Policy and Advocacy for Improving Population Health
In the United States (U.S), health care policy has been a national debate for several epochs. The genesis can be predated to 1798 during President John Adam’s administration, which introduced a contrivance to cover sailors’ medical bills.
Health being one of the pillars of a country, every president strives to make advancements through introducing new policies and legislations that address specific population health concerns. Administrative agencies, appropriate health care personnel and finances are some of the resources required for the successful implementation of the health care agendas (Powell et al., 2019).
The purpose of this writing is to analyze the current and the two previous health care presidential agendas. A further description involves the health care concerns the agendas solve, financial resources allocated and administrative agencies required for a successful implementation.
President George Walker Bush, 2001-2009
The burden of chronic diseases such as Diabetes, cancer, heart failure and chronic obstructive pulmonary disease (COPD) prompted the President to establish a chronic disease prevention plan. In 2002, chronic diseases were estimated to cause more than two thirds of all deaths in the U.S (Reinhardt, 2006). Some of the chronic diseases are attributable to physical inactivity, tobacco use and poor nutrition (Reinhardt, 2006).
In his 2002 comprehensive health reform program, the president introduced a health care policy, the Healthier US Initiative to achieve the following agenda: increase physical activity among U.S population, encourage responsible nutrition and to promote preventive disease screening (Reinhardt, 2006).
To achieve disease prevention through early screening, the President’s 2007 budget allocated $ 1 Billion for a successful implementation (Reinhardt, 2006). The approach used to realize the initiative includes inspiring the U.S citizens to be physically fit through introduction of the Presidential Active Lifestyle Award that recognized youths who actively engaged in physical exercise (Reinhardt, 2006).
Further, the administration released dietary guidelines to Americans in 2005 to ensure appropriate nutrition (Reinhardt, 2006). Additionally, in a bid to prevent chronic diseases, the administration in conjunction with Center for Disease Control and Prevention (CDC) introduced screening programs for heart failure, diabetes, and cancer. Moreover, the president promoted healthy lifestyle choice by making policies that limit use of tobacco and illegal drugs.
President Barack Obama, 2009-2017
Access to health care is one of the unmet health needs among the U.S population. Even though the federal government makes advancements in improving health care access, it is not completely solved. Access refers to the opportunity to seek, reach and obtain care services to achieve better health outcomes (US Department of Health and Human Services, 2020).
Barriers to health care access include high cost of care, lack of health insurance, sociocultural factors and lack of availability of the services (US Department of Health and Human Services, 2020). To solve the crisis, Obama’s Administration introduced the Affordable Care Act of 2010.
The policy’s agenda included increasing health insurance coverage among U.S citizens especially the low income and middle income zones, reducing the cost of health care and to improve the quality of care (Kiminski, Nonzee & Sorensen, 2017).
According to President Obama, ACA implementation would cost $940 billion over the first ten years. Implementation approach varied in different states; however, the three widely used approaches include execution of the market reforms, expansion of Medicaid eligibility for low income adults and establishing new health insurance market places.
President Donald Trump, 2017 to Date
The highlight of the health sector during President Trump’s tenure occurred in the year 2020. The current COVID-19 outbreak threatened the lives of the population. Following the significant morbidity and mortality the pandemic caused, President Trump signed various stimulus laws to address the public health and economic fallout related to the pandemic.
The Families First Coronavirus Response Act (FFCRA) was signed into law. The policy’s agenda included expanding unemployment insurance benefits, increasing Medicaid funding and providing free testing to everyone, provision of emergency paid sick leave and child care leave, and providing nutritional assistance to vulnerable populations such as the elderly, children, women and infants (James, 2020).
By April 6 2020, financial allocation for the successful implementation of the act was estimated to be $ 192 Billion. Implementation approaches were as follows: employers with 500 and less employees to provide emergency paid sick leave, Medicare and Medicaid to cover for COVID-19 testing to all individuals and finally, expanding the unemployment benefits.
Analysis
Various administrative agencies would help address the selected health care issues. As aforementioned, identified health care issue during President Bush Administration includes the high prevalence of chronic diseases in the US attributed to physical inability, poor nutrition and risky lifestyle behaviors such as tobacco smoking.
The CDC has several strategies on lifestyle and behavior modifications aimed at reducing risks for chronic diseases. Additional administrative agency that spearheaded healthier US Initiative includes the National Health Service. During Obama’s Administration, the US Department for Health and Human Services was exclusively involved in ACA. The health care administrative agencies that provided significant help during the corona virus pandemic, Trumps era, are the World Health Organization, CDC, and the agency for Health Care Research and Quality.
The selection of the chronic diseases as a health concern during Bush Administration included the significant morbidity and mortality associated with it. Even though the federal government strives to reduce the rates, chronic diseases will still remain to be a national health concern. This can be attributed to continued unhealthy lifestyles and behaviors of the US population (Reinhardt, 2006).
Obama’s Administration aimed to increase health care insurance to low income earners. The agenda was progressing well but was significantly sabotaged by the Trump’s Administration. Access therefore remains unresolved crisis. Moreover, the current COVID-19 pandemic is an ongoing predicament with attempts being made to try the vaccines. Trump’s Administration still continues to make advances in finding the treatment to the virus.
The US Department of Health and Human Services provided funding for the Healthier US Initiative. The aim of the UDHHS was to provide better health prevention and promotion programs to help prevent chronic diseases. Even though ACA was sponsored by the Representative Charles Rangel, I would propose that USS medical insurance companies such as Medicaid and Medicare also take part in sponsorship other than the implementation. In the COVID-19 pandemic, the WHO has played a significant role in mitigating the predicament. WHO have been the chief sponsor and the primary accomplice of the pandemic in U.S.
Narrative
Chronic diseases cause significant morbidity and mortality among the population. The statistics by Reinhardt (2006) reveal that chronic diseases accounted to more than two thirds of total deaths in the US. Further, the statistics reveal that chronic diseases claimed more than 1.7 million lives annually by 2002 (Reinhardt, 2006).
Bush administration therefore saw it wise to introduce the aforementioned Health initiative to solve the health concern. Nurses were tasked with health education and accomplishing the screening tests. Some of the screening procedures nurses did include measuring blood pressures and taking the blood glucose levels. President Obama was elected when majority of the US population majority were health uninsured. This led to limited access to health care due unaffordability of the services.
According to the report by (Kiminski et al., 2017) 20-million citizens who were previously uninsured got insurance coverage. Nurses being the majority of the health care provided, they provide tremendous care to insured citizens and participate in patient education (Kiminski et al., 2017). The US is one of the countries that have been negatively impacted by the current COVID-19 pandemic.
By November 25 2020, 12.4 million COVID-19 cases were confirmed with associated 259, 000 deaths. Further, COVID-19 is associated with significant economic burden prompting President Trump to introduce the FFCRA. Nurses provide diagnostic, treatment and preventive services during the pandemic.
References
James, A. (2020). Families First Coronavirus Response Act (FFCRA). NC State University Institute for Emerging Isues, https://iei.ncsu.edu/2020/families-first-coronavirus-response-act-ffcra/.
Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Healthcare for Low-income Populations. Annual Review of Public Health 38, 489-505 https://doi.org/10.1146/annurev-publhealth-031816-044555
Powell, B. J., Fernandez, M. E., Williams, N. J., Aarons, G. A., Beidas, R. S., Lewis, C. C., et al. (2019). Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda. Frontiers in Public Health, https://www.frontiersin.org/articles/10.3389/fpubh.2019.00003/full.
Reinhardt, U. (2006). President Bush’s Proposals for Healthcare Reform. Bmj 322 (7537), 314-315 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1363898/.
US Department of Health and Human Services. (2020). Access to Health Services. Retrieved from Healthy People 2020: https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
nurs 6050 Policy and Advocacy for Improving Population Health Instructions
Brief description of a population health concern (Pandemic)
Explain how each presidential administration approach the issue
identify the allocation of resources that the president dedicated to the issue
which administrative agency will be responsible for helping to address the health issue and why is this agency the most helpful
how do you think the selected issue might get to the presidential agenda
an entrepreneur /sponsor help to move the issue forward who would be chosen and why will this person be a good sponsor