Health Care Policy in Canada

Health Care Policy in Canada


The Canadian healthcare policy is bestowed in the national health insurance program, which is universal and covers a broader spectrum and group of people. The health care policy in Canada was initiated to revamp the significant inequalities evident in the region as the government tries to create a balanced system where services related to health can be evaluated based on credibility and usefulness to people and the institution at large. The health policy system in Canada is known as Medicare, as it serves approximately thirty million people who reside in the region.  Health care policy in Canada, as opposed to that realized in the United States, is based on the quality of services that such institutions can provide and maintain. Healthcare policy in Canada originates from the concern that at different levels, there is needed for the provision of quality services to people regardless of issues that might bar such actions and operations from taking place. It is, therefore, worth noting that irrespective of the services and quality services that are remitted to people across this healthcare institution, the policy holds that each member is accorded the needed services comprehensively and stably. However, the standard variety common between Canada and the United States health care policy is based on the public opinions associated with them.

Implementation Challenges

Health care policy in Canada is faced with numerous challenges during its implementation process. First, due to a large number of people in the region as opposed to that in the United States, the policy has experienced significant challenges in ensuring equitable services to all of them. Similarly, inadequate funds and qualified workforce has been a severe challenge in implementing the system and ensuring its credibility. Overall, government regulation and laws associated with such services have made its implantation passive and inconsistent.

Key Stakeholder and Policy Dynamics

Health care policy in Canada has the following stakeholders for its success: patients, insurance companies, government, employers, physicians, and pharmaceutical firms. In the system, insurance companies sell to the patients and other groups in the health coverage plans, which are done either directly to patients or sometimes indirectly through governmental intermediaries or employers. According to Leake (2016), the entire stakeholder team in healthcare service ensures that the institution is stable and able to meet the demands of both patients. Moreover, dynamics are usually associated with the changes that might be realized in an institution. In the health care policy, policy dynamics are associated with issues that not only restore the needed outcome in the institution but also reiterate the insurance covers available for the policy’s success.

Key Planning Issues and Current Events

The health care policy in Canada is the Country’s point of pride. However, the planning processes for the success of its implementation are associated with issues of inconsistent and discrimination that are of great importance to not only the Country but other stakeholders. High government demands and reduced regional Medicare systems have made it passive. Overall, inadequate support and funds have limited their functionality in different clinical practices and health requirements. Overall, the current events are inequalities in providing the system to people and its impacts on them.

Health Care Policy in Canada and the United States

Similarities: In Canada and the United States, health insurance acts as the primary way individuals make payments for their healthcare services. Similarly, in both Canada and the US, the policy is accommodative and depends on the available funds to adjust its functionality and assistance to people. Overall, Health care policy in the two depends on similar public opinions for their success and insightful application among people.

Differences: The main difference between the healthcare policy in Canada and the US is how insurance is being funded. In the United States, individuals are required to support their health care insurance, which is only possible if one has qualified. The government in the United States outlines the qualities that make one eligible for insurance programs such as disability brackets, income, and age. Similarly, as opposed to the system in Canada, US health care insurance is often, though not tied to employment (Woolhandler, Campbell & Himmelstein, 2017). Employers provide the coverage in the benefit packages that they offer to employees. However, the coverage provided varies from employer to employer, and sometimes not guaranteed.

Overall, in the United States, health care policy allows private enterprises to be the primary providers. Insurers scramble for customers and that the employers also depend on the number of consumers gotten to run other insightful issues related to the success of the care sector. On the other hand, in Canada, the health care policy allows private healthcare providers to provide the necessary services to people. In this case, the physician and the doctor have equal responsibilities in the provision of the needed care services through associating with the insurance companies.


Leake, J. L. (2016). Why do we need an oral health care policy in Canada?. Journal of the Canadian Dental Association72(4).

Woolhandler, S., Campbell, T., & Himmelstein, D. U. (2017). Costs of health care administration in the United States and Canada. New England Journal of Medicine349(8), 768-775.

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The 2017 American Health Care Act (Trumpcare)

The 2017 American Health Care Act (Trumpcare)

Policy Identification, description, and rationale

Trumpcare, or the American Health Care Act (AHCA), is a bill proposed by the Republicans in the 115th Congress that primarily targets to repeal and replace the current Obamacare (the Patient Protection and Affordable Care Act). Since his election, President Donald Trump has always been keen to replace the popular Obamacare, which was introduced and signed into law by former President Barack Obama in 2010. Commonly known as the Affordable Care Act, the current Obamacare principally targets to provide health cover to a majority of the vulnerable populations by expanding Medicaid eligibility as well as by making modifications to individual coverage markets. Obamacare managed to raise funds by introducing new taxes, cutting down Medicare fees, and providing Medicare benefits. However, a majority of Obamacare’s critics, including President Trump and his Republican supporters, have pointed out that this measure has resulted in a national budgetary deficit.

Thereby, the justification or rationale for the introduction of Trumpcare or AHCA is that it would reduce the federal spending on the current Medicaid program, thus possibly lowering the skyrocketing national debt. According to the Congressional Budget Office report released in 2017, the Trumpcare can significantly lower the current federal budget by approximately $337 billion within the nex10 years. This will imply that the government will spend roughly $1.2 trillion less (Thompson, Gusmano, & Shinohara, 2018).

Policy relevance and its effect on healthcare

Since its conception, there has always been a raging debate on whether the new Republican health policy can produce similar health benefits as the existing Obamacare. A majority of opponents of Obamacare have based their bone of contention on the incompletes and setbacks of strategy to the economy as well as the effectiveness of the entire healthcare system. According to these naysayers, health insurance remains extremely expensive for those earning less because of the mandatory health premiums imposed by Obamacare. For instance, according to Sanger-Katz (2017) of the New York Times, even though premiums for the Affordable Care Act were low during the first three years of implementation, they have steadily risen, resulting in financial shocks for people not registered on any government subsidies or aid.

There is also the worry among experts that healthcare premiums have remained confusing and complicated, and choosing the correct type of plan is almost impossible and frustrating for people not sure of their health requirements. For instance, a majority often struggle with understanding terms like “in-network provider” as well as “out-of-pocket maximum.” Finally, there is also the issue of the limited number of doctors and options available for the existing health policy. A large percentage of the ACA’s health plans have lowered the number of hospitals and doctors clients can select, especially as they struggle to maintain competitive prices. This has made it challenging for people to choose their preferred doctors, hospitals, or providers. Therefore, on top of increasing the number of health insurance subscribers countrywide, the American Health Care Act promises to ensure that a more significant part of medical care is financed from individual pockets by reducing government funding through Medicaid. Proponents of the law argue that this allows people to choose the type and quality of healthcare they wish to pursue rather than being restricted.

Deviation from the current policy that would improve its effectiveness

Unlike the Affordable Care Act, the American Health Care Act targets to remove all tax punishments imposed on employers or companies for failing to provide insurance cover as well as people for refusing to maintain their coverage. As a replacement for, the law would oblige insurance providers to increase the premiums by nearly 30% (monthly) for approximately twelve months for people who failed to keep up with their insurance coverage. Also, contrary to the present ACA, the new bill will remove the subsidies and credits based on monthly income. Instead, the law will offer a new model of tax credits that are primarily based on age rather than the amount earned by an individual. As it stands now, the massive tax imposed on the top1 percent earners (billionaires and multimillionaires) primarily funds the healthcare insurance for the bottom 40 percent of families. Obama’s regime introduced this policy to distribute resources and reduce income inequality in America.

Ways to measure policy improvements if implemented

Several methods can be used to evaluate the success of the new bill. For example, stakeholders can estimate the number of unique insured individuals in the country to determine whether or not the new policy has significantly increased the number of people covered. The second way is to determine the new federal budgetary deficit, which is indubitably the primary reason the original bill was proposed in the first place. The third and last way is by establishing the effectiveness of the new health law by estimating how people quickly and often use their premiums to seek medical assistance. For example, with the new law, the government can calculate the number of monthly subscribers on things like pharmaceuticals or mental health.

The level of oversight the national government should provide to the chosen policy

The government, without question, has a significant oversight role by ensuring that new health insurers implement the new regulations as set by the ministry of health and other concerned regulatory boards. For example, it must oversee that insurance companies do not levy people beyond the maximum fees regulatory and other statutory bodies have established.


Congressional Budget Office. (2017). American Healthcare Act Cost Estimate. Retrieved from

Sanger-Katz, M. (2017 Feb 5). Grading Obamacare: successes, failures, and ‘incompletes.’ The New York Times,

Thompson, F. J., Gusmano, M. K., & Shinohara, S. (2018). Trump and the Affordable Care Act: Congressional repeal efforts, executive federalism, and program durability. Publius: The Journal of Federalism, 48(3), 396-424. Retrieved from

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Cessation of Smoking Health Policy

Cessation of Smoking Health Policy

Smoking is a hobby of consuming tobacco and other drug substances through burning and inhaling the fumes and or smoke resulting from these substances’ burning process.  Of particular importance is the smoking of tobacco products whether locally prepared or processed.  Smoking has however been associated with grave effects and thus making smoking on n of the leading cause of health hazards and consequently deaths.  Tobacco being the component in cigarettes has been rated one of the leading cause of cancer in its consumers. This, therefore, explains the statistics collected and proven to be true over time.

 Health studies conducted and published by CDC in January 2017 indicate that cigarette causes harm to almost every organ of the body and thus causing various health hazards and thus reducing health in general (CDCD, 2017).  CDC further estimates that cigarette smoking is responsible for about 480 000 deaths every year, the statistics which imply that for every 5 deaths, one is smoking related and thus this, therefore, indicate that the smoking is one of the leading causes of deaths.  This statistics on deaths leaves some of the cause of deaths trailing behind which include firearms related deaths, HIV, motor vehicle accidents among other causes of deaths.

 Other shocking information is that smoking has caused more than ten times of premature deaths as compared to other causes of deaths and thus this clearly shows that most early adopters of smoking are likely to die early.  Further, Studies indicate that 90% of lung cancer is caused by smoking and that lung cancer statistics on women is way higher than that of breast cancer.  Other than cancer smoking has been attributed to respiratory disease and cardiovascular diseases.  I regard respiratory diseases, smokers are the leading in reporting of respiratory obstruction (CDCD, 2017). Also, tobacco smoking has been found to cause an asthma attack or escalate the cases of attack for individuals with asthma.  Cardiovascular diseases and complications such as chronic obstructive pulmonary obstruction disease, stroke, coronary heart disease, blockage of blood flow to organs such as the legs among others become a challenge and thus increasing the complications in the cardio vascular system (CDCD, 2017).  Finally, Smoking of tobacco has been to have an effect on reproductive abilities in both males and females.  Women who smoke have been found to have difficulty in becoming pregnant according to research. This has prompted various studies which have been undertaken and thus indicating that tobacco affects fertility in women. In men, smoking has been attributed to malfunctioning sperm production thus causing infertility.

All these health implications affect all people across the age and gender, and thus this means that cessation of smoking as a healthcare preventive measure will help in reducing the cost implications which are caused by smoking.  This strategy will not only help in improving the health of the employees, creating a good image in the community but also cushion the company from the huge expenditures which will be required to pay as co-pays as well as making the employees economic by ensuring their health. It will make the employees economic since the company will not have to spend time in attending to the employees and also that the company will not lose time and resources in a case where the employees have to be given sick leaves since they will be paid their dues.  Above it, all the complications which result from smoking are costly and have adverse effects in the employee, and thus the company has to spend a lot of resources in sorting out huge medical bills as well as provide their salaries. In the long run, advocating for cessation of smoking will by far help the company cut the cost caused by smoking-related health challenges.  

The company’s population is made up of 50% males and 50% female with an age bracket of 18-65. The young employees are at a higher risk of premature deaths caused by complication related to smoking whereas the old have a risk of going through the trouble of chronic complications. 18 years of age and above is also a fertile group who need to have families and consequently have children and thus advocating for smoking cessation will help reduce cases of reproductive challenges.  Successful advocacy for smoking cessation will, therefore, reduce the risk of huge expenditures on health and hiring costs which may occur time to time owing to the deaths and loss of employees as a result of chronic and acute illnesses which arise from smoking.  Loss of employee due to illness will prompt the company to replace such employees, and this means that the company has to pay the estimated cost of between $1000 and $4000, an endeavor which can be avoided if the smoking cessation is advocated for (Erickson, 2017).  This cost can be high if there are many employees who smoke in the company.

The impact of discouraging, therefore, have either a direct impact by reducing the cost which shall be spent in the treatment of smoking-related complications. This is because smoking has been rated as the leading cause of deaths in the United States and other parts of the world. Also, this campaign will also create a good image of the company since the authorities, and the community and the public at large will support the company and thus will help in having a good operating environment.  Precisely,   studies which were conducted by Cipriano and colleagues in a study which was aimed at estimating the cost involving lung cancer found that the cost of treatment ranged from $2687 in the first months of diagnosis and no treatment to $9360 with chemoradiotherapy (Cipriano et al., 2011).   This shows that the treatment alone is costly, let alone the time taken by the employee to seek medication. This, therefore, justifies the value of the campaign for the smoking cessation in the company.  

This strategy will be employed and encouraged through ensuring that new employees are familiarized with the company’s desire and how the company rewards the adopters of the strategy.  The adopters will be awarded a specific amount of money which is awarded on a monthly basis together with the salary.  For instance, smokers will be asked to voluntarily come out and register with the health safety department in order for the monitoring and assessment to be conducted from time to time.  To ascertain compliance, the health and safety departments will be enhanced by the provision of nicotine testers, and thus members who meet a set threshold which may not necessarily be zero are rewarded from time to time.  

Conclusively, smoking cessation as a healthcare strategy aimed at reducing the cost of health in the company is evidently a feasible and most promising strategy to adopt since smoking is rated one of the leading cause of deaths and grave health complication which might cost the company to a great extent if no intervention is employed.


Cipriano, L. E., Romanus, D., Earle, C. C., Neville, B. A., Halpern, E. F., Gazelle, G. S., & McMahon, P. M. (2011). Lung cancer treatment costs, including patient responsibility, by disease stage and treatment modality, 1992 to 2003. The Value in Health14(1), 41-52.

Erickson, B. H. (2017). Good networks and good jobs: The value of social capital to employers and employees. In Social capital (pp. 127-158). Routledge.

CDC. Health effects of cigarette smoking (2011). Retrieved from

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Prioritize nursing interventions when caring for pediatric clients with health disorders.


The nursing student should be able to identify seizure activity, educate the pediatric patient’s family and/or caregiver on what to do if a seizure occurs and what medications to administer, and implement safety to prevent injury and treatment of the fracture. Develop education to support discharge based on an assessment of data.


Prioritize nursing interventions when caring for pediatric clients with health disorders.


A 5-year-old Gabriel is a multiracial male weighing 48 lbs with an allergy to penicillin arrives in the emergency room, and no cultural considerations identified. You are handed the following notes on the patient read:

He arrived in ER with his mother after falling out of bed after jerking movement activity as witnessed by his older brother while sleeping. Right upper extremity appears with deformity. Mother and child speak English. The child has no significant medical history. Mother reports incontinent of urine during the episode.

Your Assessment

Vital Signs: T 102.9, P 135, R 24, BP 118/60, O2 sat 100% RA

General Appearance: appears drowsy; face flushed, quiet

Neuro: oriented X3

Cardiovascular: unremarkable

Respiratory: lungs clear

Integumentary: very warm, dry

GI/GU: abdomen normal

Physician Orders

  • Complete Blood Count (CBC)
  • Complete Metabolic Panel (CMP)
  • Urinalysis with culture and sensitivity (U/A C&S)
  • Blood Cultures x 2
  • X-rays kidneys,
  • Influenza screening
  • Acetaminophen 15 mg/kg PO now
  • Ibuprofen 10 mg/kg PO now
  • Pad side rails
  • Suction at bedside with seizure precautions
  • Radiographs of right arm
  • Cast to right arm
  • Start PO fluids and increase as tolerated

The physician discharges Gabriel from ER to home with a diagnosis of; Right ear infection, Acute Febrile Seizure and fracture of the right ulna.

Discharge orders include:

  • Follow up with pediatrician in 7 days
  • Follow up with pediatric orthopedics in 7-10 days
  • Cefuroxime 30mg/kg PO BID for 10 days not to exceed 1,000mg daily. What is the recommended dosage if cefuroxime is supplied as an oral suspension 125mg/5ml or 250mg/5ml?
  • Acetaminophen 15 mg/kg PO Q4 hours PRN fever or pain and ibuprofen 10 mg/kg PO Q6 hours PRN fever and pain for up to 3 days
  • Acetaminophen is available as 160 mg/5 mL. Ibuprofen is available as 100 mg/ 5 mL.
  • What is the amount of acetaminophen in mg and ml per dose? What is the amount of ibuprofen in mg and ml per dose?

Develop a discharge plan with three goals listed in order of priority, prior to discharge from current orders. Provide rationale for why you listed the goals in a particular order. Also, list three nursing interventions to meet each of the goals (you should have nine interventions in total). Last, give the mother the exact dosage she will need to give the child for acetaminophen, ibuprofen, and the cefuroxime when she gets home and explain why the exact dosage is important.

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Health Care Law Discussion Board

Health Care Law Discussion Board

Answer the Discussion Board board questions in paragraph form and reply to at least 1 classmate. 

1.     What are the three branches of government? Why is it necessary to separate the government in this way?

2.     What are the three levels of the judiciary? And, what is the name of the highest court in the United States?

Health Care Law Discussion Board

1 reply in depth to a fellow classmate on the topics they select. (2 total posts per week) post 1 is worth 80points, peer reply is worth 20 points.

1) Your response should be in depth (3-4 paragraphs for the initial post and 2-3 paragraphs for follow up) to fully develop your answer. Defend your position with concrete examples from the weekly content and real-life cases, if applicable.

2) APA citation is required.

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MSN5550 Health Promotion: Prevention of Disease

MSN5550 Health Promotion: Prevention of Disease
Discussion Board Rubric
Criteria Unsatisfactory-Beginning Developing Accomplished Exemplary Total
& Analysis
0-30 points 35-39 points 40-44 points 45-50 points /50
Ideas expressed lack an
understanding of the
discussion topic. Comments
are irrelevant, off-topic,
and/or confusing to follow.
Viewpoint, if given, is not
supported with evidence or
Ideas expressed in the discussion
posts show a minimal
understanding of the
discussion topic. Comments are
general in nature and/or
occasionally may not be
relevant. Rehashes or
summarizes ideas with limited
analysis, original thought,
and/or supported viewpoints.
Ideas expressed in discussion
posts are mostly substantive
and relevant to topic; some
original thought. Demonstrates
logical thinking, reasoning,
and/or analysis for most part.
Viewpoint is supported with
evidence and/or examples.
Ideas expressed in discussion
posts include original
thought, substantial depth,
and are relevant to topic.
Viewpoint shows strong
logical thinking, reasoning,
and analysis with evidence
and examples. Construction
of new meaning and insights
are evident.
to Course
0-13 points 14-15 points 16-17 points 18-20 points /20
No connections are made to
readings or other course
materials (lectures, media,
resources, etc.), and/or if
made, are not clearly stated
and are largely personal
Minimal direct connections are
made to readings and/or other
course materials (lectures,
media, resources, etc.).
Connections are largely
inferred and somewhat unclear
at times.
Some direct connections are
made to readings and/or other
course materials (lectures,
media, resources, etc.) and are
clearly stated for the most
Strong, direct connections
are made to readings and/or
other course materials
(lectures, media, resources,
etc.) and are clearly stated.
to Learning
0-13 points 14-15 points 16-17 points 18-20 points /20
Negligible contribution to the
learning community. Rarely
engages with students and
generally ignores others’
posts and/or has a negative
effect through
misrepresenting content in
other posts, inappropriate
comments made, and/or
attempts to dominate the
Somewhat contributes to the
learning community but the
focus is generally on own
posts. Occasionally interacts
with others’ postings but little
attempt to involve other
students in the discussion.
Short statements such as “I
agree with…”.
Contributes to the learning
community. Often attempts to
direct group discussion to
present relevant viewpoints
and meaningful reflection by
others. Interacts respectfully
with students.
Effectively contributes to the
learning community.
Frequently initiates dialogue
and motivates group
discussion by providing
feedback to students’
postings, asking follow-up
questions, and through
thoughtful, reflective
comments. Respectfully
encourages a variety of
viewpoints and invites
contributions from others.
Discussion Board Rubric (continued)
Criteria Unsatisfactory-Beginning Developing Accomplished Exemplary Total
0-6 points 7 points 8 points 9-10 points /10
Posts show a below
average/poor writing style that
lacks standard English, and/or
is difficult for readers to follow.
Contains frequent errors in
grammar, punctuation, usage,
and spelling.
Posts show an average and/or
casual writing style using
standard English that is
generally clear but contains
some errors in grammar,
punctuation, usage, and
Discussion posts show above
average writing style that is
clear using standard English
with minor errors in grammar,
punctuation, usage, and/or
Discussion posts are well
written and clearly
articulated using standard
English, characterized by
elements of a strong writing
style with correct grammar,
punctuation, usage, and
TOTAL POINTS (sum of 5 Criteria) /100
Source: Rubric by Denise Kreiger, Instructional Design/Technology Services, SC&I, Rutgers, 3/2014

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The Health Care Bill Of US

The Health Care Bill Of US


Abstract. 1

Introduction. 3

Environments Influencing the Health Policy Issue. 4

2.1 Historical Environment. 4

2.2 Sociocultural environment. 5

2.3 Ethical issues. 6

2.4 Economic issues. 7

2.5 Political environment. 8

3.0 History of the Bill (or Law). 10

6.0 Evaluation. 13

7.0 Recommendations for Improvement of the Policy. 15



Health is an important aspect of human life and should be treated with great care; it’s a basic commodity and a human right. Various people in a community should be considered for any health care initiative that is established, the old, the young, the poor and the sick should all be taken care of in any health plans. 

The United States government has for many years tried to come up with a Health Care Act that could be acceptable to all and cover all Americans, however this has not been always acceptable by everyone and some resistance has resulted to various bills being passed in parliament. Different stakeholders have had varying opinions on passed bills and why they were for or against the bills.

Since time immemorial different bills have been enacted in to law this paper looks at the various bills that have been passed their effects to the society and the impact they have had politically, socially, and economically to the people.  The paper traces a history of several bills that have been passed and the impact they have brought in to the society, it highlights different   categories of people who have opposed bills and their ground for opposing them. 

It later looks at the most current bill and the effect it has brought to the society and later highlights the recommendation for improving the welfare of the stakeholders





The US health care system was described as “broken” a decade ago and had not improved, and fixes promised by managed care had not materialized, premiums were rising and around 45 million Americans had not been insured (Garson, 2000). Basing on these figures policymakers and other stakeholders were quick to predict that the problems would worsen and new challenges crop up. Such predictions were made in the full realization that the ever emerging technological innovations would increase efficiency in service delivery and therefore cost would be far above the savings. The increased costs would not be accepted by employees and would mean hiring new employees while others would quit the insurance business and this would result to more people being uninsured as well as remaining unemployed.  

Cutler (2010) emphasizes this as he observes that as much as 10% of Americans are unemployed. Needless to say, this has resulted to slow economic recovery particularly in the face of the recent global financial crisis. In this regard, many measures have been put in place to enhance efficient and timely service delivery Dealing with unemployment has been at the top of the list of US current President Barrack Obama and Congress leaders.  Cutler observes that one way to deal with unemployment is to slow the growth of medical spending; he argues that if health care cost increase slows down, it will be more profitable for businesses to expand employment and workers will readily join the new jobs. High health care costs have a double effect on employment this can be illustrated as: on the side of the employer, employer paid-health premiums are a cost to the business just like other operational costs such as salaries and wages, electricity and water bills among other expenses and a reduction in health insurance premiums will enable employers to hire more workers other factors held constant. On the side of the worker most of them are ready to give up salaries and wages to receive employer’s paid-health insurance.  

According to the Presidents Health Care Bill (2010) small families and small business owners should be in control of their own health care. The Health Care Bill makes insurance more affordable by providing a large middle class tax cut for health care and reducing premium cost, it therefore helps in providing an afford health care. The bill further introduces a new competitive health insurance market and brings a greater accountability to health care by laying out rules to keep premium down and prevent insurance industries abuse that existed such as refusing to cover people with pre-existing medical conditions and denial of care. 

The passing of the bill in the House of Representative though by the Democrats only owing to the Republicans unanimously voting against the bill, led to another stage for The Patient Protection and Affordable Care Act (PPACA) that was signed by President Barrack Obama on March 23 2010, the Act will ensure that workforce health and wellness efforts will remain critical with expanded wellness incentives, in addition employers will need to prepare for generally increased oversight and interaction with the federal government regarding employees’ health benefits (Watson 2010). 

Environments Influencing the Health Policy Issue

2.1 Historical Environment

According to Economic History Association (2010), due to medical technologies very little could be done to patients and most patients were treated from home prior to 1920, therefore most people had very little or no medical expenditures. In 1919 state of Illinois study report showed that the amount of lost wages due to sickness was four times larger than that off the medical expenditure associated with treating the illness (Cited in health insurance in the United States). Reinhardt (2001) emphasizes this by stating that though the Americans economy prospered during the 1990s the number of Americans under the age of 65 without any form of insurance coverage experienced a dramatic rise from about 35 million Americans to around 40 to 44 million Americans, this was a very high rise. The situation was expected to rise if economic growth remained low and as more Americans would lose their job which tied their insurance coverage through the employer-paid premium.  He further observes that though they are those with insurance coverage, a significant proportion of them have shallow coverage due to very high deductibles and co-insurance on the total covered by the insurance or even exclusion of important and desired coverage from the insurance package the situation left many Americans vulnerable to worsening medical problems.

In addition in the late 1980 and early 1990s actual real health spending began to rise noticeably and the premiums that private employers paid for on behalf of their employees rose both for larger employer and even smaller employers, consequently most companies would not manage employing many workers as this would increase the cost of premiums while others strategized on laying off some employees. 

2.2 Sociocultural environment

The social cultural aspect deals with all members of a community, The Social Security Act Amendment  Bill signed On 30th July 1965 by  President Lyndon Johnson established Medicare which is an insurance program for the elderly and also established Medicaid which a health insurance program for the poor, this shows there was concern for wider members of the society and later in 1997, The State Children’s Health Insurance Program (SCHIP) was enacted which  gives grants to states to provide health insurance coverage to uninsured children up to 200% of the Federal Poverty Level (FPL) (Work World Inc., 2010). 

Waymack (n.d.) emphasizes that health can be regarded as a social good, the author continues to elaborate that it’s not in any nation’s interest to have a populace wracked and consumed by diseases therefore a nation’s will is to have a health population that is productive; he observes that sick people do little to contribute to economic production and income taxes, and that a healthy workforce is more productive than a sick workforce.

A healthy nation is more productive and matters of health should not be discriminated on any ground, be it gender, race, religion or age. Jeffries (2010) observes that in the past women argued that their premiums were higher than those for their male counterparts; however this issue has been addressed by the new health care reform that made it illegal for insurance companies to charge higher premiums based on gender. 

2.3 Ethical issues

Ethics is concerned with determining what is right and what is wrong on how human relate to one another, under the American Medical Association(AMA) a patient has a right to make decision regarding the health care that is recommended by the physician, this right was not upheld during the managed care era,  this was in a period of about five years from 1992 to 1997 when the demand for the America health introduced managed care, a program which gave private employers ability to force upon their employees employer-sponsored health insurance products. The employer-sponsored health insurance products limited the employee’s choice of medical providers to define networks, as a result this limited direct access to medical specialist and at times limited patients access to new and expensive medical technology like new and expensive brand name medicine, this was unethical treatment to the employees (Reinhardt, 2001).

There are members of the public who believe that health is an individual responsibility, they believe that the well being of once health is a personal issue, in this regard they do not support a system that requires them to contribute tax dollars to support fellow citizens who they feel do not act responsibly in protecting and promotion of personal health. Their argument is that the government cannot establish what is right for them and therefore people should be allowed to choose their own physician and treatment (Waymack n.d.). 

Ethics in health care can be regarded as a positive Moral Right, this is described by Waymack (n d.) who further explains that individuals have a right to health care and if a person has limited economic resources to cater for such care the society has an obligation to see that poverty does not act as an obstacle to receiving health care. Health care can also be regarded in the Business Ethics and health care has never been a completely charitable endeavor, physicians have always felt some professional moral obligation to provide care to the indigent. 

2.4 Economic issues 

In the period between 1992 to 1997, the demand for the America health sector boosted employers through managed care, this is a system which gave private employers ability to force upon their employees employer-sponsored health insurance products, consequently this limited the employees choice of providers of medical services to define networks, hence limited direct access to medical specialist and at times limited patients access to new and expensive medical technology (Reinhardt, 2001). This effect was mainly felt by those employed in the private sector, but its worth noting that a nations population is much more than just the employed people, therefore a nation’s government should take care of all parts of a nation and all citizens. 

 A country’s economic welfare should take care of every part of a country, the rural economy is in America is characterized by underinsurance and un-insurance as observed by Bailey (2009) he continues to add that the rural areas have witnessed significant decline in manufacturing jobs and a rise in service sector employment, as a result this has lend to losing jobs and a decrease in rates of employer-sponsored health insurance as well as gaining jobs with lower rates of employers–sponsored coverage. This is rampant for low-skilled jobs that are more common in rural areas. The rural economy has a very large number of self-employed and small businesses which are generally less insured, more underinsured and more dependants on the individual insurance market. Putting this in to consideration a health care reform that relies exclusively on maintaining the current employer-sponsored health insurance system will be of little relevance for rural areas due to the lower rates of employer-sponsored insurance as well as the rural economy composition. A health care reform that is viable should strengthen public programs currently depended upon by majority of the rural people. 

As observed earlier everyone’s interest should be put in to consideration while drafting a bill, a bill should cater for both the employee and the employers, if the employer-sponsored insurance is seen as putting unfair constraint on the employee by deciding where the employee should get medical attention, then the government should also consider that the employer-sponsored  insurance premiums are an additional cost to the employer and they result in reduced profits hence the need to decide where an employee should attend for medical attention.

2.5 Political environment

There are major political opportunities that have been lost in the US as observed by Starr (1994), to this category of great political opportunities lost in America; he adds the collapse of health care reforms in the first two years of Clinton’s administration. It was an idea endorsed and co-sponsored by republicans, democrats and key interest groups, it came out as a strategic mismanagement on the president’s part and his advisors,  this move was to end the season of opportunity for President Bill Clinton and by 1994 the press would undermine trust in the president, those opposing the reforms were organizing their forces and first concentrated on groups with ideological affinities and as a result the chambers of commerce that had endorsed the mandate reversed and other business organizations followed suit. 

The health care bill has been used to weigh political abilities of many in US as Malone (2010) points out; when the congressional passed the health care reform bill it was a major political boost for President Barrack Obama and the Democrats. This was a major gamble with the democrats, with the opposition republicans vowing to exact revenge. Additionally, Malone asserts that compared to his predecessors, President Obama scored a political success on health care, this sets a history for the Americans as the process was initiated a century ago when a national health insurance was initiated by President Theodore Roosevelt. Since its initiation by Roosevelt, successive presidents mainly the Democrats were in its favor, this show that since the initial stages the health care reform was a thing for the Democrats and its success was a success for the Democrats politically despite being a success to the Americans. When President Barrack Obama was elected in 2008 his top domestic priorities were change and quick made health care and therefore with the passing of the bill which he later signed in to law, this was a major achievement in his political career and a fulfillment of his promise to the public.

Though the health care bill is historic, it’s a gigantic political gamble, in response to this most Americans oppose the Obama plan which resulted to all republicans voting against the bill, the bill has also fueled the rise of Tea-party movements, loosely organized groups of grass root conservatives, liberation and anti-tax activists who opposed the health care plan on grounds that it had resulted to too much government involvement in the economy.

3.0 History of the Bill (or Law)

On 30th July 1965 President Lyndon Johnson signed the Social Security Act Amendment into law, it established Medicare which is an insurance program for the elderly and also established Medicaid which a health insurance program for the poor. The program was funded by a tax on the earnings of the employees matched by contribution by the employers and was positively received. The program had been initiated by President Harry S. Truman two decades prior to the enactment by asking the congress to establish a legislation establishing a national health insurance plan as established by the government document information. In 1985 The Consolidated Omnibus Budget Reconciliation Act (COBRA), amended the Employee Retirement Income Security Act of 1974 (ERISA). The Act requires most employers to provide continuing health insurance coverage to employees and their dependants who are no longer eligible for the company’s health insurance program; the law was later revised in 1999. The law applies to nearly all businesses that have more than twenty employees and offers a group health care plan (Lenore, 1999).

A health plan that would guarantee health insurance for all Americans was presented to the US congress in 1993 by President Bill Clinton but was opposed by congress leaders on grounds of being too expensive and excessively regulated, but a year later members of congress introduced alternative proposals though no compromise was reached. In 1994 president Bill Clinton introduced the Health Security Act that was defeated, president Clinton proposed to achieve universal coverage in the US by mandating that all employers privately provide health insurance to their employees and also giving small businesses and the unemployed Americans subsidies to purchase insurance, the move was supported by his wife Hillary as explained by Oberlander (2002). 

 In 1996 Congress passed the Mental Health Parity Act to require some employers to offer health plans with psychiatric benefits. In the same year Health Insurance Portability and Accountability Act was passed by congress, this bill was introduced to protect individuals from losing their health insurance in case one changed from one job to another or moved from private employment to self-employed (NCNMG Inc,  2007). In 1997 The State Children’s Health Insurance Program (SCHIP) was enacted and it gives grants to states to provide health insurance coverage to uninsured children up to 200% of the Federal Poverty Level (FPL) (Work World Inc. 2010).

The President Bush administration proposed to adopt tax credits that would help the uninsured purchase private insurance, due to the appeal of tax cuts the approach seemed attractive and also due to expanded coverage with minimal government involvement, but these two factors do not control medical care spending.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 

In the year 2010 The Patient Protection and Affordable Care Act (PPACA)  was signed by president barrack Obama, the law will ensure that workforce health and wellness efforts will remain critical with expanded wellness incentives and will require employees to prepare for generally increased oversight and interaction with the federal government regarding employees’ health benefits (Watson, 2010). 

4.0 Supporting Stakeholders

The American Medical Association and Health Insurance Association of America had previously opposed compulsory health insurance but later changed their stand in support of an employer mandate and universal coverage. Their move was followed by the US Chamber of Commerce and other equally large public corporations who also endorsed an employer’s mandate (Starr, 1994). 

A large potion of the public agreed with the bill, they felt that health care reforms were an issue of high priority. Even so, the republicans opposed it.  Ferraro (2010) observes that the democrats rejected the claims by the republicans by contending that once the people come to realize about the benefits (short and long term) of the bill, public support would ultimately grow. Ideally, these can be observed as conscious efforts on the part of the democrats in trying to pass the message across to the people in a bid to gain support from them. 

For instance, Dennis Kucinich who had previously opposed the bill announced that he had at long last decided to vote for the bill. Interestingly, his change of decision was after a careful consultation with his wife, speaker, president and close friends. This move from opposing to supporting the bill gave a boost to President Obama, the Congressional leaders as well as the entire pro-reform group (Alan, 2010). 

Alan further observes that further support also emanated the Catholic Bishops who were previously opposing the bill had organized a group of nuns and leaders and sent a letter to House of members urging them to pass the Senate Health Care Reform Bill. 

5.0 Opposing Stakeholders

Oberlander (2002) analyses the situation and observes that in the year 1994 the then President Bill Clinton had a plan that would see all Americans benefiting from health insurance, he wanted to achieve universal coverage in the United States by making it mandatory for all employers to provide private health insurance to their employees and also by giving small businesses and unemployed Americans subsidies with which to purchase insurance. This plan experienced fierce opposition from a number of stakeholders notably the insurance industry which was not happy with the proposed regulations. They opposed the abolishment of experience rating which enabled them to charge high premiums for patients and as a result the business community also disliked the mandate put on the employer.

The plan was also objected by Ideological Conservatives’ as viewed the plan as a warranted nationalization of the health care systems. A large segment of the community also disapproved this and was anxious about the plan’s emphasis on moving patients into Health Maintenance Organization (HMOs), in addition to these the move also lacked support from a majority in the congress and was therefore defeated.

Ferraro (2010) further explains that the legislation would expand the governments health plan for the poor, this would be through imposing new taxes on the rich and bar insurance industries abuse such as refusing to cover people with pre-existing medical conditions. These issues had been denounced by the republicans and termed as costly and misguided federal takeover. Although the bill was passed, all the republicans voted against the bill. 

Litvan and Armstrong (2010) shows that though President Barrack Obama signed the bill in to law the Congressional Republicans pledged to repeal it, the House and Senate Republicans have already written at least 30 bills to roll back provisions in the law.

The BBC news reported that immediately after signing the bill, there were 13 states attorney generals who composed of 12 Republicans and one Democrat who began legal proceedings against the federal government seeking an injunction on the reforms on grounds that they were unconstitutional and very costly. 

6.0 Evaluation

There has been enactment of several bills that deal with the medical practitioner for a period of close to five decades; each bill has led to enactment of a different bill with mixed reactions on the bill. Different parties have supported it while others have opposed it but all bills have left an impact on the society. Appleby and Steadman (2010) points out a number of parties who will be affected by the legislation both positively and negatively. These are children, aged, poor, those who had previous medical issues, the insurance companies and the employees.

The people who have been left uninsured due to their medical conditions may be able to enroll in a new federally subsidized insurance program; the legislation appropriated $5 billion for the program though it may not be enough to cover everyone that applies. They are also discounts and free Medicare for approximately four million beneficiaries who hit the doughnut hole in the program’s drug plan, this is due to plans to see the cost of drugs in the coverage gap go down by 50% while preventive care like some types of cancer screening will being provided free of co-payment or deductibles. 

The kids will also benefit from the program as the parents will be allowed to keep their on their health insurance plan until the age of 26 years unless the child is eligible for coverage through a job.  Apart from taking care of children up to the age of 26, the insurance plan is barred from excluding pre-existing medical conditions from coverage for children under the age of 19 years but a slight loophole still exists because insurers could still reject these children outright for coverage in the individual market until 2014.

The Health Care Reform also introduces tax credits for businesses in that those with less than 25 employees and an average wage of $50,000 could qualify for a tax credit of up to 35% of employees cost of premiums this is a major boost for the business fraternity. 

Insurance companies will experience changes in that they can no longer cancel insurance retroactively for things other than outright fraud and all existing insurance plans will be barred from imposing life time caps on coverage and the plan will also place restrictions on annual limits on coverage.

According to the insurance plan the government will also require insurers to report on how much they spend on medical care versus administrative costs, this will be followed by tighter government reviews of premium increase, this move was not welcomed positively by the business community as they felt the government had so much influence in the business transactions.

7.0 Recommendations for Improvement of the Policy

Bernard (2010) explains that most Americans would be required to have health insurance or face federal penalties on failure to buy but it; this means that the government would require all American to have a health insurance cover. The political and economical experts question on how strict the enforcement of that penalty could be; consequently the government should expound on how it will enforce this.

It common for business to pass an increase in cost of production to the consumers, and with increased government intervention its likely the business community will pass costs to the consumers.  The legislation should clearly state the effect if any the legislation would have if the cost of medical premium went high and the levels in which these premiums should be considered high or considerable for the Americans, putting in to consideration that all Americans are obliged to have a health insurance. 

Wilson(2010) observes that insurance companies will be required to spend no less than 80-85 % of their premiums directly on reimbursement for clinical services or on activities that improves health care quality but the bill does not explain what happens to the remaining 15-20% neither does it explain who determines what constitutes an activity that improves health care activity the bill should be clear on these issues, though the 15-20% may be for covering the operation cost of the insurance firms this will eat in to their profits and they should be consulted to reach an agreement on best percentage ratios. 

The bill should have considered the number of staffs who are employed in insurance firms, this is because once the government has control of the company’s finances, its most likely that the insurers will be forced to either lay off thousand of workers due to low profits or be forced to abandon their ant fraud programs. 

 The legislation will impose some tax changes through introducing an annual fee imposed on the pharmaceuticals/ manufacturing sector and health insurance sector, these costs will be passed on to the consumers of these products so that the organization can maintain their profit margin, the bill should be clear on how the manufacturing sector will recover their expenses without passing it on to the consumers.

Carney (2010) describes the future of the Health Care Reform as hanging on a balance since its effects are already being felt with rising insurance premiums and doctors denying to take on additional patients, the government should put measures in place to ensure that all stakeholders involved in the medical field do not suffer unjustifiably from the bill. 

The bill also requires that from 2014 all Americans will be legally obliged to have a health insurance cover, this may exert a strain on many Americans if they will be required to pay penalties for lack of insurance, the bill should omit this clause.



Lenore, J. (1999). Consolidated Omnibus Budget Reconciliation Act(COBRA): Retrieved November 2, 2010 from:

Alan, K. (2010). Support for health care reform gains support from Left and middle: Retrieved November 3, 2010 from:

Appleby, J. & Steadman, K. (2010). Immediate effects of health reform bill: Retrieved November 3, 2010 from:

Bailey, J.M. (2009). The top 10 Rural issues for health care reforms: Retrieved November 3, 2010 from:

Cutler, D. (2010).  New jobs through better health care: Retrieved October 30, 2010 from: Inc. (2010). Health Insurance in the United States: Retrieved October 30, 2010 from:

Ferraro, T. (2010, March 23). Republicans target Democrats on healthcare reform. Reuters post.  Retrieved November 3, 2010 from:

Garson, A. (2000). The US Healthcare system 2010: Retrieved October 30, 2010 from:

Malone, J. (2010). Obama’s Historic Health Care Bill also a Political Gamble: Retrieved November 3, 2010 from:

Northern California Neurosurgery Medical Group (NCNMG) Inc. (2007).  The History of Health Insurance In The United States: retrieved November 1, 2010 from:

Oberlander, J.(2002).  The US health care system: On a road to nowhere? Retrieved November 1, 2010 from:

Reinhart, U.E. (2001).  The United State Health Care System: Recent History and Prospect: Retrieved November 1, 2010 from:

Social Security Act Amendment (1965). Document information: retrieved November 2, 2010 from:

Starr, P. (1994).  What happened to health care reforms?: Retrieved  November 1, 2010 from:

Bernard, S. T. (2010). Health Insurance. The New York Times, pp A1.  Retrieved November 2, 2010 from:

The Presidents Health Care Bill (2010). Retrieved November 2, 2010, from:

Watson, T.(2010). Health Care Reforms Bulletin: retrieved October 30, 2010 from:

Waymack, M. H.(n d.). Ethical Issues In Health Care Reform: Retrieved November 3, 2010 from:

Wilson, B. (2010). Obama’s Dismantling: Retrieved November 3, 2010 from:

Work World Inc. (2010). State Children’s Health Insurance Program (SCHIP): Retrieved November 2, 2010 form:

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Explain two ways your own culture influences your definitions of mental health.

Hs culture & pysch discussion 10 & 11

Culture exerts a major influence on the identification, labeling, course, and outcomes of maladaptive behaviors. Culture provides context for abnormal behaviors.
Junko Tanaka-Matsumi
The symptoms that lead to a diagnosis of a disease or disorder in one culture may not be the same in another. Consider the cultural factors that lead to these differences and how this difference of conceptualization would impact the treatment and recovery of disease. Through your readings last week, you may now have a better understanding of how each culture has its own beliefs about the causes and treatment of illness. The same reasoning applies to mental health and the definition of abnormal psychology. Should behaviors that go against social norms define mental illness?
This week, you explore culture-specific definitions of mental health. You also analyze the influence of Western medicine on these definitions.
Global Tribe. (2003). Arun Gandhi on terrorism, nonviolence, and Gandhi. Retrieved from
Analyze cultural attitudes, beliefs, and practices of mental health
Analyze ways to promote positive social change
Discussion 1:wk#11 Defining Mental Health (One page)
Many Western groups advocate viewing mental health issues from a medical model. Providers of mental health services and advocates for the mentally ill use this medical model with the intention of reducing the stigma placed on the individual diagnosed with the mental illness. Yet, consider the startling finding that, those who adopted the biomedical and genetic beliefs about mental illness were most often those who wanted less contact with the mentally ill or thought of them as dangerous and unpredictable (Watters, 2010, p. 173). Western conceptualization of mental health and illness has spread across the globe and impacted how individuals are treated. For example, cultures may have initially been more tolerant of these behaviors due to factors such as externalized locus of control, beliefs in traditional healing, spiritual beliefs, and less expressed emotion. (Watters, 2010)

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Health economics politics and law and environmental health.



Week 3

This week we are going to talk about health care economic. Health economics, politics and law and environmental health. Health economic is a branch of economics

concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare In broad terms, health

economists study the functioning of health care systems and health-affecting behaviors such as smoking.

Read chapter 7, 8 and 12 of the class textbook and review the attached Power Point Presentations. Once you complete the task please answer the following questions;

Why is the U.S. health care market referred to as an “imperfect” market and give and example.

2. What are the financing eligibility, and covered benefits of Medicare and Medicaid?

3. What is the role of the government in the health of its citizens? Give an example.

4. What specific global environmental threats affect public health? Give an example.

As required and stated in the syllabus present your assignment in an APA format with a minimum of 2 evidence based reference, word document attached to the forum in

the discussion tab. An arial 12 font is required, 2 replies sustained with proper references are required to any of your peers. A minimum of 600 words are required.

Text Book:
Community Health Nursing, Caring for the Public’s Health. (2nd ed.) Saucier Lundy, K & Janes, S. (2009). ISBN: 978-0-7637-1786-5

Your responses must be in APA format

Publication Manual American Psychological Association (APA) (6th ed.). 2009 ISBN: 978-1-4338-0561-5

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Health Policy and Law Basics

Analyze the key components of three (3) sources of law related to the effects that each source could potentially have on your healthcare organization’s new initiative.
As a chief operating officer of a hospital, you have been tasked with opening a new ambulatory care center in your city.

Write a 2-3 page paper in which you:

Specify whether you would utilize the professional autonomy, social contract, or free market perspective as the paradigm to design the structure of your new center. Debate at least two (2) advantages and two (2) disadvantages of your chosen perspective. Provide at least two (2) examples of your perspective in action to support your response.
Analyze the key components of three (3) sources of law related to the effects that each source could potentially have on your healthcare organization’s new initiative.
Use at least two (2) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.
Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
The specific course learning outcomes associated with this assignment are:

Describe the evolution of hospitals and sources of law.
Examine tort law and the criminal aspects of health care.
Use technology and information resources to research issues in healthcare policy, law, and ethics.

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