In this Assignment you will analyze recent presidential healthcare agendas. You also
It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.
Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.
As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.
In this Assignment you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.
To Prepare:
- Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
- Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
- Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
- Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.
The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)
Part 1: Agenda Comparison Grid
Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:
- Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
- Describe the administrative agenda focus related to the issue you selected.
- Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
- Explain how each of the presidential administrations approached the issue.
Part 2: Agenda Comparison Grid Analysis
Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:
- Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
- How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
- Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
Part 3: Fact Sheet or Talking Points Brief
Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:
- Summarize why this healthcare issue is important and should be included in the agenda for legislation.
- Justify the role of the nurse in agenda setting for healthcare issues.
Expert Answer and Explanation
Agenda Comparison Grid Assignment
Part 1: Agenda Comparison Grid
| Identify the Population Health concern you selected. | Opioid Crisis | |
| The Population Health concern. | According to statistics by the National Institute of Drug Abuse, over 50,000 people died from opioid overdose in 2019. Similarly, the same statistics indicate that close to $80 billion is spent on dealing with issues associated with opioid addiction including, loss of productivity, rehabilitation, involvement with the criminal activities to list a few. Over the years, different presidents established different approaches to tackle opioid issue, with each approach eliciting different reactions. This paper will compare former President Obama and President Trump’s policy stand on the opioid crisis. | |
| Administration (President Name) | President Barrack Obama | President Donald Trump |
| How each of the two presidential administrations approached the issue. | During President Obama’s tenure as president, he raised the level of sensitization on how serious the opioid crisis is and the impact on the American community. He made all stakeholders, especially the legislative wing of the government to start recognizing the intensity of the problem. However, it was until the final days of his term that the Congress passed the 21st Century Cures Act, which among other things increased the state funding channeled towards response against the opioid crisis (Barlas, 2017). | During President Trump’s tenure, he established opioid crisis as both a security and a health issue. He was quite vocal on recognizing the fact that opioid crisis is a matter of national concern joining gun violence as part of the leading causes death in the US. To help curb the issue, president trump passed into law the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT for Patients and Communities Act, which among other things helped to increase the federal funding on evidence-based treatment for opioid use disorder. President Trump also declared the opioid crisis as a national crisis in 2018, making him the first president to do so (The White House, n.d.). |
| Allocations of resources | After the implementation of the 21st Century Cures Act, over one billion dollars was allocated by the federal government towards collaborative efforts with states and other agencies in dealing with the opioid crisis (Office of the Press Secretary, 2016). | President Trump’s administration in 2018 through congress, passed a budget of $13 billion to be spread across two financial periods. This allocation was meant to help increase research on opioid treatment, improve access to treatments, among other aspects aimed towards combating the opioid crisis in the country (Davis, 2019). However, critics still argued that this amount was still minimal given the colossal nature of the opioid crisis. |
Part 2: Agenda Comparison Grid Analysis
| Administration | |
| Administrative agency
| A collaborative interdepartmental approach, spearheaded by the department of Health and Human Services would be ideal in addressing the opioid crisis. Given the nature of the issue, involving other non-health related departments such as the department of Homeland Security might also be necessary. The opioid crisis requires all stakeholders, including the communities, and families to actively play a role in sensitization and prevention activities against misuse and abuse of opioids hence my selection. |
| How the healthcare issue might get on the presidential agenda. | Unlike other health care challenges, the opioid crisis has already been rendered a nation health crisis by the former president, making it already part of the major presidential agenda. The current president, Joe Biden who is also a supporter of the 21st Century CURES act, recently signed another bill into law. The bill will empower the Department of Veteran Affairs in terms of financing and policy to help it deal with the opioid crisis. The financing has been set to a tune of $2 billion channeled towards various efforts of the department including safe disposal of opioids (Office of The President, 2021). |
| Selected Champion | There are several personalities who can fit into this group, and the more I have the better the campaign will be. To choose one, I would go for Robert Downey Jr. who is a world renown celebrity and a reformed opioid addict. Through his own primary account, he can share the negative implications of opioid addiction and why the battle against the same is necessary to improve the wellbeing of affected individuals, families, and communities Through his popularity, he can also martial support from several other stakeholders, including his fans to participate in efforts combating the opioid crisis. |
Part 3: Fact Sheet
| Fact Sheet | |
| Why the tackling the opioid crisis is important and should be included in the agenda for legislation. | Role of the nurse in agenda setting for healthcare issues. |
The opioid crisis was declared a national crisis by the former US President Donald Trump, and rightfully so; The following are some of the facts associated with the opioid crisis;
| Nurses are placed at a strategic position in addressing the entire opioid crisis.
|
References
Barlas S. (2017). U.S. and States Ramp Up Response to Opioid Crisis: Regulatory, Legislative, and Legal Tools Brought to Bear. P & T: A Peer-Reviewed Journal for Formulary Management, 42(9), 569–592.
Davis, C. S. (2019). The SUPPORT for Patients and Communities Act—What will it mean for the opioid-overdose crisis?. New England Journal of Medicine, 380(1), 3-5.
National Institute on Drug Abuse. (2021). Opioid overdose crisis. National Institute on Drug Abuse. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis
Office of The President. (2021). Executive Office of the president Office of National Drug … The Biden-Harris Administration’s Statement of Drug Policy Priorities for Year One. https://www.whitehouse.gov/wp-content/uploads/2021/03/BidenHarris-Statement-of-Drug-Policy-Priorities-April-1.pdf.
Office of the Press Secretary (2016), Fact Sheet: President Obama Proposes $1.1 Billion in New Funding to Address the Prescription Opioid Abuse and Heroin Use Epidemic. https://obamawhitehouse.archives.gov/the-press-office/2016/02/02/president-obama-proposes-11-billion-new-funding-address-prescription
O’Rourke, N. C., Crawford, S. L., Morris, N. S., & Pulcini, J. (2017). Political Efficacy and Participation of Nurse Practitioners. Policy, Politics, & Nursing Practice, 18(3), 135–148. https://doi.org/10.1177/1527154417728514
The White House. (n.d.). The cabinet. Retrieved September 20, 2018, from https://www.whitehouse.gov/the-trump-administration/the-cabinet
Alternative Expert Answer and Explanation
Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2
Part 1: Agenda Comparison Grid
Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.
You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.
| Identify the Population Health concern you selected. | Mental Health | ||
| Describe the Population Health concern you selected and the factors that contribute to it. | Mental health is one serious population health concerns in the US. Millions of people in the US are diagnosed with mental health problems every year. According to National Alliance of Mental Health (2022), 21% (52.9 million people) of the US adults had mental health problems in 2020. The organization also notes that 5.6% of the population with mental illness experienced serious problems. Considerable number of youths about 16.5% also had mental problems. Over 50 million Americans experience mental health problems but only 40% of them get medical attention (National Alliance of Mental Health (NAMI), 2022).
| ||
| Administration (President Name) | (Current President) Joseph Robinette “Joe” Biden Jr. | (Previous President) Donald J. Trump | (Previous President) Barrack Obama |
| Describe the administrative agenda focus related to this issue for the current and two previous presidents. | Joe Biden’s administration’s focus on mental health is to improve mental health coverage. The administration demands health insurers to offer suitable network of behavioral health providers without cost-sharing. Biden’s administration wants to improve parity in mental health care.
| Trump’s administration focused on building more building more psychiatric hospitals and civil commitments as a way to improve mental health of Americans. | Obama addressed mental health by signing mental health reform into law. This law stipulated how mental health patients should be helped. |
| Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue. | Biden’s administration provided $105 million to all states and territories to strengthen Crisis Call Center services as a way of combating mental health. In 2023 fiscal year, Biden proposes $1.653 billion for the Community Mental Health Block Grant and $7.5 billion in Medicaid to improve mental health (NAMI, 2022a). | Trump allocated $10 billion to fight opioid epidemic and other serious mental health during his administration. He also provided block grand to expand Medicaid program. | In 2013, Obama provided $100 to combat mental health. From the budget, he allocated $50 million to local mental health facilities. In 2016, he gave the National Institute of Mental Health (NIMH) $31.3 billion for mental health research and the Substance Abuse and Mental Health Services Administration (SAMHSA) $3.666 billion (NAMI, 2015). |
| Explain how each of the presidential administrations approached the issue. | Biden’s administration approached mental health by focusing on increasing coverage to mental health services (NAMI, 2022a). He wanted parity when it comes to covering mental health services. | Trump approached mental health by building more infrastructure such as psychiatric hospitals to improve quality of mental health services. | Obama invested more on menta health research. Most funds regarding mental health were spend to research more mental teal treatments (NAMI, 2015). |
Part 2: Agenda Comparison Grid Analysis
Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected
| Administration (President Name) | (Current President) | (Previous President) | (Previous President) |
| Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
| Biden’s administrative agency would help me solve the problem. He wants parity in mental health care provision by compelling health insurers to provide better behavior health packages without cost-sharing. His approach aims to reduce the cost of mental care services. | Trump’s agency was also good. However, he would need huge capital to build enough psychiatric hospitals across the US and this might be difficult politically. | Obama was more focused on research. He would have also provided funds for actual provision of mental healthcare services. |
| How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there? | The health issue might get into the agenda of the current president through lobbying. The president might be lobbied to include this issue into his manifesto. The issue can made to stay there by lobbying president to pass | In Trump’s administration, the issue might get on the agenda through TV and newspapers. The media can be influenced to cover the issue and force the Trump administration to talk about it. It can stay in the agenda through policies. | The issue can get on the agenda in Obama administration through Congress. A bill can be created and taken to Congress for debate and approval. It might be made permanent by making it law. |
| Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents? | In the Biden administration, I would choose to be a champion the selected healthcare issue. I would champion for allocation for more funds in mental health. | I would be an entrepreneur in the Trump administration. I would build mental health hospitals and rent them to the government. | I would be a sponsor in the Obama administration. I would sponsor a bill that support mental health research. |
References
National Alliance of Mental Health. (2015). President Obama’s 2016 budget: What does it mean for mental health?. https://www.nami.org/About-NAMI/NAMI-News/2015/President-Obama-s-2016-Budget-What-Does-It-Mean-f
National Alliance of Mental Health. (2022). Mental health by the numbers. https://www.nami.org/mhstats
National Alliance of Mental Health. (2022a). NAMI praises mental health investments in President Biden’s FY 2023 proposed budget. https://www.nami.org/About-NAMI/NAMI-News/2022/NAMI-Praises-Mental-Health-Investments-in-President-Biden-s-FY-2023-Proposed-Budget
Fact Sheet
Mental health is an important issue and should be included in the agenda of legislation due to the following reasons. The first reason is that a high number of Americans experience mental health issues. According to the National Alliance of Mental Health (2022), 21% (52.9 million people) of US adults had mental health problems in 2020. The organization also notes that 5.6% of the population with mental illness experienced serious problems. Statistics show that mental health affects the majority of the US population.
Though the prevalence of mental health in the US is high, only 40% of the population with the health problem get affordable and quality care. The second reason is that untreated mental illness can lead to many problems. According to Ravens-Sieberer et al. (2021), the high rate of mental health illnesses in society resulted in unemployment, unnecessary disability, substance abuse, suicide, inappropriate incarceration, and poor quality of life. Intreated mental health also leads to many deaths. A high rate of deaths by suicide occurs due to one or more mental problems. Therefore, for American society to be safe, mental health issues must be addressed by including them in the agenda for legislation.
Nurses play a big role in setting the agenda for healthcare issues. One of their roles is to analyze the healthcare setting and identify the population’s health concerns (Varghese et al., 2018). Nurses are close to patients and can easily identify the health problems affecting community settings. They also have the role to advocate for their populations by proposing health issues that should be given precedence when making laws (Varghese et al., 2018). Lastly, they can set the agenda by lobbying for their health policies on different platforms such as the social and mainstream media.
References
National Alliance of Mental Health. (2022). Mental health by the numbers. https://www.nami.org/mhstats
Ravens-Sieberer, U., Kaman, A., Erhart, M., Otto, C., Devine, J., Löffler, C., … & Hölling, H. (2021). Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study. European Child & Adolescent Psychiatry, 1-14. https://doi.org/10.1007/s00787-021-01889-1
Varghese, J., Blankenhorn, A., Saligram, P., Porter, J., & Sheikh, K. (2018). Setting the agenda for nurse leadership in India: what is missing. International Journal For Equity In Health, 17(1), 1-10. https://doi.org/10.1186/s12939-018-0814-0
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6 Biggest Healthcare Issues in the US
Introduction:
The healthcare system in the United States is complex and multifaceted, with numerous challenges that impact millions of Americans. From rising costs to access barriers, there are several key issues that need to be addressed in order to enhance the overall health and well-being of the population. In this blog post, we will explore some of the biggest healthcare issues currently facing the US.
1. Cost of Healthcare:
One of the most pressing issues in the US healthcare system is the skyrocketing cost of care. Medical expenses, including insurance premiums, deductibles, and out-of-pocket costs, have been on an upward trajectory for years. This places a significant burden on individuals and families, often resulting in financial instability and even bankruptcy due to healthcare-related expenses.
According to the American Medical Association, health spending in the United States increased by 2.7% in 2021, reaching $4.3 trillion or $12,914 per capita. This growth rate is significantly lower than the 10.3% increase observed in 2020. Additionally, individuals (including those who were uninsured), health insurers, and federal and state governments spent approximately $4.0 trillion on various types of health consumption expenditures in 2021, which accounted for 17.4% of the nation’s gross domestic product.
It’s worth noting that healthcare costs in the United States have been steadily rising over the years. The average annual growth in health spending during the 2010s was approximately 3%. The percentage of personal health care expenditures from out-of-pocket spending was lower in 2019 (12.7%) than in 2009 (14.1%), while the percentages from Medicare and Medicaid (total) were higher in 2019 (23.2% and 17.1%, respectively) than in 2009 (22.3% and 16.4%, respectively) according to the Centers for Disease Control and Prevention.
Source: Centers for Disease Control and Prevention on “Health Care Expenditures”
2. Lack of Access to Healthcare:
Access to affordable and quality healthcare is another major concern. Many Americans still struggle to obtain basic healthcare services due to a lack of insurance coverage or limited access to healthcare facilities, particularly in rural or underserved areas. This lack of access can lead to delayed or inadequate treatment, resulting in poorer health outcomes.
3. Health Disparities:
Health disparities refer to differences in the health status of different groups of people in the population. These differences occur across various dimensions, including race, ethnicity, socioeconomic status, geographic location, age, disability, and sexual orientation.
Health disparities are pervasive in the US healthcare system. Certain populations, including racial and ethnic minorities, low-income individuals, and the uninsured, are disproportionately affected by various health issues. These disparities can lead to disparities in life expectancy, higher rates of chronic illnesses, and decreased quality of life. Addressing this issue requires a comprehensive approach that focuses on reducing inequities and ensuring equitable care for all.
The following are some statistics related to health disparities in the United States:
- According to the Centers for Disease Control and Prevention (CDC), in 2017, the infant mortality rate for Black babies was more than double that of White babies, and the maternal mortality rate was three times higher for Black women compared to White women.
- Life expectancy varies by race and ethnicity, with White Americans having a higher life expectancy than their Black and Hispanic counterparts. Data from 2019 shows that the life expectancy at birth for Whites was 77.3 years, compared with 72.9 years for Blacks and 81.8 years for Hispanics.
- People living in poverty, including those who experience food insecurity and unstable housing, are more likely to experience poor health outcomes. In 2018, the poverty rate was highest among Hispanic individuals (18.3%) and lowest among non-Hispanic White individuals (7.3%).
- LGBT individuals experience significant health disparities, including higher rates of mental health issues and substance abuse. A national survey conducted in 2017-2018 showed that lesbian, gay, and bisexual adults were twice as likely as heterosexual adults to use illicit drugs in the past year.
- Rural communities face numerous health disparities, including limited access to healthcare providers and facilities, higher rates of chronic diseases and obesity, and fewer opportunities for physical activity.
These statistics highlight that health disparities exist across many different populations and dimensions. Addressing health disparities requires an understanding of the root causes of these inequities and a commitment to enacting evidence-based policies and interventions to promote health equity and improve the health outcomes of all Americans.
4. Chronic Disease Management:
Chronic diseases are a significant and growing healthcare issue in the United States. Chronic diseases refer to long-lasting conditions such as diabetes, heart disease, cancer, and asthma, that often require ongoing management and treatment. Here are some statistics related to chronic disease management in the US:
- According to the Centers for Disease Control and Prevention (CDC), chronic diseases are responsible for 7 in 10 deaths in the United States each year. Four of the top ten leading causes of death in 2019 were chronic diseases: heart disease, cancer, chronic lower respiratory diseases, and cerebrovascular diseases.
- Chronic diseases are a leading cause of disability and can significantly impact a person’s quality of life. In 2019, around 60% of US adults had at least one chronic condition, and 40% had two or more chronic conditions.
Source: National Center for Chronic Disease Prevention and Health Promotion. “Chronic Disease Overview.”
- The prevalence of chronic diseases is not distributed equally across the US population. Groups that are disproportionately affected by chronic diseases include racial and ethnic minorities, low-income individuals, and people living in rural areas.
- Chronic diseases also contribute significantly to healthcare costs in the US. In 2018, chronic diseases accounted for 90% of all healthcare spending in the US, or approximately $3.5 trillion.
Effective chronic disease management requires a comprehensive approach that includes preventive measures, effective treatment strategies, patient education, and ongoing support. Healthcare professionals and policymakers are increasingly focusing on developing innovative care delivery models, leveraging technology and digital health tools, and addressing social determinants of health to improve chronic disease management and outcomes in the US.
5. Mental Health Crisis:
The US is currently facing a mental health crisis, with increasing rates of conditions like depression, anxiety, and suicide. Despite the prevalence of mental health issues, access to mental healthcare and resources remains limited. Stigma surrounding mental health further exacerbates the problem. Addressing the mental health crisis requires implementing widespread mental health education, increasing funding for mental health services, and breaking down barriers to access.
According to various sources, the prevalence of mental health issues in the United States varies. Here are some percentages reported:
- The National Institute of Mental Health estimates that more than one in five U.S. adults live with a mental illness, representing approximately 57.8 million individuals in 2021.
- The National Alliance on Mental Illness (NAMI) reports that 5.5% of U.S. adults experienced a serious mental illness in 2021, which corresponds to around 14.1 million people.
- The Substance Abuse and Mental Health Services Administration (SAMHSA) states that about 26% of Americans ages 18 and older, or approximately 1 in 4 adults, suffer from a diagnosable mental disorder in a given year.
- Mental Health America found that in 2019-2020, 20.78% of adults in the U.S. were experiencing a mental illness, equivalent to over 50 million Americans.
- Additionally, 16.5% of U.S. youth aged 6-17 experienced a mental health disorder in 2016.
6. Shortage of Nurses and Physicians:
The shortage of nurses and physicians is a significant healthcare issue in the United States. The demand for healthcare professionals continues to grow as the population ages, chronic disease rates increase, and new technologies and treatments emerge. Here are some statistics related to the shortage of nurses and physicians in the US:
- According to the Bureau of Labor Statistics, employment of registered nurses is projected to grow 6% from 2022 to 2032, which is faster than the average for all occupations. However, there is still a projected shortfall of around 1.1 million registered nurses by 2022 due to an aging nursing workforce and growing demand for healthcare services.
Source: Bureau of Labor Statistics
- The shortage of physicians is also a significant issue, particularly in certain specialties and underserved areas. According to the Association of American Medical Colleges, the US could see a shortfall of up to 139,000 physicians by 2033.
- The shortage of healthcare professionals can lead to longer wait times for appointments, reduced access to care, and lower quality of care. It can also put a strain on existing healthcare workers, leading to higher burnout rates and poorer patient outcomes.
To address the shortage of nurses and physicians, healthcare organizations and policymakers are exploring a range of strategies. These include increasing funding for healthcare education and training programs, providing incentives for healthcare professionals to work in underserved areas, leveraging technology and telemedicine to expand access to care, and promoting alternative workforce models such as nurse practitioners and physician assistants.
Conclusion:
The healthcare system in the US faces a multitude of challenges, with costs, access barriers, health disparities, chronic disease management, and the mental health crisis standing out as some of the biggest issues. Addressing these problems will require collaborative efforts from policymakers, healthcare providers, and communities. By creating a more accessible, affordable, and equitable healthcare system, we can strive towards a healthier future for all Americans.
