Agenda Comparison Grid and Fact Sheet

Introduction
The health care landscape of the United States changed dramatically in 2010, after the Affordable Care Act (ACA) was
enacted. The goals of the Act were to ensure that as many people in America were insured through making coverage affordable to
Americans and expanding access to healthcare. One way through which this was accomplished was through creating a new
marketplace where people who did not have employers could have direct access to insurers and would buy policies for themselves.
Expansion of Medicaid eligibility made more people able to purchase policies for themselves. The law requires most adults to have
health coverage, failure t which a fine is imposed. Individuals who receive moderate-income are given premium subsidies that allow
them to purchase policies for themselves in the new marketplaces. Affordable healthcare as a core issue in the development of the
U.S. hence the reason a law was enacted to ensure that access to affordable healthcare was expanded, and everyone, including low-
income earners, had access to health coverage.
Part 1: Agenda Comparison Grid
Identify the Population Health
concern you selected. Healthcare Affordability

Agenda Comparison
Grid Template

© 2018 Laureate Education Inc. 2

Describe the Population Health
concern you selected and the
factors that contribute to it.

Healthcare affordability is determined by poverty and factors related to it, such as race, ethnicity, sex,
disability status, and area of residence.
It is also contributed by one’s ability to access care in a timely and convenient manner.

Administration (President
Name)

(Current President) (Previous President) (Previous President)

Describe the administrative agenda
focus related to this issue for the
current and two previous
presidents.

Donald Trump’s administration
focuses on creating a healthcare
system that is patient-centered
and one that promotes
affordability, choice, and quality
of healthcare and health
insurance (The White House,
2018). The focus of his agenda is
to maximize flexibility and make
healthcare affordable to low-
income citizens.

Barack Obama’s administration
had an agenda focus to make
quality healthcare affordable to
everyone, not as a privilege but
as a right for every American. the
administration made healthcare
accessible and drove the
uninsured rate below 10 percent.
the focus was to build healthier
communities by making
healthcare more affordable.

The administrative agenda focus
of George W. Bush was to make
health insurance portable and
affordable. The reform agenda
aimed at improving value and
affordability and enabling every
American to choose health care
based on preferences and
individual needs (The Bush
Record, 2008).

Identify the allocations of financial
and other resources that the current
and two previous presidents
dedicated to this issue.

Trump aims at reducing the
federal deficit by $119 billion in
the next ten years. This will see
an increase in the number of
Americans that did not have
insurance coverage by 23

President Obama signed the
Affordable Care Act (ACA) in
2010 and said that it would cost
$940 billion in its first ten years.
in 2012, the Congressional
Budget Office (CBO) stated that

George W. Bush signed the
Medicare Modernization Act in

2003. Medicare beneficiaries
      increased from 5.3 million in
      2003 to 17.6 million in 2016.
      President Bush made a proposal
      for an Affordable Choices

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million.
President Trump signed Job cuts
and Tax cuts that had been in
place during the previous
administration. As a result, the
incentive for healthy people to
get insurance was dropped. CBO
estimates that the government
will spend about $194 billion in
the next ten years as a result of
Trump’s decision to stop
reimbursements.

it would cost $1.76 trillion after
an analysis (Stein & Pontari,
2016).

Initiative that was aimed at
extending coverage to Americans
that were uninsured.

Explain how each of the
presidential administrations
approached the issue.

President Trump approached the
issue through cost cuts with the
aim of reducing federal spending.
The focus is on tax cuts and job
cuts.

President Obama’s approach was
aimed at increasing the
affordability of quality health
care by ensuring that Americans
got insurance coverage regardless
of one’s financial abilities.

President Bush’s approach was
aimed at expanding coverage
through the increasing access and
affordability hence the idea
behind Medicare.

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Part 2: Agenda Comparison Grid Analysis
Administration (President
Name)

(Current President) (Previous President) (Previous President)

Which administrative agency
would most likely be responsible
for helping you address the
healthcare issue you selected?

The Department of Health and
Human Services, which is the
federal agency that deals with
protecting the health of
Americans, such as Medicaid and
Medicare.

The Department of Health and
Human Services

The Department of Health and
Human Services

How do you think your selected
healthcare issue might get on the
agenda for the current and two
previous presidents? How does it
stay there?

The issue of affordable health
care is at the core of any health
plans made in this administrative
regime. There are efforts already
to restructure the health plans,
and this has seen a reduction of
coverage. Affordable health care
has to be factored in lest the
agenda is lost, and health care
becomes less affordable to
Americans, especially low-
income earners.

Plans made by the Obama
administration placed health care
affordability at the center. The
issue was factored in the making
of key decisions, and this led to
an increase in coverage as more
Americans got medical coverage.
Health care was made more
affordable.

When President Bush came up
with the idea of Medicare, the
aim was to make health care
more affordable to Americans.
The issue was dominant in plans
made during this regime, and
more Americans were able to
afford quality health care.

Who would you choose to be the
entrepreneur/ champion/sponsor of
the healthcare issue you selected
for the current and two previous
presidents?

Senator Lamar Alexander as a
champion

Marion Kainer, the
epidemiologist who identified
that contaminated drugs caused
meningitis in 2012, as a
Champion

Tom Price, a medical doctor, as a
Champion

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Part 3
Importance of Affordable Healthcare
Affordability in healthcare is an important issue as it ensures that Americans have accessible healthcare. For instance, after the
Affordable Care Act (ACA) was implemented, it led to a reduction in the number of uninsured people from 548.6 million to 28 million
(McIntyre & Song, 2019). The implication is that the rate of people that were initially uninsured dropped by 7 percent, from 16 percent to 9
percent in about 6 years (McIntyre & Song, 2019). vulnerable populations have gained a lot from affordable healthcare. Coverage disparities,
specifically in rural areas and among minority groups, have been reduced. People are leading quality lives because healthcare is accessible and
affordable. Access to and utilization of healthcare have improved significantly. Consequently, affordability in healthcare has led to an increase
in the number of diagnoses made, especially for conditions such as cancer. Treatment for such illnesses has been consistent because the
affected have access to quality healthcare. It is evident that affordability in healthcare is an important issue because it improves access to
medical services and medications for different conditions, including people who have a problem with opioid abuse. Out of pocket medical
expenditures, medical-related debts, and unmet medical needs due to lack of money can be reduced by making healthcare even more
affordable. Also, the healthcare facilities experience less uncompensated acre burdens because families and caregivers of patients have access
to affordable healthcare. In a nutshell, affordable healthcare is a life-changer. Lives are transformed as quality healthcare becomes more and
more accessible.
Role of a Nurse in Agenda Setting for Healthcare Issues

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Nurses have a role to play in influencing health policy and protecting the quality of care accessed by patients. Nurses are positioned to
make major contributions to and lead changes that are transformative in nature. Thus, a nurse is a fully contributing member of the healthcare
professional team, as their roles shift from the episodic, service provider, providing care at a fee, to working in a team and even providing
patient-centered care in a system that provides affordable, seamless, and quality care. Nurses play a vital role in the coordination of care,
ensuring that the care provided is patient-centered, and the quality of care provided is improved (Burke, 2016). These are central roles in the
healthcare sector, and thus nurses must be well conversant with the factors that drive change within their profession. Thus, to be influential,
nurses must have a perception that as professionals, they are tasked with the responsibility and capacity to make and effect changes in their
profession. Since the nursing profession is based on a science of caring, nurses themselves have a role in setting policies that affect their work
as they affect them or the patients that they provide care to (Burke, 2016). The role of nurses in policy work is to influence practice standards
and processes that relate to are provided so that there is an assurance that quality care will be delivered to patients (Burke, 2016). When nurses
influence policies being made, they take their position in shaping the kind of care that patients receive not only today but also in the future.
besides, policies impact resource allocation, and nurses have a role in ensuring that the resources allocated are enough to allow them to provide
quality care. Overall, nurses have a unique role in the formulation of policies that are present in each healthcare setting.
Conclusion
Overall, since the ACA was adopted about ten years ago, and an additional twenty million people have been insured, while millions of
others have had access to subsidized or completely free access to medical care. The act shows the government’s dedication to making health
affordable and accessible to all its citizens. There have been attempts from different political divides to repeal the law and replace it with
reforms that will address different goals other than affordability and accessibility. As long as the reforms will make healthcare more affordable

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to Americans, then the move would still benefit the citizens. Policymakers need to weigh their choices and ensure that health policy goals are
achieved, more so, that the citizens have access to affordable care. Making such a decision will involve making calculations on the value the
reforms will have in the health care sector, as well as how the health care system will look like in the near future.

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References

Burke, S. (2016). Influence through policy: Nurses have a unique role. Retrieved 3 March 2020, from
https://www.reflectionsonnursingleadership.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role
McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2).
Stein, H., & Pontari, L. (2016). The Medicare Cost Curve Bent During the Obama Administration – Center for American Progress. Retrieved
26 February 2020, from https://www.americanprogress.org/issues/healthcare/news/2016/08/09/142386/the-medicare-cost-curve-bent-
during-the-obama-administration/
The Bush Record. (2008). THE BUSH RECORD – FACT SHEET: President Bush Has Kept America Safe. Retrieved 26 February 2020, from
https://georgewbush-whitehouse.archives.gov/infocus/bushrecord/factsheets/healthcare.html
The White House. (2018). President Donald J. Trump is Addressing the Healthcare Issues Left by the Past Administration. Retrieved 26
February 2020, from https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-addressing-healthcare-issues-left-past-
administration/