Policies impact the world we live in different ways. They influence how clean the air is, the education our children receive, who participates in our political system, how good our health care is, among other things. Most importantly, public policy can promote either equality or inequality through its design, its actors and agenda. An example of such is the presence of gender gaps in politics which can be solved through policies that implement gender quotas in order to break down gender stereotypes both within the political class and among voters. Thus, proving how public policy can promote a gender equality and access of women into positions of government. Adversely, public policy can also boost inequality. Particularly, based on the distribution …show more content…
dimensions that are chosen within the policy process by identifying the recipients, the items and the process. (Stone, 2002) The challenges that contribute to inequality among public policy consist of choosing the criteria that makes the recipient eligible, how to distribute the items in a fair way and the process by which they are addressing the problem or issue. To look at this closely, the United State health care system can demonstrate how public policy can include and exclude many.
At present, the healthcare system includes two programs, Medicare and Medicaid, and both have different policy designs. Medicare has a universal design, although it is just for the elderly. It guarantees that all seniors in the U.S. receiving social security will have access to it. Furthermore, Medicare has a two-part scheme, A and B. Part A corresponds to the plan for hospital care, the short-term nursing care, the home health care and the hospice care. Also, part A is paid by the working class through taxation. While part B, corresponds to the insurance plan, which is funded by the federal and state government. This part of the programs pays for doctors and outpatient medical costs. The other component of the health care system consists of the Medicaid program which is a targeted insurance plan administered by states and localities. The targeted population are the elderly and the dependents (mothers, disabled and children), which have weak power but a positive construction. (Schneider and Ingram, 1993). Nonetheless the way that the Medicaid program is structured, in which the States have the power to decide who is eligible or who is excluded from the program, significantly alters equality and a fair …show more content…
distribution. Thus, uplift large inequalities among recipients depending on their geographical area because although the federal government requires who is eligible below a certain income, States establish the criteria of who qualifies.
For example, States like Illinois, Texas or Michigan have a high percentage of pregnancy-related deaths, high infant mortality rate and most preventable hospitals deaths. As a result, they have a common denominator which is that a big portion of their population aren’t insured. In States like the ones previously mentioned, numerous citizens are not eligible to have insurance from the government and don’t have the economic resources to rely on the private sector. Consequently, not having Medicaid or private insurance leads to purveyor inequality among citizens. This outcome is related partly to the distribution criteria of the Medicaid program and the policies that the state government establishes. For example, a person who is not able to get Medicaid in Texas, can be eligible in California to get the same policy benefits. This variation structure and design clearly explains the extent of how the health policy in the U.S. is
unequal. Furthermore, because of the distribution criteria many people are suffering and dying. In the United States the insurance access and funding for mothers is very low and because of it many mothers, especially African-American women, are not fully covered to get the right and fair medical treatment they need. What is mostly proven in the alarming rates and news is that the members of the same target population are not being treated equally. The data shows how, although the targeted population (mothers) is the same, the members (White and African-American) are not been treated the same, thus leads to undermine equality. Maternal mortality rates in New York State is a perfect example of how racial disparities is affecting black African-American mothers. The same case goes with other Medicaid beneficiaries, because although they are targeted to the same population (disabled, mothers and children) the eligibility varies by State and purveyor’s inequality. As Michener research demonstrates, some people move to other States because they aren’t eligible to access Medicaid in the current State they reside. Thus, this health policy measures that vary by state marginalized and oppressed gravely. A potential policy change to reverse the outcome of this program can be accomplished by expanding eligibility and funding for Medicaid. In 2010 the Patient Protection and Affordable Care Act (ACA) was enacted as a policy reform to the health care system. Thus, it evidently, increased access to preventative services and decrease the uninsured rate of women (18-64 down). However, the Supreme Court decided that States are open to decide the expansion of the program. This policy reform demonstrates that increasing funding in health policy is a way to address inequality, but at the same time shows that the variation of States to decide the eligibility criteria endangers beneficiary’s lives. Moreover, examining the cases of high maternal mortality in the United States proves how policy can diminish the low outcomes by increasing funding to mitigate the information and data deficit, guarantee the access of healthcare providers, postpartum care and improve the coordination in the Health Department. Furthermore, shows how policy can promote equality in different ways in maternal mortality. For example, it can require review boards in all states to alleviate the information and data deficit. It can also mitigate the racial bias through education and standardized protocols or toolkits for health providers in order to require and guarantee the same treatment to every women. Also, policy actors in the state and local level can incentives and promote that the federal government enacts laws that benefit more people. Most importantly, federal government can regulate that all states amplify their coverage by increasing funding. As other wealthy and developed countries have done it, I suggested that the United State Health Care System has to shift to a universal policy design. In order to make a substantive policy change, having a universal design will reform the U.S. healthcare system and expand funding for the Medicaid program more broadly. Furthermore, it guarantees equal access to equal care to help reverse the outcomes of an unequal policy. It’s not a news that the healthcare system of the U.S. has failed many citizens throughout the years. For that reason, health care needs to guarantee equitable access, without discriminating by qualification requirements. More so, it has to be accessible for everyone, no matter their geographical area. The quality of the healthcare needs to be guarantee by standards and protocols through transparency and accountability. Also, it has to provide a high-quality patient and health provider relationship by taking in account cultural factors. Finally, the services have to be provided without discrimination of sex, race, religion, income or language. In one of the wealthiest country in the world, the need to continuing pressuring the government for a health care system reform to guarantee the life of its citizens shouldn’t be an issue. The United States is the only developed country that doesn’t have a universal design health system. Most importantly, health care shouldn’t be based on neediness or qualification. If a person is sick, pregnant, or in need of a surgery, a vital instrument they need to have to save their life is a good and affordable insurance and the only way to guarantee this is through public policy.
The leadership’s decision not to expand Medicaid leaves between 300,000 and 400,000 South Carolinians without health insurance (South Carolina Medical Association, 2012). The stated intent of the Affordable Care Act, pejoratively dubbed “Obamacare” by its critics, was to put affordable health care within reach of more of the 40 million Americans who lacked health insurance. The law’s grand design included an assumption that states would expand their Medicaid programs, since the federal government would pay 100 percent of the expansion costs through 2016, and 90 percent thereafter. But in demonstrating its traditional mistrust of Washington’s promises, Columbia declined the offer and, in the process, left thousands of low-income workers without the means to obtain health coverage, either because they cannot afford the premiums or because their employers do not provide it. (Advisory Committee, 2013). Ironically, in a state where the median annual income is $44,600, South Carolina’s working poor earn too much money to qualify for Medicaid; however, they would be covered under the ACA model (Hailsmaier and Blasé, 2010).
One of the most controversial topics in the United States in recent years has been the route which should be undertaken in overhauling the healthcare system for the millions of Americans who are currently uninsured. It is important to note that the goal of the Affordable Care Act is to make healthcare affordable; it provides low-cost, government-subsidized insurance options through the State Health Insurance Marketplace (Amadeo 1). Our current president, Barack Obama, made it one of his goals to bring healthcare to all Americans through the Patient Protection and Affordable Care Act of 2010. This plan, which has been termed “Obamacare”, has come under scrutiny from many Americans, but has also received a large amount of support in turn for a variety of reasons. Some of these reasons include a decrease in insurance discrimination on the basis of health or gender and affordable healthcare coverage for the millions of uninsured. The opposition to this act has cited increased costs and debt accumulation, a reduction in employer healthcare coverage options, as well as a penalization of those already using private healthcare insurance.
Senator Scott Brown a Republican from Massachusetts stated that: “States shouldn 't be forced by the federal government to adopt a one-size-fits-all health care plan; each state 's health care needs are different”. Senator Brown has a very good point, the ACA healthcare program does not fit the differentiating needs of the different states, and each state has different factors that go into the roles of their healthcare programs. Thomas Miller, a resident fellow at the American Enterprise Institute also has opposing viewpoints toward the relationship between the Affordable Care Act and state healthcare programs. “Miller says the ACA will undermine the development of free-market dynamics in the health insurance field and force states to accede to federal dictates. At first, he says, states may be able to shape their own insurance exchanges through which people purchase health coverage. But that is simply because Washington made certain “concessions” to the states to induce them to back the law, he says. Once the new health regime is deeply rooted, he predicts, “the long-term dynamics will very much have Washington in control rather than having open markets.”” (Clemmitt, Assessing the New Health Care
The United States spends vast amounts on its healthcare, while falling short of achieving superiority over other developed nations. One cannot overlook that the deepening recession has left many without jobs and therefore lacking health insurance. According to Fairhall and Steadman, (2009), even though the recession is hard on all, it is worse on the uninsured due to health care and insurance cost rising faster than incomes. Nevertheless, even those with jobs are lacking in health insurance due to employers, who provide insurance, are increasingly dropping their sponsored insurance. Many find that purchasing a health policy or paying for medical care out-of-pocket is cost prohibitive. “Since the recession began in December 2007, the number of unemployed Americans has increased by 3.6 million,” (Fairhall & Steadman, 2009). In 2009 it was stated that approximately 46 million Americans were uninsured, however not all of that number is due to the inability to afford coverage. According to a 2009 story written by Christopher Weaver of Kaiser Health News, 43% of that number should be classified as “voluntarily” uninsured. This subset of uninsured Americans consist of nearly half being young and healthy; therefo...
In recent years, the number of Americans who are uninsured has reached over 45 million citizens, with millions more who only have the very basic of insurance, effectively under insured. With the growing budget cuts to medicaid and the decreasing amount of employers cutting back on their health insurance options, more and more americans are put into positions with poor health care or no access to it at all. At the heart of the issue stems two roots, one concerning the morality of universal health care and the other concerning the economic effects. Many believe that health care reform at a national level is impossible or impractical, and so for too long now our citizens have stood by as our flawed health-care system has transformed into an unfixable mess. The good that universal healthcare would bring to our nation far outweighs the bad, however, so, sooner rather than later, it is important for us to strive towards a society where all people have access to healthcare.
The author also believes that the Medicaid expansion extends beyond the politics, and has an aim to impact the life, health, and financial stability for the state and individuals. Medicaid expansion can be beneficial to many countries that have a large proportion of low-income people that are uninsured and or with disabilities. This can aid in saving the state money because much of the cost is provided and covered by the federal government, that encourages healthier behavior and results to a reduction in chronic disease due to lower health care costs. Although Texas opted out in adopting the expansion, legislators should decide on the advantage and disadvantage of participating in the Medicaid expansion to improve the welfare of the state. The expansion of Medicaid coverage will give low-income pregnant women the chance to reduce the rate in infant mortality and provide an opportunity for those that were unable to get coverage to be
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Medicaid is a broken system that is largely failing to serve its beneficiary’s needs. Despite its chronic failures to deliver quality health care, Medicaid is seemingly running up a gigantic tab for tax payers (Frogue, 2003). Medicaid’s budget woes are secondary to its insignificant structure, leaving its beneficiaries with limited choices, when arranging for their own health care. Instead, regulations are set in order to drive costs down; instead of allowing Medicaid beneficiaries free rein to choose whom they will seek care from (Frogue, 2003)
The major way through which sexism and heterosexism shape social welfare policy is by generating issues that need to be protected or helping in identification of needs to be met. These issues and needs in turn become the backbone through which social policy are formulated in order to enhance the well-being of every individual and group in the society for better functioning of societal members.
From the baby Boomer generation, to the young adults just entering the work force for their first time, everyone will have the opportunity to access health care, some for the first time in their lives. Obama Care is an affordable choice for those who need it. When choosing a plan that is right for you, several options are available. “The marketplace allows individuals and small businesses to compare health plans on a level playing field.” (Key Features of ACA by year) With these baseline individuals are able to pick a plan, which is affordable for their lives. In addition to those who select their coverage, there is a separate plan for the population of Americans who are 65 years or older. This plan is known as Medicare. As with every insurance company, Medicare has separate breakdowns plans, to which coverage is not determined by your income. Medicare is an insurance plan for the baby Boomer generation. Robert B. Reich addresses the baby Boomer generation in his essay “Why the Rich Are Getting Richer and the Poor, Poorer” In the essay Reich was able to address the growth of our nation as a metaphor of boats rising and falling. This quote describes how workers in the twenty first century will be responsible for the Baby Boomer’s standard of living. He
... more prone to chronic illnesses. As for Medicaid, it needs to improve its chronic care management. Chronic care management should be made more affordable to those with chronic illnesses (Baicker, Katherine, & Amy Finkelstein, 2011). This way, the program will be more beneficial to more people. The program should also introduce, and support home and community based services. Providing care in home settings will be much cheaper than nursing homes. Moreover, Medicaid needs to come up with customized beneficiary services. Patients’ needs are not equal. Therefore, Medicaid should be flexible enough to abandon the one size fits all mentality. Anyway, that notwithstanding, we cannot ignore the fact that Medicare and Medicaid have revolutionized healthcare in the United States. Giving credit where it is due, these two programs continue to save millions of helpless lives.
Health reform and health policy has taken over in the United States in recent years. Medicaid is one of the top policies being implemented throughout our nation today. To understand how Medicaid and federalism cross paths with each other one must understand the basic definitions and concepts each one brings. Federalism is “system of government in which the same territory is controlled by two levels of government. Generally, an overarching national government governs issues that affect the entire country, and smaller subdivisions govern issues of local concern.” In short, federalism is a government system that has an overseeing central government over state government. While, “Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid serves low-income parents, children, seniors, and people with disabilities.” Medicaid is a test based welfare program for United States Citizens. Now the question is how does Medicaid intersect with federalism? These two intersect because Medicaid is a need-based program that is funded by the federal government and the state government and administered at the state level. The issue with Medicaid is that if it expands then a crowding-out effect may occur. Meaning, that the more the government spends on Medicaid then less they would be able to spend on other programs such as: education, transportation, or other state priorities. Medicaid is supposed to provide access to health insurance for approximately half of our nations uninsured citizens. Without Medicaid a vast amount of low-income citizens will go without having a healthcare insurance plan.
Health care inequality has long been customary in the United States. Those in lower classes have higher morbidity, higher mortality, higher infant mortality, and higher disability. Millions of low-income families and individuals have gone with out the care they need simply because they cannot afford it. Denial of benefits due to pre-existing conditions, outrageous deductibles, and unreasonable prescription prices are in large part why the low-income class suffers. In addition, not receiving preventative health care, lack of access to exercise equipment and lack of availability to fresh foods all create health problems that become to expensive to fix. Low-income families need to have better, more affordable access to health care, specifically preventative health care, and be more educated about the benefits of health care in order to narrow the gap of inequality. The new Affordable Care Act under the Obama administration expands heath care coverage to many low income families and individuals by lowering the eligibility requirements for Medicaid, although it is not mandatory for individual states to make this expansion for Medicaid coverage.(CITE) It also requires that preventative health care be included in coverage by insurance companies. So with all the benefits the expansion of Medicaid could offer, why would some states choose not to offer it?
...ds & Gelleny, 2007). Moreover, the status of women is independent on policy adjustments in developing countries. Governments in developing countries should organize an economically and political stable environment, to be economically attractive (Maxfield, 1998 as cited in Richards & Gelleny, 2007). Other critics state governments are forced to cut expenditures in education and social programs. This phenomenon especially affects women (Ayres and McCalla, 1997, as cited in Richards & Gelleny, 2007). Since the public sector is one of the main employers of females, women are often the most disadvantaged by governmental efforts to cut expenditures in the public sector (Hemmati and Gardiner, 2004, as cited in Richards & Gelleny, 2007). As a result, women will become unemployed and unable to expanded education among themselves or their children. (Richards & Gelleny, 2007)
The implementation of gender quotas in electoral politics is a mean to combat the democratic deficit that occurs when a social group is excluded from the political sphere due to structural or cultural reasons. Quotas are a form of affirmative action/positive discrimination which is meant to remove the structural and cultural obstacles that keep women out of the formal political ...