Access to Health Care: Platforms and Agendas for the 2020 Presidential Election

Access to Health Care: Platforms and Agendas for the 2020 Presidential Election

Presidential candidates are gearing up for the 2020 presidential election and are sharing their platforms and agendas for creating a stronger and more prosperous nation. Presidential hopefuls have identified a number of proposals focused on ensuring access to health care. Some candidates vow to ensure access to health care by recommending universal health care coverage through a single payer national government health care program referred to as the Medicare- for-all proposal. Other candidates are in favor of some version of this proposal by lowering the Medicare eligibility age to 50 but also retaining the private insurance option. Still, some presidential hopefuls aim to ensure health care coverage by providing a public option for people under age 65 or by strengthening health care coverage by building on the Affordable Care Act. Regardless of a candidate’s position, the debate on how to achieve universal coverage will continue to evolve overtime leading up to the election and way beyond.

Findings from a Kaiser Family Foundation’s survey found that the majority of people who voted on a regular basis are not familiar with or clear on the Medicare-for-all proposal. Survey respondents are seeking solutions to everyday problems such as paying for care, eliminating red tape, and navigating the health care system.

While there are many proposals that are under consideration, the Medicare-for-all proposal is one of the most frequently cited proposals designed to ensure universal health care coverage. There are several versions of this approach to health care coverage, such as the proposed version introduced by Senator Bernie Sanders in 2017. Here we discuss the Medicare for All Act of 2019 (M4A), one of the most recently introduced iterations of the Medicare-for-all approach to health care coverage.

Resources

National news media such as CNN, The New York Times, and The Washington Post traditionally have provided an in-depth discussion and analysis on presidential campaign issues, including health care.    

The following are a few resources that can assist nurses in staying abreast of some of the campaign health care related discussions and other issues relevant to health reform:

 

This proposed legislation is similar to the legislation introduced by Senator Sanders in 2017 and other single payer legislation proposed by members of Congress. While there are some similarities, there are also some differences. For the most part, Medicare-for-all proposals will constitute a major shift in health care financing and will move from the traditional focus on providing health care coverage exclusively for those age 65 and older to more widespread care coverage for those under age 65.

Here is a brief snapshot of some of the basic components of the M4A introduced by Rep. Pramila Jayapal (D-WA) on February 27, 2019:

  • Single federal government administered program to cover all U.S. residents (including immigrants and possibly undocumented individuals)
  • Open enrollment to those age 19 and under as well as those 55 and older one year after enactment
  • Abolishes traditional benefits covered through traditional Medicaid/Medicare program, Children’s Health Insurance (CHIP), the Federal Employees Health Benefits Program, or TRICARE (health care for active and retired military)
  • Recommends a ban on cost sharing (e.g., copays, deductibles)
  • In addition to the 10 categories of the essential benefits in the Affordable Care Act, proposed additional covered benefits and services include hospitals services; ambulatory patient services; primary and preventive services; prescription drugs and medical devices; mental and substance abuse treatment services; laboratory and diagnostic services, comprehensive services across childbearing cycle; newborn and pediatric services; emergency services and transportation, early and periodic screening as outlined in Medicaid; transportation to health care services particularly for low income and persons with disabilities; and long-term care services and support.Source: Health Affairs

As the nation’s largest group of health care workers, nurses must possess a fundamental awareness of the various proposals devoted to ensuring access to health care. This will be particularly important for the many individuals, families, and communities who continue to lack access to care and suffer disproportionately from a number of health conditions and illnesses. As the most trusted profession, we are well suited to lend our voices to advocate for better access to care for all and are encouraged to do so. Our role in educating our policy makers has never been greater as we have firsthand knowledge of how the lack of access to quality health care coverage impacts the health and well-being and even life expectancy of those residing in the United States.

Be sure to stay informed of the various debates and proposals on universal health care coverage. Efforts to revise our current approach to health care financing and access to health care is complex and will require that we stay abreast of the discussions surrounding this issue. The American Nurses Association, the Kaiser Family Foundation, The Washington Post, and Health Affairs, to name a few, traditionally provide a synopsis on where candidates stand on health care issues and universal coverage. In addition to watching the presidential debates, nurses are encouraged to visit the web sites of the various presidential candidates to become more familiar with their position on health care ( e.g., access, universal coverage, health care reform) along with a myriad of other health care issues (e.g., prescription drug coverage, supplemental coverage). As we continue to support access to health care as a human right, our awareness of the issues and advocacy for access to quality health care for all will remain an important factor in the upcoming presidential campaign.

The Presidential Election: How to Be Less Stressed

The Presidential Election: How to Be Less Stressed

This year’s presidential election is affecting just about everyone. It’s causing so much stress, arguments, and overall negativity, that we couldn’t even get any nurses to go on record with tips on how they remain less stressed in this crazed political time and help their patients remain so as well. Many were concerned that if they gave their opinions—even about how to help others—that because it had to do with politics, they may be reprimanded or even possibly lose their jobs.

That says a lot. Most nurses love to help other nurses. But in this case, the fear was tangible.

Instead, we contacted professionals in the mental health field to get their advice on what you can do to reduce your stress in this final week before the presidential election and how to keep it reduced after it’s over.

Use the Oxygen Mask First

If you’ve ever flown on an airplane, you know that the flight attendant always instructs people that in case of an emergency, to put your own oxygen mask on first. You won’t be any good to others, if you can’t breathe yourself.

The same case applies with lowering your stress. “In ‘helping’ professions, it is common for providers to ignore their own needs. Focusing on self-care, though, is critical during high-stress times like election season,” says Lisa Long, PsyD, a licensed psychologist, executive coach, and interventionist as well as owner of a private practice in Charlotte, North Carolina. “Taking a personal inventory of one’s stress level and well-being is a good start. Paying attention to yourself is a major aspect of doing and feeling your best. If you notice changes in yourself and how you are feeling, make the time to get connected with people you can talk to. Keep a list of things that make you feel relaxed, and make time to do at least one—even when you feel you have the least amount of time for it. Listen to your own body and needs—just like you do with your patients.”

Laura Dzurec, PhD, PHMCNS-BC, ANEF, FAAN, a dean and professor of the Widener University School of Nursing in Chester, Pennsylvania, says that recognizing that an individual, emotional response is not going to change the election is an important first step in lowering your stress. “The stresses accompanying the debates, deliberations, discussions, and arguments surrounding the presidential election have encouraged emotional responses,” she explains. “One important tip to use in lowering stress is to pay attention to personal responses. Are they defensive? Angry? Anxious? By backing away from pointless debates and thinking through responses that are immediate, nurses can lower their own stresses regarding what’s happening with the election.”

Tips To Help You Reduce Your Stress

Let’s face it—although we’ll get some relief after Election Day, there will still be fallout for some time no matter which candidate wins. Now that you have been reminded to take care of yourself first, what can you do?

“Humor is a fantastic coping strategy when it comes to situations that seem out of our control. Think of all the political parodies at the current time. Turning to humor helps reduce the experience of stress,” says Marni Amsellem, PhD, a licensed psychologist with a private practice specializing in health psychology. “Another great strategy—regardless of the stressor—is trying to tune out or take some time away from the stressor. For example, if the negativity of the conversation happening around you is becoming overwhelming, temporarily remove yourself from the situation, turn off the TV, take a social media holiday, and the like.”

One of the easiest things you can do is just breathe. “My tip for all nurses is to set the alarms on their watches or cell phones to remind themselves several times per day to perform two activities—breathe and practice mindfulness. Three nice deep breaths several times a day can do a world of good to clear the mind and refresh the body. As for mindfulness, take a few seconds, clearing the mind of all thoughts except for noticing the temperature in the room and being mindful of all safely and calmness,” recommends Mary Berst, PhD, the associate program director of Sovereign Health Group in Palm Desert, California.

Amy Oestreicher, a PTSD peer-to-peer specialist, health advocate, and speaker for TEDx and RAINN, suggests deep breathing as well and agrees that humor works. “Humor creates a common language the breaks barriers,” she explains.

Oestreicher also suggests that nurses try a couple styles of management with themselves, two of which are Active Management and Calming Management. With Active Management, she says, you take all of the energy that’s fueling that stress and use it—exercise, run, shout, or scream. Do whatever makes you feel better.

With Calming Management, you do just that—take actions that will work to keep you calm. That might be breathing deeply, meditating, getting a massage, or even taking a warm bath.

Finally, A.J. Marsden, PhD, a former Army surgical nurse and current assistant professor of psychology and human services at Beacon College in Leesburg, Florida, suggests that nurses encourage optimism and refute negative thoughts. “Smile! Research shows that people who smile really will feel better,” says Marsden. “Focus on all of the good work you’re doing. When we feel that our work is making a positive difference and an impact on the world, we feel more positive and happier.”

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