Presidential Agendas

Presidential Agendas

Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)

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 (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?

Reference:
New York State Department of Health. (n.d.). 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
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.

Presidential Agendas – Diabetes Policy Approaches

Diabetes has been a chronic public health problem in the United States for several years. Currently, it affects more than 37 million people and costs the American economy over 300 billion US dollars every year. This problem indicates that facilities of prevention, cost control in treatment, and access to a range of care are all intricately connected (Hill-Briggs et al., 2020). Donald Trump and Joe Biden, together with their predecessors, responded to this disease with different approaches, as the latter differ in their priorities and worldviews (Tuomilehto et al., 2023). A more detailed analysis of their accomplishments and failures is presented, as well as better ways to reach the target population.

The Trump Administration’s Approach

The Trump administration (2017–2021) placed a great deal of focus on the low pricing of drugs, and that’d be a delight to diabetic patients who need expensive drugs like insulin. The Part D Senior Savings Model, launched by the administration in the year 2020, lets Medicare Part D plans limit monthly insulin prices to $35 for seniors (Shao et al., 2020). This was a great stride towards changing the status quo as far as insulin was concerned, given that its costs put a lot of pressure on the elderly, especially those with fixed incomes (Shao et al., 2020). Trump’s policy of addressing affordability tried to target a specific group of the population, more specifically, Medicare beneficiaries. Nevertheless, this success was fungible due to other health policies that were implemented during Trump’s presidency. Actions to dismantle and replace the ACA generated unknown risks for preexisting condition consumers, including diabetics (Marino et al., 2020). While the administration did not prevail in fully repealing the ACA, the halting of the mandate’s penalties lowered coverage rates that might deter many Americans with diabetes from receiving adequate care. They said such steps eroded systemic work towards achieving health equity, especially in the prevention and control of chronic illnesses. Nevertheless, the administration sustained the funding for diabetes research through other related departments, such as the NIH (Hill-Briggs et al., 2020). However, its wider concentration on the issue of deregulation and market approaches was not very successful in addressing some systemic issues when it came to diabetes prevention as well as management listening to some communities behind.

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The Biden Administration’s Policies

The current Biden presidency from 2021 has continued on some of Trump’s policies but offers a much broader concept for healthcare evolution. Clearly, one of Biden’s major accomplishments is the Inflation Reduction Act (IRA) of 2022, which has proposed an affordable insulin price of $35 monthly for patients who are the beneficiary of Medicare. This policy was similar to Trump’s earlier Medicare effort, but this one expanded on it by pledging to make insulin cheaper for everyone. However, doing this universally would require more legislative action. The Biden administration has also focused on improving the Affordable Care Act, which provides citizens with the healthcare services they need (Marino et al., 2020).

Biden signed into law additional subsidies and pushed the expansion of Medicaid, making it possible for millions of Americans to receive such preventive services as diabetes testing and counselling (Tuomilehto et al., 2023). Of these, disparities are most affected by these measures because a large proportion of diabetic patients are from low-income or minority groups that may not have adequate insurance coverage. Furthermore, increasing affordability and access are also important in Biden’s administration approach; besides that, there are social factors, such as household income, education, and neighbourhoods, that influence diabetes incidence rates (Tuomilehto et al., 2023). Although, to date, there are still no large-scale programs addressing these determinants specifically, the administration’s focus on health equity for diabetes is a move that addresses the social determinants of this disease.

Efforts from Previous Administrations

The Obama administration (2009–2017) is significant in that it established much of the modern environment for diabetes-related reforms with the ACA (Tuomilehto et al., 2023). The exclusion for preexisting conditions and the increase in the role of Medicaid were two of the pillars in which the law helped increase the number of opportunities for those with diabetes. Further, the ACA-driven requirement for coverage of preventive services without cost-sharing made it possible for more American citizens to undergo diabetes screening and early detection. These changes can be briefly discussed as follows: These changes could be considered a new direction in the development of the national diabetes plan, which touched not only the treatment but also prevention facets. Earlier than Obama, the Bush government of 2001–2009 also stated that extending Medicare Part D meant possessing significant drug coverage on behalf of seniors. While this happened before the 15-year framework of work, it laid the groundwork for subsequent attempts at affordable diabetes medications, a goal which has remained unfulfilled (Hill-Briggs et al., 2020) Presidential Agendas.

Persistent Challenges and Policy Gaps

Although Diabetes has seen progress made across administrations, there are several persistent challenges that have prevented us from winning the war on Diabetes. Those without Medicare or comprehensive insurance coverage continue to be high on the list of those who pay high insulin prices. The Biden administration is seeking to widen access to insulin at affordable prices, but legislation establishing universal price caps there has been stalled in Congress for millions (Tuomilehto et al., 2023). Secondly, diabetes prevention is underfunded in comparison to diabetes treatments. To reduce the long-term prevalence of diabetes, preventive initiatives such as community-based programs to promote healthier lifestyles are needed. Meanwhile, diabetes outcomes continue to be exacerbated by health disparities esp, especially in underserved communities. For instance, limited access to healthy food, safe places to exercise, and good healthcare leave an unfair mark on minority and low-income populations, repeating poor health outcome cycles for millions (Tuomilehto et al., 2023).

Different Approaches

To fill these gaps, a more comprehensive and vigorous strategy is required. First, it becomes necessary to keep insulin affordable to all patients. Making the $35 price cap applicable to all citizens, independent of insurance coverage, would thus help millions (Tuomilehto et al., 2023). Thus, this could be done either by working together with Congress to pass legislation or through partnerships with drug manufacturing firms. Second, prevention can no longer be an afterthought, let alone ignored completely. Development of funding for ranks like the National Diabetes Prevention Program (NDPP) would assist Group C with more initiatives to reach high-risk populations likely to change their lifestyle to avert type 2 diabetes (Shao et al., 2020). These interventions could be delivered through schools, workplaces and various community-based organizations and initiatives teaching people the need to take healthy foods and practising exercise.

Third, improving health potential is necessary; fourth, it is correct to focus on health needs; fifth, the social determinants of health must be considered. Measures that enhance the population’s capability to purchase healthy foods, including cheaper fresh foods or gardening in city areas, decreased diabetes risk considerably. At the same time, enhancing enrollment facilities that encourage active living, such as parks and trails, would be beneficial to an individual’s health. It is a necessity that everyone, regardless of their own status in life, should have primary health care. Thus, the affirmation of extending the program Medicaid in all states and striving for a common healthcare coverage platform would entail that no one is left with no opportunity to either treat or prevent diabetes itself (Tuomilehto et al., 2023). This would also reduce inequalities that worse-off groups experienced, such as the less privileged in society Presidential Agendas.

Conclusion

The past fifteen years saw actual advancements in the management of diabetes by the US Administration, primarily in insufficiency of insulin and healthcare coverage. Recent encouraging steps taken by the Biden administration to build upon such progress underscore affordability, equity and preventive care. However, the sustained high costs, the inequalities in access to health services, and insufficient resources to support the prevention programs demand better solutions. There are three key strategies that would, collectively, prevent tens of millions of Americans from developing diabetes and enable those with the disease to live long, healthy lives: universal access to care, prevention, and systems reform.

 References

Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., … & Haire-Joshu, D. (2020). Social determinants of health and diabetes: a scientific review. Diabetes care, 44(1), 258. https://doi.org/10.2337/dci20-0053

Marino, M., Angier, H., Springer, R., Valenzuela, S., Hoopes, M., O’malley, J., … & Huguet, N. (2020). The Affordable Care Act: effects of insurance on diabetes biomarkers. Diabetes Care, 43(9), 2074-2081. https://doi.org/10.2337/dc19-1571

Shao, H., Guan, D., Guo, J., Jiao, T., Zhang, Y., Luo, J., … & Brown, J. D. (2022). Projected impact of the Medicare Part D senior savings model on diabetes-related health and economic outcomes among insulin users covered by Medicare. Diabetes Care, 45(8), 1814-1821. https://doi.org/10.2337/dc21-2601

Tuomilehto, J., Uusitupa, M., Gregg, E. W., & Lindström, J. (2023). Type 2 diabetes prevention programs—from proof-of-concept trials to national intervention and beyond. Journal of clinical medicine, 12(5), 1876. https://doi.org/10.3390/jcm12051876

Presidential Agendas

Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)

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 (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?

PRESIDENTIAL AGENDAS

References

Gross, J., & Gordon, D. B. (2019). The Strengths and Weaknesses of Current US Policy to Address Pain. American journal of public health, 109(1), 66–72. https://doi.org/10.2105/AJPH.2018.304746

Humphreys, K., Shover, C. L., Andrews, C. M., Bohnert, A. S. B., Brandeau, M. L., Caulkins, J. P., Chen, J. H., Cuéllar, M. F., Hurd, Y. L., Juurlink, D. N., Koh, H. K., Krebs, E. E., Lembke, A., Mackey, S. C., Larrimore Ouellette, L., Suffoletto, B., & Timko, C. (2022). Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet Commission. Lancet (London, England), 399(10324), 555–604. https://doi.org/10.1016/S0140-6736(21)02252-2

Jaffe S. (2020). US election 2020: public health. Lancet (London, England), 396(10256), 946–947. https://doi.org/10.1016/S0140-6736(20)32036-5

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones & Bartlett Learning

Wen, L. S., & Sadeghi, N. B. (2020). The opioid crisis and the 2020 US election: crossroads for a national epidemic. Lancet (London, England), 396(10259), 1316–1318. https://doi.org/10.1016/S0140-6736(20)32113-9