NURS 6050 Week 4 Assignment Legislation Grid and Testimony Advocacy Statement
NURS 6050 Week 4 Assignment Legislation Grid and Testimony Advocacy Statement
NURS 6050 Week 4 Assignment Legislation Grid and Testimony Advocacy Statement
Mental health access improvement bill if enacted would cause an amendment of the existing Medicare law as this bill seeks that mental health counselling, marriage and family therapist be covered under Medicare so as to give access to many who never had or can’t afford to pay for the services (“Senate introduces the mental health access Improvement Act of 2021,” 2021). In America there are statistics that shows that about 20 percent of our seniors aged from 55yrs and above are at higher risk for mental health instability hence the purpose of this bill is to give more vulnerable people especially the seniors access to mental health who can’t afford the services (“Medicare mental health access act would remove barriers to care,” 2020).
Due to the increasing level of stress, financial instability, high level of unemployment just as we have noticed during the time the world has been fighting this pandemic have destabilized a lot of our citizens mentally as the rate of suicide, depression and crime rate has been of the increase lately.
Legislation Comparison Grid Template
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| Health-related Bill Name | The Mental Health Access Improvement Act, 2019 |
| Bill Number | (H.R.945/S.286) |
| Description | The Mental health access improvement bill if enacted would cause an amendment of the existing Medicare law as this bill seeks that mental health counselling, marriage and family therapist be covered under Medicare so as to give access to many who never had or can’t afford to pay for the services. |
| Federal or State? | Federal |
| Legislative Intent | The bill will give especially the seniors access to mental health care as they can’t afford it and it will in the long run help reduce the cost of treating mental health if its identified and managed at the early onset of mental health challenges. |
| Proponents/ Opponents | Proponents: American foundation for suicide prevention, National alliance for mental illness |
| Opponents: The financial implication, The shortage of mental healthcare professionals (“Top 5 barriers to mental healthcare access,” 2020). | |
| Target Population | Children, adults, all Americans, people who use tobacco |
| Status of the bill (Is it in hearings or committees? | Currently the bill is in the committee |
| General Notes/Comments | Due to the increasing level of stress, financial instability, high level of unemployment just as we have noticed during the time the world has been fighting this pandemic have destabilized a lot of our citizens mentally as the rate of suicide, depression and crime rate has been of the increase lately. |
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Part 2: Legislation Testimony/Advocacy Statement
My position on this bill is that Medicare should be made to cover the services as proposed in this bill such as increasing access to mental health care and also covering the services of marriage and family therapy. This bill if enacted will help relieve some of the pressures people are going through (Milstead, J. A., & Short, N. M. (2019). Also having a plan that focuses on early identification and treatment of mental illness will help reduce eliminate or reduce the indirect cost of managing them in psychiatric hospitals, prisons and so on.
Addressing Opponents
One of the opponents identified in this bill is the cost implication as most committees will focus on the direct cost and not focus on the indirect cost of not identifying mental illness in the early stages. Another opponent I identified is the shortage of mental health care providers especially in the rural areas. Plans should be made at the same time the bill is enacted to ensure or have plans to increase the number of mental health providers by allowing Nurse Practitioners to practice within their license so as to cover the gap in medical care.
Conclusion
This is a welcome bill that majority of the people will be happy about but unfortunately, I feel the bill is not getting the needed attention it should be getting as it has lingered for some time now because most Politian’s have made everything to be politics as they only push for laws that restrict the basic care coupled with their attitude of downplaying on sensitive cases that will benefit the general public (Taylor et al., 2017). If the services of mental health care is covered by the Medicare, it will help in early identification of mental health problems and save the indirect cost of taking care of them in the prisons and hospitals if not well managed in time.
References
Medicare mental health access act would remove barriers to care. (2020). Mental Health Weekly, 30(36), 7-8. https://doi.org/10.1002/mhw.32512
Senate introduces the mental health access Improvement Act of 2021. (2021, March 22). American Counseling Association | A professional home for counselors. https://www.counseling.org/news/updates/2021/03/22/senate-introduces-the-mental-health-access-improvement-act-of-2021
Top 5 barriers to mental healthcare access. (2020, July 28). Social Solutions. https://www.socialsolutions.com/blog/barriers-to-mental-healthcare-access/
Taylor, D., Olshansky, E. F., Woods, N. F., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education [Nursing outlook 65/2 (2017) 242–245]. Nursing Outlook, 65(3), 346-350. https://doi.org/10.1016/j.outlook.2017.05.003
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Maternal healthcare is one of the determinants of the quality, safety and efficiency of health in a state. The US is one of the most developed countries in the world. It is therefore expected to have the lowest maternal mortality and morbidity rates in the world. However, statistics show that the rates of maternal mortality and morbidity in the US are significantly high. Consequently, this paper explores a proposed policy that aims at reducing the current rates and trends in maternal mortality and morbidity in the USA.
| Health-related Bill Name | Recognizing The Maternal Health Crisis In The United States And The Importance Of Reducing Mortality And Morbidity Among All Women And Honoring Mothers |
| Bill Number | H.Res.539 |
| Description | Maternal mortality and morbidity is a critical issue affecting the United States of America. The statistics presented in the bill shows that despite being a developed nation, America has the highest rate of maternal mortality and morbidity. The statistics also show that the risk for maternal mortality and morbidity is significantly elevated among women from ethnic minority groups when compared to the American natives. Women also experience challenges in their maternal care such as mistreatment that degrade their self-identity and autonomy. Based on the above maternal health-related issues, the Recognizing The Maternal Health Crisis In The United States And The Importance Of Reducing Mortality And Morbidity Among All Women And Honoring Mothers Act was proposed for implementation. The act seeks to address the issue by focusing on a number of aspects related to maternal health. Firstly, it seeks to raise the awareness of the public about maternal morbidity, mortality and the existence of disparities in maternal health-related outcomes. The bill also seeks to encourage states, Federal Government, territories, local communications and healthcare organizations among other stakeholders to take interventions that reduce the risk and rate of adverse maternal health outcomes as well as improve maternal safety. The other aims of the act include addressing and eliminating disparities in maternal health outcomes, ensuring the provision of equitable and respectively maternal care, honoring mothers who have died due to pregnancy-related complications, and supporting the collection of data on maternal morbidity and mortality. It also supports the need for further investment efforts to enhance maternal health and health outcomes as well as eliminate disparities in maternal healthcare. |
| Federal or State? | Federal |
| Legislative Intent | The legislative intent of the act is to recognize the seriousness of maternal morbidity and mortality issues in the US. The act also seeks to raise the awareness of the public and other stakeholders on the need to prevent maternal morbidity and mortality. Further, the act aims at ensuring the disparities in outcomes of maternal health are eliminated. Lastly, it aims at ensuring that mothers and pregnant women receive respectful care that meets their health needs. |
| Proponents/ Opponents | Proponents: They include Reps. Underwood Lauren, Kelly Robin, Spanberger Abigail Davis, Wexton Jennifer, and Adams Alma. |
| Opponents: none | |
| Target Population | The primary beneficiaries of the proposed bill are pregnant women and mothers. It also includes women from ethnic minorities. The secondary target population includes healthcare providers, policymakers, and communities. |
| Status of the bill (Is it in hearings or committees?) | The bill has been referred to the House Committee on Energy and Commerce. |
| General Notes/Comments | The proposed bill is a crucial bill that should be adopted in the US. The need for the bill is attributed to the high rate of maternal mortality and morbidity rates in the USA. Its implementation would therefore support the provision of care that addresses the needs of pregnant women and mothers from diverse ethnic backgrounds. |
Advocacy Statement
Maternal mortality and morbidity is a critical issue in the US despite it being a developed nation (Collier & Molina, 2019; Joseph et al., 2021). For example, statistics show that 60% of the maternal mortalities reported in the US are preventable. In addition, the risk of women of ethnic minority groups such as African American and American Indians dying from pregnancy related complications is three times that of the White women. Women also experience different forms of mistreatment, as they receive their needed maternal healthcare (Morton et al., 2019). Therefore, the proposed bill should be adopted in the USA to address the identified issues. The bill will increase the maternal health outcomes as well as the quality of care mothers and pregnant women receive (Congress.gov, 2021). Through the bill, the USA will rank among the world’s leading nations with lowest maternal mortality and morbidity rates. I will address the opponents in my position by presenting facts above the severity of the issue of maternal mortalities and morbidities in the US. I will also provide the socioeconomic implications of maternal mortalities and morbidities to the state. For example, I will explore the cost implications of the issue to the American economy and families.
Conclusion
The US currently has a high rate of maternal mortality and morbidity. Significant disparities exist in maternal health outcomes due to ethnicity of the mothers and pregnant women. The proposed bill is important in ensuring equity in maternal healthcare and adoption of best practices to reduce and prevent maternal mortalities and morbidities. Therefore, it should be implemented to promote public health.
References
Collier, A. Y., & Molina, R. L. (2019). Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. NeoReviews, 20(10), e561–e574. https://doi.org/10.1542/neo.20-10-e561
Morton, C. H., VanOtterloo, L. R., Seacrist, M. J., & Main, E. K. (2019). Translating Maternal Mortality Review Into Quality Improvement Opportunities in Response to Pregnancy-Related Deaths in California. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(3), 252–262. https://doi.org/10.1016/j.jogn.2019.03.003
Joseph, K. S., Boutin, A., Lisonkova, S., Muraca, G. M., Razaz, N., John, S., … & Schisterman, E. (2021). Maternal Mortality in the United States: Recent Trends, Current Status, and Future Considerations. Obstetrics and Gynecology, 137(5), 763. doi: 10.1097/AOG.0000000000004361
Congress.gov. (2021, July 19). Text – H.Res.539 – 117th Congress (2021-2022): Recognizing the maternal health crisis in the United States and the importance of reducing mortality and morbidity among all women, and honoring mothers. (2021/2022) [Legislation]. https://www.congress.gov/bill/117th-congress/house-resolution/539/text
Good Evening Shirley,
Thank you for your insight and information regarding the ACA. I am not sure for how long this will be an ongoing issue, but I understand why the ACA is such a sensitive subject. To me, I believe it revolves around the bottom dollar or the cost benefit analysis. Being as though we have people living longer, many people dealing with more chronic conditions, and a substantial increase in insured individuals, medical costs are naturally going to rise.
Carey, et al., (2018, p. 1 para 2) explained that multiple states have declined on not expanding Medicaid eligibility via the ACA related to the belief that ACA eligibility may cause strain on health care providers leading to worse care to individuals that are insured. Carey, et al., (2018, p.1 para 2) stated that many people had predicted that there would be a rush and this in turn would lead to a national shortage within the primary care workforce.
Even though states have been hesitant or declined the use of the ACA, Carey, et al., (2018, p. 2 Abstract) found no evidence regarding the expansion of the ACA and a reduction of utilization in the Medicare beneficiaries’ population. Carey, et al., (2018, p.4), stated negative spillovers that were of concern for others were not unfounded related to economic predictions that ACA’s spillovers would be big. Carey, et al., (2018, p.4) further explained that cited work from Glied and Hong on predictions related to physician care spending within Medicare beneficiaries’ group would be reduced specifically in lower income areas because of a large increase in coverage. Manner, (2018, para 1) stated that most individuals agree on the country’s healthcare system as unaffordable, a mess, and confusing. It has been suggestion that reform follows the party affiliation. The support is generally given by the overall public that family members may be eligible for insurance, but the mandatory penalties stemming from not having insurance is not something the public opinion is in agreement with. Although resolution may bot be found soon, the sentiment on giving the citizens insurance is there. It is my hope that a solution may come about sooner than later that will be able to give quality care to all, but to not have a harsh economic impact on the country and citizens. Have a great evening.
Sincerely,
Ana O.
References
Carey, C., Miller, S., & Wherry, L. (2018). The impact of insurance expansions on the already Insured: The Affordable Care Act and Medicare. https://doi.org/10.3386/w25153
Manner P. A. (2018). Editor’s Spotlight/Take 5: The Affordable Care Act Decreased the Proportion of Uninsured Patients in a Safety Net Orthopaedic Clinic. Clinical orthopaedics and related research, 476(5), 921–924. https://doi.org/10.1097/01.blo.0000532687.97507.8b
Good day! It was enlightening discussion of yours.
I agree that the ACA has been highly controversial despite the positive outcomes and the ACA is subject to changes every year. The legislation can be amended and budget decisions can affect how it is implemented.
The Affordable Care Act (ACA) was signed into law in March of 2010 and despite repeated attacks, not only has it survived – it has thrived and continues to provide tens of millions of Americans with access to health care coverage, because of the law, but millions of people also gained insurance coverage for the first time. Millions more have increased security when insured, benefitting from prohibitions on discrimination by insurers and protections for people with preexisting conditions.
The ACA was intended to expand options for health coverage, reform the insurance system, increase coverage for services (particularly preventive services), and provide a funding stream to improve quality of services. Has it improved coverage? Indisputably, yes. More than 20 million people have gained coverage as a result of the ACA. It has dramatically reduced the uninsured rate. On the day President Obama signed the ACA, 16 percent of Americans were uninsured; in March 2020, it was nine percent. Health access? Again, yes. The ACA’s first two open enrollment periods showed significant improvement not only in rates of coverage, but also in access to care, including access to a personal physician and medications and improved reported health status.
The ACA was passed by a Democratic Congress and signed by a Democratic president in 2010. This political configuration lasted only for the first two years of the Obama administration. Once Republicans gained control of Congress in 2013, having campaigned on a promise to repeal the ACA, they made more than 50 attempts to eliminate the law. President Obama vetoed attempts at outright repeal, but some targeted actions were successful, as Congress made use of its appropriation power that the President either could not or chose not to fight. For example, the ACA created a Prevention and Public Health Fund, initially authorized to disburse $15 billion over 10 years. These funds were to be used for, among other things, programs to increase access to primary care and preventive care. After Republicans gained control of Congress in 2013, they made repeated cuts to the Fund. The ACA also created a “risk corridors” program, which limited insurer profits and losses for the first three years of the program. This was intended to insulate insurers covering high needs patients from significant losses, as the ACA prohibited plans from discriminating based on health condition. When Trump took office in 2017 and Congress was under Republican control, it was widely expected that the ACA’s days were numbered. But, defying expectations, the ACA survived largely intact. One notable exception was a repeal of the financial penalty for violating the ACA’s individual mandate.
After years of neglect and sabotage, the Biden administration burst out of the gate with executive orders and proposed legislation to strengthen the ACA, and the 117th Congress passed a massive economic rescue package that includes funding to strengthen and expand the ACA’s reach and effectiveness. Yet, an imminent decision from the Supreme Court could threaten the ACA’s success – and its very existence.
In the meantime, the ACA is the law of the land and will remain so until alternative legislation is passed. It behooves Republicans not to exacerbate the churn and disruption that has been ongoing in the exchanges until alternative legislation is in place and ready to be implemented. Controlling the White House, House, and Senate, even with precarious margins will make it difficult to convince the American public that any problems with health care aren’t the government’s responsibility. Changes in the healthcare field along with changes to the political make up of future presidential administrations and Congress, make it likely that the ACA will continue to change for years to come.
References
Beauregard, Lisa Kalimon, and Edward Alan Miller. 2020. “Why Do States Pursue Medicaid Home Care Opportunities? Explaining State Adoption of the Patient Protection and Affordable Care Act’s Home and Community-Based Services Initiatives.” RSF: The Russell Sage Foundation Journal of the Social Sciences6(2): 154–78. DOI: 10.7758/RSF.2020.6.2.07.
Duggan, Mark, Gopi Shah Goda, and Emilie Jackson. 2019. “The Effects of the Affordable Care Act on Health Insurance Coverage and Labor Market Outcomes.” National Tax Journal 72(2): 261–322.
Gutierrez, Carmen M. 2018. “The Institutional Determinants of Health Insurance: Moving Away from Labor Market, Marriage, and Family Attachments Under the ACA.” American Sociological Review (6): 1144–70.
Legislation Grid and Testimony Advocacy Statement SAMPLE 2
Regardless of geographical location, race, culture, and other factors, all populations deserve quality, timely, and affordable health. Besides, health care providers and stakeholders should devise interventions for health promotion and the protection of vulnerable communities. Health care policies are instrumental in health promotion since they outline guidelines for benefitting patients, communities, and health care providers (Wolstenholme & McKelvie, 2019). As a result, Congress and other law-making bodies formulate health promotion bills to advance health in the United States. The purpose of this paper is to evaluate a recently-proposed health-related bill and an advocacy statement supporting its legislation
Part 1: Legislation Grid
| Health-related Bill Name | End Tuberculosis Now Act of 2022 |
| Bill Number | H.R. 8654 (Congress.gov, 2022). |
| Description | End Tuberculosis Now Act of 2022 underlines that the United States foreign assistance program has an obligation to end global tuberculosis (TB) pandemic through multifaceted interventions, including actions that support TB diagnosis and treatment among all adults and children and prevent new infections (Congress.gov, 2022; Kaiser Family Foundation, 2022). The bill also outlines the objectives and goals of TB-related policy, such as appropriate funding of comprehensive person-centered programs, capacity building among populations where the TB burden is high, and direct support to at-risk and impoverished populations. |
| Federal or State? | Federal |
| Legislative Intent | The bill’s intent is to prevent, cure, and treat tuberculosis globally. Besides, the bill ensures that at-risk populations are identified and get appropriate support. |
| Proponents/ Opponents | Proponents: Representative Ami Bera (Congress.gov, 2022). |
| Opponents: no opponent has been noted | |
| Target Population | All adults and children with all forms of Tuberculosis and at-risk populations in the United States (Congress.gov, 2022; Kaiser Family Foundation, 2022). |
| Status of the bill (Is it in hearings or committees?) | The bill is in the committees stage (House- Foreign Affairs) |
| General Notes/Comments | The bill focuses on a critical population health matter that deserves maximum attention from individuals, communities, health care providers, and governments. Generally, optimal health outcomes can only be achieved by protecting populations from infections, supporting health promotion programs, and identifying vulnerable populations. Since the bill will be instrumental in ending the TB pandemic and reducing health care costs, quick implementation is crucial. The federal government should also ensure that the United States foreign assistance program has adequate funding to achieve the health care goals outlined in the bill. |
Part 2: Legislative Testimony/Advocacy Statement
Healthy populations are critical for a nation’s productivity and progressive economic well-being. The End Tuberculosis Now Act of 2022 will be instrumental to people’s health and well-being and should be quickly implemented. It will be crucial to health and well-being since it promotes preventive health, which helps to reduce deaths, disability, and health inequities (Franklin & Sleet, 2018). Besides, the bill applies a global approach to achieve internal health outcomes since it will advance measures for protecting Americans from foreign TB infections. Such an approach will further help the nation to achieve Healthy People 2030 goals.
TB rates vary with populations’ characteristics. Social determinants of income affect the legislation of the End Tuberculosis Now Act of 2022 since the variance in TB rates necessitates intervention programs specific to a population’s needs. Health research demonstrates a close link between TB and poverty since TB infections are high in low-income areas (Abou Jaoude et al., 2022). People living in low-income areas are likely to live in poorly ventilated and overcrowded conditions that are ideal for the spreading of TB bacteria. The rates of malnutrition and diseases such as HIV/AIDS are also high in low-income areas and increase TB resistance (Balinda et al., 2019). Such income-related outcomes necessitate adjustments in intervention measures since a universal approach cannot be used to promote health in populations with varying needs, vulnerabilities, and cultural practices.
Opponents should understand the implications of TB on populations, health care spending, and the progressive economic well-being of the nation. The best way to address them is through research and health statistics demonstrating the link between TB and adverse health outcomes. For instance, the Centers for Disease Control and Prevention (2020) reported that TB is the leading infectious disease in the world and claims approximately 1.5 million lives annually. As a result, multifaceted health promotion programs are vital. Abou Jaoude et al. (2022) stated that Stop TB Partnerships and health promotion programs have helped to reduce TB spending. Similar measures underlined in the End Tuberculosis Now Act of 2022 should be intensified to protect general and vulnerable populations.
Conclusion
Health care bills advance health through more funding, advocacy, and the protection of special populations, among other strategies. Implementing the End Tuberculosis Now Act of 2022 will be instrumental in attaining healthy and productive populations. As a result, quick implementation of the bill is essential and more support from legislators is needed as well. The government should also supplement such interventions with other health promotion programs, particularly in vulnerable communities where TB rates are high.
References
Abou Jaoude, G. J., Baena, I. G., Nguhiu, P., Siroka, A., Palmer, T., Goscé, L., … & Haghparast-Bidgoli, H. (2022). National tuberculosis spending efficiency and its associated factors in 121 low-income and middle-income countries, 2010–19: a data envelopment and stochastic frontier analysis. The Lancet Global Health, 10(5), e649-e660. https://doi.org/10.1016/S2214-109X(22)00085-7
Balinda, I. G., Sugrue, D. D., & Ivers, L. C. (2019). More than malnutrition: a review of the relationship between food insecurity and tuberculosis. Open forum infectious diseases, 6(4), ofz102. https://doi.org/10.1093/ofid/ofz102
Centers for Disease Control and Prevention. (2020). Tuberculosis. https://www.cdc.gov/globalhealth/newsroom/topics/tb/index.html
Congress.gov. (2022). H.R. 8654– End Tuberculosis Now Act of 2022. https://www.congress.gov/bill/117th-congress/house-bill/8654
Franklin, R. C., & Sleet, D. A. (2018). Injury prevention and health promotion: A global perspective. Health Promotion Journal of Australia: Official journal of Australian Association of Health Promotion Professionals, 29(2), 113–116. https://doi.org/10.1002/hpja.191
Kaiser Family Foundation. (2022). U.S. global health legislation tracker. https://www.kff.org/coronavirus-covid-19/fact-sheet/u-s-global-health-legislation-tracker/
Wolstenholme, E., & McKelvie, D. (2019).The dynamics of care: Understanding people flows in health and social care. Springer.
Regardless of geographical location, race, culture, and other factors, all populations deserve quality, timely, and affordable health. Besides, health care providers and stakeholders should devise interventions for health promotion and the protection of vulnerable communities. Health care policies are instrumental in health promotion since they outline guidelines for benefitting patients, communities, and health care providers (Wolstenholme & McKelvie, 2019). As a result, Congress and other law-making bodies formulate health promotion bills to advance health in the United States. The purpose of this paper is to evaluate a recently-proposed health-related bill and an advocacy statement supporting its legislation
Part 1: Legislation Grid
| Health-related Bill Name | End Tuberculosis Now Act of 2022 |
| Bill Number | H.R. 8654 (Congress.gov, 2022). |
| Description | End Tuberculosis Now Act of 2022 underlines that the United States foreign assistance program has an obligation to end global tuberculosis (TB) pandemic through multifaceted interventions, including actions that support TB diagnosis and treatment among all adults and children and prevent new infections (Congress.gov, 2022; Kaiser Family Foundation, 2022). The bill also outlines the objectives and goals of TB-related policy, such as appropriate funding of comprehensive person-centered programs, capacity building among populations where the TB burden is high, and direct support to at-risk and impoverished populations. |
| Federal or State? | Federal |
| Legislative Intent | The bill’s intent is to prevent, cure, and treat tuberculosis globally. Besides, the bill ensures that at-risk populations are identified and get appropriate support. |
| Proponents/ Opponents | Proponents: Representative Ami Bera (Congress.gov, 2022). |
| Opponents: no opponent has been noted | |
| Target Population | All adults and children with all forms of Tuberculosis and at-risk populations in the United States (Congress.gov, 2022; Kaiser Family Foundation, 2022). |
| Status of the bill (Is it in hearings or committees?) | The bill is in the committees stage (House- Foreign Affairs) |
| General Notes/Comments | The bill focuses on a critical population health matter that deserves maximum attention from individuals, communities, health care providers, and governments. Generally, optimal health outcomes can only be achieved by protecting populations from infections, supporting health promotion programs, and identifying vulnerable populations. Since the bill will be instrumental in ending the TB pandemic and reducing health care costs, quick implementation is crucial. The federal government should also ensure that the United States foreign assistance program has adequate funding to achieve the health care goals outlined in the bill. |
Part 2: Legislative Testimony/Advocacy Statement
Healthy populations are critical for a nation’s productivity and progressive economic well-being. The End Tuberculosis Now Act of 2022 will be instrumental to people’s health and well-being and should be quickly implemented. It will be crucial to health and well-being since it promotes preventive health, which helps to reduce deaths, disability, and health inequities (Franklin & Sleet, 2018). Besides, the bill applies a global approach to achieve internal health outcomes since it will advance measures for protecting Americans from foreign TB infections. Such an approach will further help the nation to achieve Healthy People 2030 goals.
TB rates vary with populations’ characteristics. Social determinants of income affect the legislation of the End Tuberculosis Now Act of 2022 since the variance in TB rates necessitates intervention programs specific to a population’s needs. Health research demonstrates a close link between TB and poverty since TB infections are high in low-income areas (Abou Jaoude et al., 2022). People living in low-income areas are likely to live in poorly ventilated and overcrowded conditions that are ideal for the spreading of TB bacteria. The rates of malnutrition and diseases such as HIV/AIDS are also high in low-income areas and increase TB resistance (Balinda et al., 2019). Such income-related outcomes necessitate adjustments in intervention measures since a universal approach cannot be used to promote health in populations with varying needs, vulnerabilities, and cultural practices.
Opponents should understand the implications of TB on populations, health care spending, and the progressive economic well-being of the nation. The best way to address them is through research and health statistics demonstrating the link between TB and adverse health outcomes. For instance, the Centers for Disease Control and Prevention (2020) reported that TB is the leading infectious disease in the world and claims approximately 1.5 million lives annually. As a result, multifaceted health promotion programs are vital. Abou Jaoude et al. (2022) stated that Stop TB Partnerships and health promotion programs have helped to reduce TB spending. Similar measures underlined in the End Tuberculosis Now Act of 2022 should be intensified to protect general and vulnerable populations.
Conclusion
Health care bills advance health through more funding, advocacy, and the protection of special populations, among other strategies. Implementing the End Tuberculosis Now Act of 2022 will be instrumental in attaining healthy and productive populations. As a result, quick implementation of the bill is essential and more support from legislators is needed as well. The government should also supplement such interventions with other health promotion programs, particularly in vulnerable communities where TB rates are high.
References
Abou Jaoude, G. J., Baena, I. G., Nguhiu, P., Siroka, A., Palmer, T., Goscé, L., … & Haghparast-Bidgoli, H. (2022). National tuberculosis spending efficiency and its associated factors in 121 low-income and middle-income countries, 2010–19: a data envelopment and stochastic frontier analysis. The Lancet Global Health, 10(5), e649-e660. https://doi.org/10.1016/S2214-109X(22)00085-7
Balinda, I. G., Sugrue, D. D., & Ivers, L. C. (2019). More than malnutrition: a review of the relationship between food insecurity and tuberculosis. Open forum infectious diseases, 6(4), ofz102. https://doi.org/10.1093/ofid/ofz102
Centers for Disease Control and Prevention. (2020). Tuberculosis. https://www.cdc.gov/globalhealth/newsroom/topics/tb/index.html
Congress.gov. (2022). H.R. 8654– End Tuberculosis Now Act of 2022. https://www.congress.gov/bill/117th-congress/house-bill/8654
Franklin, R. C., & Sleet, D. A. (2018). Injury prevention and health promotion: A global perspective. Health Promotion Journal of Australia: Official journal of Australian Association of Health Promotion Professionals, 29(2), 113–116. https://doi.org/10.1002/hpja.191
Kaiser Family Foundation. (2022). U.S. global health legislation tracker. https://www.kff.org/coronavirus-covid-19/fact-sheet/u-s-global-health-legislation-tracker/
Wolstenholme, E., & McKelvie, D. (2019).The dynamics of care: Understanding people flows in health and social care. Springer.
The ACA is an important Bill that helps the American people receive health insurance; however, there are some drawbacks to the implementation of this Bill. When it first went into effect, it caused issues among Americans because they were now obligated to have health insurance or pay a penalty fee at the end of the year in taxes if they did not sign up for the ACA. With this mandate, insurance premiums rose by more than 50% nationwide due to decreased insurance availability (Slagle, 2021). Insurance premiums became an issue because more people were applying for Medicare, and not enough people were applying for private insurance. The ACA also affected hospital closures because hospitals began to struggle financially. When Medical started reimbursing hospitals for patient care, the treatment cost was much higher than what medical reimbursed. Private hospitals began to close, and surrounding hospitals became overwhelmed with patients (Dublois, 2020).
Slagle, A. (2021, June 18). Obamacare’s side effects: Higher costs, lower choices. The Heritage Foundation. Retrieved May 29, 2023, from https://www.heritage.org
Links to an external site. /health-care-reform/commentary/obamacares-side-effects-higher-costs-lower-choices
Dublois, H., & Ingram, J. (2020, May 21). Short on space : How obamacare expansion is pushing hospitals to the brink. The Foundation for Government Accountability. Retrieved May 29, 2023, from http://thefga.org/reseaarch/medicaid-expansion-hospitals-covid-19/
In its frequent attempts, last January of 2016, for the first time, congress passed a bill repealing the Affordable Care Act (ACA) to reduce federal government spending on health care by $927 billion between 2017 and 2026. During Trump’s administration, republican candidates planned to propose health policies to put in place after repeal; although, they made no broad agreement. Former President Trump wanted to revoke ACA provisions such as individual mandates, health insurance reforms, affordable insurance exchanges, employer requirements, and premium credits to eligible individuals and families (Nadesh et al., 2018). However, this impacts coverage and welfare for most uninsured individuals with preexisting health conditions and disabilities. It was predicted that if this reform succeeds and continues, by 2021, the number of uninsured individuals will rise by 24 million, 81% will lose coverage in working families, and 14.5 million fewer people with Medicaid coverage in 2021. Moreover, approximately 9.4 million people who received tax credits for private coverage will no longer receive assistance, and State spending will increase by $68.5 billion between 2017 and 2026. As reductions in Medicaid spending would be more than offset by increases in uncompensated care, and less health care treatment would be provided to modest-and low-income families (Buettgens et al., 2016).
Republicans campaigned attacking “Obamacare” during the 2010 midterm elections dishonoring and disapproving his U.S. health care system plans. Eight years later, republicans lost dozens of house seats, which was believed to have something to do with the repeal effort. In contrast, the democrats focused on health care, which involves the preservation of the revenue streams for health institutions, e.g., medical hospitals, insurance coverage, and drug industries. Between 2010-2016 House Republicans passed repeal bills more than 50 times. Elements of this campaign were arguably actions by GOP state officials who refused to expand Medicaid programs as several republican governors embraced its expansion, with the federal government picking up nearly all cost. However, GOP officials held out in states like Georgia, Florida, and Texas, and millions of low-income people remained uninsured. Trump’s 2016 victory made the repeal inevitable, yet the former president and his allies could not keep their vows. As he promised that in his term, there would be health insurance for everyone, but health care coverage is so expensive, and the government spent much money in the form of subsidies. As a result, this does not favor the public. The lack of success in repealing legislation did not end well with the Republican Party’s ultimate plan of eliminating the Affordable Care Act program. The Trump administration canceled funding for outreach, and an essential set of subsidies for insurers was already unfunded, eventually changing the policies on how states could design their Medicaid program. In 2017, congress passed a tax bill zeroing the ACA’s penalty for people who did not carry insurance, and Trump agreed to sign the provision (Cohn, 2020). In the middle of the Pandemic during Trump’s administration, with the death of Justice Ruth Bader Ginsburg days before the Supreme Court will hear oral arguments regarding the health care repeal lawsuit, the chance of the Affordable Care Act (ACA) remaining active is entirely uncertain. Totally revoking the ACA would have been disastrous to millions of Americans and wreaked havoc on the insurance markets and the U.S economy in general. As the pandemic continued, Medicaid expansion as an alternative was vital to the nation, especially for curative and preventive care during the outbreak. Finally, economic research highlighted that Medicaid expansion had enhanced public safety, especially for low-income adults, saving communities tens of billions of dollars (Rapfogel et al., 2020).
In my view, cost-benefit is vital for legislators in determining their opinions and actions regarding a specific policy that impacts every voter’s decision whether they will be re-elected or not. It is crucial for the safety of the people and our nation’s economy. The ACA has proved a stumbling block for several Republicans who want to abolish it. Every policy passed or repealed is based on the legislators’ decisions, and the probability of its consequences is inevitable. In this case, the dubious cycle of repealing the Affordable Care Act causes different opinions from democrats and republican parties; however, popularity votes regarding a specific national concern that caters more to the people’s welfare prevails and wins in the end. For example, Republican Sen. Martha McSally was one of the more vocal advocates of repealing the ACA. She publicly acknowledged that this would negatively impact her senate bid, and she indeed lost, and the seat was filled instead by Sen. Jon Kyl. Dr. Daniel Derksen, a professor of public health at the University of Arizona, said, ” The fall election will significantly revolve around people’s belief about what candidates will do for their health coverage.” According to Ashley Kirzinger, associate director of public opinion and survey research for the foundation, since Trump won the election in 2016, a larger share of the public holds’ favorable views of the health law. This was evident in 2017 after the failed repeal in the senate. ACA policies became much more prevalent in some other States, and it is believed that the people bringing up this Act are the Democrats. The foundation’s polling found that in 2014, 55% of voters opposed the ACA law, while only 36% favored it; last 2020, it shifted to 51% favoring it and 38% opposing it. A shift was seen in political groups, with only 74% of Republicans still viewing it unfavorably in the latest poll (Hawyluk, 2020).
Advocacy Statement in Support of H.R.5 – Equality Act
Good afternoon. My name is Wondeja Gibson, and I am here to speak in support of H.R.5 – Equality Act. As a Registered Nurse, I believe this bill is a crucial step towards ensuring equal rights and protections for all individuals, regardless of their sexual orientation or gender identity.
The H.R.5 – Equality Act seeks to provide explicit protections against discrimination based on sexual orientation and gender identity in various areas of life, including employment, housing, education, and public accommodations (Crissman & Berger, 2019). These protections are vital, as members of the LGBTQ+ community have historically faced significant barriers and discrimination in many aspects of their lives.
The social determinants of income, age, education, and gender can have a significant impact on the experiences of LGBTQ+ individuals and their access to equal rights and opportunities (Ogunbajo et al., 2019). For example, LGBTQ+ individuals are more likely to experience poverty and homelessness, which can limit their access to quality education, healthcare, and job opportunities (Haik et al., 2022). Additionally, LGBTQ+ individuals who are older or who have lower levels of education may be more vulnerable to discrimination and social exclusion (Hämäläinen, 2021).
Opponents of this bill argue that it could infringe on religious freedom and have unintended consequences. However, I believe that the bill’s provisions provide adequate protections for religious freedom while also ensuring that LGBTQ+ individuals are afforded the same rights and opportunities as everyone else. For example, the bill includes exemptions for certain religious organizations in certain circumstances, and it does not require individuals or organizations to violate their sincerely held religious beliefs.
Conclusion
In conclusion, I strongly support the H.R.5 – Equality Act and urge lawmakers to pass this crucial piece of legislation. The bill’s protections against discrimination based on sexual orientation and gender identity are long overdue, and it is time to ensure that all individuals are afforded equal rights and opportunities, regardless of their sexual orientation or gender identity.
References
Crissman, H. P., & Berger, R. (2019). Sexual and gender minorities and social determinants of health: Variations in discrimination and health outcomes. Journal of Social Issues, 75(3), 635-656. https://doi.org/10.1111/josi.12325
Haik, A. K., Greene, M. C., Bergman, B. G., Abry, A. W., & Kelly, J. F. (2022). Recovery among sexual minorities in the united states population: Prevalence, characteristics, quality of life and functioning compared with heterosexual majority. Drug and Alcohol Dependence, 232. https://doi.org/10.1016/j.drugalcdep.2022.109290
Hämäläinen, N. (2021). Conflict and Moral Change: LGBTQ+ Rights Education, Religion and Renegotiation. Journal of Philosophy of Education, 55(4–5), 551–563.
Hussain, Z., Rizvi, L. J., & Sheikh, H. (2022). The Equality Act (2010)-pre- and post-pandemic historic development on equality and discrimination issues for employers: review of literature. International Journal of Law and Management, 64(2), 168–183. https://doi.org/10.1108/IJLMA-03-2021-0067
Ogunbajo, A., Kershaw, T. S., Kushwaha, S., & Boakye, F. (2019). Sexual and gender minority status and social determinants of HIV-related outcomes in the United States: A scoping review. AIDS and Behavior, 23(5), 1209-1227. https://doi.org/10.1007/s10461-019-02552-9
U.S. Congress. (2021). H.R.5 – Equality Act. https://www.congress.gov/bill/117th-congress/house-bill/5
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