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PUB 210 Global Public Health Question: Evaluate the efficacy of the policy you analyzed and propose recommendations for or against the policy. Concentrate on how to improve the chosen policy in order to limit negative impact to the target population or other populations while increasing the positive impact. Answer: Introduction Health Care and Education Reconciliation Act was formulated and enforced in 2010, by the 111th United States Congress, via a reconciliation process (111th Congress, 2010). The primary aim of the act was to bring about amendments in the Patient Protection and Affordable Care Act. The PPACA is also referred to as Obamacare and acts as a milestone health reform legislation. This essay will evaluate the effectiveness of the policy and propose recommendations for its improvement. Efficacy of policy- The policy was formulated with the aim of providing access to affordable and quality health insurance to all Americans, regardless of their socioeconomic status. The effectiveness of the policy can be accredited to the fact that it worked towards increasing tax credits for buying insurance and eliminated numerous special deals that were available to the senators, thus establishing in a parity of healthcare access. Owing to the fact that people belonging to poor socio-economic strata of the society are often unable to buy the insurance, the penalty for the same was reduced to $695, thereby waiving off a considerable amount (Govtrack.US, 2018). The policy was also effective in making coverage plans related to Exchange more reasonable by restraining the premiums costs for persons under 400% poverty. Further efficacy of the policy can be attributed to its role in delivering a $250 Medicare rebate for recipients who reach “donut hole” in 2010 and fill it for generic and brand drugs by 2020 (111th Congress, 2010). Other potential advantages of the policy that made it effective, in relation to healthcare access can be associated with the fact that it extended insurance reforms to current plans, reporting of pre-existing circumstances, counting prohibitions on lifelong and annual limits, a prohibition on rescissions, bounds on waiting periods, and prolonged reportage for young adults. Advocacy- The enforcement of the Health Care and Education Reconciliation Act was a correct step taken by the then government owing to the fact that it was one of the most noteworthy supervisory refurbishments of the U.S. healthcare system (Singh & Lin, 2013). The policy enforcement was advantageous to the entire U.S population due to the specific domains that it took into consideration namely, (i) increasing the quality and affordability of the health insurances that were available to all people, (ii) lowering the population that was uninsured against any illness or accident, and (iii) ensuring the reduction of healthcare costs for all (111th Congress, 2010). This landmark legislation can be cited as a historic event that reformed the US system. Presence of subsidies would help in covering the health costs for all residents, who were initially incapable of affording insurances (Smith & Medalia, 2014). Furthermore, in the words of Kidwell et al. (2016) Medicaid expansion, free preventive care, screening for diseases, and coverage of all insurance benefits such as, lab test, maternity and newborn care, hospitalization, mental treatment, preventive and wellness visits, pediatric care, prescription medications, and outpatient care makes the policy imperative for the US population. Areas of improvement and recommendation- Cancellation of old insurance due to non-compliance with Obamacare standards made it expensive for certain people who were earlier insured, thus creating difficulties in the transition. Furthermore, unnecessary medical spending have been found to cost more dollars every year and presence of stagnant income would add to the economic disparities between people. Hence, efforts must be taken to lower the superfluous medical spending per household (Gold, Jacobson, Damico & Neuman, 2013). Additionally, the government should also take initiatives for lowering the new taxes that are imposed on the healthcare industry and the high income earners (Pasek, Sood & Krosnick, 2015). Efficient personnel should be appointed who will work towards incorporating the old company-sponsored healthcare plans into the new policies, along with the inclusions. In the words of Himmelstein and Woolhandler (2016) making amendments in the previous health insurance regulations so that they are able to meet the indispensable health benefits. Augmented coverage have been found to increase the general healthcare expenditures in the short term (Williams, 2015). Many industries found it more profitable to pay the price and let their staffs purchase coverage plans during exchanges. Hence, future efforts must be taken for ensuring better insurance plans through the nation-run exchanges. Furthermore, the government should try to increase the value of scholarship awards and reduce the loan repayment amount per month, in order to increase the affordability of education. Conclusion Thus, it can be concluded that the HealthCare and Education Reconciliation Act of 2010 was enforced into a legislation along with the Patient Protection and Affordable Care Act, with the aim of increasing the accessibility and affordability of healthcare and education services. Several changes were brought about in the earlier plans and healthcare policies and increased the tax credits for buying insurances, lowered the insurance not buying penalties, and aimed at closing the “donut hole” by 2020. To conclude, although few improvements are needed in the act, it was an effective step by the government. References 111th Congress. (2010). H.R.4872 – Health Care and Education Reconciliation Act of 2010. Retrieved from Gold, M., Jacobson, G., Damico, A., & Neuman, T. (2013). Medicare Advantage 2013 spotlight: enrollment market update(No. 84cf3dc8257a4decb655f1b9521c14d3). Mathematica Policy Research. Govtrack.US. (2018). H.R. 4872 (111th): Health Care and Education Reconciliation Act of 2010. Retrieved from Himmelstein, D. U., & Woolhandler, S. (2016). The current and projected taxpayer shares of US health costs. American journal of public health, 106(3), 449-452. Kidwell, D. S., Blackwell, D. W., Sias, R. W., & Whidbee, D. A. (2016). Financial institutions, markets, and money. John Wiley & Sons. Pasek, J., Sood, G., & Krosnick, J. A. (2015). Misinformed about the affordable care act? Leveraging certainty to assess the prevalence of misperceptions. Journal of Communication, 65(4), 660-673. Singh, G. K., & Lin, S. C. (2013). Marked ethnic, nativity, and socioeconomic disparities in disability and health insurance among US children and adults: the 2008–2010 American Community Survey. BioMed research international, 2013.  Smith, J. C., & Medalia, C. (2014). Health insurance coverage in the United States: 2013. Washington, DC: US Department of Commerce, Economics and Statistics Administration, Bureau of the Census. Williams, J. C. (2015). A systems thinking approach to analysis of the patient protection and affordable care act. Journal of Public Health Management and Practice, 21(1), 6-11.

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