Walden University Public Health Discussion

One community issue that rises to the presidential level is: individuals and family’s access to health care and coverage. Each presidential administration must address this issue by considering the effects their policy will have on the economy and on families. Consideration had to made regarding the coverage of patients with pre-existing conditions and families with low-incomes. Trump, Bush and Obama, all had a different approach to this issue, the results are below:

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The implementation by President Trump of the Patient Protection and Affordable Care Act was a concern during the 2016 campaigns. As of January 31, 2017, 12 million newly insured individuals were added to an already strained health-care system (O’Rourke, 2017). The Affordable Care Act (ACA) set new standards for virtually all private health plans, including a prohibition on pre-existing condition exclusions and a requirement for private plans to extend dependent coverage to the age of 26 (Health Reform, 2016). This is significant because young adults that would normally not be covered by their parent’s insurance were now covered during a crucial time in their transition to adulthood. It also allows patients to be covered regardless of their pre-existing condition. The law also established new marketplaces for the sale of nongroup insurance to all individuals except undocumented immigrants, and created new subsidies for nongroup coverage (Health Reform, 2016). Families that don’t have a legal status did not qualify for coverage, and therefore did not have access to care. In return, this leaves many families and children uninsured. Trump would provide a tax deduction for the purchase of individual health insurance. He would promote competition between health plans by allowing insurers to sell plans across state lines; an insurer licensed under the rules of one state would be allowed to sell coverage in other states without regard to different state laws that might apply. He would promote the use of Health Savings Accounts (HSA), and specifically would allow tax-free transfer of HSAs to all heirs. Trump would also require price transparency from all hospitals, doctors, clinics and other providers so that consumers can see and shop for the best prices for health care procedures and other services (Health Reform, 2016).
In 2010 President Obama established the Patient Protection and Affordable Care Act (commonly known as the ACA and Obamacare), a huge first for the United States (Milstead, p 11). Under this act, all people would be required to have health insurance or else there would be a fee at the end of the year. This act especially increased access to care to the most vulnerable patients, such as children and the elderly. Some of the benefits are: Parents can add their adult children (up to age 26) to their plans. If anyone gets sick, the insurance company can’t drop them from the plan or limit how much insurance your family uses. If anyone is chronically ill, a new insurance company can’t deny coverage. Wellness and pregnancy exams are now free. That includes copayments (Amadeo, 2020). Mandating coverage makes the population ensure coverage, but it doesn’t always ensure that coverage is obtained by those who are below the poverty line. Lack of education, and limited resources is still an issue.

President Bush blessed the latest thing in American health policy: “consumer directed health care,” also widely and inaccurately known by the acronym HSAs, which stands for “health savings accounts.” The idea is to “empower” “consumers” (formerly “patients”) to function as agents of both quality control and cost control in health care, through two instruments. Americans would be enticed into private health insurance with very high annual “deductibles”—out of pocket payments before insurance kicks in, from $2100 to $10 000 or more per family. Firstly, the approach inevitably delegates most of the expected belt tightening in health care to families in the lower half of the nation’s income distribution, whose decisions on health care are most sensitive to high out of pocket costs. In effect, the proposal seeks to ration health care by income. Secondly, the approach would shift more of the financial burden of health care from the chronically healthy to the chronically ill (Reinhardt , 2006). Although, this HSA comes with tax break benefits, the high out of pocket costs puts a strain on families. This is worrisome for some that will not seek care due to costs.

Personally, all of these presidential efforts to improve the populations access to health care and coverage , this issue has not been properly addressed. A lot of times, the most vulnerable are the ones that are left helpless and uninsured. Obama care was the best effort to remedy this problem but still falls short of correcting it. As a health care worker, I believe quality health care should be a basic right. Everyone should somehow have access to care for their health, especially those who have pre-existing conditions. Universal coverage should be a priority of the government in order to assure everyone is covered. I also believe the government should do a better job in regulating health services and medication pricing. The pharmaceutical companies and hospitals should not be allowed to determine pricing to their advantage. Regulations should be placed in order to make sure patients are not over charged from services that they need to stay healthy.