NSTRUCTION: BELOW IS A POST DISCUSSION FROM ANOTHER COLLEGUE. I NEED ASSISTANCE WITH THE FOLLOWING: Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example. You may also ask the collegue questions in regards to their discussions.  AT LEAST TWO REFERENCES ARE NEEDED. THANKS

                                                    Politics and Patient Protection and Affordable Care Act

Nearly 20 years ago, I got the chance to work on Capitol Hill as a congressional intern. I aspired to one day serve in the Senate or House of Representatives. I was a young naive man who strongly believed that our representatives went to Washington to make our lives a little bit easier. I sat in several conference committees as legislation was being debated.  I soon learned that what we expect from our representatives is different than what I experienced.  While I was shocked at the negotiations taking place and the give and take in order to advance the bill to the President’s desk, I realized that what I believed was not reality.  Years later, I read books based on the works of John Adams and James Madison.  I realized that similar processes were done back then as well.  I have come to the conclusion that that is the way America conducts business.  

Today, our politics is divisive and ordinary people tend to side with the politics of the party that mostly aligns with their values.  With that said, the Affordable Care Act legislation was the closest I have seen to an emotional roller-coaster on both sides.  Legislators were bombarded by their constitutes to restrain or move the legislation forward.  Fisher (2012) wrote several years after the passage of the Affordable Care act that the United States is the only highly developed industrialized nation that does not offer its citizens universal health care.  

At a time when the Affordable Care Act lowered the uninsured pool and provided a path to insurance many republican groups balked at the idea and were further enraged at the idea that people would have to pay a penalty if they did not have health coverage.  Keith (2018) noted that many states with high poverty rates had the highest uninsured rates and did not expand their Medicaid programs to non-seniors.  Texas led the pack with the highest uninsured rate of 17.3 percent followed by Oklahoma at a rate of 14.3 percent.  Massachusetts, Rhode Island, and Vermont all have the lowest rates.  

While the Affordable Care Act is not perfect it did show signs of steady progress. Shartzer, Long, and Anderson (2016) used data from the Health Reform Monitoring Survey to look at access and affordability just after the health exchanges went online in 2013. They found strong improvements in Americans access to care.  So why would this not be something politicians in Washington would want for their constituents.  Since the old adage that our politicians are “bought” also mean that insurance companies and other special interest groups were able to sway republican voters to get rid of the mandate and continue a system based on risking one’s finances and health should they get sick.  

I remember many of the same political discussions taking place in Massachusetts in 2006.  We are now 13 years into mandatory health insurance and our population is healthier then ever.  Furthermore, healthcare entities starting to climb out of the red as majority of the patients are insured.  Most have access to primary care providers and do follow up on an annual or bi-annual basis. One of the downsides to this is that primary care providers are hard to schedule with given the volume of patients enrolled in the system. It’s not a bad thing. Regardless if you like President Trump or not, the special interests prevailed and the American people pay the price. States that advocate for expanded health coverage work to improve the health and well-being of their people, states who were resistant to the change will likely continue to struggle with larger portions of their society having limited to no access to care, primary care, or oral care.  Many of our republican colleagues may pay an ultimate price by the disservice that caused to their constituents. National policies will continue to be supported based on party purpose instead of what is best for a policy leader’s districts. Finally, people who have the most need the least, and the people with the least need the support. Programs like Medicaid and Medicare are the safety vehicles for those marginalized groups. The Affordable Care Act was not a perfect bill but one that could have been worked on to become a more perfect law just like we strive to be a more perfect nation overtime.

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