NURS 6050 Week 1 Discussion: Presidential Agendas and Health Policy

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.

Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

COVID-19- Health Issue

A great deal of different health issues has risen to the presidential agenda level for decades. Various cases of health issues rise to the presidential level because of high significance and need for immediate resolution. The health topic of Covid-19 greatly rose to the presidential agenda level due to significant illness and death, which led to widespread lockdowns, and disruptions to global supply chains; severely impacting the economy (Anselm et al., 2021). This pandemic led to a combination of economic, public health, and political crisis. The covid-19 pandemic crisis dominated news cycles, putting pressure on the government to address the situation (Anselm et al., 2021). These factors combined to elevate COVID-19 to the level of a presidential agenda item, requiring direct leadership, policy development, and public communication.

I mpact of Social Determinants of Health

The social determinant of health that mostly affected Covid-19 pandemic was socioeconomic status. Social economic status intersects with many other factors, including access to healthcare, living conditions, and occupation. For instance, people with lower income levels often have limited access to healthcare, and during the pandemic it made it extremely difficult to get tested or receive timely treatment for COVID-19 (Garrett, 2023). During these times, economic pressure forced people to work even when sick, which was further spreading the viruses. Individuals in lower socioeconomic brackets were mostly living in crowded housing conditions, where social distancing was difficult (Garrett, 2023). This then increased the risk of transmission within households and communities. In addition, most citizens had jobs that required close physical proximity to others, increasing exposure to the virus (Garrett, 2023). Overall, lower socioeconomic status had less access to reliable information about the virus, prevention measures, and vaccines, leading to higher rates of infection and vaccine hesitancy (Garrett, 2023)

Past President’s Approaches

Presidents Joe Biden and Donald Trump approached the COVID-19 pandemic differently, in respect to their distinct leadership styles and policy priorities. President Trump’s initial approach to the covid 19 pandemic was inconsistent while downplaying the virus. It was treated like a flu with the prediction that it would disappear. Citizens were disappointed with the inadequate distribution of testing kits and personal protective equipment (Park, Haynes, & Gasper, 201). In March 2020, Trump initiated and signed the CARES Act which provided $2.2 trillion in economic relief. This included direct payments to individuals, expanded unemployment benefits, and support for small businesses (Park, Haynes, & Gasper, 2021). In addition, Trump emphasized on state autonomy in handling the pandemic, which led to disorganized enforcement of policies across the country (Park, Haynes, & Gasper, 2021). Federal mandates on issues like mask-wearing were not strongly imposed. Overall, Trump was a strong advocate for reopening the economy, which clashed with public health officials who recommended more cautious approaches.

President Biden’s initial approach was consistent and emphasized on the seriousness of the pandemic. He encouraged mask-wearing, social distancing, and vaccination, and was modeling these behaviors in public appearances. Biden implemented a national strategy to combat COVID-19, focusing on vaccine distribution, testing, and public health measures. His administration placed a strong emphasis on following scientific guidance. Biden’s administration prioritized the mass distribution of vaccines. By March 2021, vaccines were widely available, and were administered (Park, Haynes, & Gasper, 2021). Initiatives like mobile vaccination units were widely available while partnerships with pharmacies to increase access (Park, Haynes, & Gasper, 2021). Biden implemented several federal mandates, including a mask mandate on federal property and for interstate travel. His administration also pursued vaccine mandates for federal workers and contractors, as well as for large employers, though some of these mandates faced legal challenges. Overall, Biden’s administration took a more centralized, federal approach to managing the pandemic, whereas Trump emphasized state autonomy and limited federal intervention.

What I would do differently

What I would do differently as an individual at the presidential level who will be handling COVID-19 case will initially be to establish a dedicated pandemic response team early on to monitor global health threats. I will implement comprehensive Lockdowns and travel restrictions in the early stages to prevent widespread transmission (Anselm et al., 2021). My early on approaches will be to prioritize mass production and distribution of testing kits, ensuring widespread and easy access to testing from the outset. I will provide clear, consistent, and science-based communication to the public. I will be regularly updating citizens through briefings, ensuring that the information is accessible and transparent. I will develop a response plan that specifically addresses the needs of vulnerable populations. This will include racial and ethnic minorities, low-income communities, and frontline workers (Garrett, 2023). Also, I will work closely with community leaders and organizations to reach underserved populations with specific public health messages and support. I will ensure equal distribution of vaccines, treatments, and healthcare resources to all. In addition, I will implement economic relief measures that support both individuals and businesses. These could include direct payments, expanded unemployment benefits, and small business grants. Overall, I will rely mainly on the advice of public health experts and scientists in my decision-making processes, ensuring that policies are informed by the best available evidence. By focusing on these areas, as a presidential-level leader I could potentially manage a pandemic more effectively, and maintain public trust.

Reference

Anselm J.M. Hennis, Anna Coates, Sandra del Pino, Massimo Ghidinelli, Rodolfo Gomez Ponce de Leon, Edwin Bolastig, Luis Castellanos, Renato Oliveira e Souza, & Silvana Luciani. (2021). COVID-19 and inequities in the Americas: lessons learned and implications for essential health services. Revista Panamericana de Salud Pública, 45(130), 1–5. https://doi.org/10.26633/RPSP.2021.130

Garrett, T. M. (2023). Border securocracy: Global expansion of the U.S. Department of homeland security bureaucratic apparatus before, during and beyond covid-19. Administrative Theory & Praxis (Taylor & Francis Ltd), 45(3), 230–246. https://doi.org/10.1080/10841806.2022.2112454

Park, H. J., Hu, D., Haynes, E., & Gasper, K. (2021). When a lack of passion intertwines with thought and action: Neutral feelings about COVID-19 are associated with US presidential candidate attitudes and voting behavior. Emotion, 21(8), 1796–1800. https://doi.org/10.1037/emo0001051

Reply from Tamika Cheatham

The topic that I will be considering is mental health. As such, mental health becomes a priority concern of the presidency due to the fact of its broad ramifications affecting not only the individual but social levels as well. Socioeconomic status is one of the most common socio-ecological contributors to mental disorders that affect care availability, accessibility, adequacy, and, hence, overall outcome (Horn et al., 2021). Low income and a lack of education are some typical aggravating factors in mental health decreases, which ultimately lead to an increased risk for significant disorders such as depression and anxiety. Addressing these disparities remains important if improvement in mental health outcomes at the population level is to be realized.

During his term, Former President Donald Trump passed the Mental Health Parity and Addiction Equity Act so that similar coverage could be provided to mental health and substance use disorder services as would be provided for services of physical health (Presskreischer et al., 2022). His administration increased funding for programs in mental health and augmented access through the Affordable Care Act. Former President Donald Trump continued to keep mental health in the forefront, calling for programs such as the National Suicide Prevention Lifeline. However, he gave most of his attention to mental health regarding substance abuse. By contrast, some of the programs dealing with mental health received reduced funding during the presidency of Trump.

Presently, Joe Biden has made mental health part of his broader health agenda. His administration has sought to expand access to mental health services through initiatives like the American Rescue Plan, which, among many other things, allocated significant funding to mental health and substance use disorder services. Biden has also tried to underscore that an approach will be necessary to help ease the mental health crisis worsened by the COVID-19 pandemic to create access to more care, particularly in under-resourced communities.

If I had to approach mental health from the presidential level, I would increase the funding of mental health services and integrate mental health care into the primary setting. Because stigma plays such a huge role, the expansion of mental health education and awareness campaigns is imperative in reducing stigma and increasing access. Finally, socioeconomic determinants would be addressed through policy changes promoting access to education, jobs, and affordable housing (Adabre & Chan, 2019). If we address these social determinants, it would lead to the construction of a holistic approach toward mental health and support all individuals, especially those coming from a disadvantaged background. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

References

Adabre, M. A., & Chan, A. P. C. (2019). Critical success factors (CSFs) for sustainable affordable housing. Building and Environment, 156, 203–214. https://doi.org/10.1016/j.buildenv.2019.04.030

Horn, R., Arakelyan, S., Wurie, H., & Ager, A. (2021). Factors contributing to emotional distress in Sierra Leone: a socio-ecological analysis. International Journal of Mental Health Systems, 15(1). https://doi.org/10.1186/s13033-021-00474-y

Presskreischer, R., Barry, C. L., Lawrence, A. K., McCourt, A., Mojtabai, R., & McGinty, E. E. (2022). Factors Affecting State-Level Enforcement of the Federal Mental Health Parity and Addiction Equity Act: A Cross-Case Analysis of Four States. Journal of Health Politics, Policy and Law, 48(1). https://doi.org/10.1215/03616878-10171062 Links to an external site.

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones & Bartlett Learning.

The White House. (2023, May 18). Fact sheet: Biden-Harris administration announces new actions to tackle nation’s mental health crisis . The White House. Retrieved August 28, 2024, from https://www.whitehouse.gov/briefing-room/statements-releases/2023/05/18/fact-sheet-biden-harris-administration-announces-new-actions-to-tackle-nations-mental-health-crisis/

The White House. (2020, October 5). President Donald J. Trump is safeguarding Americans’ mental health and preventing the tragedy of suicide. The White House. https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-safeguarding-americans-mental-health-preventing-tragedy-suicide/

Initial Post on the Opioid Crisis in America

The opioid crisis in the United States has emerged as a significant public health emergency, rising to the level of a presidential agenda due to its widespread impact. Over 80,000 people succumbed to opioids in 2022. (CDC, 2023) The epidemic, characterized by the over-prescription and misuse of opioid medications, such as, Hydrocodone and Oxycodone, has resulted in a dramatic increase in opioid-related overdoses and deaths. The opioid crisis has disproportionately affected rural areas just as much as urban areas. In some rural communities, the overdose death rate is nearly twice that of urban areas. A critical social determinant of health that significantly affects this issue is socioeconomic status, and access to healthcare. Individuals in lower-income brackets are more likely to experience chronic pain, have limited access to healthcare, and consequently are more susceptible to opioid misuse. Communities with high unemployment rates and limited economic opportunities are disproportionately affected by the opioid crisis as well.

Current President Biden

The Biden Administration has prioritized addressing the opioid crisis, recognizing it as a significant public health issue that demands immediate action. A critical social determinant affecting this crisis is access to healthcare. Many individuals, particularly those in underserved communities, lack adequate access to comprehensive healthcare services, including mental health and addiction treatment. This lack of access exacerbates the misuse of opioids as individuals may turn to these substances for unmanaged pain or untreated mental health issues.

President Joe Biden’s approach to the opioid crisis involves a multi-faceted strategy focusing on prevention, treatment, and harm reduction. His administration has allocated significant resources to expand access to evidence-based treatment, including medication-assisted treatment, and has emphasized the importance of reducing the stigma associated with addiction. The administration is working to increase access to naloxone, a life-saving medication that can reverse opioid overdoses, and to improve support systems for individuals in recovery.

Past Presidents

Two past U.S. Presidents have taken different approaches to addressing the opioid crisis. President Barack Obama, during his tenure, focused on expanding access to treatment and recovery services. The Comprehensive Addiction and Recovery Act (CARA), signed into law in 2016, was one of his administration’s key legislative efforts. This act aimed to expand prevention and education efforts while also improving access to treatment for those struggling with addiction. Obama’s approach recognized the need for a multi-faceted response that included both public health and criminal justice components.

President Donald Trump, on the other hand, declared the opioid crisis a public health emergency in 2017 and focused on stricter law enforcement as well as expanding access to treatment. The SUPPORT for Patients and Communities Act, signed into law in 2018, was a comprehensive package that included measures to increase access to addiction treatment, support prevention efforts, and reduce the supply of opioids. Trump’s administration also emphasized the importance of securing the U.S. borders to prevent the flow of illegal drugs into the country.

What could be done differently

While all approaches made strides in addressing the opioid crisis, there are areas where improvements could be made. If given the opportunity to tackle this issue, I would advocate for a more vigorous emphasis on prevention through education and community-based interventions. By addressing the root causes of opioid misuse, such as poverty, mental health issues, and lack of economic opportunities, a more sustainable solution could be developed. I would also focus on expanding access to non-opioid pain management alternatives such as massage and acupuncture. And increasing funding for research into new treatments for chronic pain that do not involve addictive substances. These efforts would help reduce the demand for opioids and provide long-term relief for those affected by this crisis.

References

https://www.cdc.gov/drugoverdose/deaths/index.html Links to an external site.

Jones, C. M., et al. (2018). Trends and key correlates of prescription opioid injection misuse in the United States. Addictive Behaviors, 76, 53-61.

Kolodny, A., et al. (2015). The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. Annual Review of Public Health, 36, 559-574.

Volkow, N. D., & McLellan, A. T. (2016). Opioid abuse in chronic pain—misconceptions and mitigation strategies. New England Journal of Medicine, 374(13), 1253-1263.

Expand discussion thread from Stephania A Senter

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Tracy M Chaves

Aug 28, 2024 9:01pm | Last reply Sep 1, 2024 2:16pm

Reply from Tracy M Chaves

Per the Health Policy and Politics Nurse’s Guide, there are four categories that influence what issues would make it to a presidential agenda level. Actors refer to people or groups that draw attention to problems; ideas refer to the power or value an issue has with polls or surveys; interests are related to the benefits such as reelection addressing an issue has; and lastly institutes are the “organizational structure” or the setting where the agenda is discussed (Short, 2022).

There has been models developed to address explain how a policy rises to the presidential agenda level and change occurs, these models are the Iron Triangle Model, The Punctuated Equilibrium Model, The Advocacy Coalition Model, The Path Dependent Model, and the most popular Kingdom Model as described in the text (Short, 2022). When a problem coupled with the right timing and the right interest group leading the way an agenda gets on a presidential level.

A popular health topic that rises to presidential agenda level is the topic of health insurance. Social determinants most affected by this health issue are economical stability and healthcare access and quality. There has been numerous presidential administrations that have tried reform with difficulty. The difficulty comes on the political views and goals of each political party. A good example of this is the Affordable Care Act. Implemented by democrats in 2010, later changed by republicans, and now currently going through different change again by democrats. For the 2024 elections, health policy issues will continue to be a main debate (Emory Rollins, n.d.).

It is hard to say what I would do as no one has been successful in addressing the affordable healthcare issue. However, I would start with implementing health care professionals, such as nurses into the discussion as members. Unfortunately the decisions about our health is being made by those with little knowledge about it. “Nurses and IPHCWs bring a unique and trusted perspective to policy deliberation and development because of their training, values, ethics, and experience”(Short, 2022).

A policy briefing would also be beneficial. Due to politicians usually not coming from a healthcare background, it would be important to assess their level of understanding, give clear explanations of the significance of the policy, give the actions that are needed, and the research evidence to back it all up (DeMarco, 2014).

I know I would also would like to incorporate more preventative coverage research. On a personal level I have seen changes being made to CMS related to home health that I feel is not preventative but reactive. Insurance type also plays a factor on what services are covered or not, both with private insurance coverage and Medicare coverage.

References

DeMarco, R., & Tufts, K.A. (2014). The mechanics of writing a policy brief. Nursing Outlook, 62(3), 219-224.

Emory’s Rollins School of Public Health. (n.d.) Health policy and the 2024 elections. Retrieved Aug 28 2024, from https://sph.emory.edu/features/2024/presidential-election/health-policy/

Short, N.M. (2022). Milstead’s health policy and politics: as nurse’s guide. Seventh edition, 57-71. Burlington, MA, Jones and Bartlett Learning.

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Mihret Ghebreamlak

Aug 28, 2024 9pm | Last reply Sep 1, 2024 4:17am

Reply from Mihret Ghebreamlak

COVID-19 and the Impact of Social Determinants of Health

Main Post

The COVID-19 pandemic has underlined the profound influences that social determinants of health, broadly socio-economic status, have on population health. SES, measured by income, education, and employment, is important in determining health outcomes. The pandemic has made the low-income population face higher risks from limited access to healthcare, living in overcrowded environments, and employment in essential but high-exposure jobs (Abrams & Szefler, 2020). Each of these factors has contributed to higher COVID-19 infection rates, hospitalizations, and mortalities in marginalized communities. The disparities in health outcomes underline the need for more significant investments in public health infrastructure, notably in underserved communities, to mitigate the effects of such social determinants during future health crises (Maani & Galea, 2020).

Past President’s Approaches

President Donald Trump had earlier focused on economic measures and vaccine development. The administration initiated Operation Warp Speed to accelerate vaccine development, production, and distribution (Kellogg & Overton, 2021). His administration had been criticized for minimizing the severity of the virus and issuing confusing guidance on public health (Parker & Stern, 2022). Trump’s policies were generally directed toward opening up the economy, which made lower-income individuals particularly vulnerable as they could not work from home.

President Joe Biden came into office with a pledge for a coordinated federal approach. His administration has emphasized widespread vaccination, public health guidance, and direct financial support to individuals and businesses. Biden also moved to address health inequity, targeting vaccination efforts in underserved communities, increasing funding for public health infrastructure, and extending unemployment benefits and stimulus payments to help those facing economic hardship due to the pandemic (The White House, 2021).

What Could Be Done Differently

While both administrations took necessary steps, addressing SES as a determinant of health would have led to improved outcomes. Such policy measures would include enhancing healthcare access for the uninsured or underinsured segments of society, supporting essential workers, and investing in public health infrastructure in low-income communities. Public health messaging must remain consistent and ensure that all communities receive accurate and proper information and resources to manage future health crises.

References:

Abrams, E. M., & Szefler, S. J. (2020). COVID-19 and the impact of social determinants of health. The Lancet Respiratory Medicine , 8 (7), 659–661. https://doi.org/10.1016/s2213-2600(20)30234-4

Kellogg, K., & Overton, H. (2021, June 4). Operation Warp Speed: Innovating Vaccine Development While Addressing a National Crisis . Americafirstpolicy.com. https://americafirstpolicy.com/issues/operation-warp-speed-innovating-vaccine-development-while-addressing-a-national-crisis

Maani, N., & Galea, S. (2020). COVID-19 and Underinvestment in the Public Health Infrastructure of the United States. The Milbank Quarterly , 98 (2). https://doi.org/10.1111/1468-0009.12463

Parker, C. F., & Stern, E. K. (2022). The Trump Administration and the COVID-19 crisis: Exploring the warning-response problems and missed opportunities of a public health emergency. Public Administration , 100 (3). https://doi.org/10.1111/padm.12843

The White House. (2021, January 20). President Biden Announces American Rescue Plan . The White House. https://www.whitehouse.gov/briefing-room/legislation/2021/01/20/president-biden-announces-american-rescue-plan/

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Kayla Rena Davis

Aug 28, 2024 8:52pm | Last reply Sep 1, 2024 4:50am

Reply from Kayla Rena Davis

A widely discussed health topic that will be discussed in this post is the cost of prescription drugs and what Presidents Biden and Trump have done to assist Americans in lowering this cost. Biden and Trump aimed to bring down prescription drug prices and end surprise billing, even agreeing on some interventions to help this initiative.

President Joe Biden’s Inflation Reduction Act (IRA) grants Medicare the authority to negotiate the prices of specific prescription drugs, thereby introducing a significant shift in federal healthcare policy. Initially, the negotiations encompass ten selected drugs, with a maximum of 20 drugs per year; however, President Biden aims to expand this number to 50 drugs annually (The White House, 2024). The newly negotiated prices are slated to take effect in 2026, with projected savings estimated at $1.5 billion in prescription drug costs (Centers for Medicare & Medicaid Services [CMS], 2024). In addition to drug price negotiations, the IRA imposes a cap on out-of-pocket expenses for Medicare beneficiaries, expected to yield an average savings of $400 per year (The White House, 2024). The Act also extends the insulin price cap introduced under the Trump administration, transitioning it from voluntary to mandatory and establishing a $35 monthly cap on insulin costs.

President Donald J. Trump implemented several executive orders to reduce the cost of prescription medications and enhance access for Americans. One executive order extended the drug rebates that manufacturers offer to private insurers, making them available to Medicare beneficiaries (Robertson, 2023). Another order focused on making insulin and epinephrine more affordable for low-income individuals, reducing their cost to $35 or less. Initially voluntary, President Biden codified this measure into law (The White House, 2020). Additionally, President Trump signed an order permitting the importation of drugs from other states or countries to foster competitive pricing and abolished gag clauses, which had previously prevented pharmacists from discussing the most cost-effective options with consumers (The White House, 2020).

To build upon the efforts of the current and previous administrations in reducing prescription drug costs for Americans, I propose extending negotiated drug prices to individuals without Medicare or Medicaid coverage. Additionally, to prevent price gouging, a pricing benchmark should be established based on the prices negotiated by Medicare and the prices paid by other countries for the same medications. This approach would ensure that negotiated prices are accessible to all, enhancing affordability and equity in healthcare.

Reference:

Centers for Medicare & Medicaid Services (CMS). (2024, August). Medicare prescription drug inflation rebate program part … https://www.cms.gov/files/document/fact-sheet-part-b-rebatable-drug-coinsurance-reduction.pdf

Robertson, L. (2023, September 19). Trump’s executive orders on prescription drugs . FactCheck.org. https://www.factcheck.org/2020/07/trumps-executive-orders-on-prescription-drugs/

The White House. (2020, July). FACT SHEETS President Donald J. Trump Is Taking Action to Lower Drug Costs and Ensure That Americans Have Access to Life-saving Medications . https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-taking-action-lower-drug-costs-ensure-americans-access-life-saving-medications/

The White House. (2024, March 8). Fact sheet: President Biden takes new steps to lower prescription drug and health care costs, expand access to health care, and protect consumers . https://www.whitehouse.gov/briefing-room/statements-releases/2024/03/06/fact-sheet-president-biden-takes-new-steps-to-lower-prescription-drug-and-health-care-costs-expand-access-to-health-care-and-protect-consumers/

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Hiedi Wurster

Aug 28, 2024 8:37pm | Last reply Aug 31, 2024 6:07pm

Reply from Hiedi Wurster

The Opioid Crisis

The opioid epidemic is one of the most devastating crises of our time. Since opioids became widely prescribed in the 1990s, at least 500,000 people in the U.S. have died from an opiate overdose (Uncovering the Opioid Epidemic, n.d.). An estimated 2.5 million Americans have opioid use disorder (Abuse, 2023), and approximately 10 million Americans twelve years old and older have misused opioids in the past year (Association, 2023). This crisis has manifested in three waves (Feldscher, 2022). Oxycontin, which has a high risk for dependency, was the first legally prescribed opioid that brought on the first wave of deaths that were linked to opioids (Feldscher, 2022). The second wave came from heroin, which appealed to people who were already addicted (Feldscher, 2022). We are currently in the third wave, which is attributed to illegally obtained opioids such as fentanyl (Feldscher, 2022). In 2021 alone, close to $1.5 trillion was spent in combatting the crisis (Beyer, 2022). Opioid abuse not only takes a toll on its victims and their families, it costs society as well. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

Trump Administration Response

Trump’s strategy appeared to take a reactive approach. He allocated $1.8 billion in grants to be given to states to fight opioid abuse (Trump Whitehouse Archives, n.d.) He has contacted countries, such as China, to appeal to them to stop the flow of drugs to the U.S. (Trump Whitehouse Archives, n.d.). He has even been able to quell the distribution of drugs over the internet by getting rid of one of the biggest online distributors (Trump Whitehouse Archives, n.d.). He also expanded access to treatment for opioid use disorder by creating the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act in October 2018 (CMS, 2019).

Biden Administration Response

The Biden administration appears to be taking a more proactive approach. They have certainly allocated money to the states to combat this epidemic. But they have also taken some specific action. They enacted legislation that has allowed nearly two million more medical professionals to be able to prescribe medication to treat opioid use disorder (Whitehouse, 2024). He has prioritized keeping drugs out of the country by providing the latest drug detection technology to our federal agents who protect our ports of entry (Whitehouse, 2024). Although the Trump administration contacted China concerning their illicit exports, the Biden administration was able to convince them to close down the sources of drug manufacturing and to share information with the U.S (Whitehouse, 2024). This administration also went global by bringing over 140 countries together to fight this epidemic (Whitehouse, 2024).

Social Determinants of Opioid Abuse

Social determinants play a large role in our health and well-being. There are five main categories of determinants that are known as upstream factors (Nicholson, 2023). These five categories refer to our environment. They are economic stability, education access and quality, health access and quality, neighborhood and build environment, and social and community context (HHS, n.d.). People with lower education, lower incomes and are participating in some manner in a government program, are more likely to use opioids (Nicholson, 2023).

What Would I Do Different

I would have acknowledged the problem much earlier. But as of now, I would start locally by educating students about opioids. This would include all levels of school using age-appropriate materials. I would also contact many of the employers in this area to offer information sessions on it. I would like to allocate more resources to our local law enforcement so they can be more pro-active in getting dealers off the streets. At a state level, I would like to have more education as well as treatment available at colleges as well as in prisons. It would be great to have more affordable housing options for people with SUD who are struggling with homelessness. As Maslow has reminded us, shelter is one of our basic needs, and we cannot achieve anything unless we have the safety of housing.

References

Abuse, N. I. (2023, August 7). Only 1 in 5 U.S. Adults with opioid use disorder receive medications to treat it in 2021 . Retrieved from nida.nih.gov: https://nida.nih.gov/news-events/news-releases/2023/08/only-1-in-5-us-adults-with-opioid-use-disorder-received-medications-to-treat-it-in-2021#:~:text=News%20Release-,Only%201%20in%205%20U.S.%20adults%20with%20opioid%20use%20disorder,to%20treat%20it%20in%

Association, A. P. (2023, August 28). The Opioid Crisis: Impact, Challenges, and Paths to Recovery. Retrieved from Psychiatry.org: https://www.psychiatry.org/news-room/apa-blogs/opioid-crisis-impact-challenges-recovery

Beyer, D. (2022, September 28). JEC Analysis Finds Opioid Epidemic Cost U.S. Nearly $1.5 Trillion in 2020. Retrieved from beyer.house.gov: https://beyer.house.gov/news/documentsingle.aspx?DocumentID=5684#

CMS. (2019, November 1). Trump Administration takes Steps to Expand Access to Treatment for Opioid Use Didorder. Retrieved from cms.gov: https://www.cms.gov/newsroom/press-releases/trump-administration-takes-steps-expand-access-treatment-opioid-use-disorder

Feldscher, K. (2022, February 9). What led to the opioid crisis-and how to fix it. Retrieved from Harvard T.H. Chan School of Public Health: https://www.hsph.harvard.edu/news/features/what-led-to-the-opioid-crisis-and-how-to-fix-it/#:~:text=It%20started%20in%20the%20mid,use%20of%20legal%20prescription%20opioids.

HHS. (n.d.). Healthy People 2030 . Retrieved from healthy.gov: https://health.gov/healthypeople/priority-areas/social-determinants-health

Nicholson, H. L. (2023). Social determinanats of opioid use behaviors among adults in the United States. Journal of Substance Use , 371-378.

Only 1 in 5 US Adults With Opioid Use Disorder. (n.d.). Retrieved from National Institute on Drug Abuse.

Trump Whitehouse Archives. (n.d.). Retrieved from Trump Whitehouse Archives: https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-dedicated-administration-fighting-back-opioid-crisis/

Uncovering the Opioid Epidemic. (n.d.). Retrieved from CDC: https://www.cdc.gov/museum/pdf/cdcm-pha-stem-uncovering-the-opioid-epidemic-lesson.pdf

Whitehouse. (2024, march 8). Fact Sheet: President Biden’s Unity Agenda for the Nation . Retrieved from whitehouse.gov: https://www.whitehouse.gov/briefing-room/statements-releases/2024/03/08/fact-sheet-president-bidens-unity-agenda-for-the-nation/

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Hiedi Wurster

Aug 28, 2024 8:21pm

Reply from Hiedi Wurster

WU_6050_Discussion_Draft2-2.docx

HW

Hiedi Wurster

Aug 28, 2024 8:19pm

Reply from Hiedi Wurster

MP

Mehal Patel

Aug 28, 2024 7:16pm | Last reply Aug 31, 2024 10:13pm

Reply from Mehal Patel

Social determinants of health

According to Healthy People 2030, there are five determinants of social health, among them, neighborhood and safe environment are critical for a person’s wellbeing and quality of life. Due to the rise in gun violence, one of the five social determinants is in jeopardy. According to NICHM (National Institute of Healthcare Management), “Gun violence is a major public health problem, and a leading cause of premature death”.

Gun violence issue

On average, 118 people a day were killed from gun-related incidents in 2023. Gun violence, on average costs $557 billion annually, and among that $2.8 billion is spent on medical care, mental health services, and emergency services. For taxpayers in the United States of America, each non-fatal gun costs over $25000 and each gun death injury costs approximately $ 274,000. Its average cost is $1700 per taxpayer.

How President Trump and Biden addressed this issue

Former President Donald Trump offered one of the steps to prevent gun violence. He provided police protection to minorities. As per Donald Trump, minorities need police protection because of the hate crime. He understands what going into inner cities and need of police protection for minorities.

On the other hand, President Biden stated that he will do everything he can, to prevent such crisis after mass shooting at Texas Elementary school in May 2022. According to a Washington D.C post released by Rhode Island senator Jack Reed, President Biden needs to take long overdue steps toward keeping firearms out of the hands of dangerous people, crack down on gun trafficking, and invest significant funding in mental health and school safety measures.

How Gun Violence can be prevented

In May 2022, a horrific incident happened in Texas Elementary School which suggests that gun violence issue needs to be taken seriously and politicians and leaders across the country need to make strict laws when it comes to gun access. Addressing mental health issues in the communities and removing stigma related to mental health issues is a critical component. Nurses can play an important role by joining professional organizations to address this issue.

Nurses can join ANA and the American Academy of Nursing as it supports nurses’ engagement with family and community health screening, counseling work, and prevention training. In June 2023, ANA built upon its long-lasting advocacy with a resolution recommending heightened support and legislation, improved mental health services, and research specific to the healthcare arena. ANA has a large campaign related to violence against nurses in the workplace thus joining ANA will also help create more awareness about this issue and build networking to fight against this issue.

References

Sheehan, A. (2024). Nursing Power through Advocacy. Advocacy 101: Staying Connected with Your Legislators. Pediatric Nursing , 50 (3), 143–146. https://doi.org/10.62116/PNJ.2024.50.3.143 Links to an external site.

Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health . Healthy People 2030; Office of Disease Prevention and Health Promotion. https://health.gov/healthypeople/priority-areas/social-determinants-health https://nihcm.org/publications/gun-violence-the-impact-on-society Links to an external site.

Gartley, C. E. (2023, November 4). The role of nurses in firearm safety . American Nurse. https://www.myamericannurse.com/the-role-of-nurses-in-firearm-safety/

Black Americans want new gun laws to curb gun violence. Trump offers more police. (2017, October 12). Washingtonpost.com . https://link.gale.com/apps/doc/A509302219/OVIC?u=minn4020&sid=ebsco&xid=da661830 Links to an external site.

BIDEN SIGNS SWEEPING GUN VIOLENCE PREVENTION BILL INTO LAW. (2022, June 25). States News Service NA. https://link.gale.com/apps/doc/A708422887/EAIM?u=minn4020&sid=ebsco&xid=647ab7a1

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Amy Simmons

Aug 28, 2024 6:54pm | Last reply Aug 31, 2024 11:10am

Reply from Amy Simmons

Main Post

Prescription Drug Prices

Prescription drug costs have emerged as a significant concern in presidential discussions, mirroring the public’s growing anxiety about the increasing price of medications in the U.S. The debate centers on ways to lower drug costs for consumers while allowing pharmaceutical companies to continue investing in research and development. Although this issue has received support from both political parties, their proposed solutions can differ widely. It remains a key focus in healthcare reform debates, with many voters considering it a critical priority. According to Vincent Rajkumar (2020), about 25% of American citizens struggle to pay for their medications, which, in turn, causes those Americans to be non-compliant, increasing their healthcare needs and costs due to the worsening of their health conditions.

Present Presidents Approach

Our current President, Joe Biden, views health care as a fundamental right rather than a luxury, which I completely agree with. From the outset, he has expanded access to health care for millions of Americans and worked to reduce costs. He remains committed to enhancing and safeguarding Medicare, Medicaid, and the Affordable Care Act. Due to the President’s initiatives, more Americans have health insurance compared to any previous administration. This commitment is reflected in his support for legislation like the American Rescue Plan Act and the Inflation Reduction Act, aimed to decrease prescription drug prices and lower monthly health insurance costs (The White House, 2022).

Past President’s Approach

Trump consistently spoke out about the high costs of prescription drugs, aiming at pharmaceutical companies and pharmacy benefit managers. Although he made the issue a focal point in political discourse, his administration made limited strides in reducing drug prices. The Trump administration tried to get the co-pays lowered to $35 for Americans with Medicare and Medicaid, but even that was ultimately denied. The Trump administration has faced many challenges meeting major campaign promises, especially those requiring legislative or administrative changes (Levitt, 2024).

What could be Done Differently?

As an advanced practice provider, I will advocate for legislative and policy changes to lower drug prices and express support for bills allowing Medicare to negotiate drug prices, increase transparency, or promote generics and biosimilars. I will educate patients on the importance of preventative care, medication compliance, and healthy lifestyles to keep healthcare costs to a minimum Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

References

Levitt, L. (2024, February 15). What would another Trump presidency mean for health care? JAMA Health Forum. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2815369

The White House. (2022, October 14). Executive order on lowering prescription drug costs for Americans . The White House. https://www.whitehouse.gov/briefing-room/presidential- Links to an external site. actions/2022/10/14/executive-order-on-lowering-prescription-drug-costs-for-americans /

Vincent Rajkumar, S. (2020). The high cost of prescription drugs: Causes and solutions. Blood Cancer Journal , 10 (6). https://doi.org/10.1038/s41408-020-0338-x

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John Dulko (He/Him)

Aug 28, 2024 6:35pm

Reply from John Dulko

The topic considered that rises to the presidential agenda is mental health. Kirkbride et al. (2024) assert that the social determinants of mental health are socioeconomic disadvantage, early life adversity, childhood adversity, migration, ethnoracial discrimination, inequalities experienced by the LGBTQ+ community, sex-based inequalities, loneliness and social isolation, neighborhood socioeconomic disadvantage and inequality, social capital, fragmentation, and ethnic density, and physical environment.

A limiting factor for any project is money. The Biden administration funded several projects to expand access to mental health services. Some of these services include the 988 Suicide and Crisis Lifeline, FindSupport.Gov, the Mental Health at Work Initiative launched by the Department of Labor, the Workplace Stress Toolkit rolled out by the Occupational Safety and Health Administration (OSHA), the TodayIAm Campaign for veterans’ mental health, and the 24/7 hotline, 1-833-TLC-MAMA (The White House, 2023). All these efforts aimed to increase access to care and offer resources, which was made possible by the Biden administration’s funding and support.

The Trump administration also offered funding for mental health improvement in the United States. “The President allocated approximately $425 million in emergency funds to address mental and substance abuse disorders” (The White House 2020). The Trump administration also repealed the individual mandate of the Affordable Care Act, declared the opioid crisis a public health emergency, signed the Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act, and released emergency grants to states to improve access to treatment for substance use disorders and other mental illnesses during the COVID-19 pandemic (The White House 2020).

Walden University (2020) recommends strengthening system capacity, connecting more Americans to care, and supporting Americans by creating healthy environments to improve the mental health crisis in the United States. In addition to what has already been done to improve access to care during the Trump and Biden administrations, all health plans could cover behavioral health services, and some could offer three visits per year without a copay. Another suggestion is to embed these professionals within the community, such as libraries, community centers, and homeless shelters. Telehealth services also must be invested in to improve access to care. To create healthy environments, the effect of social media should be studied, and the number of early childhood and school-based interventions should be increased (Walden University 2020).

References

Kirkbride, JB., Anglin, D.M., Colman, I., Dykxhoorn, J., Jones, P.B., Patalay, P., Pitman, A., Soneson, E., Steare, T., Wright, T., Griffiths, S.L. (2024) The social determinants of mental health and disorder: evidence, prevention and recommendations. World Psychiatry , 23(1):58-90. 10.1002/wps.21160.

Walden University. (2022). America’s agenda for addressing the mental health crisis. Walden University. https://www.waldenu.edu/online-doctoral-programs/phd-in-clinical-psychology/resource/americas-agenda-for-addressing-the-mental-health-crisis

The White House. (2023, May 18). Fact sheet: Biden-Harris administration announces new actions to tackle nation’s mental health crisis . The White House. Retrieved August 28, 2024, from https://www.whitehouse.gov/briefing-room/statements-releases/2023/05/18/fact-sheet-biden-harris-administration-announces-new-actions-to-tackle-nations-mental-health-crisis/

The White House. (2020, October 5). President Donald J. Trump is safeguarding Americans’ mental health and preventing the tragedy of suicide. The White House. https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-safeguarding-americans-mental-health-preventing-tragedy-suicide/ Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

QF

Qiana Felder

Aug 28, 2024 3:58pm | Last reply Aug 30, 2024 9:21pm

Reply from Qiana Felder

Topic

The healthcare issue I chose is mental health, a pressing concern in the United States. Shockingly, nearly 50 million Americans are currently dealing with mental health issues, with over half of them not receiving any treatment (Mental Health America, 2022). This alarming trend persists due to various barriers, including limited coverage and socioeconomic status, making mental health a significant problem within our communities.

Current President’s Approaches

Current: The Biden administration has taken some necessary steps to prioritize mental health. In 2022, the administration launched the nationwide 988 hotline to ensure people could access support for mental health crises and suicide prevention more easily. President Biden also made more funding available for school-based mental health services and proposed a rule to make it easier for schools to bill Medicaid by reforming the billing processes (Affairs, 2023). Lastly, he intends that all insurance plans cover behavioral health services, including at least three visits yearly (The White House, 2022).

Past President’s Approaches

An emphasis was placed on improving mental health and the opioid crisis during the Trump administration. Legislation was signed to address mental health and substance abuse disorders, which allocated emergency funds to improve access to treatment (The White House, 2020). An executive order was also signed to make suicide prevention a priority for veterans. In addition, he signed the Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT). This law increases access to treatment for citizens with mental health and substance abuse disorders.

What Could Be Done Differently

I see the impact of mental health far too often working as a nurse. Both Presidents have accomplished a great deal of change to improve the crisis. However, the need for more comprehensive mental health services is urgent. Mental health services would benefit from being integrated into primary care practices to make it easier for a behavioral health and primary care team to collaborate on the patient’s needs. Integrating care would also eliminate the need for the patient to find a provider, which can be stressful. With the available funding, the focus should be on prevention and awareness. More public health campaigns should be utilized to educate and reduce the stigma around mental health to encourage people to get treatment and the support they need.

References

Affairs (ASPA), A. S. for P. (2023, September 25). Biden-Harris Administration Announces More Than $200 Million To Support Youth Mental Health . HHS.gov. https://www.hhs.gov/about/news/2023/09/25/biden-harris-administration-announces-more-than-200-million-support-youth-mental-health.html

Mental Health America. (2022). Quick Facts and Statistics About Mental Health . Mental Health America. https://mhanational.org/mentalhealthfacts

The White House. (2020, October 5). President Donald J. Trump Is Safeguarding Americans’ Mental Health and Preventing The Tragedy of Suicide – The White House . Trumpwhitehouse.archives.gov. https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trump-safeguarding-americans-mental-health-preventing-tragedy-suicide/

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 . The White House. https://www.whitehouse.gov/briefing-room/statements-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/

Expand discussion thread from Qiana Felder

LA

Lailat Andu

Aug 28, 2024 9:11am | Last reply Aug 31, 2024 3:44pm

Reply from Lailat Andu

Opioid Epidemic

Opioid abuse presents a significant challenge to the public, requiring a multifaceted response that includes education, direct patient care, and public health interventions. It is a crisis that has been described as a public health emergency, with more than 70,000 overdose deaths recorded in 2019 alone, largely driven by synthetic opioids like fentanyl (Scholl et al., 2020). I believe the opioid epidemic underscores the need for a comprehensive approach to population health strategies to address the root causes of the opioid epidemic. Numerous socioeconomic factors, such as economic instability and access to healthcare, have been identified to have a major impact on the opioid epidemic. Implementing comprehensive healthcare reforms that ensure coverage for addiction treatment services is also vital to curbing opioid epidemics (Bachhuber et al., 2023).

Social Determinant

Economic Instability plays a crucial role in the opioid epidemic by exacerbating vulnerabilities that lead to substance misuse. Patients facing unemployment, low wages, and poverty often experience chronic stress, anxiety, and feelings of hopelessness, which can increase the likelihood of turning to opioids as a coping mechanism. Economic hardships also limit access to education and job opportunities, creating a cycle where patients are trapped in environments with fewer prospects for upward mobility. In economically distressed communities, the lack of resources and support systems further contributes to the spread of opioid misuse, as people have fewer avenues for seeking help and more exposure to drug use.

Access to Healthcare is another key factor influencing the opioid epidemic. Patients in economically unstable situations often lack health insurance or have limited access to healthcare services, including mental health and substance abuse treatment. This barrier prevents early intervention, leading to the progression of addiction and increasing the risk of overdose. Even when healthcare is available, stigma, cost, and transportation issues can prevent patients from seeking or maintaining treatment. The lack of accessible, affordable, and integrated healthcare services exacerbates the opioid crisis by leaving many without the necessary support to recover and manage their addiction.

Presidential Response to Opioid Epidemic

Both President Joe Biden and former President Donald Trump have addressed the opioid epidemic as a significant public health issue, but they have taken different approaches based on their administrations’ priorities, strategies, and political contexts.

President Trump’s approach to the opioid crisis focused heavily on law enforcement, border security, and public health emergency declarations. Here are some key aspects; In October 2017, Trump declared the opioid crisis a public health emergency. This declaration allowed for the mobilization of resources and directed federal agencies to prioritize the crisis, though it did not unlock significant new funding. President Trump emphasized the need to strengthen law enforcement and border security to combat the influx of illegal opioids, particularly fentanyl, from other countries like Mexico and China. His administration increased funding for the Drug Enforcement Administration (DEA) and other agencies to crack down on drug trafficking. His administration also focused on prosecuting opioid manufacturers and distributors that were believed to be contributing to the crisis. He Also launched multiple public awareness campaigns to educate Americans about the dangers of opioid abuse, often framing it within the context of law and order. The campaigns emphasized the importance of prevention, and the risks associated with opioid misuse.

President Biden’s administration’s approach to the opioid crisis has been more focused on public health, treatment, and harm reduction, while also maintaining an emphasis on law enforcement and border security. Under President Biden’s administration, the American Rescue Plan allocated significant funding to address the opioid crisis, including $4 billion for behavioral health and substance use disorder services. This funding aimed to expand access to treatment, recovery services, and harm reduction programs. The administration has also emphasized harm reduction strategies, such as supporting syringe service programs, expanding access to naloxone, and advocating for medication-assisted treatment (MAT) for opioid use disorder. Biden’s approach is more public health-oriented, focusing on reducing the stigma associated with addiction and ensuring that those affected have access to the care they need. President Biden’s administration also focused on reducing overdose deaths by promoting overdose prevention sites, supporting community-based interventions, and ensuring that emergency medical services are equipped to respond to overdoses.

I believe both of the last two presidential approaches to the opioid pandemic are very good. However, I would have combined the two approaches with more funding allocated to prevention and treatment for opioid abuse. A study by Volkow and Blanco (2021) highlights that improving physician training on pain management and the risks of opioid addiction can significantly reduce the number of new cases of opioid misuse. I believe curbing the opioid pandemic requires a holistic approach that combines prevention, treatment, harm reduction, and policy reform. By addressing the issue from multiple angles, society can reduce the incidence of opioid misuse and provide support to those affected by addiction.

References

Bachhuber, M. A., et al. (2023). Healthcare reform and opioid use disorder: A review of evidence. Journal of Substance Abuse Treatment, 146, 108-115. https://doi.org/10.1016/j.jsat.2023.01.012

Centers for Disease Control and Prevention. (2022). Prescription drug monitoring programs (PDMPs). Retrieved from https://www.cdc.gov/drugoverdose/pdmp/index.html

Scholl, L., Seth, P., Kariisa, M., Wilson, N., & Baldwin, G. (2020). Drug and opioid-involved overdose deaths—United States, 2013–2019. Morbidity and Mortality Weekly Report, 69(11), 290–297. https://doi.org/10.15585/mmwr.mm6911a4

Volkow, N. D., & Blanco, C. (2021). The changing opioid crisis: Development, challenges, and opportunities. Molecular Psychiatry, 26(1), 218-233. https://doi.org/10.1038/s41380-020-00841-6

Expand discussion thread from Lailat Andu

Julia N Taylor

Aug 28, 2024 7:57am | Last reply Aug 30, 2024 2:04pm

Reply from Julia N Taylor

More than 1.8 million new cancer cases are expected to be diagnosed. About 607,000 Americans are expected to die of cancer in 2024, which translates to about 1,660 deaths per day, of which lung cancer makes up almost 25% of all cancer deaths (American Cancer Society [ACS], 2020a; ACS, 2020b). The estimated national expenditures for cancer care in 2017 were $147.3 billion (National Cancer Institute [NCI], 2018). The cost of treatment significantly impacts patients when deciding which treatment to use. The question is proposed which is safer and more cost-effective, alternative medication and/or conventional treatment for lung cancer, with the intent of comparing their effectiveness. Both cancer treatment approaches are beneficial and available; therefore, exploring treatment options using evidence-based sources and provider recommendations is critical. The clinical issue is the existence of competing options in treating lung cancer. People with cancer are interested in trying anything that may help them. Some people prefer alternative medication and others conventional treatment because each approach has benefits and limitations that suit the preferences or perceptions of an individual (Johnson, Park, Gross, & Yu, 2018a).

Biden-Harris Administration’s goal is to reduce the cancer death Rate by at least 50 % over the next 25 years and improve the experience of living with and Surviving Cancer. This administration is said to put up $150 million in new federal funding to develop technology to help surgeons successfully remove cancerous tumors (white house). The issue is important in healthcare because a more practical option needs to be identified and recommended. Lung cancer has ravaged the population in terms of deaths and illnesses. Therefore, there is a need to identify effective evidence-based solutions to help the patients (ACS, 2020).

While President Biden tried to reduce the cancer death rate, Former President Trump stated, “We’re going to get to the cure for cancer and Alzheimer’s and so many other things.” (med page today). I feel if finding the cure for cancer was that easy, then it would have been done a long time ago. Looking back on this administration, Trump talked a good game when he spoke about finding the cure for cancer, but it doesn’t seem as though he took it seriously. I say this because Trump is a money guy, and there is no money in the cure, but it is in the treatment. So the question remains: was his statement from the heart, or was it something his team put together for him to say? Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

As cancer is a terrifying disease, and patients would be interested in anything that may help, the existence of competing options for curing the disease or achieving good palliation increases the dilemma and anxiety when deciding the treatment approach that needs to be used. I personally would explore different treatment options, such as alternative medication versus other conventional treatments, which are widely used and likable treatment approaches, with the intent of comparing their effectiveness on lung cancer. Evidence supports the use of AM compared to CCT, but more research with more excellent quality and evidence supports CCT over AM. The unintended finding on this topic is that using CCT combined with AM is the most effective approach for treating lung cancer because CCT is more effective in reducing tumors. At the same time, AM is more appropriate for enhancing general wellness during treatment.

American Cancer Society. (2020a). Cancer facts & figures 2020. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf

American Cancer Society (2020b). Key statistics for lung cancer. https://www.cancer.org/cancer/lung-cancer/about/key-statistics.html Links to an external site.

Johnson, S. B., Park, H. S., Gross, C. P., & Yu, J. B. (2018a). Use of alternative medicine for cancer and its impact on survival. JNCI: Journal of the National Cancer Institute, 110(1), 121-124. https://doi.org/10.1093/jnci/djx145 Links to an external site.

https://www.medpagetoday.com/washington-watch/electioncoverage/111158

National Cancer Institute. (2018, April 27). Cancer Statistics. https://www.cancer.gov/about-cancer/understanding/statistics Links to an external site.

https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/02/fact-sheet-president-biden-reignites-cancer-moonshot-to-end-cancer-as-we-know-it/

Expand discussion thread from Julia N Taylor

MM

Miriane Meigueu

Aug 28, 2024 7:46am | Last reply Sep 1, 2024 1:22am

Reply from Miriane Meigueu

The rising cost of healthcare has been a persistent and significant issue in the United States, frequently reaching the presidential agenda due to its profound impact on the nation’s overall well-being (Galvani et al., 2020). Among the various social determinants of health, economic stability stands out as the most critical factor influencing this issue. The ability of individuals and families to afford healthcare services directly affects their access to necessary medical care, preventive services, and overall health outcomes. When healthcare costs are prohibitively high, it exacerbates health disparities, particularly among low-income populations, leading to worse health outcomes and increased mortality rates. Economic stability, or the lack thereof, plays a pivotal role in determining whether individuals can afford insurance, pay for out-of-pocket expenses, or access necessary treatments without facing financial ruin (Rahman et al., 2022). This determinant directly impacts the overall health of the population, making it a crucial focus area in addressing the cost of healthcare.

In addressing the cost of healthcare, two recent U.S. presidents, Barack Obama and Donald Trump, approached the issue with differing policies and strategies. President Obama’s approach was primarily centered around the Affordable Care Act (ACA), which aimed to increase access to healthcare while attempting to control costs. The ACA expanded Medicaid eligibility, established health insurance marketplaces, and provided subsidies to make health insurance more affordable for low- and middle-income individuals (Terrizzi et al., 2022). One of the ACA’s significant achievements was its provision preventing insurance companies from denying coverage based on pre-existing conditions, thereby improving access to care for many Americans. However, while the ACA made strides in increasing coverage, it did not fully address the rising costs of healthcare services and prescription drugs, which continued to burden many Americans.

On the other hand, President Donald Trump’s administration sought to dismantle many aspects of the ACA, arguing that it imposed excessive government regulation and led to increased premiums for many consumers. Trump’s approach included efforts to repeal the ACA, which ultimately failed in Congress, and the promotion of short-term health plans and association health plans as more affordable alternatives (Levitt, 2024). These plans, however, often provided less comprehensive coverage, leaving consumers vulnerable to high out-of-pocket costs. Additionally, Trump signed executive orders aimed at increasing price transparency in healthcare and reducing prescription drug costs, but these measures had limited impact on the overall cost trajectory of healthcare in the United States.

While both presidents addressed the issue of healthcare costs, their approaches highlight the complexity of the problem and the challenge of finding a comprehensive solution. The ACA’s expansion of coverage was a significant step forward, but it fell short in controlling the underlying factors driving healthcare costs, such as high prices for services, administrative expenses, and prescription drug prices. Conversely, Trump’s emphasis on deregulation and market-driven solutions failed to provide meaningful relief for those struggling with high healthcare costs, as these measures did not address the systemic issues contributing to the problem (Vogenberg & Marcoux, 2018).

If I were to approach the issue of healthcare costs differently, I would advocate for a multi-faceted strategy that addresses both the affordability and the underlying cost drivers of healthcare. First, I would prioritize the implementation of a public option within the existing healthcare framework. A public option would provide consumers with a government-run insurance plan that competes with private insurers, potentially driving down premiums and out-of-pocket costs through increased competition (Geruso & Layton, 2020). This approach would maintain the consumer choice inherent in the current system while providing a more affordable alternative for those struggling to afford private insurance.

Additionally, I would focus on addressing the underlying cost drivers in the healthcare system. This would include efforts to negotiate lower prices for prescription drugs, as well as implementing payment reforms that incentivize value-based care rather than fee-for-service models. By shifting the focus from the volume of services provided to the quality and outcomes of care, healthcare providers would be encouraged to deliver more efficient and effective care, ultimately reducing costs. Finally, I would invest in preventive care and public health initiatives aimed at addressing the social determinants of health that contribute to high healthcare costs. By improving access to preventive services, promoting healthy behaviors, and addressing factors such as housing, education, and food security, we can reduce the incidence of chronic diseases and other costly health conditions, ultimately lowering the overall demand for healthcare services and reducing costs. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

References

Galvani, A. P., Parpia, A. S., Foster, E. M., Singer, B. H., & Fitzpatrick, M. C. (2020). Improving the prognosis of health care in the USA. The Lancet , 395 (10223), 524–533. https://doi.org/10.1016/s0140-6736(19)33019-3 Links to an external site. .

Geruso, M., & Layton, T. J. (2020). Selection in health insurance markets and its policy remedies. The Journal of Economic Perspectives , 31 (4), 23–50. https://doi.org/10.1257/jep.31.4.23 Links to an external site. .

Levitt, L. (2024). What would another Trump presidency mean for health care? JAMA Health Forum , 5 (2), e240262. https://doi.org/10.1001/jamahealthforum.2024.0262 Links to an external site. .

Rahman, T., Gasbarro, D., & Alam, K. (2022). Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature. Health Research Policy and Systems , 20 (1). https://doi.org/10.1186/s12961-022-00886-3 Links to an external site. .

Terrizzi, S., Mathews-Schultz, A. L., & Deegan, M. M. (2022). State versus federal health insurance marketplaces: A bigger deal for Medicaid and a smaller deal for the individual mandate. Health Policy OPEN , 3 , 100059. https://doi.org/10.1016/j.hpopen.2021.100059 Links to an external site. .

Vogenberg, F. R., & Marcoux, R. (2018, September 1). Challenges to the U.S. health care system from legal and regulatory changes in the Donald Trump era . PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110638/ Links to an external site. .

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CK

Chhinderpal Kaur

Aug 28, 2024 5:54am | Last reply Aug 29, 2024 3:36pm

Reply from Chhinderpal Kaur

Presidential Issue

One of the topics of presidential concern is mental health. Mental health is a subject that has grown over the decades and gained much awareness among populations. In the USA, mental health is an important part of everyday life and therefore must be given the attention it deserves. According to a study by the Centers for Disease Control and Prevention (CDC), about 51 million US adults 18 years and above were suffering from a mental illness in 2019 (McKnight-Eily, 2021). According to the same report, the COVID-19 pandemic contributed to an increase in mental disorders, with 40.9% of people aged 18 and above reporting having mental issues during the pandemic (McKnight-Eily, 2021).

Related Social Determinants of Health

According to Santamaria-Garcia et al. (2020), there are negative and positive factors that influence mental health. In the research, adverse factors include different forms of violence, inadequate access to resources, and discrimination (Santamaria-Garcia et al., 2020). Positive aspects include social and family support (Santamaria-Garcia et al., 2020). Another study by Anglin et al. (2021) identifies broader factors including neighborhood, trauma, racial disparities in antenatal and postnatal care, and discrimination. The study further discusses these in broader detail as social determinants of health that are related to psychosis in the USA.

Actions of USA presidents

President Donald Trump

During his presidency, Donald Trump implemented several initiatives and policies related to mental health in the United States. First, he signed into law the SUPPORT Act, which stands for Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities. This Act addressed mental health by targeting opioid use which usually is a cause for mental health disorders. Second, he signed an executive order creating PREVENTS (President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide). This service was targeted to help veterans cope by improving their access to mental health services to reduce suicide rates among them. Lastly, he improved mental healthcare in schools to help in diagnosing and treating mental health issues in school-going students after the Parkland shooting of 2018 (Yan et al., 2021).

President Joe Biden

In 2021, The American Rescue Plan (ARP) was signed as an initiative to improve American health care by increasing funding for mental health due to the increase in mental illnesses posed by the Covid 19 pandemic. This initiative was meant to benefit especially the underserved communities as they were the most affected by the pandemic. The ARP also addressed funding for mental health care accessibility in schools. A second initiative by Biden was that he supported the full implementation of the 988 Suicide & Crisis Lifeline, which launched in July 2022. The hotline is toll-free and meant to help people 24/7 get access when they are in a mental crisis or are suicidal. President Biden also addressed the Surgeon General Advisory on Mental Health by directing funds toward mitigating issues such as bullying and social media that cause mental illnesses among the youth (Mezuk et al., 2022).

What I Would Do Differently

Mental health according to my understanding, begins at the basic unit of society, which is a family. I would focus my interventions on the community level. I would increase access to mental health services in the community and make them affordable. I would increase community mental health workers to improve mental health service delivery. This will help to address other factors that lead to mental illnesses at the community level which will generally improve health outcomes.

References

Anglin, D. M., Ereshefsky, S., Klaunig, M. J., Bridgwater, M. A., Niendam, T. A., Ellman, L. M., … & van der Ven, E. (2021). From womb to neighborhood: a racial analysis of social determinants of psychosis in the United States. American Journal of Psychiatry, 178(7), 599-610. https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2020.20071091

Mezuk, B., Maust, D., & Zivin, K. (2022). A Response to the President’s Call to Support Public Mental Health. American journal of preventive medicine, 63(4), 660-663.

McKnight-Eily, L. R. (2021). Racial and ethnic disparities in the prevalence of stress and worry, mental health conditions, and increased substance use among adults during the COVID-19 pandemic—United States, April and May 2020. MMWR. Morbidity and mortality weekly report, 70. https://www.cdc.gov/mmwr/volumes/70/wr/mm7005a3.htm?ACSTrackingID=USCDC_921-DM48285&ACSTrackingLabel=This%20Week%20in%20MMWR%20-%20Vol.%2070,%20February%205,%202021&deliveryName=USCDC_921-DM48285

Santamaría-García, H., Baez, S., Gómez, C., Rodríguez-Villagra, O., Huepe, D., Portela, M., … & Ibanez, A. (2020). The role of social cognition skills and social determinants of health in predicting symptoms of mental illness. Translational psychiatry, 10(1), 165. https://www.nature.com/articles/s41398-020-0852-4 Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

Yan, B. W., Hsia, R. Y., Yeung, V., & Sloan, F. A. (2021). Changes in mental health following the 2016 presidential election. Journal of general internal medicine, 36, 170-177. https://link.springer.com/article/10.1007/s11606-020-06328-6

Expand discussion thread from Chhinderpal Kaur

RS

Romel Suason

Aug 27, 2024 11:45pm | Last reply Sep 1, 2024 9am

Reply from Romel Suason

Covid 19 Pandemic

I will be discussing Covid 19 Pandemic. This is the topic I chose because Covid19 started when President Trump was still in office and ended in the President Biden Administration. Covid 19 crippled the whole world. Crashed economies of multiple countries. People resorted to using social media platforms to get their opinions across to family, friends, government agencies and the whole world.

President Donald Trump initial Approach

President Trumps saved millions of lives because of his decisive response to Corona Virus Pandemic. Even with all the negative and positive feedback from a lot of people he stopped unnecessary travel to foreign countries. A Corona Virus task force was immediately created to guide the country and everyone to prevent the spread of the virus. President Trump made sure that front line workers have all the necessary equipment (PPE, Gloves, Mask and Face shield) to protect frontline workers and their families and everyone. At first very little was known about Corona Virus.

President Joseph Biden

President Biden followed through with what President Donald Trump started. Testing sites were doubled. He made sure that social distancing was Implemented, vaccines, test kits were made available to everybody. Families, Schools, Small Businesses were guided properly on how to combat Corona Virus. The Biden Administration invested $25 billion dollars in vaccine manufacturing and distribution plan that it will get to all the states, cities and families. Elderly and immune compromised people were protected to reduce the mortality rate. Prepared for any pandemic threats that may or may not happen.

Reflections

I respect and believe both President Trump and President Biden did what they think was necessary to prevent the Spread of this deadly disease. They have succeeded in preventing this disease from getting worst.

Being a Front Liner during the said pandemic. I will always be biased in the protection of health care workers. I have read in the Nursing, Health, & the Environment electronic book that was given to us as one of the references that really struck me.

Among health care providers, registered nurses occupy a unique position. In both rural and urban settings, nurses are often the initial, and sometimes the only, point of contact for people seeking medical care. They are also the largest group of professional health care providers in the United States: an estimated 2.2 million. In occupational health practice, nurses outnumber physicians by six to one. Yet the vast majority of nurses have had no formal training in occupational or environmental health.

If environmental health hazards and health effects are to be recognized and dealt with effectively, it is of fundamental importance that all health care providers have a clear understanding of the association between the environment and health. Toward that end the committee makes a series of recommendations for the integration and enhancement of environmental health in nursing education, practice, and research.

What I would do differently if I was in the position to make a change is educate people first on how to prevent the spread of an infectious disease. Social media is being utilized for sports, news, music, people’s daily lives and all you can think of. It is part of people’s daily lives now a days. I would urge people from Centers for Disease Control and Prevention to post on every page in Facebook, twitter, Instagram ways to prevent spread of diseases. Rather than report about how many people have been infected. Communities and Schools should have periodic exercises about disease prevention. So, in the in the future if something like this pandemic happens again people will be equipped with the knowledge of prevention. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses

Reference

Institute of Medicine (US) Committee on Enhancing Environmental Health Content in Nursing Practice, Pope, A. M., Snyder, M. A., & Mood, L. H. (Eds.). (n.d.). Nursing health, & environment Links to an external site. Links to an external site. : Strengthening the relationship to improve the public’s health.

https://trumpwhitehouse.archives.gov/issues/coronavirus/ Links to an external site.

https://www.whitehouse.gov/priorities/covid-19/ Links to an external site. Walden University NURS 6050 week 1 Presidential Agendas discussion post and responses