Discussion: Presidential Agendas
NURS 6050 Discussion: Presidential Agendas
Healthcare in general is abused in so many ways. It costs a lot, there is so much waste and not everyone seems to be able to have access to it. On top of that, on a daily basis it is witnessed that there are vials of insulin thrown away, cards of pain medications, blood pressure pills, and antibiotics destroyed (Fugate, 2018). People who have no payer source are using our ambulance services as a taxi for non-emergency trips. America is concerned with these rising costs, and the need to have affordable quality healthcare.
Past President’s Approaches
Bush had many trials in his presidency. However, he did focus on wanting more affordable health care. He had tax cuts and was making healthcare savings accounts (HSA) more affordable (White house, n.d.). President Bush wanted quality healthcare and wanted medications to have better coverage in his Medicare plans (Office of the Press Secretary, 2004). President Obama came up with what is more commonly known as Obamacare which he wanted to be more affordable healthcare for everyone. However, there was a fee if you could afford insurance and did not purchase qualifying insurance and that was tough on some who did not want to purchase health insurance(Healthcare.Gov, 2021). President Trump also followed in previous president’s footsteps in wanting to make the healthcare system better by lowering prescription prices and improving the quality of healthcare for our veterans (White house, n.d.). The Trump administration had made historical advances in getting prices of medications lowered (US Food and Drug Administration, 2019).
What could be done differently
All three presidents had made great attempts in making healthcare more affordable, lowering prescription prices, and making the quality of health care better. What I would do different is to look at areas where services are being abused and helping with triage capabilities in determining what is an emergency and what is not. Along with that, open insurance across state lines preventing monopolies and price gouging. Higher education for first responders, EMT’s and the paramedics. Possibly more funding to home health programs were people have better healthcare come to their homes. Redistributions of medications, if medications have not been touched and are in sealed bubble packed cards, they can be redistributed to others who are on the same medications to cut down on waste. Healthcare is not an easy thing to regulate, and it seems so far there is no right way only steps to continue to improve what is safe for all.
Fugate, T. (2018). Medical waste and the rising cost of healthcare. Minnesota Nurses Association. Drug Prices, Health Care Reform, Home, Issues, Single Payer. https://mnnurses.org/medical-waste-rising-cost-healthcare/
Healthcare.Gov (2021). The fee for not having health insurance: No health insurance? See if you’ll owe a fee. Healthcare.gov. https://www.healthcare.gov/fees/fee-for-not-being-covered/
Office of the Press Secretary of The United States. (2004). Fact Sheet: The President’s Health Care Agenda. https://georgewbush-whitehouse.archives.gov/news/releases/2004/01/print/text/20040128.html
The White House. (N.D.) About the white house presidents: Presidents. https://www.whitehouse.gov/about-the-white-house/presidents/
United States Food and Drug Administration. (2019). Trump administration takes historic steps to lower U.S. prescription drug prices. https://www.fda.gov/news-events/press-announcements/trump-administration-takes-historic-steps-lower-us-prescription-drug-prices
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Access to healthcare is widely known to be challenging for many persons especially ones residing in vulnerable populations. I personally on my path of becoming an NP wishes to serve in these areas to help gain access to health and health education so people can be equipped to make better choices. According to the U.S Department of Health and Human Services, there are still many persons in the U.S who still face difficulty in accessing healthcare which can be largely due to a lack of health insurance. I also concur, more emphasis needs to be placed on expanding insurance coverage rates so more persons can access the health system and more so on preventative care and treatment of chronic illnesses.
You spoke of more work that needs to be done in Mental Health and I do agree. A national objective to improve health and well being over the next decade is the Healthy People 2030 framework that focuses on screening, prevention, and assessment of mental health disorders. I believe the most vulnerable population that suffers from mental health disorders are adolescents. The reason being, during that developmental stage, thought processes are formed and behaviors are formed into early adulthood. Without a clear understanding and early diagnosis, one can be misled into a whole span of negative issues. This can continue into adulthood and may affect the person’s productivity and contribution to society. Other than the different array of the healthcare team who mentioned that is needed what other aspects in mental health do you think need greater impact?.
U.S Department of Health and Human Services. (n.d.). Health Care Access and Equality.https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality
U.S Department of Health and Human Services. (n.d.). Mental Health and Mental Disorders. https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders
The healthcare system is highly sensitive and that is why presidents have to make critical decisions and ensure the safety of their citizens. I agree with you that the opioid epidemic is one of the healthcare issues that rose to the presidential level. Opioid misuse presents various health risks and that is why it was necessary to engage the presidential intervention. President Bush’s administration approached the issue in three ways. First, the administration provided efforts to stop the kids from using the drug. Secondly, the treatment for those already using the drug was expanded and finally, the flow of the drug into America was controlled. The measure would be undertaken for infectious diseases that arise, Breaking the infection cycle is important in managing health crises and emergencies (Hedberg, et al., 2019).
The Obama administration approached the issue more comprehensively and approved the CAR bill to fight the epidemic. Similarly, President Donald Trump declared the epidemic a national state of emergency and this was appropriate. I agree that health issues require urgent intervention to curb the causative factors and prevent the issue from spreading further and this is what the three presidential administrations did.
The presidents must be sensitive to identify the impacts of given health issues and develop appropriate policies that will minimize the harmful effects the citizens suffer (Smith, 2020). In this case, the use of opioid drugs was on the rise and the level could have been very disastrous if the relevant measures developed were not adopted. It is important that government systems set aside funds to handle medical emergencies whenever they rise because they cannot be postponed (Katz, Attal-Juncqua & Fischer, 2017).
Hedberg, K., Bui, L. T., Livingston, C., Shields, L. M., & Van Otterloo, J. (2019). Integrating public health and health care strategies to address the opioid epidemic: the Oregon Health Authority’s Opioid Initiative. Journal of Public Health Management and Practice, 25(3), 214-220. doi: 10.1097/PHH.0000000000000849.
Katz, R., Attal-Juncqua, A., & Fischer, J. E. (2017). Funding public health emergency preparedness in the United States. American journal of public health, 107(S2), S148-S152. doi: 10.2105/AJPH.2017.303956
Smith, H. J. (2020). Ethics, Public Health, and Addressing the Opioid Crisis. AMA Journal of Ethics, 22(8), 647-650. doi: 10.1001/amajethics.2020.647.
Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
New York State Department of Health. (n.d.). Making New York the healthiest state: Achieving the triple aim. Retrieved June 21, 2021 from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf
- Review the Resources and reflect on the importance of agenda setting.
- Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
By Day 3 of Week 1
Post your response to the discussion question: Consider a population health topic that rises to the presidential agenda level. Which social determinant most affects this health issue? How did two recent presidents handle the problem? What would you do differently?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
*Note: Throughout this program, your fellow students are referred to as colleagues.
The purpose of this discussion is to identify and describe a population health concern and explain how the past and current presidential administrations approached the issue, including resource allocations. Population health describes the health status and outcomes within specific groups or communities. For public health professionals, there is need for proper understanding and optimization of population health outcomes. The selected population health concern is access to quality and prompt healthcare through Medicaid for opioid treatment. According to Milstead and Short (2019), improving access to health of an entire population can enhance physical and mental health outcomes and wellbeing, significantly reducing inequalities and inequities.
The selected health concern is the opioid crisis in the United States. The health concern is characterized by the overdose of pain medicine such as morphine, hydrocodone, oxycodone, fentanyl and tramadol for non-medical purposes. Thousands of Americans have died from drug overdoses. Disabilities and incarceration have also increased in the United States because of opioid crisis.
President Trump Administration focused on reforming Medicaid by introducing and imposing work requirements and placing caps on the spending growths. The Administration also emphasized the need to convert Medicaid to block grants (Schubel et al., 2020). These changes sought to radically overhaul Medicaid coverage for adults in states. For instance, the Administration proposed that states should convert the Medicaid programs for adults into block grants with capped federal funding, significantly reducing access to care for opioid addiction treatment (Schubel et al., 2020). States that implement the block grant waivers could by law deny coverage for prescription drugs and impose higher copayments on low-income individuals. The Administration secured about $6 billion to address opioid use disorder over 2 years through the Initiative to Stop Opioid Abuse (Wen & Sadeghi, 2020).
Alternatively, the President Biden Administration believes that healthcare access is a fundamental right for all Americans, including those with opioid addiction. The President’s Build Back Better Agenda focuses on lowering the costs of health insurance and expanding coverage for every American (Keith, 2021). Under the landmark American Rescue Plan, ACA premiums have been significantly reduced while enrollment has increased. The Administration is also asking states to use Medicaid funds to cover opioid addiction treatment, especially in correctional facilities experiencing intense cravings and withdrawal. To advance President Biden’s plan to beat the opioid epidemic as part of his Unity Agenda, the Administration released the FY 2024 budget request to Congress, which calls for a historic investment of $46.1 billion for National Drug Control Program agencies (The White House, 2023).
While Trump Administration wanted to defund Medicaid, Biden Administration makes it easier for more Americans to enroll in, better understand their coverage options, and expand eligibility. Defunding Medicaid means less or reduced access to quality care for most American. This would also hugely impact the treatment of opioid-related addiction in the United States.
The United States Department of Health and Human Services (HHS) is responsible for addressing the risks and harms associated with opioids. This agency is important because it focus on the provision of effective health and human services and by fostering robust, consistent advances medicine, public health, and social services.
The negative impacts of opioid crisis such as absenteeism, increased workplace accidents, and withdrawal from the labor force because of disability, incarceration, and death might make the healthcare issue get on the presidential agenda. The issue can stay on the presidential agenda is the proposed interventions yields the targeted outcomes.
I would chose a celebrity such as Eminem to champion for the prevention and eradication of opioid crisis in the United States. The musician can use his massive following to influence positive behavior changes and pursue related policy changes.
Keith, K. (2021). Biden administration finalizes first marketplace rule, including new low-income special enrollment period. Health Affairs Forefront. https://www.healthaffairs.org/do/10.1377/forefront.20210919.154415
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Schubel, J., Katch, H., Solomon, J., & Aron-Dine, A. (2020). Trump administration’s Medicaid block grant guidance: frequently asked questions. Center on Budget and Policy Priorities. https://www.cbpp.org/sites/default/files/atoms/files/2-6-20health_0.pdf
The White House. (2023). President Biden calls for historic funding to beat the overdose epidemic being driven by Fentanyl. https://www.whitehouse.gov/ondcp/briefing-room/2023/03/09/president-biden-calls-for-historic-funding-to-beat-the-overdose-epidemic-being-driven-by-fentanyl/
Wen, L. S., & Sadeghi, N. B. (2020). The opioid crisis and the 2020 US election: crossroads for a national epidemic. The Lancet, 396(10259), 1316-1318. https://doi.org/10.1016%2FS0140-6736(20)32113-9