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Discussion: Health Care Reform

NURS 8100 Discussion: Health Care Reform

Discussion: Health Care Reform

The Affordable Care Act (ACA) was signed into law over 10 years ago and it has remained highly controversial by many law makers since its inception on March 23, 2010. Many law makers have tried to get rid of the ACA but have yet to find a health care system to replace the ACA that works with law makers and the public. Even though people may not like the ACA it has improved the health care system, provided health insurance to the uninsured, provided more prevention program to help improve the overall health of the American people. There was so much resistance to passing the ACA since the President at that time was African American and a Democratic (Silberman, 2020). The Patient Protection and Affordable Care Act (ACA) was passed by a Democratic Congress and signed into law by a Democratic president in 2010. Republican congresspeople, governors, and Republican candidates have consistently opposed the ACA and have vowed to repeal it during every election, but more than 50% of Americans support ACA. In the first year of ACA 10 million Americans gained accessed to health insurance. The ACA also eliminated the no coverage for prior conditions, it also decreased prescription drug cost and eliminated co-pay for preventive services. When people are asked why they oppose the ACA they mention they do not like the government involved in their healthcare, but they pay into Medicare which is a mandatory federal government insurance. Despite positive changes the ACA has brought to many Americans many politicians and people oppose ACA and want to get rid of ACA(Silberman,2020). While ACA has made great strides in improving health care, health disparity remains a major problem among people of color. The recent pandemic has shown the world once again that the health care system is even though Black Americans make up 13 percent of the US population over 23 percent of COVID deaths were Black Americans (USA, 2021).

In spite of significant advances in the diagnosis and treatment of most chronic diseases, there is evidence that racial and ethnic minorities tend to receive lower quality of care than non-minorities and that, patients of minority ethnicity experience greater morbidity and mortality from various chronic diseases than non-minorities. The Institute of Medicine (IOM) report from 2006 showed unequal treatment “racial and ethnic disparities in healthcare exist and, because that lead to worse outcomes in many cases. Minorities were provided less access to health care intervention, sources, and funding (Egede, 2006).

References

Egede, L. (2006). Race, Ethnicity, Culture, and Disparities in Health care

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924616/

Silberman, P. (2020). The Affordable Care Act: Against the Odds, It’s Working. North Carolina Medical Journal, 81(6), 364–369. https://doi-org.ezp.waldenulibrary.org/10.18043/ncm.81.6.364

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USA FACTS. (2021).US COVID-19 cases and deaths by state

https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/

Hello Cindy, I enjoyed reading your post.

All major policies including the healthcare reforms require a bi-partisan agreement from Congress, with specific and clear policy goals from each party. This becomes both a challenging and complicated battle because both republic and democrats disagree and differ on

Discussion Health Care Reform
Discussion Health Care Reform

priorities. The republicans’ goal and priority are to reduce costs, and have a small government over all other goals, while democrats’ goals and priority are to improve health and equity. They both however have some common ground, and that is the sufficiently challenging task of tackling health care costs, The other barrier is the fundamental conflict, the government’s role in health care provision, and subsidizing tradeoffs between reducing costs and increasing access (Pagel et al., 2017), complicating a complicated process. The only way they can pass the reform policies is to acknowledge each parties’ goals, begin the reform process in the issues which they are all agreeable, and then start to explore and negotiate a compromise on the non-agreeable issues to improve the long due US health system (Pagel et al., 2017).

President Trump defined the Patient Protection and Affordable Care Act (PPACA) as one of the greatest threats, “unsustainable and will lead American into complete insolvency” (Collier, 2017), and had a goal was to repeal it and replace it with cheaper, and better to provide insurance for all. The Republican efforts to weaken or repeal the individual mandate were fruitless and further undermined the individual market’s stability and exacerbate current marketplace trends (Willison, & Singer, 2017). President Trump was only able to whittle down aspects of coverage protection and finally admitted that the challenge of transforming health care was bigger than he had imagined, stating “nobody knew that health care could be so complicated” (Collier, 2017). President Biden managed to undo some of former President Trump’s policies that hindered access to health insurance in his first quarter of presidency, enacted a stimulus bill, and premium subsidies were increased substantially, making coverage much more affordable, but legislation is still needed for the larger parts of his health care agenda (Rice et al., 2021).

It is extremely difficult to improve the flawed American health care because American history has resulted in “a very different center of gravity from the politics of nearly every other industrialized country looking much less to government solutions” (Rice et al., 2021). The other factor is the enormous unfavorable influence of major lobbying groups representing the health care industry. They make it extremely hard to emulate other countries’ systems, which rely on government involvement, to guarantee coverage, setting, or negotiation of provider fees (Rice et al., 2021).

References.

Collier, R. (2017). Why Trumpcare failed. CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne189(17), E645–E646. https://doi.org/10.1503/cmaj.1095414

Pagel, C., Bates, D. W., Goldmann, D., & Koller, C. F. (2017). A Way Forward for Bipartisan Health Reform? Democrat and Republican State Legislator Priorities for the Goals of Health Policy. American journal of public health107(10), 1601–1603. https://doi.org/10.2105/AJPH.2017.304023

Rice, T., Barnes, A. J., Rosenau, P., Unruh, L. Y., van, G. E., & van Ginneken, E. (2021). Health reforms in the United States: The outlook after Biden’s first 100 days. Health Policy125(10), 1277–1284. https://doi.org/10.1016/j.healthpol.2021.08.003

Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act Essential Health Benefits: Threats and Obstacles. American journal of public health107(8), 1225–1226. https://doi.org/10.2105/AJPH.2017.303888

I enjoyed reading your post.

The issue of health disparities and racial inequities in health care, still remains a major thorny issue, with politics being one of the contributory factors. The ongoing COVID 19 pandemic exposed the longstanding structural drivers of health inequities, precarious and adverse working conditions, growing economic disparities, anti-democratic political processes, institutions, breaches, racial and social inequities, disparities in health delivery, especially in the minority communities (Paremoer et al., 2021).  The contributing factors were indicated long before the pandemic, and yet nothing was done to alleviate them. This, unfortunately, led to high discrepancies rates of infection and death in racial and ethnic minority communities compared with white communities (Gómez et a., 2021), which could have been avoided. The Covid-19 has hence, crystallized the need to address the “toxic combination of poor social policies, unfair economics, and bad politics, which are responsible for the health inequities” (Paremoer et al., 2021). The pandemic indicated that the health effects of the longstanding inequities, vulnerability to diseases, are determined by “labor market structures, lack of social protection, and anti-democratic processes” (Paremoer et al., 2021), while the structural inequity on populations is mediated by intersecting social dimensions. These can be resolved by eliminating obstacles to health, such as poverty, discrimination, and their consequences, powerlessness, lack of access to good jobs with fair pay, quality education, and housing, safe environments (Gómez et a., 2021). The governments must and should take responsibility for” rebuilding social protection and solidarity to protect populations from future health challenges” (Paremoer et al., 2021), and society with other social movements should hold them accountable. Having equal access to opportunities for all citizens to lead healthy lives, translates to achieving health equity, the “attainment of the highest level of health for all people” (Gómez et al., 2021).

References.

Gómez, C. A., Kleinman, D. V., Pronk, N., Wrenn Gordon, G. L., Ochiai, E., Blakey, C., Johnson, A., & Brewer, K. H. (2021). Addressing Health Equity and Social Determinants of Health Through Healthy People 2030. Journal of Public Health Management & Practice27, S249–S257. https://doi.org/10.1097/PHH.0000000000001297

Paremoer L, Nandi S, Serag H, Baum F. (2021). Covid-19 pandemic and the social determinants of health BMJ; 372: n129 doi:10.1136/bmj. n129

The Affordable Care Act (ACA) was signed into law over 10 years ago and it has remained highly controversial by many law makers since its inception on March 23, 2010. Many law makers have tried to get rid of the ACA but have yet to find a health care system to replace the ACA that works with law makers and the public. Even though people may not like the ACA it has improved the health care system, provided health insurance to the uninsured, provided more prevention program to help improve the overall health of the American people. There was so much resistance to passing the ACA since the President at that time was African American and a Democratic (Silberman, 2020). The Patient Protection and Affordable Care Act (ACA) was passed by a Democratic Congress and signed into law by a Democratic president in 2010. Republican congresspeople, governors, and Republican candidates have consistently opposed the ACA and have vowed to repeal it during every election, but more than 50% of Americans support ACA. In the first year of ACA 10 million Americans gained accessed to health insurance. The ACA also eliminated the no coverage for prior conditions, it also decreased prescription drug cost and eliminated co-pay for preventive services. When people are asked why they oppose the ACA they mention they do not like the government involved in their healthcare, but they pay into Medicare which is a mandatory federal government insurance. Despite positive changes the ACA has brought to many Americans many politicians and people oppose ACA and want to get rid of ACA(Silberman,2020). While ACA has made great strides in improving health care, health disparity remains a major problem among people of color. The recent pandemic has shown the world once again that the health care system is even though Black Americans make up 13 percent of the US population over 23 percent of COVID deaths were Black Americans (USA, 2021). 

 

 In spite of significant advances in the diagnosis and treatment of most chronic diseases, there is evidence that racial and ethnic minorities tend to receive lower quality of care than non-minorities and that, patients of minority ethnicity experience greater morbidity and mortality from various chronic diseases than non-minorities. The Institute of Medicine (IOM) report from 2006 showed unequal treatment “racial and ethnic disparities in healthcare exist and, because that lead to worse outcomes in many cases. Minorities were provided less access to health care intervention, sources, and funding (Egede, 2006). 

 

References 

 

Egede, L. (2006). Race, Ethnicity, Culture, and Disparities in Health care 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924616/ 

 Silberman, P. (2020). The Affordable Care Act: Against the Odds, It’s Working. North Carolina Medical Journal, 81(6), 364–369. https://doi-org.ezp.waldenulibrary.org/10.18043/ncm.81.6.364  

USA FACTS. (2021).US COVID-19 cases and deaths by state 

https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/