Category: Nursing

Question 2            1 pts

On physical examination, pale atrophic depigmented tissue that has a “cigarette paper” appearance is consistent with:

Group of answer choices

 

Vaginal candidiasis

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Contact dermatitis

 

Lichen sclerosis

 

Gonorrhea

Question 1    1 pts

Endometriosis can effectively treated with:

Group of answer choices

 

Combined oral Contraceptive (COC)

 

Depo-Provera Injection

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Progestin Implant

 

B and C

Question 25                                                       1 pts

Most malignancies in breast tissue occur in:

Group of answer choices

 

The areolar area

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The upper outer quadrant

 

The lower outer quadrant

 

None of the above

NRNP 6552 Midterm Exam Walden University

Politics and the Patient Protection and Affordable Care Act

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.

Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.

Resources

ORDER HERE

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).

Consider who benefits the most when policy is developed and in the context of policy implementation.

By Day 3 of Week 3

Post
 an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.

By Day 6 of Week 3

Respond
 to at least 
two
 of your colleagues
* on two different days
 by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

*Note:
 Throughout this program, your fellow students are referred to as colleagues.

The Affordable Care Act (ACA) was enacted in 2010 to expand coverage, improve the quality and the cost of healthcare. It was aimed to improve healthcare value, reduce unnecessary spending, increase access to care, and enforce strategic investments in public health. A critical provision within the ACA that changed the United States (U.S.) healthcare system is by extending Medicaid coverage for low-income and uninsured patients. In addition to ACA Medicaid expansions, insurance purchasing subsidies have been offered to patients with incomes under 400% Federal Poverty Line. Medicaid enrollment in 2015 grew by 5.6 million or by 50% and ACA has decreased the budget deficit by $143 billion between 2010 and 2019 (Walker, V. et.al.,2022).

The Affordable Care Act’s main objective is to increase coverage, make healthcare insurance affordable with a goal of improving health among Americans.

Politicians on the other hand, are politicians. In 2017, President Trump had tried to repeal the ACA with his American Healthcare Act of 2017 but unsuccessful and never went into law. Obamacare or ACA still exist and still the law for healthcare coverage. Though, with the introduction of AHCA, some minor changes had been made including the elimination of the penalty among individuals who refused to get a healthcare coverage.

In early 2022, approximately 35 million Americans enrolled in ACA supported healthcare. This record numbers are part of the substantial impact ACA has on the American healthcare. On the other side, this law has a lot of flaws especially those whose income bracket passed the federal poverty line.

One example, my friend got diagnosed with staged 4 uterine cancer. As a nurse, her income is above federal definition of low-income families. For six months, she did not work, her health insurance coverage is under our employer. She has to come back to work after six months to make sure her health insurance coverage remained active to continue her medical treatment. She and her family are not qualified to get a subsidize healthcare because of her income, having a house and a car. Not until she passed away that her family got qualified for the Obama care and the sad thing, everything had to change because Obama care don’t cover the medications that her daughter is taking and cannot see her previous primary care physician because it is not contracted under Obama care insurance. On the opposite side, we have patients who are uninsured or even undocumented and can have medical access until everything has been exhausted. Their only problem is the follow up after discharge. I found out that county clinics are always full and will take months before an md or a nurse practitioner can see these patients.

Our healthcare system is overwhelmed, needs hauling and changes to better serve the American people and not repeal the ACA for political reasons but improve it to serve and benefit the majority.

With Affordable Care Act, substantial impact has been achieved on health insurance coverage, improve health care utilizations for minority patients, improve equity and reduce disparities through affordability (Ma, A., et al 2022).

 

References:

Walker, V., Ruley, M., Nelson, L., Layton, W., & Coustasse, A. (2022). The effect of the Affordable Care Act on Medicaid payments in long-term care facilities. 
International Journal of Healthcare Management
, 
15
(1), 62–69.
https://doi.org/10.1080/20479700.2020.1843886

 

Ma, A., Sanchez, A., & Ma, M. (2022). Racial disparities in health care utilization, the affordable care act and racial concordance preference. 
International Journal of Health Economics and Management
, 
22
(1), 91–110.
https://doi.org/10.1007/s10754-021-09311-8

 

Entress, R. M., & Anderson, K. M. (2020). The Politics of Health Care: Health Disparities, the Affordable Care Act, and Solutions for Success. 
Social Work in Public Health
, 
35
(4), 152–162.
https://doi.org/10.1080/19371918.2020.1767750

 

Davalon (2022).https://www.ehealthinsurance.com/resources/affordable-care-act/trumpcare-vs-obamacare

 

My colleague Sara,

I liked your post on The Affordable Care Act. Yes, many low-income families would have died or struggled to pay medical bills without health care coverage. Thanks to   President Barack Obama’s plan. The Affordable Care Act was signed into law on March 23, 2010. The Affordable Care Act created great peace for many American families, dealing with several underlying medical conditions.  This comprehensive health plan has implemented a change in how Americans receive health care.  Insurance companies now can no longer deny low incomes families, the elderly, and people living with debilitating conditions such as HIV and AIDs insurance coverage. I agreed with you Sara 100%, for example, children born to low incomes mothers should not be denied health care coverage due to the lifestyles of their parents.   The elderly population should not be denied prescription drug coverage for any chronic conditions that he or they have been dealing with for decades.  The Affordable Care Act will ensure a sense of security, and stability for low-income Americans.

 

The Cost-benefit analysis helps lawmakers determine the effects of The Affordable Care Act. According to (CDC, 2020) The Centers for Disease Control and Prevention supports the affordable care act. More healthcare centers are open, and patients can now receive the healthcare needed to live longer. This gives more access to patient wellness such as early health screenings for certain cancers, HIV/AIDS, and STD screening without coming out of pocket. In my hospital, Kaiser Permanente, California I have seen an increasing number of patients coming in for healthcare screening such as wellness exams, blood pressure, and diabetes screening.

 

The Department of Human Health uses The Affordable Care Act to expand and strengthen cultural competency training for all healthcare workers to provide more equality that will reduce healthcare disparities.

 

52% of registered voters supported the affordable care act. In August 2022 President Joe Biden signed into law The Inflation Reduction Act to extend plans to support the affordable care act.

 

References:

 

Centers for Disease Control and Prevention. (2010. March 23). The Affordable Care Act

Care act. policy and laws.

HTTPS:// 
www.cdc.gov.policies.aca
Links to an external site.

 

Census. Bureau. (gov). 2022

 

https:// 
www.healthline.com
Links to an external site.
 health

 

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Rafael Carlos Martinez

Dec 15, 2022 7:22pm
| 
Last reply Dec 18, 2022 3:44pm

Reply from Rafael Carlos Martinez

The Republican party has largely opposed the passing of the Affordable Care Act (ACA) from the time of its inception to present times. “From January to December of 2011, the (Republican controlled 112
th
 Congress) House voted on ACA changes or repeals 24 times (Williams & Anderson, 2020),” even going so far as “declining to fund the federal government unless the implementation of the ACA was delayed (Williams & Anderson, 2020)” in 2013. Because there has been such staunch opposition to the ACA from Republican politicians, repealing or replacing the ACA has now become part of the Republican party’s platform and a core political position for many Republican politicians who seek re-election, although repealing or even simply replacing aspects of the ACA would have a significant impact on the availability of affordable healthcare for many of their constituents and would cost the federal government millions. Even simply removing the Medicaid expansion package from the ACA or decreasing federal funding for Medicaid would have a significant impact on healthcare coverage and access to healthcare for people of color (Williams & Anderson, 2020), and a full repeal of the ACA would cost the federal government an estimated $350 billion through 2027 (Committee for Responsible Federal Budget, 2017).

Because fully repealing the ACA will have a significant impact on healthcare coverage and access to healthcare for millions of potential voters, many Republican lawmakers have openly opposed only certain aspects of the ACA, while advocating for either ACA reform or replacement rather than full repeal to not damage their chances of re-election while still staying within their party’s political platform guidelines.

Committee for Responsible Federal Budget (2017). 
The cost of full repeal of the affordable care act
. Retrieved December 14, 2022 from https://www.crfb.org/papers/cost-full-repeal-affordable-care-act

McDonough, J. E. (2017). 
Health and taxes and the values at stake in the aca debate
. Milbank Quarterly, 
95
(2), 237–240. https://doi.org/10.1111/1468-0009.12251

Williams, N. D., & Anderson, E. A. (2020). 
A critique of repealing the affordable care act: implications for queer people of color
. Analyses of Social Issues & Public Policy, 
20
(1), 195–210. 
https://doi.org/10.1111/asap.12197
Links to an external site.

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Jestanon Ratunil

Dec 15, 2022 12:27pm
| 
Last reply Dec 15, 2022 12:59pm

Reply from Jestanon Ratunil

The Affordable Care Act.docx

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Kayla Holt

Dec 15, 2022 12:44am
| 
Last reply Dec 17, 2022 6:58pm

Reply from Kayla Holt

Health insurance in the United States is a misnomer: What we are actually purchasing is sickness insurance (Milstead & Short, 2019). Like other forms of insurance, health insurance is a form of collectivism in which people pool their risks – in this case, the risk of incurring medical expenses (Milstead & Short, 2019). The health insurance mandate in the Affordable Care Act (ACA) provided for the enlargement and balance of the risk pool (Milstead & Short, 2019). Without the option to refuse to cover preexisting conditions the insurance market would collapse: in 2017, many insurers pulled out of the Health Insurance Exchanges because of uncertainty about the continuation of the mandate (Milstead & Short, 2019). Congress and the Trump administration were engaging in a debate over how to “repeal, replace, repair, or starve” healthcare finance in the United States (Milstead & Short, 2019). The American public is strongly divided about how to finance health care in the country (Milstead & Short, 2019).

The realization (for better or worse) that policymakers are not necessarily focused on how real people will be affected by changes to Obamacare or Medicare and Medicaid but rather on how the changes will affect their own re-election chances (Milstead & Short, 2019). For example, political interference in sexual and reproductive health research and health professional education threatens the health of women and men (Taylor et al., 2017). While some may find this focus disturbing, it demonstrates not just that elections results do matter but also that even the threat of an upcoming election cycle affects what policymakers are willing or able to do (Milstead & Short, 2019). Timing is everything (Milstead & Short, 2019).

Awareness can be used in developing strategies for appealing to what really matters to policymakers (Milstead & Short, 2019). Deciding which of several policy options will lead to the greatest benefits and the fewest costs, in a world where re-election is a key consideration and media are a relentless presence, means the best solution may not be the path ultimately chosen (Milstead & Short, 2019).

References

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

Taylor, D., Olshansky, E., Fugate-Woods, N., 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), 346–350

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Sarah E. Tasker

Dec 14, 2022 10:38pm
| 
Last reply Dec 14, 2022 10:42pm

Reply from Sarah E. Tasker

Politics and the Patient Protection and Affordable Care Act

Based on the shared goals of the legislators recently elected into congress, there have not been efforts to repeal or replace the Affordable Care Act (ACA) but to “protect and build on” the act instead (Unknown, 2020, para 8). Current President, Joe Biden, started his presidency with plans to strengthen the ACA by closing loopholes that allow the rich to avoid taxes on capital gains (Unknown, 2020). Instead, people making over $1 million will pay the top rate on capital gains and double their typical tax rate on possessions such as their assets (Unknown, 2020). Overall, by taxing the rich, President Biden hopes to strengthen the ACA by doing things such as; lowering healthcare premiums and out-of-pocket costs, easing the enrollment of affordable coverage, expanding Medicaid services in remaining states, improving home care for older Americans and Americans with disabilities, introducing new options for people with a mental health crisis, and extending postpartum coverage during the first year after delivery (The United States Government, 2022).

The voter’s view can significantly influence the decisions of legislative leaders. According to Figure 10-3 in the text 
Health Policy and Politics
, the views on repealing the ACA were split almost evenly, with 45% saying they should vote to repeal, 51% saying they should not vote to repeal, and 6% undecided or refused to answer (Milstead & Short, 2017). With this being said, the voters who share their views also vote for each legislator’s re-election. To analyze further, each legislator can research the majority’s view regarding Medicare and Medicaid. For example, suppose most voters would feel they would benefit from Medicare or Medicaid changes. In that case, the legislator should feel the need to represent those changes to impress the voters.

 

References

Unknown. (2020). 
Plan to protect and build on Obamacare
. Democratic National Committee. Joe Biden for President: Official Campaign

Website. https://joebiden.com/healthcare/#

The United States Government. (2022). 
Fact sheet: Biden Harris Administration proposes rule to fix “Family glitch” and Lower Health Care Costs
.

The White House. https://www.whitehouse.gov/briefing-room/statements-releases/2022/04/05/fact-sheet-biden-harris-administration

-proposes-rule-to-fix-family-glitch-and-lower-health-care-costs/

Milstead & Short. 
Health Policy and Politics
 (6th ed.). Jones & Bartlett Learning. https://mbsdirect.vitalsource.com/books/9781284155235

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Essie Tani Richardson

Dec 14, 2022 10:23pm

Reply from Essie Tani Richardson

           Since its introduction, the Affordable Care Act (ACA) 2010 has generated a lot of discussion. It is to thank for the rise in the number of Americans with health insurance and for giving millions of individuals access to high-quality healthcare. The ACA has drawn criticism for its exorbitant expenditures and effects on the economy and healthcare sector. The Republican-controlled Congress made a failed attempt to abolish the ACA in 2017. In 2018, states were permitted to waive parts of the ACA’s requirements as a result of a Trump administration executive order.

For a legislator, evaluating cost-benefits and efforts to repeal/replace any policy when being reelected is of utmost importance because “[d]eciding which of the several policies could lead to low costs and great benefits, the best solution may not be the path ultimately chosen,” according to the Affordable Care Act (ACA) (Milstead & Short, 2019, p. 51). The Affordable Care Act (ACA), sometimes referred to as Obamacare, was drafted and put into effect during the presidency of President Obama. The ACA’s three main objectives are to lower the cost of healthcare by promoting innovative care delivery models, expand Medicaid to cover all individuals with incomes that are 138% or less below the poverty line, and cover more people with health insurance (HealthCare.gov, n.d.). Since the Affordable Care Act (ACA) was a contentious issue both during President Obama’s administration and at the beginning of President Trump’s, it was crucial for lawmakers who wanted to win reelection. It meant upheaval at the risk of the dominant party losing control of both houses of Congress if Obamacare was repealed and replaced.

The Affordable Care Act was heavily covered in the media around the time President Trump started his campaign for president, and Republicans, the majority party, naturally seized the chance to act on the timing of a problem (healthcare) and a policy (Affordable Care Act) during the season of politics within an election (Kingdon, 2001, para. 4). In fact, the discussion over whether to repeal and replace was in full swing before a large portion of the Republican party took government. Obamacare must be repealed immediately, replaced later, or a replacement strategy must be established first and an appeal made afterwards (Milstead & Short, 2019, p. 39). Milstead & Short (2019) assert that there were technicalities in eliminating and altering the Medicare and Medicaid systems, raising concerns that doing so would coincide with the 2018 election cycle (p. 40). Voters’ opinions were not always a major consideration in the ACA law’s decision-making for Medicare and Medicaid when a technicality resulted in changes to insurance and their implementation. The implementation issues would be ominous for the legislation and would have an impact on insurance firms, people, and both big and small businesses. The majority party’s policymakers “are not necessarily focused on how real people will be affected by changes to Obamacare or Medicare and Medicaid but rather on how the changes will affect their own reelection chances” when faced with the reality of inevitable problems with implementation of repealing and replacing (Milstead & Short, 2019, p. 40).

 

References

Healthcare.gov (2010). Affordable Care Act. Retrieved March 17, 2021 from https://www.healthcare.gov/glossary/affordable-care-act/

Kingdon, J.W. (2001). A model of agenda-setting with applications. Detroit College of Law at Michigan State University Law Review, 2001, 2(331). https://advance lexiscom.ezp.waldenulibrary.org/api/document?collection=analytical materials&id=urn:contentItem:44N6-2010-00CV-V1SC-00000-00&context=1516831.

Milstead, J.A., & Short, N.M. (2019). Health Policy and politics: A nurse’s guide (6th ed.). (pp. 37-56). Burlington, MA: Jones & Bartlett Learning.

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Bonita Leone
 (She/Her)

Dec 14, 2022 9:33pm
| 
Last reply Dec 18, 2022 1:28pm

Reply from Bonita Leone

Affordable Care Act Winners and Losers

The question of who benefits the most when the policy is developed is a great question related to the Affordable Care Act (ACA). Legislatures lose focus on how their constituents will benefit from change and instead focus on their prospects for reelection (Milstead & Short, 2019). I see no true winners. As a legislature’s primary goal is to win reelection, one strategy many follow to achieve reelection is to follow the money. Sometimes that is in the form of campaign contributions from big pharmaceutical companies, often referred to as “big pharma.” One prominent opponent of the ACA is a Republican Senator of South Carolina whose goal is to repeal and replace Obamacare. From June to December 2021, this Senator was the top earner of big pharma campaign contributions in Congress, receiving $99,000. Political expert Joel Teitelbaum fears that a major reform for universal healthcare for the 20-25 million still left uninsured after the passage of the ACA will fall to the wayside as politicians often fear the backlash. Ultimately, the cost of universal coverage for all may end up a victim of the political aspirations of legislatures wanting to stay in the game.

One way voters band together to influence legislative outcomes to support their views is by forming political action committees (PACs). The American Nurses Association has a PAC. State legislatures also have access to studies within a bipartisan organization called the National Conference of State Legislatures. This group can provide bipartisan information for the state legislatures, giving them insight into the views of their constituents.

References

Here’s the republican senator that big pharma is betting on
. (2022, April 1). Tampa Bay Times.
Links to an external site.
 
https://www.tampabay.com/news/health/2022/04/01/heres-the-republican-senator-that-big-pharma-is-betting-on/
Links to an external site.

Legislators and legislative staff
. (n.d.).
Links to an external site.
 
https://www.ncsl.org/legislators-staff.aspx
Links to an external site.

Milstead, J. A., & Short, N. (2019). 
Health policies and politics a nurse’s guide
 (6th ed.). Jones & Barlette.
Links to an external site.

. (n.d.).
Links to an external site.
 
Walden University, LLC. (Producer). (2018). Contemporary Issues in Public Health Policy with Joel Teitelbaum [Video file]. Baltimore, MD: Author.
Links to an external site.

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Holly Anne Mayes

Dec 14, 2022 9:20pm
| 
Last reply Dec 17, 2022 7:54pm

Reply from Holly Anne Mayes

The Affordable Care Act is a comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).

The law has three primary goals:

Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the 
federal poverty level
Links to an external site.
 (FPL).

If your income is above 400% FPL, you may still qualify for the premium tax credit in 2022.

If your income is at or below 150% FPL, you may qualify to enroll in or change Marketplace coverage through a 
Special Enrollment Period
Links to an external site.
.

Expand the Medicaid program
Links to an external site.
 to cover all adults with income below 138% of the FPL. (Not all states have expanded their Medicaid programs.)

Support innovative medical care delivery methods designed to lower health care costs generally (HHS, 2022).

When it comes to reelection, many campaigns’ cost-benefit analyses depend on the success of either replacing or repealing Obama care. Many Republicans, for instance, look to pull back the affordable care act as they believe it is an overreach of power from the government (Hollingsworth et al., 2019). On the flip side, the democrats, when supporting Obama care, felt that there was a lack of coverage for Americans seeking treatment that could not afford it. To completely pull back healthcare coverage that the ACA has provided to many Americans would not be a popular position; I do not see that happening in future administrations, considering it would affect many.

Voter decisions and views directly impact legislation; to move legislation forward, one has to have the support of their constituents. Depending on the demographic and needs of the voter, those running have to ensure they can meet their needs. Those on Medicare and Medicaid will rely heavily on the government for their care. Legislators have to consider those individuals’ needs to secure their votes.

Hollingsworth, A., Soni, A., Carroll, A. E., Cawley, J., & Simon, K. (2019). Gains in health insurance coverage explain variation in Democratic vote share in the 2008-2016 presidential elections. 
PloS one
, 
14
(4), e0214206.

U.S. Department of health and human services. (2022, March 17). 
About the affordable care act
. HHS.gov. Retrieved December 13, 2022, from www.hhs.gov

 

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Madeline Reighard

Dec 14, 2022 8:30pm

Reply from Madeline Reighard

When discussing cost-benefit analysis in regard to legislators, the cost of supporting or opposing policies can either aid a legislator in gaining votes or losing votes which in turn will hinder their likelihood of being re-elected. America is politically divided by two main parties, Republicans and Democrats, that being said in the last two decades opposition between the parties is more widespread than it has ever been (Pew Research Center, 2014). Since the political parties are increasingly polarized and hostile in their conflicting views this makes it even more difficult for politicians to please the public. Legislators must weigh what their constituents want when taking their own political stance, but also must interpret how it will likely affect their political standing.

The Affordable Care Act (ACA)
otherwise known as Obamacare is a perfect example of division among the American people. The ACA was signed into law on March 23, 2010 and has three main goals. First, to provide affordable health care to more Americans by providing individuals with subsidies that decrease health insurance premiums especially for those in the middle- and lower-income classes (HealthCare.gov, n.d.). Second, the ACA aims to grow Medicaid so that adults with an income 138% below the federal poverty line would be covered and lastly the law encourages change in the way medical decisions are made by lowering healthcare costs in general (HealthCare.gov, n.d.).

Through the ACA, uninsured rates fell from 18% to 13.4% in roughly one year (Dalen et al., 2015). Obamacare has faced public scrutiny and multiple attempts have been made to repeal and replace the act. Ultimately, the public was divided according to a survey coordinated by the Pew Research Center (2012), that found “48% of the general public disapprove of the 2010 Affordable Care Act, while 43% approve” (para. 2). The public is almost evenly split on their views of the ACA which makes the decision for legislators difficult in whether or not they should support the act in its entirety or repeal and replace. Most notable in trying to reconcile the ACA is the American Health Care Act of 2017 (AHCA), proposed by the House Republicans and fully endorsed by Trump which would dismantle the ACA’s premiums and penalties and instead of generalized healthcare for all the AHCA would put more control into the states which would end up in Americans having to expend more money for chronic or pre-existing conditions (Ballotpedia, n.d.). Many Americans would argue that the power given to the states is justified and since it would cut taxes on the middle and upper class this would be a discernible win; however, the AHCA cuts to just Medicaid would end up in 14 million Americans losing health insurance (Nadash et al., 2018). This would greatly affect poverty stricken older adults and those that are no longer able to work because of health-related issues or other reasons, thus this a large portion of the country that would be against and/or wary of repealing or replacing the ACA.

Overall, the role of a legislator is not an easy undertaking, and there will constantly be voters for and against their decisions. Voters will support who they feel will best represent their morals and views and impact political changes in favor of their opinions. Legislators will support policies that they feel constituents want which in turn will aid them in being re-elected in the long run.

 

References

Ballotpedia. (n.d.). Obamacare overview. Retrieved December 9, 2022, from https://ballotpedia.org/Obamacare_overview

Dalen, J. E., Waterbrook, K., & Alpert, J. S. (2015). Why do so many Americans oppose the Affordable Care Act? 
The American Journal of Medicine, 128
(8), 807-810. https://doi.org/10.1016/j.amjmed.2015.01.032

HealthCare.gov (n.d.). Affordable Care Act (ACA). Retrieved December 9, 2022, from https://www.healthcare.gov/glossary/affordable-care-act/

Nadash, P., Miller, E. A., Jones, D. K., Gusmano, M. K., & Rosenbaum, S. (2018). A series of unfortunate events: implications of Republican efforts to repeal and replace the Affordable Care Act for older adults. 
Journal of Aging & Social Policy, 30
(3-4), 259-281. https://doi.org/10.1080/08959420.2018.1462683

Pew Research Center. (2012). Obama health care law: Where does the public stand? Retrieved December 9, 2022, from https://www.pewresearch.org/politics/2012/06/15/obama-health-care-law-where-does-the-public-stand/

Pew Research Center. (2014). Political polarization in the American public. Retrieved December 14, 2022, from https://www.pewresearch.org/politics/2014/06/12/political-polarization-in-the-american-public

Question 24                                                       1 pts

The new guideline for systolic blood pressure cut-off for hypertension is:

Group of answer choices

 

150

 

140

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130

 

120

 

NRNP 6552 Midterm Exam
Walden University

Agenda Comparison Grid and Fact Sheet – Walden University NURS-6050 Week 2 Assignment

 

Part 1: Agenda Comparison Grid

Identify the Population Health concern you selected.

Mental illness

Describe the Population Health concern you selected.

Mental illness is a disorder that affects many people in the United States every year. It refers to various conditions or diseases that affect one’s behavior, mood, and thinking. A prerequisite is mainly associated with family, social, or work functioning or distress. It is so common in the U.S. that 19% of the adults in the U.S., experienced it in a particular year, out of which 4.1% experienced severe mental illness (Conley, 2021). During the same year, 8.5% suffered a diagnosable substance disorder associated with substance use. Different types of mental illness affect American citizens, including anxiety disorders, mood disorders, psychotic disorders, eating disorders, impulse control medication disorders, Obsessive-compulsive disorder, Personality disorders, and post-traumatic stress disorder. Different administrations approached the issue of mental illness in different ways.

 

GET ASSIGNMENT HELP HERE

Administration (President Name)

Joe Biden

Donald Trump

Explain how each of the two presidential administrations approached the issue.

In his administration, the current American president Joe Biden has proposed several ways through which his administration will tackle the problem of mental illness (Canady, 2021). Biden’s focus is improving the mental health outcomes for the American citizen at the lower possible cost. His government seeks to expand the program of affordable mental care through the bipartisan safer community act. The bipartisan act includes unprecedented resources to help address the mental issue across America. The government announced that it would fund to grow schools that produce mental-based professionals and make improvements to trauma-informed services (Conley, 2021). The government has also equipped the mental health centers with the necessary resources to deal with mental health and supported the heroic mental health workers. The government has also committed to building and protecting the affordable care act (ACA) (Canady, 2021). Finally, the administration has doubled the number of psychologists, health professionals, and counselors.

During his administration, the 45
th
U.S. president tried to address the issue of mental illness in several ways after the long period of lockdowns. He signed an executive order that addressed the negative mental effects of the prolonged covid19 lockdowns, which included reducing suicidal cases (Smith et al., 2022). He established a group that worked at the cabinet level to assess the mental health needs of the elderly, children, minorities, the disabled, and other vulnerable groups. Trump’s government also funded cognitive treatment services for Americans, including safe therapeutic services for in-person patients, telehealth, and peer-to-peer services (Smith et al., 2022). His administration also awarded contracts to community organizations that dealt with mental health and suicide prevention support services.

Identify the allocations of resources that the current and previous presidents dedicated to this issue.

Increasing the number of counselors, mental health professionals, and psychologists by doubling the previous number. He also expanded and strengthened mental health programs for veterans within and outside the Veterans Health Administration.

Trump’s administration allocated $10 billion to combat serious mental illness and the opioid epidemic. The administration increases the number of health workforce by 24%.

 

Part 2: Agenda Comparison Grid Analysis

 

Administration

 

Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected? Why is this agency the most helpful?

 

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the most likely agency to deal with mental illness. The agency would deal with mental health issues because it is mandated to advance the nation’s behavioral health and improve the value of people living with mental disorders. Through its mission, (SAMHSA) leads in the prevention of substance abuse and promotes mental health support. Another agency responsible for addressing the mental illness issue is The National Alliance for mental illness, the largest mental health organization in the country dedicated to improving the lives of millions suffering from different mental disorders.

It would better fit because it is a non-profit, volunteer health organization dedicated to providing people affected by mental illness, their families, and friends with mutual support, education, advocacy, and research funding.   The CDC and legislation continued to find ways to treat mental illness, more mental health clinics are now available throughout our local communities. (CDC 2019) 19.2% of adults have received mental treatment and 15.8% had taken prescription drugs. In 2020 an increasing number of mental health clinics opens to treat this growing population. In my hospital, I find that doctors are spending more time addressing patients’ mental issues rather than just giving them a referral to seek outside help.

 

How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there?

The issue of mental illness might get into President Biden’s agenda because, during his campaign, President Biden promised to protect the Affordable Care Act, which helps most citizens afford healthcare services for mental patients. He also vowed to improve the number of psychologists during his administration, so the issue could easily enter his agenda. It can stay there through the allocation of a recurrent budget for each year. President Trump also gave an executive order to address the negative impact of covid19 lockdowns; therefore, the issue of mental illness would easily enter his agenda.

Whom would you choose to be the entrepreneur/ champion/sponsor (a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected?
An example is Michael J. Fox a champion for Parkinson’s disease.

I would choose President Joe Biden to be the time champion of the mental illness issue in the United States.  Joe Biden continued to support efforts to protect the Affordable Care Act (ACA), which gives marginalized groups equal access to healthcare services. Agenda Comparison Grid and Fact Sheet – Walden University NURS-6050 Week 2 Assignment

Part 3: Fact Sheet

In the United States, the number of people suffering from different types of mental issues is increasing at an Alarming Rate. Various family and economic challenges are driving people crazy, and the issue of mental illness should be included in the legislative agenda to pressure the administration to improve the budget for mental disorders. The increased economic hardship, mainly because of inflation, has also driven most citizens to mental disorders, including anxiety and psychological disorders. The United States has too many resources not to make mental illness a top agenda for legislation.

Nurse’s Role in Agenda Setting for Mental Illness

Nurses have the Role of raising the alarm to the management and the higher authorities regarding the state of mental illness in this country because, they are always the frontline soldiers dealing with people with mental health conditions (Foster et al., 2018). Nurses assess patient conditions and evaluate plans for the patients. Nurses collaborate with counselors, and therapists to provide the best outcomes for patients. Nurses follow up with patients and families on resources.   (Foster et al., 2018).
Allocation of Care
is a health professional organization that works with nurses and therapists to assure patients are receiving the best possible care that will treat their mental problems.  When seeking medical help nurses are the first person of contact for assessment.  (Foster et al., 2018).

 

References

Canady, V . A (2021). NAMI Calls on Biden Administration for Mental Health Support Weekly, 31(4), 7-7.

Centers for Disease Control and Prevention (CDC). (n.d.).

Step by step: Evaluating (2020).

Conley, D. L. (2021). The Impact of Structural Stigma and other factors on State Mental Health Legislative Outcomes During the Trump Administration. Stigma and Health.

Foster, K., Cuzzillo, C., & Furness, T. (2018). Strengthening Mental Health nurses’ resilience through a workplace resilience program: A Qualitative Inquiry. Journal of Psychiatric and Mental Health Nursing, 25(5-6), 338-348.

Smith, W. R., & Sisti, D. A. (2022). Rapprochement and Reform: Overcoming Factionalism in Policymaking for Serious Mental Illness. Psychiatric Services, 73(5), 539-546.

 

To Prepare:

Review the agenda priorities of the current/sitting U.S. president and at least one previous presidential administration.

Select an issue related to healthcare that was addressed by two U.S. presidential administrations (current and previous).

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.

Use your Week 1 Discussion post to help with this assignment
.

The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page. This is an APA paper. Use 2-3 course resources and at least 2 outside resources.

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 previous president, and their agendas related to the population health concern you selected. Be sure to address the following:

Identify and provide a brief description of the population health concern you selected.

Explain how each of the presidential administrations approached the issue.

Identify the allocation of resources that the presidents dedicated to this 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 (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected and why is this agency the most helpful for the issue?

How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there?

An entrepreneur/champion/sponsor helps to move the issue forward. Who would you choose to be the entrepreneur/champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected and why would this person be a good entrepreneur/ champion/sponsor? An example is Michael J. Fox is champion for Parkinson’s disease.

Part 3: Fact Sheet

Using the information recorded on the template in Parts 1 and 2, develop a 1-page fact sheet 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.

By Day 7 of Week 2

Submit
 your final version of Part 1: Agenda Comparison Grid, Part 2: Agenda Comparison Grid Analysis, and Part 3: Narrative.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the 
Turnitin Drafts
 from the 
Start Here
 area.

To submit your completed assignment, save your Assignment as 
WK2Assgn+LastName+Firstinitial

Then, click on 
Start Assignment
 near the top of the page.

Next, click on 
Upload File
 and select 
Submit Assignment
 for review.

Rubric

NURS_6050_Module01_Week02_Assignment_Rubric

NURS_6050_Module01_Week02_Assignment_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome
Part 1: Agenda Comparison GridExplain how each of the presidential administrations approached the issue. Identify the allocations of resources that the two presidents dedicated to this issue.

20
 
to >
17.0
 pts
Excellent
The response clearly and accurately explains how the presidential administrations approached the issue and identifies the resource allocations dedicated to the issue.

17
 
to >
15.0
 pts
Good
The response accurately explains how the presidential administrations approached the issue and identifies the resource allocations dedicated to the issue.

15
 
to >
13.0
 pts
Fair
The response is vague or partially inaccurate in its explanation of how the presidential administrations approached the issue, and/or in the identification of the resources allocated to the issue.

13
 
to >
0
 pts
Poor
The response is missing or inaccurate in its explanation of how the presidential administrations approached the issue, and/or in the identification of the resources allocated to the issue.

20
 pts

This criterion is linked to a Learning Outcome
Part 2: Agenda Comparison Grid Analysis- Address the following:Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected? Why is this agency most helpful?How do you think your selected healthcare issue might get on the agenda? How does it stay there?Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected and justify your selection. Agenda Comparison Grid and Fact Sheet – Walden University NURS-6050 Week 2 Assignment

25
 
to >
22.0
 pts
Excellent
The response clearly and accurately identifies an administrative agency most likely to be responsible for addressing the selected healthcare issue and why that agency is most helpful. …Response clearly and accurately explains how the healthcare issue gets on the agenda and remains there. …The response clearly and accurately identifies and justifies the entrepreneur/champion/sponsor of the healthcare issue selected.

22
 
to >
19.0
 pts
Good
The response identifies an administrative agency most likely to be responsible for addressing the selected healthcare issue and why that agency is most helpful. …Response clearly and accurately explains how the healthcare issue gets on the agenda and remains there. …Identification and justification of the entrepreneur/champion/sponsor of the healthcare issue is included.

19
 
to >
17.0
 pts
Fair
The identification of an administrative agency responsible for addressing the selected healthcare issue is vague or inaccurate and justification is inaccurate or misaligned for why that agency is most helpful. …Explanation of how the healthcare issue gets on the agenda and remains there is vague or inaccurate. …Identification and/or justification of the entrepreneur/champion/sponsor of the healthcare issue selected is inaccurate or does not align with the healthcare issue.

17
 
to >
0
 pts
Poor
Identification of an administrative agency responsible for addressing the selected healthcare issue is missing. …Explanation of how the healthcare issue gets on the agenda and remains there is inaccurate or missing. …Identification and/or justification of the entrepreneur/champion/sponsor of the healthcare issue selected is inaccurate or missing.

25
 pts

This criterion is linked to a Learning Outcome
Part 3: Fact SheetBased on your Agenda Comparison Grid for the healthcare issue you selected, develop a 1-2-page narrative that you could use to communicate with a policy- maker/legislator or a member of their staff for this healthcare issue.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

30
 
to >
26.0
 pts
Excellent
Creates an accurate and thorough fact sheet. …Using sufficient evidence, the response provides an accurate synthesis of evidence on why this healthcare issue is important and should be included in the agenda for legislation. …Response accurately justifies the role of the nurse in agenda setting for healthcare issues.

26
 
to >
23.0
 pts
Good
Creates an accurate fact sheet. …Using sufficient evidence, the response provides an accurate summary evidence on why this healthcare issue is important and should be included in the agenda for legislation. …Response accurately justifies the role of the nurse in agenda setting for healthcare issues.

23
 
to >
20.0
 pts
Fair
Creates a fact sheet that is partially accurate or incomplete. …Response provides an incomplete or inaccurate summary of evidence on why this healthcare issue is important and should be included in the agenda for legislation. …Response partially or inaccurately justifies the role of the nurse in agenda setting for healthcare issues.

20
 
to >
0
 pts
Poor
Creates a fact sheet that is inaccurate or incomplete. …Response provides an inaccurate summary of evidence or evidence is missing on why this healthcare issue is important and should be included in the agenda for legislation. …Response justifying the role of the nurse in agenda setting for healthcare issues is inaccurate and incomplete or missing.

30
 pts

This criterion is linked to a Learning Outcome
Resources

10
 
to >
8.0
 pts
Excellent
Response includes 3 or more course resources and 2 or more outside sources.

8
 
to >
7.0
 pts
Good
Response includes 2-3 course resources and 2 outside sources.

7
 
to >
6.0
 pts
Fair
Response includes fewer than 2 course resources and/or fewer than 2 outside resources.

6
 
to >
0
 pts
Poor
Response includes 2 or fewer resources.

10
 pts

This criterion is linked to a Learning Outcome
Written Expression and Formatting: ParagraphParagraphs make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

5
 
to >
4.0
 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

4
 
to >
3.0
 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

3
 
to >
2.0
 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%-79% of the time.

2
 
to >
0
 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. 5  pts This criterion is linked to a Learning Outcome Written Expression and Formatting: English Writing StandardsCorrect grammar, mechanics, and proper punctuation. 5   to >
4.0
 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.

4
 
to >
3.0
 pts
Good
Contains a few (1-2) grammar, spelling, and punctuation errors.

3
 
to >
2.0
 pts
Fair
Contains several (3-4) grammar, spelling, and punctuation errors.

2
 
to >
0
 pts
Poor
Contains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5
 pts

This criterion is linked to a Learning Outcome
Written Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, indentations, parenthetical/in- text citations, and reference list.

5
 
to >
4.0
 pts
Excellent
Uses correct APA format with no errors.

4
 
to >
3.0
 pts
Good
Contains a few (1-2) APA format errors.

3
 
to >
2.0
 pts
Fair
Contains several (3-4) APA format errors.

2
 
to >
0
 pts
Poor
Contains many (≥5) APA format errors.

5
 pts

Total Points: 
100  Agenda Comparison Grid and Fact Sheet – Walden University NURS-6050 Week 2 Assignment

Question 231 pts

A pharmacologic treatment for patients with Hydradenitis Suppurativa (HI) may include

Group of answer choices

 

Clindamycin

GET EXAM HELP HERE

Minocycline

 

Metformin

 

All of the
above

Presidential Agendas – NURS 6050 week 1 discussion

Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?

Reference:

New York State Department of Health. (n.d.). 
Making New York the healthiest state: Achieving the triple aim
. Retrieved June 21, 2021 from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf

Resources

 

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Review the Resources and reflect on the importance of agenda setting.

Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1

Post
 your response to the discussion question: Consider a population health topic that rises to the presidential agenda level. Which social determinant most affects this health issue? How did two recent presidents handle the problem? What would you do differently?

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues
* on two different days
 by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

*Note:
 Throughout this program, your fellow students are referred to as colleagues.

Reply from XX

Opioid Epidemic

Policies are available to ensure that healthcare services are rendered appropriately (Lamb et al., 2015). Policies depend on available healthcare challenges and issues that may require urgent consideration (DeMarco & Tufts, 2014). A health issue that has risen to the presidential level in the United States of America is the opioid epidemic. Opioid use and addiction have been long-term issues in the country. This health issue endangers many people’s health and negatively impacts the economic output and national security. The health topic is considered a crucial issue. Whenever the president declares opioid addiction a national emergency, the healthcare sector is sure to have treatment and recovery resources for the affected population.

Social Determinants of Health

Two social determinants of health related to health topics. Level of education plays a crucial role in determining the type of decisions an individual shall make regarding opioid usage or seeking healthcare interventions. There are higher chances of individuals with a low level of education being at a higher risk of misusing opioids. The individual may not understand the effects and may not have the opportunity of making the necessary decision to seek immediate healthcare interventions. The second social determinant of health is income (Islam, 2019). Low-earning individuals may have limited chances of fully utilizing the available treatment and resources that lead to positive outcomes. Low-income earners may not have enough to purchase private health insurance to facilitate accessing the required healthcare services.

How did Presidents Trump and Biden Handle the Issue?

The recent presidents enacted much effort in ensuring the opioid emergence issue has been resolved. For instance, during President Trump’s reign, numerous statements, reforms, and declarations were made to ensure that the affected population could receive necessary healthcare help. In October 2017, the president declared the opioid epidemic a national public health emergency. The declaration was followed by the formation of the Commission for Combating Drug Addiction and the Opioid Crisis; the commission’s role was to inform the country on how best to address the issue. In November 2019, he signed an executive order allowing the federal government and agencies to have strategies to prevent opioid overdose-related deaths. The declaration made it possible to have an increased supply of overdose reversal medications such as naloxone, making treating opioid overdose an easy journey.

In the current era, President Biden has also contributed to addressing the health issue by proposing $4 billion to be channeled to address the opioid epidemic in the country. It is evident that the effects of the opioid epidemic are devastating to the communities, and the funds shall be crucial for addressing the issue. President Biden has also encouraged an increment in the accessibility of the overdose reversal drug that is naloxone. The president has expanded the available resources and accessibility to resources. Naloxone is a safe and effective medication for reversing the effects of opioids and can be used or provided by anybody regardless of the medical foundation.

GET HELP HERE

What would I have done differently?

Like President Trump, I would have declared the opioid epidemic a public health emergency. By doing so, it could be easy to access additional resources. Other willing agencies will contribute to ensuring that the issue is resolved. I would also consider ensuring that the affected population gets the necessary support. I would focus on expanding the treatment and resources that shall ensure that there is unlimited access to available resources and ensure the achievement of quality health outcomes. Treatment and recovery across the country are essential for individuals struggling with addiction. I shall also focus on ensuring that the research institutions conduct studies on how the issue can be managed effectively.

References

DeMarco, R., & Tufts, K. A. (2014). The mechanics of writing a policy brief. 
Nursing Outlook
, 
62
(3), 219-224. https://www.nursingoutlook.org/article/S0029-6554(14)00057-8/fulltext

Islam M. M. (2019). Social Determinants of Health and Related Inequalities: Confusion and Implications. 
Frontiers in Public Health
, 
7
, 11. https://doi.org/10.3389/fpubh.2019.00011

Lamb, G., Newhouse, R., Beverly, C., Toney, D. A., Cropley, S., Weaver, C. A., … & Peterson, C. (2015). Policy agenda for nurse-led care coordination. 
Nursing Outlook
, 
63
(4), 521-530. 
https://www.nursingoutlook.org/article/S0029-6554(15)00183-9/fulltext
Links to an external site.

Reply from

     More Americans now die every year from drug overdoses than they do in motor vehicle crashes. New data from the Centers for Disease Control and Prevention (CDC) show that opioids—a class of drugs that include prescription pain medications and heroin—were involved in 28,648 deaths in 2014 (Office of the Press Secretary, 2016). More Americans now die every year from drug overdoses than they do in motor vehicle crashes. New data from the Centers for Disease Control and Prevention (CDC) show that opioids—a class of drugs that include prescription pain medications and heroin—were involved in 28,648 deaths in 2014(Office of the Press secretary, 2016). The opioid epidemic has been an ongoing crisis for years. People from all ages and walks of life have been affected by opioid misuse. There are several social determinants that affect the opioid epidemic such as the neighborhood where the person resides, access to healthcare, access to food, safe housing, quality education, and economic well-being (MN Dept. of Health, n.d.).

President Trump and Barack Obama have both made proposals to help the opioid epidemic, In 2016, Obama made a proposal of $1 billion in new funding to address prescription opioid and heroin abuse (Press Release, 2016). This funding will boost efforts to help individuals with opioid use disorder seek treatment, successfully complete treatment, and sustain recovery (Office of the Press Secretary, 2016). The program was created during the Obama administration and subsidizes state Medicaid programs that provide insurance coverage for roughly 40% of Americans receiving opioid addiction treatment (Mann, 2020).

In 2017, President Trump declared the opioid epidemic a public health emergency. He declared 3 parts under his opioid crisis plan. Part 1 consisted of reducing overprescription and educating patients on the dangers of misusing opioids. Part 2 focused on the supply chains through international and domestic drug supply. Part 3 provided Americans with treatment and recovery support services for those struggling with addiction. As of October 2018, the Trump Administration had secured $6 billion in new funding over a two-year window to fight opioid abuse (Mann, 2020).

What I would do differently would be to mandate treatment services in jails, prisons, and hospitals. For instance, if you were in the hospital for an opioid overdose, I would mandate all persons to attend outpatient or inpatient treatment. I would have more recovery centers and mental health services to help. Many persons with opioid addiction struggle with mental health so they turn to drugs. Providing more mental health services can help prevent opioid overdoses, addiction, misuse, and deaths. For persons who have drug charges in detentions, I would mandate treatment and recovery centers upon release. I would organize outreach resources that will go out to shelters and to the streets recruiting persons for treatment recovery. Both presidents secured a substantial amount of funds to help the opioid epidemic. I would use the same funds but within mandates.

References

Social Determinants of Substance Use and amp; Overdose Prevention – MN Dept. of Health
. (n.d.). 
https://www.health.state.mn.us/communities/opioids/prevention/socialdeterminants.html
Links to an external site.

Cummings Praises President Obama’s Proposal to Address Prescription Opioid and Heroin Abuse. (2022, September 7). 
House Committee on Oversight and Reform
. https://oversight.house.gov/news/press-releases/cummings-praises-president-obama-s-proposal-to-address-prescription-opioid-and

FACT SHEET: President Obama Proposes $1.1 Billion in New Funding to. (2016c, February 4). 
Whitehouse.Gov
. https://obamawhitehouse.archives.gov/the-press-office/2016/02/02/president-obama-proposes-11-billion-new-funding-address-prescription

Mann, B. (2020, October 29). Opioid Crisis: Critics Say Trump Fumbled Response To Another Deadly Epidemic. 
NPR.Org
. 
https://www.npr.org/2020/10/29/927859091/opioid-crisis-critics-say-trump-fumbled-response-to-another-deadly-epidemic
Links to an external site.

Ending America’s Opioid Crisis –. (n.d.). 
The White House
. https://trumpwhitehouse.archives.gov/opioids/

 

 

 

 

 

 

Expand discussion thread from Dewona K Wilson

1 Reply

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HG

Henry Ros Gonzalez

Nov 29, 2022 8:14pm
| 
Last reply Dec 1, 2022 10:31pm

Reply from Henry Ros Gonzalez

Pain has always been one of the most critical
healthcare issues
that providers address regularly. In doing so, many have been introduced to and left to struggle with opioids. In the nineties, many pharmaceutical companies insisted to physicians that patients would not become addicted to opioid pain relievers (Assistant Secretary of Public Affairs (ASPA), 2021). The opioid crisis has, therefore, been recently addressed as a crisis and made a core topic in political debates that have reached the presidential level. With prevention being the main target when fighting substance abuse, previous administrations have attempted to carry out plans that have the same goal via different strategies. These strategies have similar approaches, although certain implementations were unique to every administration. According to (House, 2022), the administration of our president, Joe Biden, has focused efforts on investing billions of dollars in expanding resources allocated to support strategic organizations and entities. The predecessor administration of former president Donald Trump developed plans to reduce over-prescription, targeting supply chains and extending education campaigns and evidence-based treatment (
Ending America’s Opioid Crisis –
, n.d.).

The efforts that the scientific community, healthcare professionals, and legislators have carried out for decades to fight the opioid crisis tell about their dedication to the issue. We must always ask ourselves and our colleagues how to improve and work together to solve the problems plaguing our communities. We must also target the difficulties from which opioid abuse stems. It would be ideal to see researchers encountering new methods to address pain without relying on substances and that we can receive the full support of the government and other entities to develop them. That is what I would consider doing differently if I had the opportunity of bringing my voice to a presidential administration. That is why it is so important to learn how to bring up research to our legislators and effectively communicate their importance so they can help move the engines of our nation to get us on the right path.

 

References

Assistant Secretary of Public Affairs (ASPA). (2021, October 
27
). 
About the Epidemic
. HHS.gov. 
https://www.hhs.gov/opioids/about-the-epidemic/index.html
Links to an external site.

House, T. W. (2022, September 23). 
FACT SHEET:  Biden-Harris Administration Announces New Actions and Funding to Address the Overdose Epidemic and Support Recovery
. The White House. 
https://www.whitehouse.gov/briefing-room/statements-releases/2022/09/23/fact-sheet-biden-harris-administration-announces-new-actions-and-funding-to-address-the-overdose-epidemic-and-support-recovery/
Links to an external site.

Ending America’s Opioid Crisis –
. (n.d.). The White House. https://trumpwhitehouse.archives.gov/opioids/

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Madeline Reighard

Nov 29, 2022 6:45pm
| 
Last reply Dec 2, 2022 10:21pm

Reply from Madeline Reighard

        According to the National Institute on Drug Abuse (NIDA, n.d.) opioids are defined as “a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription” (para. 1). The opioid epidemic has been an ongoing issue in America that countless policymakers have attempted to spearhead with no real victory. The economic cost alone of $120 billion dollars in loss of productivity related to drug abuse treatment, overdose, and imprisonment portrays the sheer effect opioid abuse has on our economy as a whole (Office of National Drug Control Policy, para. 2). Opioid abuse and misuse are straining our resources in terms of healthcare, employment, and our communities.

Social determinants of health (SDOH), are factors that impact where individuals live, learn, and grow (World Health Organization, n.d.). Given this opioid epidemic is affected by numerous social determinants of health, I feel education quality is a prevailing social determinant that most affects this health issue. Education is at the route of several other factors that affect the opioid epidemic problem such as healthcare access, one’s built environment, and economic stability. If one’s quality of education is poor their health literacy can in turn be diminished which can ultimately affect the lifestyle decisions one makes and their level of growth both physically and mentally.

In 2015, President Obama announced that prescriber training would be implemented to over 540,000 health care providers in order to educate prescribers in proper opioid prescribing (Office of the Press Secretary, 2015). The Obama administration also improved access to treatment by means of investing in drug overdose prevention strategies, greater access to treatment programs, as well as additional access to naloxone which is an opioid overdose reversal medication. Similarly, President Trump released his initiative to halt opioid abuse in 2018 and focused on decreasing over-prescription through providing education to Americans about opioid misuse and abuse, cutting down on drug supply chains, and providing aid to those struggling with recovery support (The White House, n.d.). If I were to make a change in regard to the opioid epidemic I would start downstream in lower and higher education. Students should be educated about opioid misuse and abuse and recognize the signs of addiction and the dangers associated with opioid addiction. Children will grow up to be adults and some children may even face opioid addiction in their own home, it is essential that they can recognize the issue, repercussions, and recovery and/or treatment options. If we provide our society with this knowledge early on in our lives even teaching it within health classes, we may have hope in decreasing opioid addiction in our future population.

References

National Institute on Drug Abuse. (n.d.). Opioids. Retrieved November 27, 2022, from https://nida.nih.gov/research-topics/opioids

Office of National Drug Control Policy. (n.d.). How Illicit Drug Use Affects Business and the Economy. Retrieved November 27, 2022, from https://obamawhitehouse.archives.gov/ondcp/ondcp-fact-sheets/how-illicit-drug-use-affects-business-and-the-economy

Office of the Press Secretary. (2015). Fact Sheet: Obama Administration Announces Public and Private Sector Efforts to Address Prescription Drug Abuse and Heroin Use. Retrieved November 29, 2022, from https://obamawhitehouse.archives.gov/the-press-office/2015/10/21/fact-sheet-obama-administration-announces-public-and-private-sector

The White House. (n.d.). Ending America’s Opioid Crisis. Retrieved November 29,
 
2022, from https://trumpwhitehouse.archives.gov/opioids/

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Sara Catherine Tuck

Nov 29, 2022 12:13pm
| 
Last reply Dec 3, 2022 12:10pm

Reply from Sara Catherine Tuck

    So why is agenda setting important to the health care professionals such as ourselves? For quality health care and to advocate on behalf of the nursing profession and patients. This opens the doors to power brokers and decision-makers.(The Online Journal of Issues in Nursing, 2017)For this discussion, obesity is the topic chosen mainly because it is the root of so many chronic conditions. While Obama was president they put together a “let’s move campaign” and the goal was to create practical tools tailored to children and their families facing a wide range of challenges and life circumstances. (American Public health association & Goodman, 2009)One of the main pillars was putting healthier foods in schools, I remember this- do you?

    On the other hand, President Trump in 2017 announced that schools would no longer have to meet some of the requirements. previously mandated which could have possibly hindered the prevention of childhood obesity in the United States. (Duramy, 2018). Of course these are only examples and the problem is way bigger than just food in schools. What would I have done differently?? I really believe the restructuring of “health class” would be a great start. Showing kids what can happen to them if they make bad choices and not choosing a healthy lifestyle. I think kids need to be a little afraid of this. Obviously, it begins at home and the parents need to promote healthy behaviors.

References

American Public health association & Goodman, A. (2009). President Obama’s health plan and community based prevention. American Journal of Public Health, 99(10), 1736–1738. 
https://doi.org/www.ncbi.nlm.nih.gov
Links to an external site.

Duramy, B. F. (2018). Child Obesity, School Food Environments and the Best Interests of the Child. Retrieved November 29, 2022, from 
https://doi.org/digitalcommons.law.ggu.edu
Links to an external site.

The Online Journal of Issues in Nursing. (2017). Influencing health care in the legislative arena. OJIN. Retrieved November 28, 2022, from 
https://doi.org/10.3912/OJIN.Vol12No01Man02

Question 22                                                                                1 pts

The only antimicrobial medications that are effective against Trichomoniasis vaginalis are:

Group of answer choices

 

tinidazole or metronidazole

 

Amoxicillin or Augmentin

BUY EXAM HERE

doxycycline or minocycline

 

cephalexin or ceftriaxone

 

NRNP 6552 Midterm Exam Walden University

Presidential Agendas

Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?

Reference:

New York State Department of Health. (n.d.). 
Making New York the healthiest state: Achieving the triple aim
. Retrieved June 21, 2021 from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf

Resources

 

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Review the Resources and reflect on the importance of agenda setting.

Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1

Post
 your response to the discussion question: Consider a population health topic that rises to the presidential agenda level. Which social determinant most affects this health issue? How did two recent presidents handle the problem? What would you do differently?

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues
* on two different days
 by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

*Note:
 Throughout this program, your fellow students are referred to as colleagues.

To my colleagues,

I struggled to write this post, as it is not of popular opinion that a medical professional stand up against these initiatives and regulations. My feelings about chronic pain sufferers do not in any way diminish the importance of a person who is plagued with Substance Use Disorder.

In 2015, President Obama announced that prescriber training would be implemented for over 540,000 healthcare providers in order to educate prescribers in proper opioid prescribing (Office of the Press Secretary, 2015). President Trump released his initiative to halt opioid abuse in 2018 and focused on decreasing over-prescription by providing education to Americans about opioid misuse and abuse, cutting down on drug supply chains, and providing aid to those struggling with recovery support (The White House, n.d.).

While education can provide the knowledge needed for adults to know the risks of using and abusing illicit substances, it cannot prevent it. The world is a wide and vast place with so many different places and circumstances, that education being the be-all-end-all in reducing Substance Use Disorder, although ideal, is misguided.

President Obama and President Trump’s initiatives to halt opiate abuse by creating a narrative that opioid abuse is most common due to overprescribing by medical providers is at best incorrect and negligent. These initiatives have left patients that live with chronic medical conditions, resulting in pain, to be pushed away by the medical community for fear of sanctions and revocation of their licensure and criminal prosecution and imprisonment. The government’s own data, collected from the Centers for Disease Control and Prevention and the National Survey on Drug Use and Health, show no association between the volume of opioid prescriptions and the nonmedical use or addiction in persons over age 12. This tragic finding is the result of policymakers refusing to reassess their assumption that the overdose crisis was caused by doctors overprescribing opioids to their patients in pain. And this is aside from the fact that there is no concise definition of overprescribing. Yet, policymakers keep doubling down on a misguided mission to reduce or eliminate opioid prescribing, putting patients back in miserable pain, and mental anguish and sometimes driving them to the black market. All the while, overdoses soar among the population of nonmedical users who long ago moved on to heroin and fentanyl, provided cheaply and efficiently by the black market generated by drug prohibition.

GET HELP HERE

As a member of the medical community, I have worked with patients suffering from chronic pain, and from Substance Use Disorder. These patients present very differently. Patients who suffer from medically diagnosed illnesses that cause chronic pain have documentation to provide a base for their claims. These patients are apprehensive to ask for anything for fear of being labeled a “drug seeker” and will often suffer in silence, ending up sitting across from me or my colleagues because they attempted suicide to end the pain.  They are literally sick and tired of being sick and tired. Conversely, patients with Substance Use Disorder have no to minimal fear of asking for anything to alleviate their suffering related to withdrawals from their substance of choice. These patients are provided MAT (Medication Assisted Treatment) medications and given referrals to outpatient mental health providers, counselors, and meetings. Chronic pain patients are left to deal with their pain with injections that do not work, physical therapies that increase their pain, and over-the-counter medications that do not work.

How can we as medical professionals and patient advocates escalate the proper treatment of chronic pain patients to lawmakers? I would perform extensive research on the conversion of legally prescribed opiate medication to overdose deaths in my state. From there, I would draft a proposal document to obtain signatures to get the information in front of lawmakers and voted on. While this would be daunting, it would be a step in the right direction for patients who have a diminished quality of life because their pain is being left un or undertreated.

 

2020 National Survey of Drug Use and Health (NSDUH) Releases. (2022). Retrieved November 30, 2022, from https://www.samhsa.gov/data/release/2020-national-survey-drug-use-and-health-nsduh-releases

Office of the Press Secretary. (2015). Fact Sheet: Obama Administration Announces Public and Private Sector Efforts to Address Prescription Drug Abuse and Heroin Use. Retrieved November 30, 2022, from 
https://obamawhitehouse.archives.gov/the-press-office/2015/10/21/fact-sheet-obama-administration-announces-public-and-private-sector
Links to an external site.

White House. (n.d.). Ending America’s Opioid Crisis. Retrieved November 30,
 
2022, from https://trumpwhitehouse.archives.gov/opioids/

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Shelly Bailey

Dec 1, 2022 1:09am
| 
Last reply Dec 2, 2022 10:25pm

Reply from Shelly Bailey

Mental health
 is a severe health topic that requires the attention of the president of the United States of America. Mental health needs to be at the top of the presidential agenda so that policies and resources can be made to help serve those Americans who have mental illness and mental health issues. 

Social determinants affecting mental health are access to care, poverty, transportation, geographical location, educational level, and ethical and cultural backgrounds. According to Whealin et al. (2017), telehealth treatment for veterans facing mental health issues can alleviate the social determinants of rural area locations and veterans with diverse backgrounds or cultures. Rural areas are associated with higher suicide rates (Tarlow et al., 2019). Rural areas are underserved, and most live below the poverty line. Rural areas have low socioeconomic status, which gives way to underserved medical care, primarily mental health care (Tarlow et al., 2019).

The past two administrations have made great strides to improve mental health and work toward awareness, prevention, treatment, and wellness. 

The Trump administration can be credited for the majority of these improvements. The Biden Administration has continued with these improvements and made more funding available. 

As noted by Satel & Torrey (2021), President Trump appointed the first psychiatrist for the positions of the assistant secretary for mental health and substance use and the director of the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA is a federal agency that facilitates federal mental health policy. Dr. Elinore McCance-Katz is known for many improvements to SAMHSA by focusing on the agency’s priorities and treating mental illness (Satel & Torrey, 2021). On October 3, 2020, President Trump signed Executive Order 13954, “Saving Lives Through Increased Support for Mental and Behavioral Needs.” Light of the Coronavirus pandemic caused many to face stress, loss of jobs, and social isolation (The White House, October 5, 2020). These factors increased the number of Americans’ facing mental and behavioral health issues due to the negative impact of shutdowns. Trump also signed into law a designated 9-8-8 hotline for suicide prevention and mental health crisis (States News Services, October 19, 2020). 

The Biden Administration, on March 12, 2021, announced that SAMHSA would be providing $2.5 billion to help the states with addressing continuing mental health and addiction crises through grant programs (State News Service, March 12, 2021). Biden Administration also has sourced millions in funding through grants for community behavioral health centers. The grant funding will come from the Bipartisan Safer Communities Act (Gonzalez & Harris, 2022). The Biden Administration has provided $4 billion for the American Rescue Plan (ARP) and made the connection to care more accessible along with a continuum of care and support for Americans’ facing mental health or substance abuse factors (The White House, May 31, 2022). 

One thing I would do differently is to focus on access to telehealth care for rural areas. I would make funding available to provide the equipment and services to provide telehealth care via the person’s home setting.

 

References:

Gonzalez, A., & Harris, E., (October 18, 2022). Biden administration announces millions in

Funding for community behavioral health center.

https://www.nyl.com/nyc/all-boroughs/politics/2022/10/18/biden-administration
Links to an external site.

Satel, S. & Torrey, E. F. (February 01, 2021). Don’t undo Trump Administration’s mental-

health reforms. American Enterprise Institute,

https://www.aei.org/articles/don’t-undo-the-trump-administartions-mental-health-reform/
Links to an external site.

States News Services, (March 12, 2021). Trone Hails Biden Administration’s $2.5

Billion investment in mental health and addiction services. Gale,

https://go.gale.com/ps/i.do?=EAIM&u=minn4020&v=2.1&it=r&i/A654735553
Links to an external site.

State News Service, (October 19, 2020). Trump signs Reed’s Bipartisan plan to adopt national

9-8-8 suicide and mental health crisis hotline into law. Gale,

https://go.gale.com/ps/i.do?p=Eaim&u=minn4020&id=GaleA6338890961
Links to an external site.

Tarlow, K. R., Johnson, T. A., McCord, C. E. (2019). Rural status, suicide ideation, and

Telemental health: Risk assessment in clinical sample. 
The Journal of Rural Health
, 35,

247-252. 
https://doi.org/10.111/jrh.12310
Links to an external site.

The Whitehouse.  (May 31, 2022). Fact Sheet: Biden-Harris Administration highlights strategy    to address the national mental health crisis. The White House,

https:www.whitehouse.gov/briefing-room/statement-release/2022/

The Whitehouse. (October 5, 2020). President Donald J. Trump is safeguarding Americans’ 
https://doi.org/10.1177/0091217417703291
Links to an external site.

Whealin, J. M., King, L., & Spira, JL., (January 2017). Diverse veterans’ pre- and post-

intervention perceptions of home telemental health for posttraumatic stress disorder

delivered via tablet. 
The International Journal of Psychiatry in Medicine, 
52, 3-20,

            
https://doi.org/10.1177/0091217417703291
Links to an external site.

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Jestanon Ratunil

Dec 1, 2022 12:25am
| 
Last reply Dec 3, 2022 5:06pm

Reply from Jestanon Ratunil

My topic of interest is childhood obesity. Childhood obesity is a national problem that carries the risks of potential co-morbidities and increased risk of chronic diseases. In the United States alone, the prevalence has tripled in the last thirty years and at present, more than 30% of American children are overweight or obese. (Vash, P.D. 2015).

 

The cause of the increased rates of childhood obesity is complex and multifactorial and must be addressed on different levels. (Sommer, A., Twig, G. 2018). One of the most obvious problems is to change the messages our children received about food (Casazza, K.R.& Hanks, L.J., 2015).

 

One of my observations as I traveled to Paris, France last year, where obesity is one of the lowest in the world for both children and adults was, I barely see any soda bottles lining the store shelves including the hallways of the airport. According to the Journal of American Dietetic Association, 70% of Americans consumed more than 1 glass of sweetened beverage per day which is linked to obesity (ncbi.nlm.nih.gov).

 

Given that big corporations are unlikely to readily change their advertising practices about food, the government needs to get involved. (Vash, P.D. 2015).  One example was the project of then-former first lady Michelle Obama in 2010 who introduced the “Let’s Move” movement which emphasized solving childhood obesity problems on a different level, from educating parents to schools to communities.

 

As practicing nurses with always have a goal to help and have a responsibility to be an advocate for our patients and their families, it is very difficult to witness when the patient is unable to access what they need. With a problematic healthcare system, we nurses are dealing with serious healthcare disparity in the communities we serve. (Abood, S. 2007). Through this learning and discussions, I hope to learn and be able to be proactively influenced my patient and their families and colleagues to bring about change in the community I served.

 

 

References:

 

Vash, P. D. (Ed.). (2015). 
The childhood obesity epidemic : Why are our children obese-and what can we do about it?
. Apple Academic Press, Incorporated.

 

Casazza, K. R., & Hanks, L. J. (Eds.). (2014). 
Clinical insights : Obesity and childhood
. Future Medicine Ltd.

 

Abood, S. (January 31, 2007). “Influencing Health Care in the Legislative Arena”. OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 1, Manuscript 2. from 
https://doi.org/10.3912/OJIN.Vol12No01Man02Links to an external site.
Links to an external site.

 

Sommer, A., & Twig, G. (2018). The Impact of Childhood and Adolescent Obesity on Cardiovascular Risk in Adulthood: a Systematic Review.
 Current Diabetes Reports, 18
(10), 1-6. https://doi.org/10.1007/s11892-018-1062-9

 

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Cheryl Athurine Spence

Nov 30, 2022 11:51pm
| 
Last reply Dec 4, 2022 2:36pm

Reply from Cheryl Athurine Spence

 

Income as a Social Determinant of Mental Health

Numerous studies have established a high incidence of mental disorders in poor and disadvantaged communities all over the world. The social determinants of health act reflexively upon one another such that an effect such as poor mental health can hardly be attributed to only one factor. Poverty results from low incomes, and low incomes result from a wide array of other factors, for instance, racial discrimination, poor education, and unemployment. Notably, this part of the discussion looks only into low income as the most impactful social determinant of mental health.

Income level is crucial to individual and group health outcomes. Low incomes have been associated with premature mortality, life expectancy, and mortality rates in physical health. Low incomes impact mental health by contributing to poor mental health, increased incidence and risk for mental disorders and substance abuse, and worsening outcomes for those already affected by substance use disorders and mental illnesses. Katz-Wise et al (2017) found that low income is related to the higher incidence of suicide attempts, self-harm, and depression in transgender adults. Low income has also been linked to increased anxiety and depression among pregnant women, a condition that elevates the risk for neonates. Compton & Shim (2015) suggest that low incomes are associated with more mentally unhealthy days, a higher risk of death from a drug overdose, and poor child well-being scores.

Trump and Biden Administration response to mental illness

Interventions to healthcare issues can be clinical-level or policy-level interventions. While clinical interventions are applicable for individuals, lasting population-wide effects can only be achieved through policy action at the state and federal levels. President Trump held stewardship of the country at a time of healthcare crisis, where COVID-19 was running rife, and people had to adapt to a new way of life. The losses and uncertainties of this period resulted in aggravated mental health with 40% of adults showing symptoms of mental health disorders. President Trump signed Executive Order 13594 on October 5, 2020, creating a Coronavirus Mental Health Working Group to evaluate existing federal mental health programs and mitigate the negative effects of COVID-19 on mental health (Knopf, 2020). Another action by the Trump administration was to increase funding for suicide prevention by $50 through the CARES Act.

One of President Biden’s actions to tackle mental illness is approving funding for the launch of the 988 mental health crisis hotlines for emergency care. The $180 million from the Biden administration goes to staffing crisis call centers and local response teams. In addition, the Biden administration has invested approximately $4 billion in expanding access to mental health and substance use services through the American Rescue Plan; issued an advisory on healthcare worker burnout; and expanded provider training via Nurse Corps, AmeriCorps, and community behavioral facilities (Smith & Sisti, 2022).

Criticism and Concluding Thoughts

Even though the Trump administration increased funding for suicide prevention programs, this was directed to veterans and not to the mass of Americans undergoing mental health crises. Also, Executive Order 13594 was largely an academic exercise where concrete action was required. More effective action would be directing additional funding to training counselors and increasing access to mental healthcare providers for millions of Americans in poor mental health. Even though veterans are a vulnerable group, other similarly vulnerable groups did not receive suicide prevention assistance. The Biden administration is commendable in its response to mental health disorders as demonstrated by increased funding for mental health, improved access to care, the crisis hotline pilot test, and the expansion of provider networks. My Change would create more community centers for underserved populations and open more counseling centers.

References

Compton, M. T., & Shim, R. S. (2015). The social determinants of mental health. 
Focus
, 
13
(4),

419-425.

Katz-Wise, S. L., Reisner, S. L., White Hughto, J. M., & Budge, S. L. (2017). Self-reported

changes in attractions and social determinants of mental health in transgender adults. 
Archives of Sexual Behavior
, 
46
(5), 1425-1439.

Knopf, A. (2020). The transition of the federal government: The path forward for SAMHSA. 
Alcoholism

& Drug Abuse Weekly
, 
32
(44), 1-5.

Smith, W. R., & Sisti, D. A. (2022). Rapprochement and reform: overcoming factionalism in

policymaking for serious mental illness. 
Psychiatric Services
, 
73
(5), 539-546.

 

 

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Bonita Leone
 (She/Her)

Nov 30, 2022 10:02pm

Reply from Bonita Leone

Main Question Post

During his campaign, President Donald Trump had a platform to fight drug addiction. He planned to build a wall on the US-Mexican border to stop illegal drugs from coming into the country. Ultimately, by the end of his four years in office, 80 miles of the wall had been built. Short of covering the nearly 1,200-mile Texas and Mexico border, according to Garcia and Cai (2016). Trump’s Vice President, Mike Pence, acknowledged that drugs were mainly coming into the US through ports of entry (Gomez, 2019) and not the border.

Converse to Trump, Biden’s platform was not building a wall but holding big pharmaceuticals responsible and directing services to support people with substance use disorders. Biden also identified the need to stop smuggling from Mexico and China, according to Joe Biden for President: Official Campaign Website (2020). In comparing funding to support their drug policies, Trump’s first budget requested 27.8 billion Souza (2017). In 2022, Biden’s budget asked 41 billion Cunningham (2022).

What would I do differently? Good question. Recognizing the checks and balances in place with the different branches of government, not all a president-elect or president says can be done independently. In a world where budgets go through the multistep process of checks and balances, I would have focused some funding on identifying illegal drugs coming into the country through the US Postal Service. I would also support legislation to normalize drug testing to be an annual health screening to help identify people who may need treatment starting in adolescents. I would look for expert opinions to predict future trends and recommendations. Last, I would utilize a committee to study these issues in other countries, see how countries with the most successful outcomes handle drug addiction and provide funding to set up pilot programs.

References

The Biden plan to end the opioid crisis. Joe Biden for President: Official Campaign Website. (2020, August 3). Retrieved November 28, 2022, from 
https://joebiden.com/opioidcrisis/#
Links to an external site.

Cunningham, D. (2022, March 2). Biden’s budget would spend $41 billion on drug policy efforts. UPI. Retrieved November 29, 2022, from 
https://www.upi.com/Top_News/US/2022/03/02/Biden-drug-policy-budget/9461646237606/
Links to an external site.

Gomez, A. (2019, January 16). Fact-checking Trump officials: Most drugs enter us through legal ports, not vast, open borders. USA Today. Retrieved November 29, 2022, from 
https://www.usatoday.com/story/news/politics/2019/01/16/fact-check-mike-pence-donald-trump-drugs-crossing-southern-border-wall/2591279002/
Links to an external site.

Souza, S. (2017, May 23). President Trump’s first budget commits significant resources to fight the opioid epidemic – AAAP. American Academy of Addiction Psychiatry. Retrieved November 29, 2022, from 
https://www.aaap.org/president-trumps-first-budget-commits-significant-resources-fight-opioid-epidemic/
Links to an external site.

Use of Postal Service Network to – oversight.gov. (n.d.). Retrieved November 30, 2022, from 
https://www.oversight.gov/sites/default/files/oig-reports/SAT-AR-18-002.pdf
Links to an external site.

 

 

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Kayla Holt

Nov 30, 2022 9:40pm
| 
Last reply Dec 1, 2022 7:46pm

Reply from Kayla Holt

 

A population health topic that rises to the presidential agenda level is obesity. Effective obesity prevention requires intervening at all levels of society, including the governmental level (Kobes et al., 2022).  According to the American Heart Association (AHA), obesity puts you at an increased risk for many serious health problems, including heart disease, stroke, high blood pressure, high cholesterol, and diabetes.

It is important to educate children on the benefits of an active lifestyle along with a healthy diet (American Heart Association, 2017). If we can change nutritional related behaviors and beliefs among children, we can prevent the cycle of obesity throughout the lifespan (Cook et al., 2017). The education effort must be collaborative among adults, including teachers and parents (Cook et al., 2017). Adult lifestyle behaviors have a direct influence on children’s nutrition patterns (Cook et al., 2017). Several policies and programs have been put into place nationwide to provide nutrition based education and make healthy food options more accessible to all people (Cook et al., 2017). Many school-aged children rely on government programs for their basic nutritional needs (Cook et al., 2017).

Presidents Trump and Biden have both made efforts to encourage lifestyle changes. President Trump’s healthcare vision put American patients, families, and seniors first by providing more choice, better care, and lower costs (The White House, 2015). The Trump Administration took historic actions to lower prescription drug prices, expand access to affordable coverage, deliver hospital and insurer price transparency, and allow Americans to access trusted doctors (The White House, 2015). President Trump guaranteed to always protect people with pre-existing conditions, and he signed legislation to end surprise medical billing after repeatedly calling on Congress to take action (The White House, 2015). Biden pushed for national soda tax. Reducing sugar-sweetened beverage consumption through taxation is a promising public health response to the obesity epidemic in the U.S. (Long et al., 2015). Public health intervention will be required at the policy level to promote healthy behavioral changes in consumers (Frank et al., 2013).

I would implement free educational programs that are available to the community on ways to improve health. For instance, I would do one lecture on how losing a few pounds if you are overweight can improve your health (American Heart Association, 2017). I believe that it is important to provide communities with knowledge, to provide a safe place to ask questions, and to provide resources.

 

References

American Heart Association. (2017). Keeping a healthy body weight. Retrieved from 
https://www.heart.org/en/healthy-living/healthy-eating/losing-weight/keeping-a-healthy-body-weight
Links to an external site.

Cook, S., Gerber, S., Heines, K., Martin, C., Reeder, B., Schmidt, S., Sidebottom, E., & Wimsatt, S. (2017) Combating Obesity: Teaching Children to Eat Right. 
Kentucky Nurse, 65
(2), 10-11.

Franck, C., Grandi, S. M., & Eisenberg, M. J. (2013). Agricultural Subsidies and the American Obesity Epidemic. 
American Journal of Preventive Medicine, 45
(3), 327-333. https://doi.org/10.1016/j.amepre.2013.04.010

Kobes, A., Kretschmer, T., & Timmerman, M. (2022). The association between obesity-related legislation in the United States and adolescents’ weight. 
Health Policy Open, 3
(100056-). 
https://doi.org/10.1016/j.hpopen.2021.100056
Links to an external site.
.

Long, M. W., Gortmaker, S. L., Ward, Z., Resch, S. C., Moodie, M. L., Sacks, G., Swinburn, B. A., Carter, R. C., & Claire Wang, Y. (2015). Cost Effectiveness of a Sugar-Sweetened Beverage Excise Tax in the U.S. 
American Journal of Preventive Medicine, 49
(1), 112-123. 
https://doi.org/10.1016/j.amepre.2015.03.004
Links to an external site.

The White House. (2015). Retrived from 
https://trumpwhitehouse.archives.gov/issues/healthcare/
Links to an external site.

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Essie Tani Richardson

Nov 30, 2022 9:23pm

Reply from Essie Tani Richardson

            The COVID-19 conflict is the first major international crisis since the end of the Cold War in which the US has not taken the initiative to respond. For better or worse, virtually every international crisis has seen the US serve as a model for the rest of the world by providing leadership, direction, coordination, and assistance to nations. But this did not take place during the coronavirus crisis. Everyone who is interested in learning about the US reaction to the new coronavirus, or SARS-CoV-2, is aware by this point that there were significant errors in judgment and inaction in January, February, and even March of this year. While errors are unavoidable in the face of such a sizable and swiftly evolving local and global threat, our federal government’s response fell short of many other countries, many of which were already affected by the virus before us. It will take years to fully analyze the faults that led to our poor response, even though we will likely find ways to fix them in the near future.

The president during the Pandemic was Donald Trump who was preoccupied with impeachment at the beginning of that crucial lost month, when his government could have recovered, and he disregarded the harm to the economy and public health. At the month’s conclusion, Trump declared, “It’s going to leave,” indicating that the virus was about to disappear in the US. It will almost suddenly disappear one day. Less than a week before taking office, Biden released a major $1.9 trillion plan that included short-, medium-, and long-term solutions to reduce the current infection and mortality rates and position the US for a long-term recovery from COVID-19 and the economic havoc it has caused.

What I would have done differently was tackle the crisis with all seriousness in the very early stages by getting the vaccines made, which may necessitate invoking the Defense Production Act (DPA), which requires industry to accept and prioritize government contracts in order to ramp up production quickly. I would set an Administration to rely on states to broaden and standardize the categories of people who are eligible for vaccinations, such as all people 65 years and older and front-line workers who are not necessarily medical workers, such as transit, pharmacy, and grocery store employees.

 

References

https://www.americanprogress.org/issues/security/news/2020/03/26/482274/us-leading-global-response-coronavirus-crisis/
Links to an external site.

https://www.brookings.edu/research/the-federal-governments-coronavirus-actions-and-failures-timeline-and-themes/%3famp
Links to an external site.

https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html
Links to an external site.

http://zimmer.csufresno.edu/~johnca/spch100/7-4-agenda.html
Links to an external site.

 

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Lima Vadakkedam

Nov 30, 2022 8:29pm

Reply from Lima Vadakkedam

In the United States, there are many different socioeconomic 
factors
 that 
impact
 healthcare policy. Healthcare is one of the top burdens in the day to day lives of Americans who do and do not have ins
urance. Medical bills take years to pay off for some, 
especially
 for 
those who
 fall into the low-income gap. Those individuals who 
fall into the low-income 
category
 
find that healthcare bills can become a huge stressor and financial burden 
especially
 if they do not have any coverage or insurance. 
Knowledge as
 well plays a 
crucial
 role
. Most individuals do not have the essential education 
when it comes to 
the healthcare world which in turn can affect them for potential health hazards. Finally, where the individual lives as well can play a
crucial
 role. Some people who live 
in different regions of the world may lack the medical treatment that other 
individuals
 from other geographic areas have. 
 

. 
The two former presidents, President Barack Obama and President Donald Trump took on two different views when it came to healthcare. President Obama 
created the Affordable Care Act. USA.gov states that the act entails making health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the
  federal overtly level. (USA.gov 2018). This act created by the Obama administration allowed for those with
 lower 
economic
 classes to be able to afford health insurance. 
On the 
contrary, Donald Trump wanted to reform the Affordable Care Act.
 President Obama’s desire to want to expand Medicaid to 
assist
 those 
individuals
 in obtaining private insurance. President Trump on the other hand wants to reduce the f
unding 
for Medicaid. 
 

Working in healthcare, if I were to become president there are a few things that I would have handled differently that 
President
 Obama
and
 Trump 
failed to
 do. I would first push for a universal 
healthcare
 plan that allowed for healthcare to be free like it
 is for Canadians.
The
 Commonwealth fund 
states
 that “all citizens and permanent residents receive medically necessary 
hospital
 and 
physician
 services free at the point of 
use. This
 allows for everyone to have access to quality healthcare regardless of their ability to pay. Regardless of e
conomic status everyone should have 
access
 to quality healthcare. Another big issue is what some known as Big Pharma. Big Pharma will not let its profit margin suffer; therefore, the cost will forever be escalating. (Meller & Ahmed, 2019). 
As we know, in hospital setting a simple bag of IV fluids can cost up to seven hundred dollars, 
whereas
 the production cost 
is
 not 
nearly as
 expensive. I would try to work with the various pharmaceutical corporations to reduce the cost of medications.Overall minimizing the cost of healthcare would be 
beneficial
 for all Americans. 
 

References: 

USA.gov. (n.d.). 
A-Z index of U.S. government departments and agencies
 
Links to an external site.
. Retrieved September 20, 2018, from 
https://www.usa.gov/federal-agencies/a
Links to an external site.

Meller, A., & Ahmed, H. (2019, August 30). 
How Big Pharma Reaps Profits While Hurting Everyday Americans
. Center for American Progress. 
https://www.americanprogress.org/article/big-pharma-reaps-profits-hurting-everyday-americans/

 

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Marie V Licin-Valerius

Nov 30, 2022 8pm

Reply from Marie V Licin-Valerius

NURS:6050 Week 1 Discussion

Mental health consists of psychological, emotional, and social well-being. Mental health determines how people feel, think, and act and determines a person’s ability to relate with other people, handle stress, and make healthy choices. Mental health is needed during childhood, adolescence, and adulthood. However, mental health is different from mental illness. Mental health is as important as physical health because an individual with mental health issues is likely to suffer other physical health complications such as heart disease, stroke, and diabetes. Mental illnesses are prevalent in the United States. For example, over 50% of Americans are diagnosed with mental illness at some point. Similarly, 1 in every 5 American experiences mental illness in a specific area, while one in five children are currently affected by mental illness. One in every 25 Americans lives with severe mental illness like bipolar disorder, schizophrenia, or depression (Centers for Disease Control and Prevention, 2021). Mental illnesses do not have definite causes, but numerous factors contribute. They include early adverse life experiences, experiences linked to chronic conditions like diabetes, use of drugs or alcohol, chemical imbalances or biological factors, and isolation (Centers for Disease Control and Prevention, 2021). Mental illness is an issue that has reached the presidential level and has been handled by two recent presidents.

Management of Mental Health Issues by President Donald Trump and President Joe Biden

The administration of President Trump has been supporting mental health in various ways. One of the remarkable ways is to sign the Law Enforcement Mental Health and Wellness Act into law. President Trump signed the Act into law on January 10th, 2018, after it was passed by the House of Representatives and the Senate. The law is significant to mental health because it has grants that help to fund mental health. The grants also help fund mentorship pilot programs and research focused on determining the impact of Annual mental health checks and crisis hotlines (U.S. Government Publishing Office, 2020). Similarly, Triumph’s administration supported mental health through executive order 13954. Section 1 of this order explains that Trump’sTrump’s administration is committed to preventing suicide tragedies and ending the opioid crisis by improving behavioral and mental health. Section 2 elaborates on the policy to prevent drug-related deaths, suicide, and poor behavioral health outcomes (U.S. Government Publishing Office, 2020). This is crucial because mental health issues increased with the prolonged effect of covid 19.

Similarly, President Joe Biden supports mental health wellness and views it as a bipartisan issue that his administration is committed to serving. President Biden is committed to increasing mental health professionals across the United States and working towards developing an emergency response system with an emergency hotline for mental illnesses. Bi

Biden’s administration also supports mental health and has recently announced two new actions addressing the youth mental health crisis. The initiative helps to understand mental health issues, integrated treatment, and access to healthcare services. Biden announced the awarding of 300 million dollars secured through FY2022 to a bipartisan agreement to expand mental health services across U.S. schools (The White House, 2022). The action was to encourage governors to invest more resources in school-based mental health services.

What I Would do Differently

The two presidents have supported mental health in recommendable ways. Each of them has dedicated a good amount of funds toward mental illness. What I would do differently is to ensure more facilities are built in every state. This ensures that those affected by mental health issues can be admitted into facilities within their locality. It helps to increase social support because family and friends can easily visit the patient because they are within. Similarly, I would increase mental health awareness programs to ensure the community is sensitized about mental health.

References

Centers for Disease Control and Prevention. (2021, November 23). About mental health. 
https://www.cdc.gov/mentalhealth/learn/index.htm

U.S. Government Publishing Office. (2020). Executive Order 13954—Saving Lives Through Increased Support for Mental- and Behavioral-Health Needs. 
https://www.govinfo.gov/content/pkg/DCPD-202000758/pdf/DCPD-202000758.pdf

The White House. (2022, July 29). FACT SHEET: Biden-Harris administration announces two new actions to address youth mental health crisis. 
https://www.whitehouse.gov/briefing-room/statements-releases/2022/07/29/fact-sheet-biden-harris-administration-announces-two-new-actions-to-address-youth-mental-health-crisis/

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Sarah E. Tasker

Nov 30, 2022 7:45pm

Reply from Sarah E. Tasker

Presidential Agendas and Health Policies

When thinking about health policies that have risen to the presidential level is the Patient Protection and Affordable Care Act (ACA). As previous President, Barack Obama, established this history-making law in 2010 to address insurance accessibility, rising healthcare costs, and preventative medicine (Affordable Care Act, n.d.). The ACA improved many aspects of the nation’s healthcare and took the uninsured rate from 16.0% in 2010 to 8.9% in 2016 (National Archives and Records Administration, n.d.). The American Hospital Association claims that studies show that people with insurance coverage have better access to care, more positive health outcomes, and are more likely to use appropriate healthcare resources (American Hospital Association, 2022). In 2016 when President Donald Trump came into office, he proposed the American Health Care Act (AHCA) that would shape the Affordable Care Act so that people may choose to obtain health insurance coverage (Obamacare Enrollment, 2021). This law also would have let insurance companies charge more if a person had preexisting or chronic health conditions (Obamacare Enrollment, 2021). The senate did not approve Trump’s proposal (Davalon, 2022). Contradictory of Donald Trump’s original proposition, current President Joe Biden has later restored the ACA to its original form (Luhby, 2021). Knowing how much of an impact preventative medicine and accessibility of health care make, I believe in and would act upon strengthening the ACA to lessen each person’s burdens of their social determinants of health. 

 

References

     Affordable Care Act
. (n.d.). Health Affairs. https://www.healthaffairs.org/topic/4#:~:text=The%20purpose%20of%20the%20ACA,curb%20rising%20health%20care%20costs

     
American Hospital Association. (2022). 
Report: The importance of health coverage
. 
https://www.aha.org/guidesreports/report-importance-health-coverage
Links to an external site.
.

     Davalon. (2022). 
Trumpcare (AHCA) vs. Obamacare (ACA)
. eHealth. 
https://www.ehealthinsurance.com/resources/affordable-care-act/trumpcare-vs-obamacare
Links to an external site.
.

     Luhby, T. (2021). 
Biden signs executive order to reopen Affordable Care Act enrollment
. CNN. 
https://www.cnn.com/2021/01/28/politics/biden-executive-orders-health-care-aca-medicaid
Links to an external site.
.

     National Archives and Records Administration. (n.d.). 
Improving health for all Americans
. whitehouse.gov. https://obamawhitehouse.archives.gov/the-record/health-care.

Obamacare Enrollment. (2021). 
Trumpcare vs. Obamacare
. Obamacare Enrollment 2022. https://obamacareenrollment.org/trumpcare-vs-obamacare/.

    

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Rafael Carlos Martinez

Nov 30, 2022 7:43pm
| 
Last reply Dec 4, 2022 8:06pm

Reply from Rafael Carlos Martinez

According to Healthy People 2030, approximately 1 in 10 people within the United States do not have health insurance, which significantly limits their access to healthcare services. Access to quality healthcare, is in of itself a social determinant of health (U. S. Department of Health and Human Services, 2022). President Obama addressed this issue directly when he passed the Affordable Care Act in 2010, which provided financial assistance to improve access to healthcare for millions of Americans who previously could not afford health insurance through state and federally funded marketplaces (Patient Protection and Affordable Care Act, 2010). The Affordable Care Act also improved access to healthcare by ensuring that health insurance companies could not deny coverage for individuals who have pre-existing health conditions (Patient Protection and Affordable Care Act, 2010). President Biden also improved access to healthcare for our nation’s veteran population through the Health Care for Burn Pit Veterans Act which became law this year. This legislation improved access to healthcare for veterans who were exposed to toxic burn pit fumes while deployed overseas during the Global War on Terrorism. Prior to this legislation, veterans like myself who were exposed to toxic burn pit fumes had to go through a lengthy process to prove that our health problems were caused by these toxic burn pits. This legislation expanded the list of presumptive positive conditions associated with burn put exposure to include a myriad of health care problems, including a number of different kinds of cancer, and extended VA eligibility periods for these individuals who had previously been denied care under the previous guidelines.

In terms of what I would have done differently, I don’t think I would amend anything regarding the Affordable Care Act. It did have the unintended consequence of increasing health care premiums across the country for many individuals, but I am not sure how this could have been prevented through the legislation. I would, however, have worked to pass legislation improving access for veterans exposed to toxic burn pits a decade ago. Toxic burn pit exposure was a known problem that the VA and the Department of Defense refused to take responsibility for, and as a result many veterans died before they were able to receive any healthcare related to their burn pit exposure. I personally had friends and comrades who died from burn pit associated cancer that the VA denied was service related for years. In my opinion, this was an incredible disservice to our veterans who have sacrificed so much for our country.

References:

H.R.3590 – 111th Congress (2009-2010): Patient Protection and Affordable Care Act. (2010, March 23). 
https://www.congress.gov/bill/111th-congress/house-bill/3590
Links to an external site.

S.3541 – 117th Congress (2021-2022): Health Care for Burn Pit Veterans Act. (2022, February 18). https://www.congress.gov/bill/117th-congress/senate-bill/3541

The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. (2017). 
Annual Review of Public Health
, 
38
, 489. 
https://doi.org/10.1146/annurev-publhealth-031816-044555
Links to an external site.

S. Department of Health and Human Services. 2022. 
Healthy People 2030
: 
Health Care Access and Quality. 
Retrieved November 30, 2022 from https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality

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Rachel Butcher

Nov 30, 2022 5:36pm
| 
Last reply Dec 2, 2022 5:10pm

Reply from Rachel Butcher

There are so many different issues in America that are addressed at the presidential level. Some of the issues that America tries to help prevent or reduce are HIV, mental health problems, the opioid epidemic, pandemics, obesity, and prescription drug prices. All these issues are addressed on the presidential level by people trying to correct them. The issue that I want to talk about on a presidential level is opioid drug abuse and how the American president has tried to fix it.

President Biden sent his Administration’s inaugural National Drug Control Strategy to Congress. This was when drug overdose had reached its record high. The goal was to access evidence-based prevention, treatment, recovery, and harm reduction. The plan is to help reduce the drug supply of fentanyl. Biden wanted to treat drug addiction like any other disease. Biden’s plan is to help prevent drug trafficking and stop delivery routes, supply chains, and actions happening on the internet. President Biden wants to beat the overdose epidemic. (
President Biden Releases National Drug Control Strategy to Save Lives, Expand Treatment, and Disrupt Trafficking
, 2022). In 2018, almost 68,000 Americans died from drug overdoses; of those 68,000 Americans, 47,000 were involved with opioids. Bidens wants to ensure Americans access good quality healthcare, including substance use disorder treatment plans and mental health services in their healthcare. Biden’s plan is to hold the pharmaceutical companies because of their role in the opioid crisis and wants to make recovery services and effective prevention services available.  Biden has invested $125 billion in federal investments toward opioid treatment and helped prevent overprescribing medication while ensuring the needed pain management was available. (
The Biden Plan to End the Opioid Crisis
, 2022).

 

President Trump, on March 29, 2017, signed an Executive Order for Combating Drug Addiction and Opioid Crisis. Five meetings were held in 2107 going over the Addiction Policy Forum, young people in recovery, the National Council on Alcoholism, Drug Dependence, Community Anti-Drug Coalitions of America, and Partnership for Drug-Free Kids. (
President’s Commission on Opioids
, n.d.). President Trump has stated that there are $1.8 billion dollars in grants to prevent people’s lives from being taken by overdose and to help stop the opioid crisis.  There is also another $900 million going toward the research in overdoses for treatment and improving overdose data through the Center for Disease Control and Prevention. During President Trump’s running the country, there had been almost 5,000 pounds of fentanyl stopped along the border in one year. President Trump had 3,000 high areas of drug trafficking stopped, along with money laundering organizations. When President Trump was in office, he provided Americans with education about how dangerous opioid misuse was. He had organizations called  The Office of National Drug Control Policy along with the Truth Initiative partner to educate the youth about the misuse of opioids. By January 2017, there was a 31 percent decrease in the number of opioids that were prescribed. During the first two years President Trump was in office, and there was a 28 percent decrease in the number of veterans on opioids by the Department of Veterans Affairs. There were more efforts in providing supplies of naloxone to help prevent Americans from losing their lives to overdose. Kentucky, New Hampshire, West Virginia, Pennsylvania, and Ohio were most affected by people overdosing. There was a 5% decrease Nationwide in drug overdoses between 2017 and 2018. The drug overdose levels had decreased by 8 percent in West Virginia, 10 percent in New Hampshire, 24 percent in Pennsylvania, 16 percent in Kentucky, and 24 percent in Ohio. There was a decrease in American drug misuse by 11.4 million in 2017 to 10.3 in 2018. (
President Donald J. Trump Has Dedicated His Administration to Fighting Back against the Opioid Crisis
, 2019).

I agree with what both presidents were trying to achieve by reducing drug overdose to help save American lives. When it comes to educating Americans on drug addiction, there also needs to be more facts about how people will eventually turn to IV drugs to get their fix. Once that happens, the sharing of needles will happen. That is how HIV gets spread and hepatitis. There needs to be more education for Americans on what the effects of misuse of drugs can cause if left untreated. There is more drug abuse in the low-income part of towns because of not having access to proper health care. People need education so they can learn prevention. Their local health departments can help them to get the proper health care. Having more nurse practitioners help with this also. People need to be educated on the resources available in their area to help avoid drug abuse. Both presidents focused more on drug treatment and how they stopped drug trafficking than on prevention. I think more attention should be put on prevention. My local health department provides a nurse practitioner for low-income people. They provide addiction prevention and information on how to get medical insurance. I believe this would help reduce or prevent opioid misuse.

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Marie V Licin-Valerius

Nov 30, 2022 5:07pm
| 
Last reply Dec 4, 2022 4:19pm

Reply from Marie V Licin-Valerius

NURS: 6050

Week 1 Discussion

It is almost apparent that every American President faces a crisis at work regarding various issues such as unlawful intimidation, catastrophic events, financial disasters, and political outrage. Some of the issues that have reached the presidential agenda level include controlling and managing infectious diseases. During the tenure of President George W Bush, the issue of HIV/AIDS was rampant. President Bush put much effort into the fight against HIV/AIDS across the world, especially in Africa (Green, 2021). Their efforts are commendable and recognized by both Democrats and Republicans. His efforts stood out among his father’s mixed cultures.

For example, during the reign of senior Bush, he signed two legislations to protect people with HIV-AIDS. One of the policies is the Individuals with Disability Act which ensures that disabled people suffering from HIV AIDS are not secluded. The other Act is Ryan White Comprehensive Aids Assets Emergency Act which helps to offer sick people funds for their treatment. Although the initiative was good and President Bush put much effort, he was still criticized because he declined to sign a policy that would have prevented individuals suffering from HIV AIDS from getting into the nation (Green, 2021).

In addition, he created the President’sPresident’s Emergency Plan for HIV/AIDS Alienation (PEPFAR) for efficiently handling the pestilence. The program was the most popular worldwide and was a satisfactory component of the Bush Administration. Since it started, PEPFAR has used over 80 billion dollars in preventing, treating, and researching HIV/AIDS (Jacobson, 2020). Therefore, it is the most significant global health initiative focusing on a single disease across history. The initiative is popular because it has saved many lives, especially in sub-Saharan Africa.

Shortly after PEPFAR was established in 2003, there was an outbreak of severe acute respiratory syndrome (SARS). The President requested that SARS be added to the infectious disease category that can cause segregation of people. Over 8,000 people were affected by SARS, and around 775 died in 2003 (Roussel et al., 2020).

Similarly, President Barack Obama had to deal with health issues concerning infectious diseases. However, during his tenure, the prevalent infectious diseases were not SARS and HIV but Ebola and Zika. During his reign, an Ebola outbreak killed more than 11,000 people in West Africa (Ostergard Jr, 2020). In July 2014, President of Barack Obama established an emergency operations center to offer specialized help, such as deploying people to West Africa to respond to the situation. The initiative facilitated training more than 25,000 Clinical services personnel in West Africa to help manage and prevent Ebola (Ostergard Jr, 2020).

Like President Bush, President Obama was criticized for not signing the law preventing all infected people from coming to the U.S. President Obama also received a backlash from Republicans for not imposing travel restrictions from nations with Ebola outbreaks. However, only 11 people all over the United States have been treated for Ebola (Ostergard Jr, 2020). His failure to impose travel restrictions did not expose the Americans to significant risks.

Shortly after the struggles with Ebola, Obama also battled with the zika insect that spread the infectious virus. The zika outbreak in 2015 originated in Brazil, and by the end of 2016, around 40,000 cases had been reported across the United States (Grillet et al., 2019). To fight zika, President Obama’s administration allocated 1.9 billion Dollars as an emergency fund. Around $1.1 billion of the budget was ratified by Congress. Another critical initiative during President Obama’s tenure is establishing a health safety and biodefense Unit. The organization’s main aim was to take responsibility for pandemic preparedness (Grillet et al., 2019).

References

Green, A. (2021). A history of US engagement in the HIV/AIDS response. 
The Lancet
, 
398
(10315), 1956-1957. https://doi.org/10.1016/S0140-6736(21)02540-X

Grillet, M. E., Hernández-Villena, J. V., Llewellyn, M. S., Paniz-Mondolfi, A. E., Tami, A., Vincenti-Gonzalez, M. F., & Alarcón-de Noya, B. (2019). Venezuela’s humanitarian crisis, resurgence of vector-borne diseases, and implications for spillover in the region. 
The Lancet Infectious Diseases
, 
19
(5), e149-e161.

Jacobson, L. E. (2020). President’s Emergency Plan for AIDS Relief (PEPFAR) Policy Process and the Conversation around HIV/AIDS in the United States. 
Journal of Development Policy and Practice
, 
5
(2), 149-166.https://doi.org/10.1177/2455133320952210

Ostergard Jr, R. L. (2020). The West Africa Ebola outbreak (2014-2016): a health intelligence failure?. 
Intelligence and National Security
, 
35
(4), 477-492. https://doi.org/10.1080/02684527.2020.1750136

Roussel, Y., Giraud-Gatineau, A., Jimeno, M. T., Rolain, J. M., Zandotti, C., Colson, P., & Raoult, D. (2020). SARS-CoV-2: fear versus data. 
International journal of antimicrobial agents
, 
55
(5), 105947. https://doi.org/10.1016/j.ijantimicag.2020.105947

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Nchetaka Okeke

Nov 30, 2022 5:03pm
| 
Last reply Dec 2, 2022 9:30pm

Reply from Nchetaka Okeke

Presidential Agendas

Mental Health Issues

A quarter of adult Americans report experiencing emotional distress or having a mental health disorder like depression or anxiety. People with mental health issues are much more likely to experience various health issues and difficulties, such as substance abuse and chronic diseases like diabetes and heart disease (Milstead & Short, 2019). Spending on healthcare for adults with chronic illnesses and mental health conditions is nearly three times higher than for adults with chronic illnesses only. Generally, Americans have some of the worst outcomes related to mental health, including the highest rate of suicide and the second-highest rate of drug-related deaths among high-income nations.

Social Factors That Impact Mental Health

Age, educational accomplishment, gender, income, place of residence, sexual orientation, and a few more variables have all been linked to mental health. Other social factors, such as family and community dynamics, social support, housing quality, employment opportunities, and working conditions, can have a good or negative impact on mental health outcomes and risk (Milstead & Short, 2019). For example, safe public spaces for social gatherings, such as churches and recreational areas, might be beneficial for mental health. Maintaining and enhancing the mental health of all Americans requires a thorough understanding of these social elements, their effects, and how they interact.

The management of mental health issues by two recent presidents

The year 2018 saw the launch of President Donald Trump’s Law Enforcement Mental Health and Wellness initiative, which provided funding for initiatives for the mentally ill. He also signed a bill creating a national suicide hotline (Conley & Baum, 2022). Additionally, President Trump provided more than $700 million in funding for mental health services and initiatives in 2019. He advocated for treating people with mental health disorders in public and community hospitals (Conley & Baum, 2022). President Trump also prioritized decreasing suicides among veterans, and he issued an executive order urging campaigns to boost public awareness of mental health issues and financing research into suicide prevention.

President Biden, on the other hand, presented the nation’s mental health problems as a problem with broad bipartisan support and unveiled a determined plan to solve them. The plan’s main objectives are to increase system capacity and link those who require assistance to a continuum of care (The White House. 2022). It includes initiatives to increase the number of mental health professionals, work to build an emergency response system to support the launch of the 988-emergency hotline, a focus on children’s mental health, and proposals to pressure insurance companies to improve their behavioral health care coverage. Every health plan will be required by the Biden administration to include comprehensive behavioral healthcare services.

What I would change in the future

The absence of sufficient resources for treating mental health illnesses remains a major concern, notwithstanding the presidents’ various mental health programs. Naturally, this delays patient care. Frequently, people with mental health issues wind up being admitted to facilities outside of their home states without the support of friends or family. Furthermore, many persons who struggle with substance misuse wind up in psychiatric hospitals rather than facilities or programs that cater to their needs (Everett et al., 2019). Therefore, I would make changes by implementing more outreach and mental health treatment programs to increase the accessibility to these services. Additionally, I would guarantee that everyone has access to mental health care and advise states to increase the number of facilities for both substance misuse and mental health treatment.

References

Conley, D. L., & Baum, M. J. (2022). Predictors of structural stigma in state mental health legislation during the Trump administration. 
Social Work in Mental Health, 36
(12), 1-27. 
https://doi.org/10.1080/15332985.2022.2062272
Links to an external site.

Everett, A., Lee-Tauler, S. Y., & Bommersbach, T. (2019). Community and public mental services in the United States. Public Mental Health, 28(09), 417-438. 
https://doi.org/10.1093/oso/9780190916602.003.0016
Links to an external site.

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

The White House. (2022, March 1). 
FACT SHEET: President Biden to announce strategy to address our national mental health crisis, as part of unity agenda in his First State of the union. 
Retrieved August 28, 2022, from 
https://www.whitehouse.gov/briefing-room/ststements-releases/2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-state-of -the-union/
Links to an external site.

 

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Nchetaka Okeke

Nov 30, 2022 4:51pm
| 
Last reply Dec 1, 2022 6:46pm

Reply from Nchetaka Okeke

Presidential Agendas

Mental Health Issues

A quarter of adult Americans report experiencing emotional distress or having a mental health disorder like depression or anxiety. People with mental health issues are much more likely to experience various health issues and difficulties, such as substance abuse and chronic diseases like diabetes and heart disease (Milstead & Short, 2019). Spending on healthcare for adults with chronic illnesses and mental health conditions is nearly three times higher than for adults with chronic illnesses only. Generally, Americans have some of the worst outcomes related to mental health, including the highest rate of suicide and the second-highest rate of drug-related deaths among high-income nations.

Social Factors That Impact Mental Health

Age, educational accomplishment, gender, income, place of residence, sexual orientation, and a few more variables have all been linked to mental health. Other social factors, such as family and community dynamics, social support, housing quality, employment opportunities, and working conditions, can have a good or negative impact on mental health outcomes and risk (Milstead & Short, 2019). For example, safe public spaces for social gatherings, such as churches and recreational areas, might be beneficial for mental health. Maintaining and enhancing the mental health of all Americans requires a thorough understanding of these social elements, their effects, and how they interact.

The management of mental health issues by two recent presidents

The year 2018 saw the launch of President Donald Trump’s Law Enforcement Mental Health and Wellness initiative, which provided funding for initiatives for the mentally ill. He also signed a bill creating a national suicide hotline (Conley & Baum, 2022). Additionally, President Trump provided more than $700 million in funding for mental health services and initiatives in 2019. He advocated for treating people with mental health disorders in public and community hospitals (Conley & Baum, 2022). President Trump also prioritized decreasing suicides among veterans, and he issued an executive order urging campaigns to boost public awareness of mental health issues and financing research into suicide prevention.

President Biden, on the other hand, presented the nation’s mental health problems as a problem with broad bipartisan support and unveiled a determined plan to solve them. The plan’s main objectives are to increase system capacity and link those who require assistance to a continuum of care (The White House. 2022). It includes initiatives to increase the number of mental health professionals, work to build an emergency response system to support the launch of the 988-emergency hotline, a focus on children’s mental health, and proposals to pressure insurance companies to improve their behavioral health care coverage. Every health plan will be required by the Biden administration to include comprehensive behavioral healthcare services.

What I would change in the future

The absence of sufficient resources for treating mental health illnesses remains a major concern, notwithstanding the presidents’ various mental health programs. Naturally, this delays patient care. Frequently, people with mental health issues wind up being admitted to facilities outside of their home states without the support of friends or family. Furthermore, many persons who struggle with substance misuse wind up in psychiatric hospitals rather than facilities or programs that cater to their needs (Everett et al., 2019). Therefore, I would make changes by implementing more outreach and mental health treatment programs to increase the accessibility to these services. Additionally, I would guarantee that everyone has access to mental health care and advise states to increase the number of facilities for both substance misuse and mental health treatment.

References

Conley, D. L., & Baum, M. J. (2022). Predictors of structural stigma in state mental health legislation during the Trump administration. 
Social Work in Mental Health, 36
(12), 1-27. 
https://doi.org/10.1080/15332985.2022.2062272
Links to an external site.

Everett, A., Lee-Tauler, S. Y., & Bommersbach, T. (2019). Community and public mental services in the United States. Public Mental Health, 28(09), 417-438. 
https://doi.org/10.1093/oso/9780190916602.003.0016
Links to an external site.

The  White House. (2022, March 1). 
FACT SHEET: President Biden to announce strategy to address our national mental health crisis, as part of unity agenda in his First State of the union. 
Retrieved August 28, 2022, from 
https://www.whitehouse.gov/briefing-room/ststements-releases/2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-state-of -the-union/
Links to an external site.

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

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Holly Anne Mayes

Nov 30, 2022 1:48pm
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Last reply Nov 30, 2022 3:30pm

Reply from Holly Anne Mayes

Consider a population health topic that rises to the presidential agenda level. Which social determinant most affects this health issue? How did two recent presidents handle the problem? What would you do differently?

 

I live in New Mexico, and while there are many population health topics I could discuss, the opioid epidemic is truly rampant here. With the cartels sending it over the border in droves, our local news has reported that we have seen a 900% increase in Fentanyl alone our state over the last few years. According to (Murray, 2019), “Millions of Americans are impacted by the opioid crises.” People are dying at alarming rates due to opioid overdoses. Drug abuse has crippled our neighborhoods and communities for decades and continues to be on the rise.” The opioid epidemic has so many crucial impacts that it is a significant population health issue that will continue to rise to the presidential agenda level with each new president. With growth rates of 900% in some areas of the United States and no signs of slowing down, it is easy to see why. Education, poverty, and mental health are all social determinants of health that have factored into the opioid epidemic.

President Obama signed the very first Bipartisan bill that addressed the opioid epidemic. On July 22, President Barrack Obama signed the Comprehensive Addiction and Recovery Act, the first of its kind to offer a multifaceted federal response to the prescription opioid and heroin epidemic ravaging communities across the United States (Reilly, 2016). The purpose of this bill was to combat the misuse of opioids and ensure that people have access to effective treatment.

According to (Ending America’s Opioid Crises, The White House) “President Trump’s Initiative to Stop Opioid Abuse, unveiled in 2018, confronting the driving forces behind the opioid crises”. President Trump saw education as a critical piece of addressing the opioid problem and allocated funds to support education efforts. Next, he wanted to address how the drugs were coming into the U.S. he believed that building the wall between the U.S. and Mexico would help decrease drugs crossing the border. Finally, President Trump pushed for more treatment centers to address the growing number of Americans who had become addicted and were seeking help.

As opioid addiction has continued to grow and become a more pronounced issue that many Americans face, I am thankful for the support our Presidents have shown in trying to address it. I believe there is more we can do, starting with mental health. We continue to see a link between drug use and mental health. I genuinely believe it is time to dedicate suitable funds and resources to help address the opioid problem from a mental health standpoint: more treatment options and facilities and more coverage for patients seeking treatment.

                                                                                                               References

Murray, K. (2019).Racial Disparities in Opioid Addiction Treatment in Black and White Populations. Retrieved June 1, 2020, from https.//www.addictioncenter.com/news/2019/10/racial-disparities-opioid-addiction-treatment/

Ending America’s Opioid Crises|The White House,(2020). The White House. Retrieved June 1, 2020, from https://www.whitehouse.gov/opioids/

Reilly, K., (2016). President Obama Signs Bipartisan Bill to Combat Opioid Epidemic. Retrieved on June 1, 2020, from https://www.pewtrusts.org/en/research-and-analysis/articles/2016/07/22/president-obama-signs-bipartisan-bill-to-combat-opioid-epedimic

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Anna Fortenberry Williams

Nov 30, 2022 12:58pm
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Last reply Dec 3, 2022 7:12pm

Reply from Anna Fortenberry Williams

 

Prescription drug costs are astronomical and rob Americans of the ability to maintain health. The cost of prescriptions continues to skyrocket, and people’s health continues to decline. Overuse of the emergency room due to inability to afford medications. The cost of healthcare as a whole continues to increase and one way to correct this is to get patients preventative and maintenance care before an acute exacerbation of chronic illness.

 

Trump and Biden have made attempts to address this issue, although the proposal will likely not help. Healthcare is just simply not affordable. (Meller & Ahmed, 2019) Biden believes an affordable help care act could reduce the cost of healthcare. This act will allow Americans to obtain affordable health care. While health care may be more affordable the quality will be worse. (Office, 2022) The cost of drugs is driven by the gain from drug companies. Big Pharma will not let its profit margin suffer; therefore, the cost will forever be escalating. (Meller & Ahmed, 2019) Biden has an agenda to continue to address this issue, but nothing as of now has been effective and we are still at a standstill. (House, 2022)

 

I am not certain there is a solution or a way I would handle it better. The structure of health care is not benefiting the providers or patients. We hand out a lot of free healthcare and we practice liability medicine due to providers’ fear of being sued. The problem in health care is we do too much. If I were to fix the problem, I would shave off over half the health care we provide. Million-dollar work ups in the ER over and over again drives the costs up. I would reduce the use of medical resources and only order what is necessary for patients.

 

Resources

 

Office, A. P. (2022, September 29). 
Biden-Harris Administration Announces Lower Premiums for Medicare Advantage and Prescription Drug Plans in 2023
. HHS.gov. 
https://www.hhs.gov/about/news/2022/09/29/biden-harris-administration-announces-lower-premiums-for-medicare-advantage-and-prescription-drug-plans-in-2023.html
Links to an external site.

 

‌Meller, A., & Ahmed, H. (2019, August 30). 
How Big Pharma Reaps Profits While Hurting Everyday Americans
. Center for American Progress. 
https://www.americanprogress.org/article/big-pharma-reaps-profits-hurting-everyday-americans/
Links to an external site.

 

‌House, T. W. (2022, October 14). 
Executive Order on Lowering Prescription Drug Costs for Americans
. The White House. https://www.whitehouse.gov/briefing-room/presidential-actions/2022/10/14/executive-order-on-lowering-prescription-drug-costs-for-americans/

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Stephen Blickley

Nov 30, 2022 12:42pm
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Last reply Dec 2, 2022 3:51pm

Reply from Stephen Blickley

One thing I have noticed throughout my career as a nurse is how difficult our healthcare system is to navigate. Even for nurses working within their own healthcare system, maximizing what they can get for their patients is difficult. Without assigning responsibility for this, it is easy to see why your average joe has issues doing everything that is asked of them by healthcare professionals. As a nurse that works in home health, I am provided with a unique perspective of just how poorly healthcare facilities do with discharging and educating patients to succeed in the home environment. This isn’t the facilities’ faults, but the fact is if we were able to improve that portion of the process, I think we would see huge improvement in patient outcomes. One huge issue facing providers trying to do right by their patients is the price of prescription drugs and how they vary depending on the patient’s coverage. This issue results in different people paying outrageous prices for medications while others pay nothing. As a home health nurse, there have been numerous times I have been forced to help a patient budget what medications they can take instead of taking them as ordered.

One thing President Trump did to address this concern was met with some controversy but was aimed at reducing drug costs across the board. He signed an executive order on September 13, 2020 with the aim at aligning our drug prices with the best offered across the globe (Mulaney, 2020). While this sounds good on paper, it wasn’t successful and not held up in courts. I believe part of the reason for it’s lack of success was related to the added costs our country incurs related to all the testing we conduct. A drug might cost cheaper elsewhere, but it also might not test to the point that it is as safe as drugs we manufacture and distribute.

Current President Biden’s approach was more direct and has me feeling more optimistic. In October, Biden announced the plan to allow Medicare to negotiate directly with pharmaceutical companies for the first time and cap the out-of-pocket expenses for those on medicare at $2,000 a year (Whitehouse.gov, 2022). This has me excited because a lot of people are paying over that in co pays yearly, often for one medication. An example of this that I personally experienced when I was prescribed Xarelto, my insurance wanted me to pay $500. Luckily, I was able to apply for a program through the manufacturer to get that largely discounted, but last time I checked that program wasn’t available for those on Medicaid and medicare. I often have patients who thought they had great coverage end up paying close to what I did for their Xarelto, and they can’t get it discounted due to their status. If I were President I would make sure that everyone has the same prices for medications universally. I also would make sure that people didn’t lose insurance coverage if they were unemployed. Hopefully that would help our most vulnerable populations.

 

President Trump Signs Executive Order on prescription drug pricing
. AAMC. (2020, September 18). Retrieved November 30, 2022, from https://www.aamc.org/advocacy-policy/washington-highlights/president-trump-signs-executive-order-prescription-drug-pricing

The United States Government. (2022, October 14). 
Fact sheet: President Biden takes action to lower health care and prescription drug costs for Americans
. The White House. Retrieved November 30, 2022, from https://www.whitehouse.gov/briefing-room/statements-releases/2022/10/14/fact-sheet-president-biden-takes-action-to-lower-health-care-and-prescription-drug-costs-for-americans/