Essay Sample on Medical Insurance Cover

Introduction

Today millions of Americans do not have medical insurance cover. This is a challenge that needs to be addressed out of necessity. Our economy is struggling. We need our youth to engage in the economic growth of this great nation however, they are disproportionately affected by illness and injuries which limit their ability to do so. We need to find a viable long term solution to America's medical insurance crises as part of my administrations human development agenda geared towards lifting the quality of life for ordinary inhabitants of this nation.

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The Affordable Care Act

When the Barak Obama was sworn in as the 44th President, the economy was in dire straits(Rawal,2016:1-2). Almost 50 million citizens were uninsured, and medical costs were close to 16 percent of the nation's Gross Domestic Product (GDP). The Congressional Budget Office(CBO) projected that this cost would rise to 30 percent of GDP by the year 2034. The most frustrating thing was that the American health care system was spending more money than any other industrial nation without getting the same outcomes as a nation like Singapore(Obama 2009). President Obama faced social and fiscal pressures to deal with the problems caused by inadequate coverage and unsustainability of costs.

The solution arrived at was the Affordable Care Act (ACA) was a legislative response to these public policy problems(Rawal,2016:1-2). The law came after almost two years of public deliberations. While some of the initial deliberations were a bi-partisan , its final passage was completely due to superior Democrat numbers in Congress. This caused the lasting political fractures that would last for years. The Trump administration got rid of the individual mandate in ACA .The statute was not perfect, it did need legislative reforms , however, its subsequent repeal took away essential medical insurance to America's backbone, the working class.

Apart from solving the inadequate insurance cover problem, the ACA provides us today with a path to reducing the debt at federal and state level (Rawal,2016:34). The Republic party at the time and conservative think tanks perpetrated the lie that ACA would damage the nation's fiscal health by increasing the federal financial deficit(Cannon 2013). This narrative contradicted projections by the CBO in 2012 that repealing ACA would actually increase the federal deficit by almost 109 billion dollars in the years between 2013 to 2022 (Rawal,2016). According to CBO projections at the time ,the ACA was projected to reduce the deficit because of cuts to the Medicare and taxes to cover ACA expenses.

As stated earlier , ACA was not perfect.For example, people who were satisfied with their insurance providers before the ACA came into force could not stay with their preferred insurance providers(Rawal ,2016:66-67). This weakness became a perceived weakness of ACA's that its advocates could not shake .ACA had an objective of making changes to America's individual insurance market by accounting for unemployed people not covered by their employer but in this regard , there was poor drafting.

This weak legislative crafting allowed insurance companies post-ACA to keep their right to reject insurance coverage because of a pre-existing conditions; reject renewal of coverage outright for any reason they wanted ; and continue to operate in a market without uniform regulations on the kinds of terms that had to offer in the individual insurance market (Rawal,2016:67-68). For instance, pre-ACA, most individual market insurance enrollees were refused maternity care, drug rehabilitation , mental health services, and prescription drug insurance coverage .The ACA was supposed to address these gaps through an essential health benefits scheme (EHB) plus rules which denied medical insurers the freedom to deny coverage for a preexisting condition or eliminating annual and lifetime benefit limits.

Another bone of contention which led to the eventual repeal of ACA was the Prevention and Public Health Fund(PPHF) in ACA created to finance public health initiatives that would improve community health status(Rawal,2016:171-2). Improper legislative crafting made oversight of the PPHF weak. Finances originally scheduled for community health were sometimes used to address money shortages in Medicare and Medicaid because of Republican budget cuts. This gave credence to claims by opponents of ACA that PPHF was put in place as a Democratic party slush fund especially after it was used, for example, to supplement the financial roots of ACA's health insurance marketplaces

The New ACA

The ACA provides a blue print for my administration to follow. The difference will be that the new Affordable Care Act will not have penalize citizens for opting not to buy health insurance; it shall not have a public health fund; and it shall implement EHB in a more aggressive way. Consequently , working with Congress, through a bipartisan effort, and public participation, the statute I am proposing will be anchored on the following basic principles:

• Consumer protection;
• Tax cuts for medical insurers;
• Group plans available through other organizations including employers;
• Removing barriers to completion by allowing removing physician-owned hospitals from the new ACA scheme to facilitate competitive pricing;
• Remove of antitrust exemptions for insurance operators to enhance consumer protection and competition;
• Breaking up hospital monopolies through laws which empower the states to directly choose when to open a new hospital in a given locality;
• Consumer protection by cracking down on insurance collusion
• Enhance competitions by not having reimbursement policies which sideline independent medical facilities; and
• Consumer protection by protecting and vindicating the right to opt for self-funded plans(AAPS 2017).

Conclusion

Government policy can be understood as decisions the state makes , directly or indirectly , which influences the ordinary lives of its citizens (Longest,2006). It can also be understood as political decisions which guide the implementation of government programs for the benefit of society. Because of the fact that government policies are backed by the coercive power of the state, public policy is an 'authoritative decision' made by the government about different things with the intent to impact the quality of life for citizens(Longest,2016). Consequently, the term 'health policy' can be best understood as policies made by government which impacts the quality of health of its citizens. Health policies are important because they determine health of a given population depends on availability and access to healthcare services (Longest,2006). These services could be preventive in nature ; emergency; therapeutic; or hospice care.

The state has the largest obligation to ensure its citizens get access to adequate health care .Health policies are therefore an essential tool in this work. Health delivery needs strategic management which is optimized by a nation having policies in place generated by executive policy or written law.This is because healthcare is transmitted to the public through systems "....[w]hich comprises the organizations and systems or networks of organizations that transform these resources into health services and distribute them to consumers. ....The system itself is also influenced by health policies. Similar to their impact on the other determinants of health, health policies have major bearing on the nature of the health services available to people through their impact on the resources required to produce the services, as well as on the healthcare system through which the services are organized, delivered, and paid for"(Longest 2006).

With my healthcare policies, the mistakes of the past will be avoided and our great nation will finally get its house in order in regards to the health of its people.

References

Rawal,PH(2016).The Affordable Care Act:Examining the Facts.Santa Babra(CA):ABC -CLIO.

AAPS(2017). Policy Statement: A white Paper on repeal/ replacement of Affordable Care Act. Retrived from www.aapsonline.org

Longest ,BB(2006) Health Policy Making in America. 4th edition .Chicago(IL):AuPHA.

Cannon, M. F. (2013). 50 Vetoes: How States Can Stop the Obama Health Care Law. Cato Institute.

Obama, B. (2009). Obama's health care speech to Congress. New York Times.