NURS 6050 week 1 Discussion: Presidential Agendas

Initial Post

The health care topic that I’ve chosen to explore that has reached the Presidential level is the  Opioid epidemic.  Health care disparities seem to arise daily. Opioid abuse /addiction occurs from the use of prescription drugs, none prescription drugs as well as illegal drugs. Drug abuse has been an ongoing challenge in years past and present.  According to (Murray 2019) “Millions of Americans are impacted by the opioid crises”. People are dying at alarming rates due to opioid over doses. Drug abuse has crippled our neighborhoods and communities for decades and continues to be on the rise.” The misuse of and addiction to opioids including prescription opioids, heroin, and synthetic opiods such as Fentanyl, is a serious problem that affects not only the health of many Americans but social and economic welfare of our country” (National Institute on Drug Abuse [NIDA,2018]). In this forum I will explore the stance of President Bush, Obama, and Trump and their strategic efforts to address this epidemic which continues to be an ongoing concern to date.

Presidential Agendas

According to (Ending America’s Opioid Crises, The White House) “President Trump’s Initiative to Stop Opioid Abuse, unveiled in 2018,  confronting the driving forces behind the opioid crises”. The first part of his plan was to educate American’s on the the dangerousness of abusing opioids. Secondly, he wanted to get better control on how drugs were being imported into the United States. To date the President plans to build a wall on the Mexican boarder, who tends to be a heavy supplier. He also, plans to rid the state of illegal immigrant drug traffickers. His final efforts are to aid those who struggle with addiction with more treatment options. President Trump has allocated billions of funds to address the ongoing concerns of the opioid crises. I agree with his on going efforts to limit access to these drugs both legally and illegally. My only opposition is that I would place more treatment centers in those areas that are largely affected, giving equal access to all that has fallen victim.

President Obama signed a Bipartisan Bill to Combat Opioid Epidemic. According to (Reilly, 2016) “On July 22, President Barrack Obama signed into law the Comprehensive Addiction and Recovery Act, legislation that is the first of its kind to offer a multifaceted federal response to the prescription opioid and heroin epidemic ravaging communities across the United States”. The purpose of this bill will be to combat the misuse of opioids and ensure that people have access to effective treatment. This plan includes proper surveillance by Medicare prescription drug plans to oversee safe prescribing. According to (Reily,2016) “In 2011, more than 1.7 million Medicare beneficiaries received an opioid dose that put them at increased risk of overdose; nearly a quarter million of them received these high doses for 90 or more consecutive days”. Expanding treatment options is also at the forefront of this plan as well. Commonly compared to President Trump’s plan the Comprehensive Addiction and Recovery Act also addresses the intricate concern of ensuring proper treatment.

In 2002 President Bush announced his drug control strategy. President Busch stated ” We’re determined to limit drug supply, to reduce demand and to provide addicts with effective and compassionate drug treatment” (Bush, 2002). Bush also vowed to fight drug use and substantially those who dealt in drugs. Another effort was to target drug supply, by  calling on the coast guards to increase security at the boarders to limit drugs from coming in overseas. The president also sought help from our Homeland Security Director to examine ways to improve our national boarder management system. President Bush urged Americans to do their part as well and to not misuse and abuse drugs in any way. He also urged parents to do their jobs by educating their children on the importance of staying clear of drugs. I also agree with Presidents Bush’s efforts as well, and although the drug crises has continued to arise I believe with every effort put into place we become a step closer in bridging this problem. My only draw back is that president Bush did not implement in his plan how he would combat the control of prescription opioids which continues to be on the rise.

While opioid addiction continues to be a common place among American’s, as a health care professional I am grateful that this is not only viewed as an addiction but also an illness that requires proper treatment. I believe that it is also important to educate our patients after major surgeries the potential risk of becoming addicted to prescription pain medications. As health care providers we really need to encourage patients to choose the least addictive form of medications possible. I also believe that its important to place treatment centers in the most affected areas and in places were patients can easily access them. I commend all three presidents for their conscious efforts to combat this epidemic. Although American’s continue to struggle with this issue, I believe with the strategies that have been put into place Americans have a greater chance at being liberated from this deadly addiction.

References

Murray, K., (2019).Racial Disparities in Opioid Addiction Treatment in Black and White Populations. Retrieved June,1,2020 from https.//www.addictioncenter.com/news/2019/10/racial-disparities-opioid-addiction-treatment/

Ending America’s Opioid Crises|The White House,(2020). The White House. Retrieved June, 1, 2020, from https://www.whitehouse.gov/opioids/

Reilly, K., (2016). President Obama Signes Bipartisan Bill to Combat Opioid Epidemic . Retrieved on June, 1, 2020, from https://www.pewtrusts.org/en/research-and-analysis/articles/2016/07/22/president-obama-signs-bipartisan-bill-to-combat-opioid-epedimic

President Bush Announces Drug Control Strategy (2002). Retrieved June, 2, 2020, from https://2001-2009.state.gov/p/inl/rls/rm/8451.htm.

Discussion: Presidential Agendas

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 that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

To Prepare:

  • 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 topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) 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.

 

Discussion – Week 1

After reading the discussion question, I had a lot of topics that came to mind. I work in the Emergency Department and we receive a lot of patients who has narcotic addiction and are mentally disabled. So instantly, I wanted to choose between the two but I think that health insurance is a bigger topic and so I decided on that. I have been in this country for 20 plus years and I can say that I have been lucky and blessed that I never had to worry about having insurance. The hospital I currently work at is located in a underserved community where a high percentage of our patients are homeless. Our hospital was built to provide care to these communities and we are able to do so with the help of the government. Yes, we are funded by the government. Due to the pandemic, our hospital is facing a budget cut and we are not really sure whats going to happen to these communities who have leaned on us for support. We have never turned anybody away. We don’t ask if you have money to pay or if you are legal in this country. We serve everyone equally. In my opinion, this is how it should be. We should be a country where we can take care of our people, not based on what insurance they have or if they have papers. With that thought, I will discuss what President Bush, Obama and Trump have done regarding this topic.

President Bush was believed to have strengthened  America’s health care system (The white house, n.d.). The president enacted policies that helped more than 40 million Americans get better access to prescription drugs (The white house, n.d.). He also ensured healthcare was affordable, transparent, portable and efficient by empowering Americans to take charge of their health care decision making, helped provide treatment to nearly 17 million people, increased funding at the National Institutes of health and expanded the trade adjustment assistance program add a tax credit to help lower the price (The white house, n.d.). He also made sure the veterans were included in his policies. He increased funding for their medical care, created a program for seriously-injured members, provided money to support traumatic brain injury patients, and he created the defense center for psychological health (The white house, n.d.).

During the Obama administration, he created Affordable Care Act, also known as Obamacare, which ensures all Americans has health insurance (Health for California, n.d.) During this time, everyone had to have health insurance or you might be subjected to a penalty (Health for California, n.d.) With Obamacare, businesses who has more than 50 employees have to provide health care insurance (Health for California, n.d.) Health insurance also cannot deny a person based on their pre-existing conditions (Health for California, n.d.). More advantages include covering adults over 65 years of age, young adults are added to their parents until age of 26 and the premium is based on your income to ensure they are affordable.

During Trump’s campaign, he already mentioned asking Congress to immediately repeal Obamacare (Atkinson, 2017). On the official white house website (n.d.), it stated:

“Obamacare is hurting American families, farmers, and small business with skyrocketing health insurance cost. Moreover, soaring deductibles and copays have made already unaffordable plans unusable. Close to half of U.S. counties are projected to have only one health insurer on their exchanges in 2018. Replacing Obamacare will force insurance companies for their customers with lower costs and higher-quality service. In the meantime, the President is using his executive authority to reduce barriers to more affordable options for Americans and U.S. businesses.”

What do you think Trump has done?

References

Atkinson, J. (2017). The health care policies of President Trump. Retreived from  https://journal.practicelink.com/reform-recap/the-health-care-policies-of-president-trump/

Health for California (n.d.) Obama Care California. Retreived from  https://www.healthforcalifornia.com/obamacare#:~:text=Obama%20Care%20California,Affordable%20Care%20Act%20(PPACA).&text=Obamacare%20ensures%20all%20Americans%20in,of%20money%20in%20the%20process.

The White House: President George W. Bush. (n.d.) The Bush Record. Retreived from  https://georgewbush-whitehouse.archives.gov/infocus/bushrecord/factsheets/healthcare.html

White house (n.d.). Healthcare. Retreived from  https://www.whitehouse.gov/issues/healthcare/

 

Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. 

Supported by at least three current, credible sources. 

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. 

At least 75% of post has exceptional depth and breadth. 

Supported by at least three credible sources. 

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)
Responds to some of the discussion question(s). 

One or two criteria are not addressed or are superficially addressed. 

Is somewhat lacking reflection and critical analysis and synthesis. 

Somewhat represents knowledge gained from the course readings for the module. 

Post is cited with two credible sources. 

Written somewhat concisely; may contain more than two spelling or grammatical errors. 

Contains some APA formatting errors.

(0%) – 34 (34%)
Does not respond to the discussion question(s) adequately. 

Lacks depth or superficially addresses criteria. 

Lacks reflection and critical analysis and synthesis. 

Does not represent knowledge gained from the course readings for the module. 

Contains only one or no credible sources. 

Not written clearly or concisely. 

Contains more than two spelling or grammatical errors. 

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
(0%) – 0 (0%)
(0%) – 0 (0%)
(0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are fully answered, if posed. 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. 

Demonstrates synthesis and understanding of learning objectives. 

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are answered, if posed. 

Provides clear, concise opinions and ideas that are supported by two or more credible sources. 

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)
Response is on topic and may have some depth. 

Responses posted in the discussion may lack effective professional communication. 

Responses to faculty questions are somewhat answered, if posed. 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

(0%) – 12 (12%)
Response may not be on topic and lacks depth. 

Responses posted in the discussion lack effective professional communication. 

Responses to faculty questions are missing. 

No credible sources are cited.

Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are fully answered, if posed. 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. 

Demonstrates synthesis and understanding of learning objectives. 

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are answered, if posed. 

Provides clear, concise opinions and ideas that are supported by two or more credible sources. 

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)
Response is on topic and may have some depth. 

Responses posted in the discussion may lack effective professional communication. 

Responses to faculty questions are somewhat answered, if posed. 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

(0%) – 11 (11%)
Response may not be on topic and lacks depth. 

Responses posted in the discussion lack effective professional communication. 

Responses to faculty questions are missing. 

No credible sources are cited.

Participation
(5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
(0%) – 0 (0%)
(0%) – 0 (0%)
(0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

 

Discussion – Week 1

The topic I chose for this initial discussion is improving healthcare access in the American Indian population. According to the Indian Health Service (IHS), “The American Indian people have long experienced lower health status when compared with other Americans” (ihs.gov). 28.6% of American Indians under the age of 65 are without health insurance coverage (CDC.gov). Due to economic adversity, inadequate education, poverty, discrimination of health services, cultural differences and poor social conditions, lower life expectancy (approximately 5.5 years less) and disease burden is seen among the American Indian people when compared with other Americans (IHS.gov). The leading causes of death in American Indians include diseases of the heart, malignant neoplasm, unintentional injuries, and diabetes (IHS.gov). Regardless of political affiliation, the past three presidents of the United States, George W. Bush, Barack Obama and Donald Trump, incorporated methods in their administrative agendas regarding access to healthcare in an attempt to improve quality of life for the American Indian people.

President George Bush’s administration pushed to cut funding to healthcare for American Indians, indicating that “urban Indians can find care at community centers” (Indianz, 2007). Democrats and Republicans alike worked to reverse the cut in the 2007 and 2008 budgets. According to the same article, “Urban Indian organizations provide health services such as dental, pharmaceutical, vision, alcohol or mental health treatment, suicide prevention and family wellness” (Indianz, 2007). By cutting funds to this important organization, American Indians would be without access to healthcare and health services.

President Barack Obama and his administration focused on strengthening the government-to-government relationship with Indian Tribes by implementing Executive Order 13175, “Consultation and Coordination with Tribal Governments” (Obama, 2011). Further, President Obama “signed into law the Affordable Care Act (ACA), which is improving the quality of health care and making it more accessible and affordable for all Americans, including Native Americans” (Obama, 2011). The Obama administration continued to provide resources for the American Indian people by ensuring the ACA implemented new and expanded services available through IHS (Obama, 2011). Additionally, First Lady Michelle Obama launched Let’s Move in Indian Country to ensure healthy and affordable choices of food for children and families and improving opportunities for physical activity (Obama, 2011).

President Donald Trump, considering the recent COVID-19 pandemic, provided multiple resources for American Indians regarding access to healthcare. According to President Trump, in early May 2020, “the CARES Act [was signed] into law, providing $8 billion to address coronavirus preparedness, response, and recover for American Indians” (Trump, 2020). An additional $1 billion was allocated through the IHS to support tribes and tribal organizations in their coronavirus response efforts (Trump, 2020). Continuing with President Obama’s efforts in improving government relationships, President Trump worked to enhance coordination between the Federal Government and tribal leaders. Finally, “President Trump re-activated the White House Council on Native American Affairs to promote economic development and rural prosperity in Indian Country” (Trump, 2020).

As healthcare workers, we are drawn to helping those who are in need, and ensuring our patients have access to the highest level of care. As a registered nurse in a rural area, I often encounter the American Indian population. By keeping myself educated on the government’s agenda regarding access to healthcare for the American Indian people, I can implement change and ensure my community continues to receive the access and resources needed to receive this highest level of care.

 

 

References

Disparities: Fact Sheets. (2019, October). Retrieved June 2, 2020, from https://www.ihs.gov/newsroom/factsheets/disparities/

FastStats – Health of American Indian or Alaska Native Population. (2017, May 3). Retrieved June 2, 2020, from https://www.cdc.gov/nchs/fastats/american-indian-health.htm

Indianz. (2007, March 12). Bush administration takes limited view of Indian health. Retrieved June 2, 2020, from https://www.indianz.com/News/2007/001803.asp

Obama, B. (2011, December 2). Obama Administration Record for American Indians and Alaska Natives. Retrieved June 2, 2020, from https://obamawhitehouse.archives.gov/sites/default/files/docs/american_indians_and_alaska_natives_community_record_0.pdf

Trump, D. J. (2020, May 5). President Donald J. Trump is Protecting the Native American Community as We Combat the Coronavirus. Retrieved June 2, 2020, from https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-protecting-native-american-community-combat-coronavirus/

 

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