NURS 6050 Discussion 3 (Walden)

Politics and the Patient Protection and Affordable Care Act

The divisive politics and polarization have made it difficult for American leaders to rethink about the much-anticipated reforms in healthcare sector. There are those arguing that the current affordable healthcare program under the Affordable Care Act is economical. From a cost benefit analysis approach, for a program to be economical, the benefits must be high compared to the amount incurred in the implementation of the program (Milstead & Short, 2019). The Act makes it possible for most of the citizens to access healthcare services and, therefore, repealing it may make legislators lose political support.

The politics around the affordable healthcare Act is that if it is repealed, some political leaders fear that many people will lose the insurance cover (Hagan et al., 2017). There is also fear that the repeal of the Act will result in a massive loss of jobs with the reduction of people who have access to the insurance cover. For instance, if the Act is repealed, many people who acquired their insurance coverage under the affordable healthcare program will automatically lose them. Millions of low-income earners who got covered under the Medicaid program will lose them, and consequently, many Americans will end up uninsured. This will affect their ability to access and afford healthcare services.

From Feldstein’s point of view, it is unlikely that the politicians will support the repeal of the Affordable care Act. This is based on the fact that from a cost-benefit analysis, the politicians are only likely to support a legislative agender that has more beneficial to them (Feldstein, 2006). On this basis, they are not likely to repeal the Affordable Care Act because it will not be beneficial to the Americans. This is reflected by the fact that despite the efforts by President Trump’s efforts to have the Act repealed, he has not been succeeded. For instance, even when the republics were in the control of the Congress, they could not Marshall the necessary support for the votes required to repeal the law. The coat benefits (political support), in this case, outweigh the cost (losing political support). Therefore, they are not likely to support the repeal.

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References

Feldstein, P. (2006). The politics of health legislation: An economic perspective. Chicago, IL: Health Administration Press.

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

Taylor, D., Olshansky, E. F., Woods, N. F., 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 (2017) 242–245]. Nursing Outlook, 65(3), 346-350.

Hi Lenick,

The fact that if the Affordable Care Act is repealed will cause many people to lose insurance is troubling. The United States will have up to 21 million individuals uninsured (Abelson, Goodnough & Pear, 2019). In addition to, Abelson, Goodnough and Pear state “without the A.C.A, the cost of care for people who cannot pay for it could increase as much as $50.2 billion…Hospitals and other medical providers will incur losses” (2019). Therefore, one of the Affordable Care Act’s goal was to promote primary care and preventative care which will reduce visits to the emergency department or reduce worsening chronic illnesses. According to Araujo’s Average Health Care Costs and Ways to Save, she states “health care spending is projected to grow at an average rat3e of 5.5% per year between 2018 and 2027” (2019). If the Affordable Care Act is repealed and an uninsured visit the emergency department without paying their bill it would lead to money loss in health care. “Once a patient declared bankruptcy [for medical bills], the hospital had to declare a loss on any unpaid treatment” (Amadeo, 2019). Furthermore, in Amadeo’s article, she concludes “Obamacare reduced the number of bankruptcy filings” (2019), which is a benefit to the economy and Americans.

References

Abelson, R., Goodnough, A. & Pear, R. (2019). What happens if Obamacare is struck down?. The New York Times. Retrieved from https://www.nytimes.com/2019/03/26/health/obamacare-trump-health.html

Amadeo, K. (2019). Benefits of Obamacare-What you will and won’t lose if Obamacare is replaced. Retrieved from https://www.thebalance.com/benefits-of-obamacare-advantages-of-the-aca-3306066

Araujo, M. (2019). Average health care costs and ways to save-Be prepared by understanding what you might pay. Retrieved from https://www.thebalance.com/healthcare-costs-3306068

Discussion Week 3 Nurs 6050 Policy and Advocacy Essay Completed Sample/ Example 

Financing of Health Care in the United States depends greatly on the organization of payment and delivery of services to the public. As the video this week pointed out, giving free healthcare benefits to people doesn’t fix the problem because there is a vast shortage of providers in every arena of healthcare. In previous attempts to reform healthcare policy, we shifted emphasis from care provided on a new basis to prevention services such as regular health screenings. Healthcare is not a universal service where individuals receive the exact amount of attention due to genetics, the environment in which we live, and the personal way we choose to care for our body. Insurance was created to help Americans obtain medical care and not be deterred by the high costs. There are numerous programs in which Americans pay for medical care such as Medicaid, Medicare, and prepaid health plans. When payment is quantity based, the quality of attention decreases, I believe this isn’t fair to the public nor is it fair to the provider. Providers have specialized training and have a skill set not easily attained. They should be allowed to use their talent to heal. I think to pay for performance that offers extra funds when health outcomes are high, and the disparity is small is a superb idea.

It utilizes the reward system to provide the best care thus making our communities healthier. There is an enormous amount of overconsumption which leads to wasted resources. To prevent the same tests or services from being duplicated communication and coordination must improve. Policymakers need to include the consumer and provider when formulating proposals. Bridging the communication gap would be the first step. Expanding the scope of practice for nurse practitioners and lowering the cost of education may prove to be beneficial. Insurance funded through federal funds need more regulation and an established criterion. Many providers have chosen to not accept federally funded insurance due to being paid less for the same care provided to a payee with private insurance. Community health centers for psychiatric care decreased for acute stay- some are only approving one day. We have argued that patient stabilization does not occur in one day. Also, private insurances have formed strong standards (i.e. they will not pay for medical detox of methamphetamines, cocaine, or marijuana. From a nursing standpoint, I understand their rationale. However, it’s hard to explain to the family of a drug addict why they can’t receive help for their family member even though they are paying a significant amount for the insurance coverage.

It is interesting to note approximately 7.1% of veterans (1.8 million) reported a substance disorder in 2015 (Healthy People 2020, 2014). These issues become unresolved without adequate support from healthcare providers and community resources. Healthy People 2020 has acted proactively to assist with these issues by providing information and resources for veterans allowing them to be involved in their health and subsequent treatment (Healthy People 2020, 2014). Ethically I do not believe our veterans receive the care they deserve for defending our country.

The American Board of Internal Medicine (ABIM) work with stakeholders and policy leaders to influence national decision makers such as U.S. Congressman. Regulatory organizations ensure quality care is given. They believe accountability achieves the quality of attention through board certifications and accreditation (American Board of Internal Medicine, 2017). ABIM policy focus is on physician performance measurement, patient-centered, coordinated care, delivery of interventions, transparency and public reporting. Additional monitoring is payment reform and medical education and training. They conduct discussions with organizations that form policy agenda (American Board of Internal Medicine, 2017). Some of the organizations they actively work with are AARP, Centers for Medicare and Medicaid Services, The Joint Commission, and MedPAC.

Not allowing policy makers to use the cost of care in decision making can prove to be beneficial but can also prove detrimental. Without knowledge of costs, it is virtually impossible to contain costs and create a budget. After reviewing the information in the Washington Post article “Review of Prostate Cancer Drugs Provenge Renews Medical Cost-Benefit Debate” I believe it is unethical to allow only financially secure access to the medication. It places the connotation that one man’s life is more valuable than another and that is not right. A critical consideration should be the drug companies and limits on the prices of medication. Perhaps if we lower the costs for pharmaceuticals health disparities would decrease. Regulation of drug costs may prove beneficial as well.

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