Health Care Policy and Advocacy

Nurs 8100 Health Care Policy and Advocacy
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Nurs 8100 Health Care Policy and Advocacy
Health care policy and associated issues remain a major debate and at times contentious in contemporary America beyond the political sphere, and to the public domain. Issues in health care policy are categorized into two primary divisions; there are those that relate to health care coverage and others to the underlying cost of health care. The former accounts for health insurance encapsulating other fundamental elements including how it is paid for and the extent of its coverage. The latter constitutes policies that underscore costs aimed at reducing overall health care spending. Coverage and costs are major staking points because coverage facilitates access to health care and insulates persons from high health care spending burdens, while costs relate to the reduction in prices for health care services. The two elements will be central in addressing the controversial lining in the costs associated with the Affordable Care Act of 2010 (ACA), with the prevailing matter being placed under scrutiny of the CDC’s (Centers for Disease Control and Prevention) policy analytical framework.
Definition of the Policy Issue
Former United States (U.S.) president, Barack Obama will be fondly remembered for the inception of the ACA. The law was enacted in March 2010, and some consider it “the most monumental change in U.S. health care policy since the passage of Medicaid and Medicare in 1965” (Eno et al., 2016; Center et al., 2017, p. 111). Also known as the Patient Protection and Affordable Act of 2010 (PPACA), ACA aims at ensuring that healthcare among American citizens is a right rather than a privilege. This aspect is enshrined in the law’s three primary goals. The first among these is making affordable health insurance available to more people, orchestrating the expansion of the Medicaid program, and supporting innovative medical care delivery methods whose design facilitates an overall reduction in health care costs (Healthcare.gov, n.d.). The plans were ambitious for the newly-formed government.
One can relate to the great considerations in highlighting the government ambition was apparent in the then prevailing numbers. In that regard, approximately 50 million Americans were uninsured and even worse, close to 19% of this figure constituted the non-elderly population (Kominski et al., 2017). On the other hand, about 91% of this uninsured population has incomes below 400% federal poverty level, which means that they were eligible for the advantages accrued under the ACA. This position meant that ACA was well placed to enhance the healthcare access and outcomes for low-income populations. The people in the 400% threshold mentioned earlier were to receive subsidies that would be fundamental in the helping them buy insurance. The inception of the law in 2010 has resulted in the number of uninsured falling from the 50 million mentioned earlier to about 20 million (McIntyre & Song, 2019). This improvement cannot be disregarded, although one has to question the cost of these changes.
The authors of the law expected to achieve these proposition through the standardization of benefits and cost-sharing levels of qualified health plans. Still, the act remains contentious and retains significant opposition from mostly Republicans, which an interested audience must seek an understanding of their concerns. Kominski et al. (2017) posit that in the initial stages, this act posed hypothetical concerns in costs because of the sheer number of people it intended to serve, considering other thresholds relative to FPL. The controversy around ACA is highly premised upon the prevailing costs.
The desire to include as many people as possible has resulted in a rise in premiums, considering that companies are expected to offer an extensive range of benefits. People who had health insurance perceive it as unfair to have their premiums increased (Sullivan, 2019). In addition, taxes have risen as the government plots a convenient path in paying for ACA. Medical devices and pharmaceutical sales have faced the brunt of the situation as the taxes have increased. In addition, people with high incomes have been subjected to higher taxation schemes. Business, on the other hand, are being compelled to search for creative ways of circumventing these regulations, and most have cut employee hours to alleviate the incurring burden of covering employees. The last cost-initiated effect is that people can be fined if they lack insurance. Undoubtedly, money must be a major topic for a capitalistic economy and its people, which explains the narrow 49-to-51 vote defeat of the most recent repeal effort of the ACA (McIntyre & Song, 2019). Nonetheless, it is essential to analysis this issue relative to a policy analytical framework.
Application of the Policy Analysis Framework
Health policy analysis can never be understated. Its aim is in explaining the existing linkages among institutions, interests, and ideas in the policy process. Walt et al. (2008) are pleased with the utilitarian aspect of health policy analysis because its retrospective and prospective capabilities in helping people comprehend past policy failures and successes and more importantly, assisting them in planning for future policy implementation. The desire to reach some of these conclusions explains the application of CDC’s policy analytical framework, which consists of three domains (Centers for Disease Control and Prevention, 2013). These include problem identification, policy analysis, and strategy and policy development. However, its implication on the cost issue implication from the ACA will be analyzed relative to the social, ethical, legal, historical, and economic underpinnings of the policy.
To begin with, the social inclinations of the CDC framework accord the potential for the issue at stake to impact risk factors, quality of life, disparities, morbidity and mortality. In this regard, an effective cost-benefit analysis must be conducted to determine the advantages and burden arising relative to the factors mentioned in the immediate presupposition. Therefore, a redirect on the cost aspect of the ACA, one can generalize that the law is benefiting a significant number of people who would otherwise have found it difficult to access medical treatment. In ths case, although the costs of the entire process might be staking factor, there is no doubt that ACA has benefited the utmost number of American citizens. Consequently, people can access social amenities such as hospitals with minimal concerns over inability to receive treatment. Further, persons from minority groups can gain relieve from systemic racism that perpetuates their inability to receive health care services.
Ethically, the framework focuses on the population being impacted negatively and health disparities. When these metrics are considered, the high-net worth people and those with businesses could be considered as the victims of the act, given that they account for the greatest share of taxes and burden bestowed upon them. Retrospectively, health disparities have declined immensely since a higher equity in access and affordability of health care has been afforded to many people. This development is a classic example of utilitarianism, which is an ethical theory that advocates for decisions and policies where the impact is directed to the maximum number of people possible (Marseille & Khan, 2019). Therefore, the ethical aspect can be addressed from different perspectives.
The legality, historical, and economic aspects are also prevalent. The CDC policy analytical framework posits that scholars must question the constitutionality of the code and historically, assess whether it has been debated previously. The ACA received the presidential veto, when Barrack Obama was in office and thus, it was unlikely that it would receive an...