The reflection paper is based on three videos and several journal articles and has its own Assignments and due date.
The videos to watch are Sicko (available on Vimeo and other sites for free viewing), and two more on PBS Frontline entitled ‘Sick Around America’ and ‘Sick Around the World’, also free viewing. Links are in D2L contents. These videos document healthcare in the U.S. before the Affordable Care Act and contrasts the U.S to other developed countries.
Also read the three journal articles in contents Module 5 authored by Dr. Moore. They are entitled:
a. ‘Determining the Effects of the Trump Administration’s Erosion of the Affordable Care Act on Americans Needing Healthcare’ (2020)
b. ‘Why Universal Healthcare is a Trend in the U.S.’ (2018); and
c. ‘Teaching the Affordable Care Act to Aspiring Healthcare Administrators’ (2016).
Two other links in Module 5 lead to other articles available on the Kaiser Family Foundation website. These offer additional background regarding current constitutional threats to the Affordable Care Act from the Trump administration.
Your assignment is to write a paper documenting your reflections on healthcare reform in the U.S. after viewing the videos and reading the articles. What is your assessment of healthcare in America relative to other developed nations? What trends do you see in the U.S. healthcare system? What would you like to see happen? What policy or legal changes would facilitate your vision becoming reality? Use and cite the articles and videos to support your assessment and observations. Be sure to title your paper and state in the beginning its purpose and the questions you will address. The paper should be about 3-5 pages, double spaced, and be submitted into the Assignments designated ‘Module 5 Reflections on Healthcare Reform Paper’ by its due date
Sicko: the movie
Sick Around America
Sick Around the World
2
Determining the Effect of the Trump Administration’s Erosion of the Affordable Care Act on Americans Needing Healthcare
Gregory A. Moore
Professor, Health and Human Performance
Austin Peay State University
Clarksville, TN 37040
mooreg@apsu.edu
March 8, 2020
Abstract
The purpose of this paper is to determine the legal and economic effects on the Affordable Care Act (ACA) from recent attempts by the Trump administration to undermine the law. After failing to repeal the law and seeming to lack the patience to see if it will unravel on its own, the Trump administration has used executive orders and administrative agency rules to take steps designed to reduce consumers’ ability to benefit from the law. The enrollment period was cut in half and the marketing budget to promote enrollment cut 90%. Trump cancelled Cost-Sharing Reduction subsidies for those lower-income buyers in the healthcare insurance exchanges. Insurers are being allowed to sell short-term and Association policies that do not meet the ACA regulations for minimum benefits. The Republican controlled Congress repealed the tax penalty for those not having insurance beginning 2019. (Center for American Progress, 2018). The projected net effect of these acts means millions will forego or not be able to afford insurance (Beaton, 2018: Levitz, 2018). Insurers can circumvent ACA rules regarding pre-existing conditions and sell plans without minimum benefits. The young and healthy will leave the insurance market, causing premium prices and costs to rise for those needing insurance and healthcare. (Beezley-Smith, 2018) All but the repeal of the tax penalty mandate can be changed immediately by the next presidential administration and its administrative agencies. Those states that did not support the ACA will find this administration helpful in undermining the law. Those states that have supported the ACA, can exercise their state powers to promote the law at their level. The ACA was operating soundly at the time Trump took office. The damage these recent acts might have will depend in part on how long they are in place. One also finds that the acts lack any ideology, appearing to be more disruptive and malicious than attempting to achieve any policy purpose (Dickinson, 2018). Upon learning Trump dismissed a bi-partisan effort Senator Lamar Alexander (R-TN) was working on to fund the subsidies for the exchanges, the Senator asked, “What’s conservative about creating chaos so millions cannot buy health insurance.” (Williams, 2017) Ultimately the effects of the sabotage are not uniform across all states and some consumers will benefit from the continued operation of the ACA.
Introduction, Focus, and Research Question
Although failing to repeal the Affordable Care Act (ACA) the Trump administration and Republican controlled Congress have continued their efforts to undermine the law. The full frontal attack to repeal the ACA failed, so with the exception of Congressional legis
Teaching the Affordable Care Act to Aspiring Healthcare Administrators
Gregory A. Moore
Professor
Health and Human Performance
Austin Peay State University
Clarksville, TN 37044
mooreg@apsu.edu
Abstract
As the first major healthcare law in half a century the Affordable Care Act of 2010 represents a major change in the healthcare system in the United States. Not since Medicaid and Medicare were enacted in 1965 has any legislation been this comprehensive and far reaching in the healthcare field. University departments of public health, health administration, and related areas have an obligation to students to have been incorporating the teaching of this new legislation into health related courses like healthcare Economics, finance, management, human resources, and law. Like any change, there is a learning curve to mastering the elements and provisions of this legislation. Additionally the controversy related to the politics and ideology of the passage and implementation of the law has created misinformation, uncertainty, and other additional barriers to learning and teaching the law.
The purpose of this manuscript is to determine what the law is and how it should be taught in courses for students aspiring to become healthcare professionals, primarily administrators. The paper addresses the content, elements and provisions of the law. The implications of this legislation for administrators are examined. Resources instructors can use are included. The paper is about teaching the law. It is not about the value of the law or its expected life, having been voted on numerous times for repeal by one branch of Congress. The paper is about how this legislation might change the way managers will need to manage, but not about the efficacy or popularity of the act. However, the nature of the law, how it passed, and its implications serve as opportunities for teaching aspiring managers about the impact this law can have healthcare on management.
Background and Purpose
What is so special about incorporating the teaching of new legislation like the Affordable Care Act into the teaching of healthcare? Is it not like the other legislation we have had in the last fifty years? The Affordable Care Act (ACA) of 2010 is the first major healthcare legislation in the United States in half a century. It represents a major change in the healthcare system in the United States. Not since Medicaid and Medicare were enacted in 1965 has any legislation been this comprehensive and far reaching in the healthcare field. Teitelbaum and Wilensky (2013) observe that after decades of inactivity the U.S. passed a national health reform law that provides near-universal coverage and has seemingly made health insurance both an obligation and a right.
University departments of public health, health administration, and related areas have an obligation to students to have been incorporating the teaching of this new legislation into health related courses like healthcare Econom
1
Why Universal Healthcare is a Trend in the U.S.
Gregory A. Moore
Professor
Department of Health and Human Performance
Austin Peay State University
Clarksville, TN 37044
mooreg@apsu.edu
Abstract
Is the recent Congressional House of Representatives repeal and replacement of the Affordable Care Act a significant event in America’s healthcare? Is this a hiccup in a trend for one nation that lacks universal healthcare or the end of a movement? The purpose of this research is to determine if there is a movement to developing universal healthcare in the United States. If there is one, what influences are promoting and supporting that effort, and what influences are slowing or prohibiting that effort? This paper will examine the possibility universal healthcare is a trend over time.
Why might the recent Congressional House of Representatives’ repeal and replacement of the Affordable Care Act with the American Healthcare Act not be a significant event in America’s future in healthcare? Is this action only a hiccup in a far more significant trend for the one modern nation that still lacks having implemented universal healthcare for its citizens? The purpose of this research is to determine if there is a movement to developing universal healthcare in the United States. If there is a trend, what influences are promoting and supporting that trend? What influences are slowing or prohibiting that effort? This paper will examine the possibility universal healthcare is a trend over time. It will also examine recent events that indicate support for and against a movement toward universal healthcare.
Analysis of Influences
Supporting Forces
ACA Shifts Attitudes
The U.S. spends about twice as much of its Gross Domestic Product (GDP) for healthcare than do other developed nations, but the U.S. only achieves mediocre outcomes in care to its citizens (Teitelbaum and Wilensky, 2017). The more Americans learn about healthcare, it seems they are more willing to expand their options in what healthcare Americans should have. When the Affordable Care Act was introduced in 2010 opponents seemed sufficiently successful in convincing more than half the country to object to the Affordable Care Act (The Daily Signal, 2010). The Kaiser Family Foundation has found some change in those original views about the ACA (Kaiser Family Foundation, Health Tracking Poll, n.d.) Other recent polls have shown higher favorability. Gallup (Norman, 2017) reported the popularity of the ACA had reached 55% favorability. The argument can be made that as the elements of the law are learned and experienced, acceptability of the ACA and its provisions grow among rank and file citizens. The guaranteed coverage of those with pre-existing conditions and coverage of children up to age 26 on their parents’ insurance plans are examples of positively accepted elements. (Feldstein, 2011a) Other elements that were initially unacceptable, like a mandate to be insured or pay a tax, were be
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