Policy & Advocacy for Improving Population Health Essay Assignment Paper

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Policy & Advocacy for Improving Population Health Essay Assignment Paper

High health care costs due to poor implementation of the Patient Protection Affordable Care Act

Health Issues

Part 1

Health Care Issue High health care costs due to poor implementation of the Patient Protection Affordable Care Act

Description The cost of healthcare coverage in America has denied several families and individuals access to quality health care for several years. In 2010 however the Affordable Care Act was passed and it now gives all Americans the opportunity of getting high quality, affordable and comprehensive coverage of healthcare. However, the insurance and healthcare industry and the citizens of America at the moment are still facing challenges when it comes to health care costs due to the poor implementation of the Patient Protection and Affordable Care Act.

(Presidents name)

President Bill Clinton


President George W Bush ( 2001-2009) President Barrack Obama


Administrative agenda focus related to the issue First Democrat president to be elected after 12 years. He sent the American Health Security Act of 1993 to Congress (Schimmel, 2016). The act proposed the provision of health insurance that is affordable for all American citizens through a concept called managed competition. The proposal however failed due to bitter opposition 9/11 occurred during his tenure as the president. Much of his time was spent dealing with terrorism, and not much was done to reform the health sector. However, the largest expansion of Medicare occurred during this tenure (Schimmel, 2016). This includes the Medicare Drug Improvement and Modernization Act of the year 2003. President Obama made reforms in the health sector one of his major priorities. During his campaign, he promised to change the health sector by reduction of healthcare costs and making coverage available for most Americans (Schimmel, 2016)Despite political opposition, bitter partisan divides and public information the Patient Protection Affordable Care Act was passed into law on 23rd March 2010.
Allocation of financial and other resources towards this issue. Clinton’s proposal was aimed at controlling the rates of increasing insurances premium. 80% of the premium was to be paid by the employer, and the family’s expenditure was not to exceed 3.9% of their income(Koijen, Philipson, &Uhlig, 2016). However, it was funded by savings from Medicaid and Medicare with increased taxes on tobacco. The total running cost was about $150 billion. The costs of funding president Bush expansion of Medicaid and Medicare program successfully the government allocated 250 billion dollars in running the program which was insufficient and the government’s debate to the public became 3.5 % in the year 2005 (Koijen, Philipson, &Uhlig, 2016). The cost of successfully running the PPACA or Obama care is roughly around $ 300 billion (Koijen, Philipson, &Uhlig, 2016). However, this would have saved the government $ 143 which translates into $ 1.73 trillion if the program is implemented successfully over the next decade.
Note on Administrators approach to the issue President Clinton during his first days in administration worked on expanding the access to quality and affordable healthcare to all Americans. He passed measures that ensured that the Medicare program is strengthened through the Balanced Budget Act of 1997. George W Bush improved the cost of health care by signing the Medicare prescription drug into law. Through this, the cost of healthcare was improved and became affordable to all American citizens. President Obama was able to achieve his goal of reducing the cost of health care when the Patient Protection and Affordable Care Act was enacted as a law in 2010. This act ensures that those who could not be insured due to their jobs or low income could still have access to quality and affordable health care.
General notes/comments Although his proposed bill was not passed by Congress his efforts in improving the costs and reforming the health care sector were evident. Despite being overwhelmed with the fight against terrorism, President George W Bush ensured that health care services were available and affordable to the American citizens. Lowering the costs of health care and improvement of the quality of life among Americans was one of his major priorities which he managed to accomplish through the enactment of PPACA in 2010. This remains to be the legacy of his administration.

The administrative agency that would ensure that the PPACA act is fully implemented in the health sector is the United States Department of Health and Human Services. Despite the implementation of several aspects of the law other provisions are yet to be implemented such as affordable insurance exchanges and full extension of Medicaid and Medicare covering those with a low income. The way this issue or agenda can get to the Department of Health and Human Services table is through running a campaign. There are several ways of running campaigns today without necessarily taking to the streets with banners or posters. Social media could be an effective tool for running the campaign (Koehler, 2018). This would include all the platforms such as Instagram, Twitter, Facebook, and WhatsApp to get their attention that would prompt change. There are several campaigns that have been run successfully through social media.

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The need to reform the health sector begun after the Second World War and the need for affordable healthcare was introduced to Congress by President Truman. Although it was unsuccessful under several presidents due to the opposition and other politically related issues, during President Obama’s term the Affordable Care Act was enacted into being a law. It was faced with a lot of challenges, but despite all that, it managed to be enacted into law. This is one of the most successful legacies that his administration has had.

Part 2: Fact Sheet

Access to quality and affordable health care is essential for any nation. This is because a healthy nation is a working nation and by working the country’s economy grows. Reforms in the health sector are important in ensuring that all citizens in a particular nation have access to quality and affordable health care. The Affordable Care Act requires citizens and legal immigrants to pay a penalty if they do not have a qualified health plan (Milstead, 2019). However, in America, it is not the first time that the nation is caught debating on proposed healthcare reforms that are controversial. It is rather not the first time that those partisan politics have complicated and at times obstructed attempts made to reform the healthcare system in America. Some reforms, however, have managed to succeed while others have not and the political process is always the one to be blamed (Schimmel, 2016). After the Second World War president Truman endorsed to the Congress a proposal for universal health coverage, to be administered and paid for by a National Health Insurance Board. The bill had several opponents including the American Medical Association, and it just ended in the Congress. This was the first step in ensuring that American citizens have access to healthcare.

Several presidents have made attempts through the endorsement of bills reforming the health sector to the Congress but several are faced with bitter partisan politics, and they fail. However through president Obama despite the opposition, the bill passed and it is successfully implemented across several states in the country. In some states, the act has not been implemented fully, and some patients are still denied quality healthcare due to low income, rejection of insurance companies to cover certain costs and many more (Koehler, 2018). The role of a nurse is the delivery of quality health care services to all patients despite their social or financial status. Therefore such cases where a patient is unable to receive treatment due to financial related issues put a nurse in an ethical dilemma of whether to treat the patient and get fired or face disciplinary action later, take care of the costs on their own or watch the patient suffer.

A patient might indeed require medical care, but due to the costs, they are unable to get the services. In a situation where the hospital decides to treat a patient who doesn’t have health insurance, what will happen if people come into the hospital to be treated without no insurance. It is therefore essential for PPACA to be implemented so that all Americans have access to affordable and quality health care.


Koehler, W. J. (2018). Health Care as a Right of Citizenship: The Continuing Evolution of Reform.

Koijen, R. S., Philipson, T. J., & Uhlig, H. (2016). Financial health economics. Econometrica84(1), 195-242.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.173-179.

Schimmel, N. (2016). Presidential Healthcare Reform Rhetoric: Continuity, Change & Contested Values from Truman to Obama. Springer.

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