Discussion: Two posts need reply with references

Lovely Brown <[email protected]>

(no subject)

Blessing Okafor <[email protected]> Wed, Sep 14, 5:57 PM To: Lovely Brown <[email protected]>

Politics and the Patient Protection and Affordable Care Act

One of the most important health reforms in the United States since the creation of Medicare and

Medicaid in 1965 is the Affordable Care Act (Obama, 2016). This policy was implemented a decade ago

but has come to be associated with significant improvements in the U.S. healthcare delivery system. For

instance, since it was adopted, the policy has led to increase in access to comprehensive health coverage

to millions of individuals who were previously not insured. This was achieved through the expansion of

Medicaid, the establishment of the Health Insurance Marketplace, and the passage of several consumer

protection provision that are in place to mitigate discrimination by providers as well as healthcare

systems; and to limit insurers’ ability to deny, limit, or cancel coverage (Warner et al., 2020). Notably,

even with the achievements that have been directly linked to this policy reform, the Trump administration

sought to repeal and/or replace the Affordable Care Act. This demonstrates the role of politics in in the

development of health policies. Indeed, there are interests other than those of the society that play a

significant role in the development and implementation of health policies. It is important to note that in

the process of agenda setting, health issues come to the attention of policy makers when problems,

solutions and political developments or motivations align, hence creating windows of opportunity

(Shiffman, 2016). Simply put, the personal interests of legislators, especially in regard to reelection have

significant effects on the development of health policies as it was seen in the efforts to repeal/replace the

Affordable Care Act.

Efforts to Repeal/Replace the ACA

The main job of a legislator is to be reelected. This means that the legislator has to do whatever it

takes to please his or her electorates. As such, important health issues continue to be politicized. These

are issues such as access to care, insurance coverage, and health disparities that the Affordable Care Act

was meant to address. During the process to repeal/replace the Affordable Care Act, it was clear that no

alternatives were presented. In fact, it was almost impossible for lawmakers to have a bipartisan approach

towards the implementation of further health reforms in the country. Politicking seems to be the order of

the day when it comes to discussing health issues that affect many Americans because of how much

health matters to the masses. In fact, health is always on the minds of the public and is said to always rank

among the top 3 concerns (Maddox et al., 2019). Since legislators are aware of this, their personal

interests come first and they will be easily swayed towards the making of a particular decision provided

that the decision guarantees them an office. This is despite the fact that the decision may not have any

scientific or empirical basis. In fact, in a particular survey which involved more than 12,000 American

respondents, it was established that there is public distrust with scientists because many Americans

believe that political motives influence the manner in which scientific research is done (McLaughlin et

al., 2021).

Impact of Voters Views

In recommending or positioning national policies, the analyses of voters’ views may affect the

decisions by legislators. This is because of the desire to be reelected. One of the most important

limitations of democracy is that the majority may not always be right. Voters may also be affiliated to a

political party and push for an agenda without necessarily having the right knowledge regarding the

health issue. In addition, while health policies should always be guided by evidence and scientific

research, the need to win votes creates a situation where science may not only be disregarded but

politicians may also influence the direction of scientific research in order to secure their desired positions.

This is always at the expense of population and public health. Health workers should strive to take part in

policymaking in order to ensure that evidence is considered throughout the process.

References

Maddox, K. E. J., Bauchner, H., & Fontanarosa, P. B. (2019). US health policy—2020 and beyond:

Introducing a new JAMA series. JAMA, 321(17), 1670-1672

McLaughlin, D. M., Mewhirter, J., & Sanders, R. (2021). The belief that politics drive scientific research

& its impact on COVID-19 risk assessment. Plos One, 16(4), e0249937

Obama, B. (2016). United States health care reform: Progress to date and next steps. Jama, 316(5), 525-

532

Shiffman, J. (2016). Agenda setting in public health policy. In International encyclopedia of public

health (pp. 16-21). Elsevier Inc.

Warner, J. J., Benjamin, I. J., Churchwell, K., Firestone, G., Gardner, T. J., Johnson, J. C., ... & American

Heart Association Advocacy Coordinating Committee. (2020). Advancing healthcare reform: The

American Heart Association’s 2020 statement of principles for adequate, accessible, and affordable health

care: A presidential advisory from the American Heart Association. Circulation, 141(10), e601-e614

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