Presidential Agendas Discussion

Presidential Agendas Discussion 

Presidential Agendas

Population health emerges as an important practice towards better health outcomes and health status within populations. In most instances, the health care providers, including employers, insurers, and care providers, look at population health in relation to their specific patients’ needs. However, population health is a broad practice according to health reform and should include everyone by evaluating social determinants that affect health (New York State Department of Health, 2021). Political class is among the part of the actors that are actively involved in the population health especially when it comes to developing policies. In this response, the different presidents in the United States have had diverse opinions when it comes to population health reforms and responses. For instance, during the rise of pandemics in the United States presidents have shown different ways of responding to pandemics because pandemics are fast spreading and may wipe populations within days when not adequately managed (Kerr et al., 2021). In this response, there is a need to explore the presidential agendas in response to pandemics specifically during the reign of President Donald Trump and President Joe Biden.

President Trump and Biden are referred to as pandemic presidents due to their tenures in office during the rise of major pandemics, including Covid-19, H1N1, Ebola Outbreak, and Zika Virus. Among these pandemics, Covid-19 emerges as the biggest and the most widely spread across the United States. The rise of COVID-19 got President Trump off-guard and this led to America seeing huge losses in terms of lives where it accounted for over 21% of all global cases and 21% of all deaths came from the United States (Kerr et al., 2021). President Trump was not prepared for the pandemic and this is the reason the federal government left all the responsibilities to the states and the national government only served as a backup and offered supplies as a last resort. This demonstrated a lack of proper understanding of pandemics and guidelines by the national government hence leading to worse community spread. At first, Trump capitalized on closing the border between the United States and China, which came late, and community transmission was becoming immense. The travel restrictions and testing of the arriving passengers were not as effective since there was little information about the pandemic to public health and their capacities. It was unfortunate that the president downplayed the first incidences of COVID-19 cases in the country and moving forward gave contradicting information and unsupported reports about the control and the causes of the pandemic (Himmelstein, 2021).

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On the other hand, President Biden has been a critical part of population health since his time as the Vice president during Obama’s administration and as the current president of the United States. As a vice president, he spearheaded the management of H1N1 in 2009, the Ebola outbreak in 2014, and the Zika virus in 2016 (Schiff, 2023). The Obama administration was effective in coming up with a ‘Global health security agenda’ that aimed to protect the world from being destroyed by infectious diseases. Biden has put across several measures that will help respond to pandemics like COVID-19 moving forward including having an effective national emergency response made of frontline workers for saving lives and reducing spread. He also believes in coming up with decisive economic measures to support the worst-hit families and businesses. Biden believes that the federal government must be on the frontline in offering solutions to Coviod-19 including better vaccine research and development and ethical task force that works to eliminate racial disparities in times of pandemics (Himmelstein, 2021).

Conclusion

The presidential agendas are an important part of population health advancement and this helps in policy development. Through the time of pandemics, presidential agendas are crucial in helping reduce the spread and mortalities. The coming of Covid-19 reflected the major failures of President Trump in making vital decisions and his inconsistencies led to huge spread and loss of lives. However, the reign of President Biden has worked to restore sanity in the response to pandemics by developing practical solutions that will be used in responding to COVID-19 and other future pandemics.

References

Himmelstein, D. U., & Woolhandler, S. (2021). Recovering from Trump: Biden’s first 100 days. Lancet (London, England), 397(10287), 1787–1791. https://doi.org/10.1016/S0140-6736(21)00979-X

Kerr, J., Panagopoulos, C., & van der Linden, S. (2021). Political polarization on COVID-19 pandemic response in the United States. Personality and individual differences, 179, 110892. https://doi.org/10.1016/j.paid.2021.110892

New York State Department of Health. (2021). 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

Schiff, E., & Mallinson, D. J. (2023). Trumping the Centers for Disease Control: A Case Comparison of the CDC’s Response to COVID-19, H1N1, and Ebola. Administration & Society, 55(1), 158–183. https://doi.org/10.1177/00953997221112308

Presidential Agendas Discussion

Initial Post

Healthcare reform has been a major political topic over the past two decades. Policies have been debated on and implemented over the past ten to fifteen years that has changed the way healthcare works in America.

George W. Bush

George W. Bush stated in his state of the union address, that he proposed an agenda to make health care more affordable, transparent, portable, and efficient. In 2003, President Bush signed a bill into law that started the healthcare savings account. He also implemented policies changes that helped pave the way to bring more generic medication to pharmacies to lower the cost of prescription drugs. In 2004, President Bush started the initiative that all medical records would be electronic and available to the American people over the next 10 years (Reforming Health Care for the 21st Century, 2006). There is a significant reduction in cost for the consumer when buying generic prescriptions. This plan signed by President Bush was a gamechanger for consumers, especially the “baby boomers” that have many prescription medications that they rely on for their healthcare. The consumer can take advantage of the tax-free healthcare savings account putting money aside for expected costs of healthcare each year.  This lowers the taxable income each year and essentially saves the consumers at tax time.  Electronic medical records streamline the process of access to your medical record so any healthcare facility can get your records quickly in the case of any emergency Presidential Agendas Discussion.

Barack Obama

 President Obama is most known for the passage of the Affordable Care Act, or Obamacare.  In this legislation, he started a National Health Insurance Exchange (NIE), savings for preventative coverage, prescription drug coverage savings for generic medications (Ventola, 2009).  The National Health Insurance Exchange offers private insurance options for those that are not offered insurance by their employers, those who are self-contractors, and those whose employers offer insurance that is too costly. These plans have specific tiers of coverage ranging from low-cost premium to low deductibles. The plan for Obama to lower cost of prescription drugs were to make it legal to have them imported from other countries at a discounted cost to the consumers Presidential Agendas Discussion. 

Donald J. Trump

President Trump on day one of his term started trying to dismantle Obamacare. One of the changes he made was to get rid of the individual mandate for coverage. Another change was the federal government stopped paying the cost sharing reduction subsidies. He also expanded access to short term plans (Simmons-Duffin, 2019). The individual mandate was a penalty for those who did not have insurance and did not apply on the national insurance database.  The whole reasoning behind Affordable Healthcare Act was to ensure that most Americans had an opportunity to have health coverage which would lower the cost of healthcare because Americans could become healthier by having some health coverage. By taking away this mandate, there would be no penalty enforced to those who did not sign up for healthcare. Cost sharing subsidies were a way to keep insurance cost down by the government payments sent to the insurers to stay in the national database. Apparently, President Trump decided he did not want the government to pay this any longer, so they stopped paying. “What ended up happening is, insurers, by and large, addressed this by increasing the price of the silver plan on the health insurance exchanges.” (Simmons-Duffin, 2019) Presidential Agendas Discussion.

What Would I do Differently?

I would fist start by not entirely changing the healthcare system, like President Obama did. The ideas he had, some of them were good, but this type of healthcare system does not work in a democracy that is America. The point of a reduced option for healthcare is a great idea for those that are unemployed and self-contractors that can not afford the cost on their own.  I would have, instead of making a penalty for those that did not sign up for healthcare, make a tax break for those that did sign up. I would also not limit this tax break to income limitations.  The problem with Obamacare is that a family of 4 may not pay a high premium, but the deductible is high. I would change the plans in the national database to preventative care only plans. This would cover any primary care visits, preventative care, wellness visits, lab work, and so on.  There would be a copay, but everything would be 100% covered after your copay.

References:

Reforming Health Care for the 21st Century. (2006, February 15). Https://Georgewbush-Whitehouse.Archives.Gov/. https://georgewbush-whitehouse.archives.gov/stateoftheunion/2006/healthcare/#:%7E:text=In%20his%20State%20of%20the,world%20in%20cutting%20edge%20medicine.

Ventola C. L. (2009). President Obama’s health care reform policies: Issues of interest to P&T committees. P & T: a peer-reviewed journal for formulary management, 34(6), 296–308 Presidential Agendas Discussion.

Simmons-Duffin, S. (2019, October 14). Trumps Five Big Changes to Obamacare: Shots. WWW.NPR.ORG. https://choice.npr.org/index.html?origin=https://www.npr.org/sections/health-shots/2019/10/14/768731628/trump-is-trying-hard-to-thwart-obamacare-hows-that-going

Discussion: Presidential Agendas

By Day 3 of Week 1

By Day 6 of Week 1

Topic that Rises to the Presidential Level

Health care policies and plans have been an important issue and topic that our presidents have had to discuss during and prior to elections, this is primarily due to the size of the health care system in America, and how it budgets a large sector in our economy (Lambrew, 2018). That being said, Americans are monitoring every move of our presidential candidates with their health care policies, because the American voting citizens can affect the election outcomes regarding how our presidential candidates discuss health care plans (Lambrew, 2018). Although, our recent presidents; George W. Bush, Barack Obama, and Donald Trump have been modifying ideas and making improvements in our health care system to benefit the needs of American citizens, we have been struggling with this reform since the 1940’s according to Milstead and Short (2019).

Former President George W Bush, Republican party, had a similar style as to the now former President Donald Trump regarding health care priorities. The Bush administration put their focus on private plans, primarily in Medicare. The idea of this is great because you participate more in your health care and be treated ‘fairly’ for your prices (premiums, deductibles, etc.) since it would be based off your annual income (Reinhardt, 2006), but there are several pitfalls that come along with this idea. Such as some of the financial burdens, which would greatly impact those individuals with co-morbidities that are causing them to be chronically ill. Although, former president Bush did recommend and encourage individuals to enroll into Health Savings Account (HSA) which is tax deductible and in theory should decrease some of the financial burden on some individuals’/families (Reinhardt, 2006).

After an eight-year term from Republican George W. Bush, Former Democratic President Barack Obama was elected, and his administration had a different approach with our health care policy. During his eight-year term he was able to make several changes such as making health care available for everyone even if there were pre-existing health conditions and attempt to lower costs for all. For in the past, insurance companies had the opportunity to deny individuals/families for pre-existing conditions (Lambrew, 2018). This is how the Affordable Care Act (ACA) was created and implemented. Although, many great movements occurred within this program, one of the biggest downfalls was that individuals that declined this or still could not afford this, would be taxed on their yearly taxes because they did not participate in this program. Basically, a loophole to have all Americans have health care to bring money into our economy, but also receive money from those who do not participate in the ACA, making it an equal playing field on participating within our growing economy Presidential Agendas Discussion.

Lastly, our most recent former Republican President, Donald Trump, sought very similar ideas as George W. Bush as I previously mentioned. Near the beginning of his term the Trump foundation eliminated the mandate that required individuals under the ACA have health coverage, meaning individuals will not be taxed additional if they do not have health care coverage. Trumps ultimate goal was to repeal the ACA completely, but approximately halfway through his four-year term had been engulfed with the current pandemic and was trying to maintain calmness while our health care facilities where becoming overwhelmed and millions of Americans were having astronomically high medical bills due to COVID-19 (Melillo, 2020). While dealing with the pandemic he continued to work on similar items are George W. Bush, such as “expand access to health care, lower Americans health coverage costs, negotiate lower prescription drug prices… Medicaid expansion (Melillo, 2020, para. 9).”

All three of our former presidents had great intentions to reform our health care system and I agree that our system does need to be reformed. My belief is health care should be readily available for everyone (previously chronic/acute health issues), rates that are reasonable (monthly premium and affordable deductibles), education to the general public for what they are being charged for with a standard price across all health care facilities, and to look at the foundation of the use of ICD10 codes. The fact that one ICD10 code could cover the cost for a test that is required, but a different ICD10 will charge the patient and their insurance more, does not make sense. I do not have all the answers on the ‘best’ way to reform our health care system or even that bad ways, but I know we have to learn from the plans that did pan as anticipated and to consider what is happening in the current day within the health care society. As I mentioned we have been struggling with this issue since the 1940’s with our health care system and I am sure we will continue to until we can figure out what works best for the largest number of Americans (Milstead & Short, 2019) Presidential Agendas Discussion.

References

Lambrew, J. M. (2018, June). Getting ready for health reform 2020: What past Presidential campaigns can teach us (Rep.). Retrieved March 1, 2021, from The Commonwealth Fund website: https://www.commonwealthfund.org/sites/default/files/2018-06/Lambrew_getting_ready_hlt_reform_2020_presidential_0.pdf

Melillo, G. (2020, June 25). Trump administration, republican attorneys general ask supreme court to repeal ACA. The American Journal of Managed Care.                              https://www.ajmc.com/view/republican-attorneys-general-file-briefs-to-repeal-aca

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

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed., pp 11-13). Burlington, MA: Jones & Bartlett Learning.

Reinhardt U. (2006). President Bush’s proposals for healthcare reform. BMJ (Clinical research ed.), 332(7537), 314–315.                                                               https://doi.org/10.1136/bmj.332.7537.314 Presidential Agendas Discussion