Hi, I am a qualified and excellent writer, but too much busy and have Five Modules incomplete assignments ( Healthcare policy course / Master's degree), including a course project due on 10th Dec. R

Sheena Lamon

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After completing this mindmap, it has become obvious to me that there is a definite need for these healthcare policies based on the utilization of the programs these policies have created.  Our healthcare system relies on these government programs as much as it opposes them. The Democratic Party and Republican Party are the two predominate parties in our government system and with so much money spent on healthcare in our country, health care has become part of their political platforms for decades.  While the Democratic Party supports government run and funded healthcare programs for anyone who needs them, the Republican Party is always trying to reduce spending to these programs thinking private insurance companies and the market will reduce healthcare costs through competition. (democrats.org, 2020)  I believe there is too much income inequality in our country to allow capitalism to fix the problems with our healthcare system, especially when there are so many factors that determine our individual health. Some of these factors are out of our control and the availability of healthcare resources can widen the income inequality even more. Medicare and Medicaid are still around after their implementation in 1965 because vulnerable people need health insurance. The creation of the Affordable Care Act (ACA) is one way to help decrease the amount of money we are spending as a country on healthcare and improve the quality of care by making insurance more affordable, comprehensive, and fair. If the ACA is able to accomplish its goals and decrease the amount of money that is being spent on Medicare and Medicaid programs, I do not see how the Republican Party can justify its party platform to get rid of this policy. Bipartisan support for the other two policies presented in this mindmap illustrate that we do want our citizens to be healthy, who pays for it and how the program runs is always the partisan issue. By making health insurance affordable and accessible to everyone, I believe we will be one-step closer to having an equal playing field for everyone. As stated by Stone (2011) “…nations that have more equal income distributions do as well or better than more unequal nations on measures of economic prosperity, including employment, gross domestic product (how much output a country produces), and economic growth rates” (p. 81) and I believe the same is true for health outcomes. By eliminating the inequity in who has health insurance coverage, I think health outcomes can be improved.  I believe we are all just a diagnosis away from being a high utilizer of healthcare and having bills we cannot afford and I want everyone to get the care they need, when they need it to improve the health and success of our country for the future. 

References:

Achieving universal, affordable, quality health care. (2020, August 29). Retrieved March 30, 2021, from https://democrats.org/where-we-stand/party-platform/achieving-universal-affordable-quality-health-care/

Stone, D. (2011). Policy paradox: The art of political decision-making (3rd ed.). New York: WW Norton & Co. Inc. Publishers. ISBN: 0393912728

Ansley Rushing

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This summary will look at the democratic party and the republican party. Each political party has their own viewpoints that skew to one side to the other. I am in the middle of these two political parties when it comes to my viewpoints. The republican side wants to keep the government out of healthcare whereas the democratic party wants healthcare for all. My personal opinion is that we can have it both ways. The government should stay out of healthcare in the sense that they should not make rules and regulations for hospital staff that are not formed for a safety reason. In the United States we should be at the point where healthcare is a right for all people.

Current bills proposed by the republican party aim to reduce government presence in the healthcare sector (King, 2019).  More moderate republicans are open to the idea of the government getting involved to reduce the costs of current healthcare. For example there is speculation that the republicans loss their favor in the house due to the attempt to repeal the ACA (King, 2019). This is speculation, but the ACA has grown on the population and has helped many people afford care they previously were unable to receive. The reversal of this would be harmful for many Americans.

Current bills proposed by the democratic party are attempting to pass bills that they are unable to agree on. This party has a wider range of viewpoints on how to expand into the healthcare sector to provide care for all (Pramuk, 2021). This ranges from modifying the current ACA to moving to a single payer system.

I lie in the middle of this. The ACA was never meant to be a one size fits all solution. It was started in 2009 and signed into law in 2010 (eHealth, 2020). Similar to Medicare it started an important and necessary reform for the American healthcare system. Those in the U.S. should be able to receive care without the fear of bankruptcy. Healthcare costs should not be an area that price gouges people because they can. The government should be there to protect the people, but not assert control over medical care. My basis for this statement is the fact that if the government controls healthcare then it can refuse procedures for reasons that are not supported by science. It is important to remember that not long-ago same sex marriage was not allowed due to an old rule. This is something that could play into trans rights and cause issues with cosmetic procedures. 

References:

EHealth. (2020). History and Timeline of the Affordable Care Act (ACA). eHealth. https://www.ehealthinsurance.com/resources/affordable-care-act/history-timeline-affordable-care-act-aca (Links to an external site.).

King, R. (2019, October 22). A group of Republicans has unveiled its healthcare plan. Here is what's new and what isn't. FierceHealthcare. https://www.fiercehealthcare.com/payer/a-group-republicans-have-a-new-healthcare-plan-here-what-new-and-what-isn-t (Links to an external site.).

Pramuk, J. (2021, April 1). Biden ran on a health insurance public option, but it's not clear if he will include it in his recovery plan. CNBC. https://www.cnbc.com/2021/04/01/biden-considers-health-care-public-option-in-economic-recovery-plan.html (Links to an external site.).

Melanie Coffey

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I chose to keep the MindMap assignment simple, by comparing and contrasting the Democratic and Republican parties health care plans. Besides the ACA, Medicaid, and Medicare, I focused on the COVID response and VA healthcare. The ACA was established under President Obama and had a lot of Democratic support. While it still remains the law of the land, Republicans have tried to overturn it ever since it was implemented. The parts of the plan that I think had the greatest impact to healthcare were keeping children on their parents' plan until the age of 26, no one could be turned down for pre-existing conditions, the expansion of Medicaid, the tax breaks given to lower income families, and free preventative care (Healthcare.gov). One way to help pay for the ACA was the individual mandate which meant that you needed to sign up for insurance or pay a tax penalty (Healthcare.gov). This is the area that many Republicans wanted to do away with, and after Trump did by executive order, many premiums went up. My views on the ACA are that it opened the door for many more people to have access to care that may otherwise have gone without. I am not a fan of the low premium plans with high deductibles, because I feel like people who have them would probably be better off with nothing. The make you come out of pocket for so much before they even begin to cover anything. It seems to me that we can do better. We need to take lobbyists out of the equation and think about the people of this country. If we continue to allow the drug and insurance companies to dictate health care, we'll never do any better. 

Medicaid and Medicare are my favorites. They both at one time had bipartisan support and have continued to help our most vulnerable populations. With Medicaid funded by both Federal and State governments, it has opened the door for many in the most underserved populations to have access to quality care at little or no cost to them. Medicare is funded through tax money collected from employees and employers. 7.65% of everyone's pay goes to FICA and then 81% of that money goes to social security and the other 19% goes to Medicare (CMS.gov). While Democrats try to expand these programs, it seems that Republicans want to cut funding. My opinion is that we need more social programs like these in our country. I am not a socialist, but the reason these and Social Security were set up were to help vulnerable populations. If we want to be the greatest country there is, we need to be willing to give everyone an equitable chance. I did not say equal, because some need more than others, which is why programs like these are so important. 

The VA, under President Obama, was expanded to give veterans better access to care. It expanded VA clinics, giving them the ability to hire more staff and open more clinics. It allowed immediate same day access for mental health services as well. The bill ensured veterans would receive timely care, and if they couldn't within the VA system, they would have access to care elsewhere. passed with overwhelming bipartisan support (VA.gov). The bill is paid for by the federal government. Like Medicaid and Medicare, I think VA care is just as important. The biggest problem with VA care and, actually, care in general in this country is the time it takes to actually get an appointment. That is something that needs to be changed across the board. If we can find a way to expand health clinic and doctors offices, it could be better for everyone. We need to make medical school, nursing school, and any other health provider training free in order to give people the incentive to become providers. We need to give bonuses to mental health providers, because that is a huge problem in this country is the lack of mental health care and facilities. We can do better for our veterans, and honestly, for everyone else as well.

COVID-19 continues to plague us today. This was handled terribly from the start. While money was sent out, some PPE and other equipment needed was provided, and companies were given funding to create a vaccine, the overall response was dismal (FEMA.gov). While the current response is much more encouraging, I think the disinformation that has been floating around from the beginning is making it impossible to get this virus under control. I blame both parties for this. While Republicans downplayed it, Democrats should have been more forceful in their response. Some governors did a great job at trying to mitigate the virus, but the fact that this became such a partisan issue is why we lost so many people. If there was ever a time to come together as a country, this would have been it, and I believe we failed miserably. 

References:

Healthcare.gov. "The Affordable Care Act." healthcare.org. https://www.healthcare.gov/where-can-i-read-the-affordable-care-act/ (Links to an external site.)

Center for Medicare and Medicaid Services. (2015). "Financial management" CMS.gov. https://www.medicaid.gov/medicaid/financial-management/index.html#:~:text=The%20Medicaid%20program%20is%20jointly,Medical%20Assistance%20Percentage%20(FMAP) (Links to an external site.).

FEMA. (2020) "Recovery and economic support" FEMA.gov. https://www.fema.gov/disasters/coronavirus/economic Keith, K. (2020). "Taking stock of Republican health policy in the Trump era." Health Affairs. https://www.healthaffairs.org/do/10.1377/hblog20200821.513686/full/  (Links to an external site.)

US Department of Veteran Affairs. (2021). "Office of budget." VA.gov. https://www.va.gov/budget/products.asp (Links to an external site.)

Amber Shaver

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           Looking at Medicare, the origin was a compromise; a blending of two ideas. According to Oliver, Lee and Lipton (2004), in their article on the history of Medicare stated, “Representative Wilbur Mills (D-Ark),…, made the surprise suggestion that the Democratic and Republican proposals essentially be combined into Title XVIII of the Social Security Act, a new Medicare program with two parts A (hospital insurance) and B (supplementary medical insurance)” (p. 291). Since its inception, Medicare has been under constant scrutiny regarding expanded benefits, cost and coverage issues.

           These challenges can also be seen when looking at Medicaid and the ACA. Patel and Rushefsky (2014) said it best;

The Medicaid program, in many ways, represents the best and the worst of American politics. It reflects the best of the American tradition of helping the poor and disadvantaged groups who cannot help themselves. It also reflects the worst of American politics and policy making—that of an incremental, patchwork approach to policy making—influenced by the vagaries of electoral and economic cycles and partisan and ideological battles that often produce irrational and incomprehensible public policy. (pp. 121-122)

The same challenges exist, rising costs and extending coverage. With the ACA it was met with legal challenges from the moment it was signed. Questions regarding constitutionality with the individual mandate and the effects on state budgets (Patel & Rushefsky, 2014).

            Additional policies I researched were CHIP and HIPAA. The Children’s Health Insurance Program provides health coverage to eligible children that is funded by both state and federal government. With CHIP, expansion and finances are a reoccurring theme with the Democrats favoring expansion to all children and favoring cuts to Medicare Advantage and increasing tobacco costs. And the Republicans favoring lowering funding to cover it, resulting in covering less children. Republicans also favor cuts to administrative expenses. Expansion of CHIP to cover all children, not just those with parents below a certain income threshold is the proposed policy I favor the most. Not only does the expansion provide health insurance benefits for children, but it is an investment in our children and future generations.

           HIPAA, the last policy I researched, owes its creation to bipartisan support, that has evolved over time. Most people think of the privacy portion of the policy when HIPAA is mentioned, but equally important at the time it was enacted was the portability aspect, allowing workers to change jobs without fear of losing their health coverage and preexisting conditions being covered. While the ACA furthered the preexisting condition coverage to all people, this initial legislation set the tone for the ACA 14 years later.

           This class has taught me that I am not as educated in laws or policymaking as I had originally thought. (Which was not high to begin with). In the most simplistic form, my perspective on Democratic healthcare policies are focused around expansion of coverage. While the Republicans are centered around budget costs. And I agree with both, there should be a way of extending coverage while maintaining costs. However, there will always be a tradeoff, and neither option is without fault. 

References

Ku, L., Lin, M., & Broaddus, M. (2007). Improving Children's Health. Center on Budget and Policy Priorities, Washington, DC.

Oliver, T. R., Lee, P. R., & Lipton, H. L. (2004). A political history of Medicare and prescription drug coverage. The Milbank Quarterly, 82(2), 283-354.

Patel, K., & Rushefsky, M. (2014). Healthcare politics and policy in America (4th ed.). M.E. Sharpe.