intensify the patrol and security measures to avoid smuggling drugs illegally into the country. There have also been measures taken to ensure that opioid prescriptions ate regulated thoroughly, by introducing a Safer Prescribing Plan that will reduce any opioid refill prescription by 1/3 in the next 3 years. Finally, the administration is that will cut opioid prescription fills by one-third within three years. Finally, the administration has been a strong proponent for vaccines that prevent opioid addiction. (WhiteHouse.gov) The Obama administration offered health care coverage plans that were mandatory for individuals battling with opioid abuse and addiction. This was able to facilitate their treatment regimen and made provision for naloxone, a drug of choice administered to patients that have been suspected of high levels of Opioid-Induced complications. This administration also strengthens efforts at combating drug trafficking which drastically reduces opioid overdoses and deaths. The White House National Drug Control Strategy devised a strategic plan based on evidence-based practices that aims at controlling opioid addiction and substance abuse. The primary goal of this approach was focused on public health, by creating programs that encourage the safe and proper use of opioids and comprehensive treatment plan for this suffering from opioid dependency. Finally, the administration encouraged clinicians and their stakeholders to collaborate effectively in the implementation of more structured protocols while prescribing opioid to the right patients. (WhiteHouse.gov) The primary objective of the Bush administration’s focus on the issue of opioid addiction was to get the individuals suffering focused on getting people into treatment.

This was a focus on “compassionate Coercion” which begins with family and friends. The focus was on prevention and seeking help for the addict along with using the criminal justice system as a deterrent for getting people into programs. The administration focused on confrontation to heal the addict. Guidance was sought from family, friends, the workplace and places of worship. (WhiteHouse.gov) Part 2: Agenda Comparison Grid Analysis Using the information, you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected Administration (President Name) (Current President) (Previous President) (Previous President) Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected? The Trump administration has made collaborative efforts in cross boarder internationally to establish more through security measures in partnerships with law enforcements that have proved to be effective in treating and preventing opioid abuse and addiction. There are specialized training sessions on a regular basis offered by federal agencies to assist clinicals in treatment of patients with opioid addiction, ensure that the stand of practice in treating these patients met the national guidelines requirements, and encourage long term rehabilitation. There are also measures set in place to inspect drug rehabilitation programs in an effort to improve the. Quality of care provided and patient satisfaction This has led to a drastic reduction of cases involved in drug related offences and criminal activities.

Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003.

Reference

Agboola, A. A., Esan, O. T., Afolabi, O. T., Soyinka, T. A., Oluwaranti, A. O., & Adetayo, A. (2018). Economic burden of the therapeutic management of mental illnesses and its effect on household purchasing power. PLoS ONE, 13(9), 1-13. https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.0202396

Fekadu, W., Mihiretu, A., Craig, T. K. J., & Fekadu, A. (2019). Multidemsional impact of severe mental illness on family members: systematic reviow. BMJ Open, 9(12), 1.

RE: Discussion – Week 1

Policies, Problems, and Planning to Reach Rural Veterans

Suicide accounts for 8.3% of deaths among U.S. adults, and Veterans alone represent an unignorable 14.3% of these tragedies (Department of Veterans Affairs [VA], 2018). Consequently, death by suicide for the veteran patient population is 1.5 times the rate of non-veteran sufferers (VA, 2018). Our current and previous presidential administrations have contributed to the funding and development of veteran suicide research and interventions. Since the inception of the Veterans Access, Choice and Accountability Act (CHOICE Act) of 2014, veteran suicide data and research has enabled policy makers to focus on reaching veterans living in rural areas. Veterans living in rural areas account for nearly one fourth of the veteran population (VA,2018). Veterans living in rural areas have a 20%-22% greater risk of death by suicide in comparison to veterans living in urban areas. According to the Veterans Affairs Office of Rural Health, 4.7 million veterans return from active military careers to live in rural areas, only 2.5 million are enrolled to receive VA health care services, and far more than half of enrolled veterans living in rural areas have service-connected disabilities (VA.gov: Veterans Affairs 2016).

In 2014, President Barrack Obama and Senator John McCain III set the groundwork for veteran mental health care reform with the passage of the Veterans Access, Choice and Accountability Act (CHOICE Act) of 2014. With this act, veterans in rural areas had expanded options to receive care from non-VA providers with the VHA’s coordination and approval. The CHOICE Act also highlighted health care staffing disparities via staff shortage reports required by the VA Office of Inspector General, and the identification of the need to increase Graduate Medical Education (GME) residency positions in the mental health specialty.

The Choice Act was further amended in 2016 with the passing of the Jeff Miller and Richard Blumentha Veterans Heath Care and Benefits Improvement Act to further increase the number of GME residency positions over 10 years instead of five and extended the program to 2024 (Albanese et al., 2019). Despite the increase in GME residency positions and extensions of program funding, health care disparities in rural areas continued their negative trend. At this point, veteran advocates and policy makers identified the physician shortage gap in rural areas as a mission-critical priority for the VHA and began working towards the John S McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal System and Strengthening Integrated Outside Networks (MISSION) Act of 2018.

In June 2018, the Obama administrations groundwork for the MISSION Act paved the way for the Trump Administration to see it through to fruition. With the problem stream of rural access leading policy formation, the MISSION Act created interventions based on physician shortages that now determine location, specialty, and amount GME residency positions within outlined parameters. Essentially focus has shifted from interventions to bring veterans to health care providers (HCP), to interventions to bring HCP to veterans. These interventions include expanding VA Health Care Profession Scholarships (HPSP) to graduate education for nurse practitioners select, who are allowed to practice at their full scope of practice without physician supervision. These expansions will increase patient access to quality health care and improve staffing shortages in rural veteran communities (American Association of Colleges of Nursing [AACN], 2016). In addition to GME improvements, veterans now could seek medical assistance from non-VA facilities without penalty when in need.

Most recently, the Biden Administration passed the Sgt. Ketchum Rural Veterans Mental Health Act of 2021. This bill was created in honor of its name’s sake, Sergent Brandon Ketchum, in addition to many other sailors, marines, and soldiers who lost their battles with suicidal ideation in the face of limited access to care. Sgt. Ketchum was a 33-year-old Operation Iraqi Freedom Veteran who served in Iraq and Afghanistan struggled with post-traumatic stress disorder and substance abuse after returning home to a rural area in Iowa. In 2016 he presented to the Iowa City VA Hospital where he asked to be admitted before the psychiatrist determined inpatient care was not needed at the time. Brandon returned home and committed suicide that night. An investigation was completed and no HCP’s were found to be directly responsible for his death; however, quality patient education on suicidal ideation, risk factor ratings, and access to routine outpatient psychiatric mental health services or the lack there of could be at fault. Under this bill, rural veterans diagnosed with Schizophrenia, Schizoaffective Disorder, Bipolar Affective Disorder, Major Depression, PTSD, and any severe or chronic mental health condition will have access to Rural Access Network for Growth Enhancement (RANGE) programs (Veterans Health Administration, VA.gov: Veterans Affairs 2013). The RANGE program provides intensive case management to veterans with serious mental illness who are experiencing homelessness or who are at risk of experiencing homelessness with an emphasis on recovery. The Sgt. Ketchum Rural Veterans Mental Health Act of 2021 bill also requires the government to conduct a study and report on whether the VA has adequate resources to provide services to rural veterans whose lives depend on mental health care the is more intensive than traditional outpatient therapy (Monteith et al., 2020).

Unfortunately, VA healthcare reform is faced with similar challenges of establishing universal health care but on a smaller scale. Agendas, interest groups, insurance stakeholders, pharmaceutical suppliers, and access to care are all variables in creating policies that appear to be relentless barriers to healthcare reform; however, change is a process. The evolution of the CHOICE act to the Sgt. Ketchum Rural Veterans Mental Health Act of 2021 is promising. Findings from this living body of veteran health data and research will continue to shape policy improvement. I am hopeful that with each future bill and amendment passed, a new layer of protection will be provided to those who have sacrificed their lives to protect us.

References

Albanese, A. P., Bope, E. T., Sanders, K. M., & Bowman, M. (2019). The VA mission act of 2018: A potential game changer for rural GME expansion and Veteran health care. The Journal of Rural Health, 36(1), 133–136. https://doi.org/10.1111/jrh.12360

American Association of Colleges of Nursing. (2016, December 13). VA ruling on APRN practice: a breakthrough for veterans health care. Message posted on the American Association of Colleges of Nursing Listserv:web@aacn.nche.edu

Department of Veterans Affairs (2018b). VA National Suicide Data Report: 2005–2015. Retrieved from

https://www.mentalhealth.va.gov/ docs/data-sheets/OMHSP_National_Suicide_Da ta_Report_2005-2015_06-14-18_508-compliant.pdf

Monteith, L. L., Wendleton, L., Bahraini, N. H., Matarazzo, B. B., Brimner, G., & Mohatt, N. V. (2020). Together with veterans: Va national strategy alignment and lessons learned from community‐based suicide prevention for rural veterans. Suicide and Life-Threatening Behavior, 50(3), 588–600. https://doi.org/10.1111/sltb.12613

VA.gov: Veterans Affairs. RURAL VETERANS. (2016, January 19).

https://www.ruralhealth.va.gov/aboutus/ruralvets.asp.

Veterans Health Administration, D. U. S. for O. and M. (2013, May 8). VA.gov: Veterans Affairs. Enhanced RANGE Program. https://www.lexington.va.gov/services/Enhanced_RANGE_Program.asp.

The opioid abuse and addiction has been a continuing challenge for many years. The most commonly misused and addictive opioids include heroin, prescription opioids, and synthetic opiods like Fentanyl. Opioid misuse and addiction has caused serious negative outcomes including deaths and disabilities (Park & Otte, 2019). Moreover, the problem does not only affect the health but also the social and economic wellbeing of Americans. This paper seeks to explore how Presidents Trump, Obama, and Bush administrations addressed this issue as an administrative agenda.

Part 1: Agenda Comparison Grid

Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.

You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.

Identify the Population Health concern you selected.

Opioid concerns

Describe the Population Health concern you selected and the factors that contribute to it.

Drug and substance abuse in US continues to bring several adverse effects such as mortality and disabilities. In particular, opioids is highly prevalent and has turned into crisis that is currently ravaging many people. The issue of opioids mostly emanates from inadequate information on medications prescriptions (Kaye et al., 2017).

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.

The administration of President Trump approached the issue of opioids crisis by declaring it as a public health emergency. Trump then opted to address the issue by controlling the supply and distribution among the masses, increasing access to prevention, treatment services, and recovery services to the victims.

The agendas President Obama’s administration implemented to curb the opioid crisis included setting legal framework to address the issue through legislation, enhancing better and efficient access to healthcare and limiting the capacity of prescribers to overprescribe.

The administration of President Bush considered the opioid issue mostly as a criminal issue rather a public health concern. As such, the administration invested heavily on law enforcement agencies to fight the drug issue.

Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

According the department of Health and Human Services (HHS) (2019), President Trump allocated more than $1.8 billion to be distributed to states to address the opioid crisis and expand access to treatment and also support near-real data on the crisis of drug overdose.

President Obama prioritized fight against opioid overdose and created measures to reduce drug use and overuse. In 2016, Obama proposed $1.1 Billion to be used in addressing the prescription opioid abuse and heroin use epidemic (The White House, 2016)

According to the White House (2002), President allocated nearly $2.3 billion dollars to help in interdicting drugs and prevent them from reaching the borders. This allocation was an increment of about 10% from the previous year. He also allocated human resources, especially security agencies to help guarding coastlines and borders to prevent illegal importations.

Explain how each of the presidential administrations approached the issue.

The Trump administration approached the opioids crisis using strategies such as deterrence, treatment, helping in recovery, studies on addiction and pain, and advanced pain management practice.

The Obama administration approached the issue by enhancing capacity for healthcare services and also increasing Medicaid coverage to the underserved and rural communities to increase access to healthcare services. The administration also provided education on healthcare professionals to enhance awareness and treatment and also help in treatment medication and reduction of stigma.

The Bush administration approached the issue through funding to help in management and also treating it as criminal issue, with much emphasis based on law enforcement agencies to address the issue from the crime perspective, while little attention was given healthcare approach.

Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected

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?	Since President Trump’s administration declared opioid crisis as public health emergency, the administrative agency that could best help in addressing the issue is health agencies such as CDC to help in creating the professionalism, tools, and information that enable people and communities to promote health, prevent injuries, diseases, disabilities, and become sensitive for new health risks. Trump also formed a Commission on Combating Drug Addiction and the Opioid Crisis, which is essential in recommending the best measures to address the opioid issue. The International Narcotics Trafficking Emergency Response By Detecting Incoming Contraband With Technology (INTERDICT) Act which was signed by Trump is also essential in enhancing screening tools for custom agents.	The best administrative agency that would be best responsible in addressing opioid crisis is CDC. President Barack Obama’s administration could cooperate with CDC to help in creating the professionalism, tools, and information that enable people and communities to promote health, prevent injuries, diseases, disabilities, and become sensitive for new health risks.	Although the Bush administration heavily relied in security agency and treated the issue of opioid crisis as more of criminal than public health issue, the best administrative agency that could address this was CDC. CDC is essential in creating the professionalism, tools, and information that enable people and communities to promote health, prevent injuries, diseases, disabilities, and become sensitive for new health risks
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?	Since, many people are affected by this issue, it is imperative that the issue gets on the agenda of this administration. One way is ensuring that politicians participate in planning how to address the issue. The issue of opioid crisis should be discussed through legislation and become part of the government agenda. Government leaders need to deliberate and create new ideas on addressing the problem.	Since, many people are affected by this issue, it is imperative that the issue gets on the agenda of this administration. One way is ensuring that politicians participate in planning how to address the issue. The issue of opioid crisis should be discussed through legislation and become part of the government agenda. Government leaders need to deliberate and create new ideas on addressing the problem.	Since, many people are affected by this issue, it is imperative that the issue gets on the agenda of this administration. One way is ensuring that politicians participate in planning how to address the issue. The issue of opioid crisis should be discussed through legislation and become part of the government agenda. Government leaders need to deliberate and create new ideas on addressing the problem.
Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?	During the Trump administration, the best champion could be Admiral James Winnefeld due to his focus on drug addiction leading to creation of Stop Addiction Fatality Epidemic (SAFE).	The person who could be chosen as the best champion for the issue is Senator Sheldon Whitehouse. He introduced the Comprehensive Addiction and Recovery Act, which was later signed into law.	Hillary Clinton could be chosen due to her influential status as the first lady by the time opioid crisis started and also serving as a Senator.

Part 3: Narrative

Why Opioid Crisis Issue is Important and Should be Included in the Agenda for Legislation

The issue of opioid misuse is increasing at an alarming rate in the in the US and is associated with dire consequences such as mortality and disabilities. According to HHS.gov (2019), two out of three drug overdose deaths in US in the year 2018 involved opioid. Moreover, Painter (2017) reports that opioid crisis is responsible for over 30,000 deaths annually. In the year 2017 alone, drug overdose killed over 70,000 people, with 50,000 of this being numbr being opioid related deaths. Currently, opioid crisis is highly prevalent and affecting everyone despite age, gender, race, status, or ethnic group. Long term use of Opioid is also associated with severe physical, social, psychological, and physiological effects. In fact, in severe cases, users can develop opioid use disorder and the associated withdrawal symptoms such as inability to control opioid use, inability to carry out work or academic responsibilities, and addiction, inability to conduct activities of daily life, and social and interpersonal problems. Concerning economic implications, opioid use disorder and associated symptoms requires heavy financial resources to manage, which causes remarkable financial burden on individuals, state, and federal government. Based on the above mentioned facts, the issue of opioid crisis is crucial and needs to be included in the legislative agenda of government.

Role of Nurses in Opioid Crisis Agenda Setting

Nurses can play significant role in setting agenda for opioid crisis such as provision of professional advice, early detection and prevention of opioid abuse and misuse, monitoring of opioid prescription, thus, can help in identification of patients who begin to be addicted (Hunnicutt et al., 2018). Nurses can also play advocacy roles by championing for application of best policies and techniques in managing pain, developing protocols for treating opioid addiction, and formulation of new standards on writing opioid prescription.

Conclusion

It has been established that the misuse and addiction of opioids possess a serious national crisis with negative effects on public health, economic, and social wellbeing. The seriousness of opioid crisis attracted the attention of Presidents Bush, Obama, and Trump who made significant contributions to address the issue. It is imperative for government to set serious health issues such as opioid crisis in government agenda to help in strengthening health systems and provide resources such as human and financial to address the issue. Moreover, setting opioid as legislative agenda is crucial in policy development and strategic management and planning for the issue.

References

Health and Human Services (HHS). (2019). Trump Administration Announces $1.8 Billion in Funding to States to Continue Combating Opioid Crisis. https://public3.pagefreezer.com/browse/HHS.gov/31-12-2020T08:51/https://www.hhs.gov/about/news/2019/09/04/trump-administration-announces-1-8-billion-funding-states-combating-opioid.html

HHS.gov. (2019). Opioid Crisis Statistics. https://www.hhs.gov/opioids/about-the-epidemic/opioid-crisis-statistics/index.html

Hunnicutt, J. N., Chrysanthopoulou, S. A., Ulbricht, C. M., Hume, A. L., Tjia, J., & Lapane, K. L. (2018). Prevalence of long‐term opioid use in long‐stay nursing home residents. Journal of the American Geriatrics Society, 66(1), 48-55. https://doi.org/10.1111/jgs.15080

Kaye, A. D., Jones, M. R., Kaye, A. M., Ripoll, J. G., Galan, V., Beakley, B. D., … & Manchikanti, L. (2017). Prescription opioid abuse in chronic pain: an updated review of opioid abuse predictors and strategies to curb opioid abuse: part 1. Pain physician, 20(2S), S93-S109. https://europepmc.org/article/med/28226333#impact

Painter, S. G. (2017). Opiate crisis and healthcare reform in America: A review for nurses. OJIN: The Online Journal of Issues in Nursing, 22(2). DOI: 10.3912/OJIN.Vol22No02Man03

Park, K., & Otte, A. (2019). Prevention of opioid abuse and treatment of opioid addiction: current status and future possibilities. Annual review of biomedical engineering, 21, 61-

https://doi.org/10.1146/annurev-bioeng-060418-052155

The White House (2016). FACT SHEET: President Obama Proposes $1.1 Billion in New Funding to Address the Prescription Opioid Abuse and Heroin Use Epidemic. https://obamawhitehouse.archives.gov/the-press-office/2016/02/02/president-obama-proposes-11-billion-new-funding-address-prescription

The White House. (2002). The President's National Drug Control Strategy. https://georgewbush-whitehouse.archives.gov/news/releases/2002/02/20020212-2.html\

Assignment: Agenda Comparison Grid And Fact Sheet Or Talking Points Brief NURS 6050