The Impact of Healthcare Models on Health Policy: A Focus on the Current U.S. Presidential Administration
Introduction
The organization and financing of healthcare in the United States are influenced by various models and frameworks that shape health policy and delivery. As healthcare evolves rapidly, understanding these frameworks is crucial for healthcare professionals, particularly nurses. This report explores how the current presidential administration has structured the nation’s healthcare plan, examines the presence of social determinants in existing healthcare policies, and summarizes proposed changes to the healthcare framework.
Organization of the Current Healthcare Plan
The current U.S. presidential administration under President Joe Biden aims to strengthen and expand access to healthcare through several initiatives. The administration’s approach is rooted in the Affordable Care Act (ACA), which was enacted during the Obama administration and aimed at increasing healthcare coverage and affordability. President Biden has emphasized a commitment to:
1. Expanding Coverage: The administration aims to increase enrollment in health insurance plans through the Health Insurance Marketplace and to expand Medicaid in states that have not yet done so.
2. Lowering Costs: Through subsidies and provisions to lower out-of-pocket costs for individuals purchasing insurance, the administration seeks to make healthcare more affordable for low- and middle-income families.
3. Protecting Medicaid: The Biden administration has focused on safeguarding Medicaid from cuts and promoting its expansion to cover more individuals, particularly vulnerable populations.
4. Addressing Prescription Drug Prices: The administration has proposed measures aimed at lowering prescription drug prices, including allowing Medicare to negotiate prices for certain medications.
These strategies are indicative of a movement toward a more inclusive and equitable healthcare system that prioritizes access and affordability.
Social Determinants in Existing Healthcare Policy
Social determinants of health (SDOH) refer to the conditions in which people are born, grow, live, work, and age, influencing their health outcomes. The current healthcare policies, particularly those shaped by the ACA, recognize the importance of SDOH by emphasizing preventive care and addressing health disparities among different populations.
For instance, initiatives aimed at expanding Medicaid have been particularly beneficial for low-income individuals who often face barriers related to income, housing, education, and access to nutritious food. Programs that incorporate community health workers and outreach efforts seek to address these determinants by facilitating access to care and providing support services in underserved communities (Berkowitz et al., 2019).
Evidence of Social Determinants in Policy
Research indicates that policies focusing on social determinants can lead to improved health outcomes. For example, a study by Walker et al. (2020) highlights how integrating SDOH into care models can reduce hospital readmissions and improve chronic disease management. These findings underscore the significance of addressing SDOH in healthcare policy to enhance overall population health.
Proposed Changes Under the Current Administration
In response to ongoing challenges within the healthcare system exacerbated by the COVID-19 pandemic, the Biden administration has proposed several significant changes to enhance healthcare delivery:
1. Healthcare Affordability Programs: The American Rescue Plan included provisions for increased subsidies for health insurance premiums under the ACA, which would lower costs for millions of Americans (KFF, 2021).
2. Public Option: Although not fully realized, discussions around implementing a public option—a government-run health insurance plan—have gained traction within the administration. This would provide an alternative to private insurance, fostering competition and potentially lowering prices.
3. Investments in Telehealth: The administration has recognized the need for robust telehealth services, particularly after the pandemic accelerated its use. Proposed changes include permanent reimbursement for telehealth services under Medicare.
4. Mental Health Services Expansion: There is an emphasis on increasing access to mental health services as part of comprehensive care reforms. This includes integrating mental health into primary care settings and expanding community-based mental health resources.
5. Reproductive Health Access: The administration has also proposed changes that aim to protect and expand access to reproductive health services, reversing some policies established under previous administrations.
Conclusion
The current U.S. presidential administration’s approach to healthcare policy reflects a commitment to expanding access, reducing costs, and addressing social determinants of health. By focusing on inclusivity and equity within the healthcare system, these proposed changes aim to improve outcomes for all Americans, particularly vulnerable populations.
Understanding these policies is crucial for healthcare professionals as they navigate the complexities of patient care within this evolving framework. As nurses, recognizing the impact of social determinants on health can guide us in advocating for our patients and contributing to more effective health policies.
References
1. Berkowitz, S. A., Basu, S., & Phillips, R. L. (2019). Addressing Social Determinants of Health in Primary Care: A Systematic Review. Journal of General Internal Medicine, 34(12), 2577-2586. https://doi.org/10.1007/s11606-019-05022-2
2. Kaiser Family Foundation (KFF). (2021). The American Rescue Plan: A Summary of Key Health Provisions. Retrieved from https://www.kff.org/coronavirus-covid-19/issue-brief/the-american-rescue-plan-a-summary-of-key-health-provisions/
3. Walker, R. J., et al. (2020). The Relationship Between Social Determinants of Health and Outcomes in Patients with Chronic Disease: A Systematic Review. Journal of General Internal Medicine, 35(1), 218-228. https://doi.org/10.1007/s11606-019-05023-1
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