Healthcare Policies of U.S. Political Parties

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Healthcare Policies of U.S. Political Parties af Mind Map: Healthcare Policies of U.S. Political Parties

1. Libertarian Party

1.1. Public Policies

1.1.1. Medicare Historical Development Health insurance and health care both as an inpatient and outpatient, were affordable and accessible prior to the implementation of Medicare in 1965. The Libertarian party did not support the implementation of Medicare as well as the other public policies that the government has introduced. The Libertarian party did not support the Medicare Expansion of 2003. Implementation Medicare should be terminated or at least have an opt-out option in order to spend money on private investments. The young population should not have to pay for care of the older population. Although they sympathize with the seniors who would suffer now, the Libertarians believe that Medicare should end now. Restoring or reviving the free market system that once existed prior to government funded programs. With the termination of Medicare, Libertarians will provide a program in which individuals could deposit tax-free money into a Medical Savings Account (MSA). Whenever money is needed to pay medical bills, the money can be withdrawn (Libertarian Party, n.d.). Medicare Part D covers prescription medications and the Libertarians believe that the FDA should be replaced with a more free-market alternative to remove barriers to access safe medications. Impacted Population All Medicare recipients who would be faced with finding alternative resources for health care. All working individuals who would no longer be paying into the Medicare benefit. All individuals anticipating and relying on Medicare coverage who would need to adjust their life plans to fit within the free market program. Stakeholders Proponents Opponents Financing Program Costs Financing Plans

1.1.2. Medicaid Historical Development The Libertarians view on Medicaid is identical to that of Medicare, the party was content with the free market health care system that was available prior to the introduction of Medicaid. Implementation According to the Libertarian party platform, "People should be free to purchase health insurance across state lines" (2012). The previously mentioned Medical Savings Account (MSA) will replace the need for Medicaid. As a state monitored program, Medicaid mandates determine the coverage for specific diseases and under Libertarian law, all government policies will be repealed and deregulated in order to reduce costs and increase patient accessibility to medical care. Impacted Population Destruction of Medicaid will directly impact all current and future Medicaid recipients including children, pregnant women, disabled, and poor adults. Stakeholders Proponents Opponents Financing Program Costs Financing Plans

1.1.3. Free Market Health Care System Historical Development Although Ron Paul is a noted left-wing Republican, he introduced the Health Freedom Protection Act in the U.S. Congress in 2005. Implementation Libertarians propose reducing or eliminating the subsidy for employment provided health insurance. Affordable insurance plans will be available for everyone, as well as "catastrophic" insurance for major emergencies. No pre-existing conditions will be excluded although insurance plans will allow an increased contribution due to health change status. Medical Savings Accounts available for pre-tax contributions. Deregulation of the healthcare industry Removing barriers to safe, affordable medicine. Impacted Population Patients: All patients including public program recipients, private policy recipients, and uninsured will all have major changes with the implementation of a free market health care system. Stakeholders Proponents Opponents Financing Program Costs Financing Plans

1.2. Private Policies

1.2.1. Third Party Payer Insurance Companies Historical Development Prior to the implementation of Medicare and Medicaid, the Libertarian party were strong advocates for the free-market health care system in which individuals had the freedom to choose whichever health care policy they wanted. Libertarians were strong opponents to the Health Maintenance Organization Act of 1973 (Wikipedia, n.d.) Implementation With the implementation of a free-market system, individuals would have the freedom to select whatever private insurance policy that they want. The free-market would allow individuals to decide what level of insurance they want, which providers they want, which medications and treatments they want, and how to manage their own end of life care. Impacted Population The entire nation would be impacted by the Libertarian platform on health care because with the removal of Medicare and Medicaid, the entire health care landscape would be transformed and public and private policy holders will all feel the impact of this new program. Stakeholders Proponents Opponents Insurance companies are both proponents and opponents due to different reasons. Financing Program Costs Financing Plans

1.2.2. Health Freedom Movement Against Pharmaceutical Companies Historical Development In the 1940's, Libertarians and Conservatives rebelled together against President Roosevelt's welfare state. Dating back to the 1970's, organizations petitioned for freedom to choose desired health treatments whether unorthodox or untraditional. Congress passed the Dietary Supplement Health and Education Act of 1994 (DSHEA) which according to Wikipedia states that the FDA must prove that a supplement poses significant or unreasonable risk of harm rather than on the manufacturer to prove the supplement’s safety, reversing the burden of evidence required of medicines (n.d.). According to an article written by Leo Cashman , "Minnesota Senator Twyla Ring and Minnesota Representive, Lynda Boudreau successfully championed health freedom in their state" (2001). Health Freedom Movements have persisted through the early 2000's and continue today allowing Americans to be treated by non-licensed practitioners and utilize alternative medical treatments. Implementation Health Freedom Zone United States Health Freedom Congress Libertarian Conservatism One key objective in the health freedom movement is removal of any residual controls on advertising and sale of vitamins, minerals, herbals, botanicals, amino acids and other food supplements. Additionally, the dietary supplement industry wants to see less stringent regulations than those applied to food (Wikipedia, n.d.). Impacted Population Pharmaceutical Companies Patients Providers Stakeholders Proponents Opponents Financing Program Costs Financing Plans

1.2.3. Food and Drug Administration Historical Development Although its origin dates back to the 1800's, the organization known as the FDA has been established with this name since 1930. Although there have been many revisions and changes since the introduction of the FDA, the core mission toward public health has remained the focus of the agency. Prior to the enactment of public programs in the 1960's, opponents to the FDA believe that decades of a relatively free markets show that free-market institutions and the tort system succeeded in keeping unsafe drugs to a minimum. Economists have collaborated with Liberalists in communicating their concerns regarding the FDA and notorious economist Milton Friedman stated that, "The FDA has done enormous harm to the health of the American public by greatly increasing the costs of pharmaceutical research, thereby reducing the supply of new and effective drugs, and by delaying the approval of such drugs as survive the tortuous FDA process" (2000). The Libertarian Party has campaigned for a free market system and if this proposal went into effect, their efforts would also include the destruction of the FDA. Implementation The Libertarian party believes that we should replace harmful government agencies like the Food & Drug Administration (FDA) with more agile, free-market alternatives. Adopt a more European way of managing consumer products with quicker approvals and lighter restrictions. Provide a reliable resource online, such as Consumer Reports for the public use to check on the safety, efficacy, and price of drugs (Heerden, 2007). Impacted Population Pharmaceutical companies Consumers Providers may find an increase in drug related events due to improper usage and unsafe practices. Stakeholders Proponents Opponents Financing Program Costs Financing Plans

2. Democratic Party

2.1. Public Policies

2.1.1. Medicare Historical Development The Democratic Party created Medicare to provide health care to seniors. According to the Santa Clara County Democratic Party, "In 1965, over 80% of House and Senate Democrats voted to create the federal Medicare government program for our nation’s seniors. " (n.d.). In 1994, Bill Clinton proposed a plan for universal healthcare and one aspect of his proposal was voluntary enrollment in a new Medicare Part D plan but both parties felt this plan was not thoroughly prepared. In 2002 the House Democrat proposed another voluntary Part D plan which was unsuccessful shortly before the Bush administration implemented the Medicare Prescription Drug, Improvement, and Modernization Act (Milbank, 2004). In 2010 President Obama passed the Affordable Care Act providing health care access to all Americans. Implementation The promise of Medicare is preserved including avoidance of privatizing or voucherizing Improving the Medicare Part D benefit by adding the Prescription Drug program Tax credits available to individuals approaching retirement age According to, "health reform strengthens Medicare by reducing fraud, improving quality of care, and closing the Medicare “donut hole” gap in seniors’ prescription drug coverage" (2014) . Impacted Population (Longest, 2010, p. 217). Individuals 65 and over. Those entitled to Social Security or Railroad Retirement disability cash benefits for at least 24 months Those with end-stage renal disease Some other non-covered aged persons who elect to pay a premium for Medicare Those with Amyotrophic Lateral Sclerosis Stakeholders Proponents Opponents Financing Program Cost Financial Plan

2.1.2. Medicaid Historical Development According to Longest, "Medicaid is the largest source of funding for medical and health-related services for America's poorest people" (2010, p. 233). According to the Centers for Medicare and Medicaid Services, in 1965, Medicaid was implemented "providing health care services to low-income children deprived of parental support, their care­taker relatives, the elderly, the blind, and individuals with disabilities" (2005-2006). Implementation Medicaid Expansion 2014 (Washington State Health Care Authority, 2014) CHIP Reauthorization Act Impacted Population Each state determines its own requirements and services so the impacted population varies depending on the state of residency. Children Non-Disabled Adults Pregnant women Individuals with Disabilities Seniors and Medicare and Medicaid Enrollees Stakeholders Proponents Opponents Financing Program Costs Financial Plans

2.1.3. Affordable Care Act Historical Development President Obama introduced the idea of "Obamacare" to the public in 2009 with strong opposition In March 2010 President Obama signed into law the Patient Protection and Affordable Care Act There was extensive opposition from individuals from all political parties but in 2012 the Supreme Court upheld most of the provisions of the proposed law. Although changes were implemented earlier on, the major provisions of the ACA were enacted starting January 1, 2014. Implementation There are no arbitrary insurer cancelations, regardless of pre-existing conditions Improving the Prescription Drug program shifting the benefit to seniors rather than drug companies. Security and expansion of Medicare benefits Offer tax credits to individuals, businesses, those between jobs, individuals approaching retirement age, and low income adults. Impacted Population Medicare recipients Medicaid Recipients Uninsured individuals Patients with pre-existing conditions Students Stakeholders Proponents Opponents Financing Program Costs Financing Plans

2.2. Private Policies

2.2.1. Affordable Care Act - Third Party Payer Insurance Companies Historical Development According to the Stay Smart Stay Healthy website, private payer insurance policies were introduced in the 1930's and were the only options for health insurance until the passing of the public programs in the 1960's (Humana, 2014). In early discussions about the ACA, private policies were in support of the health care reform law, however, more recently the private policies rescinded their Democratic support because along with affordable health care, other health related expenses are expected to drop which does not coincide with the private policy agenda. Implementation With the implementation of the ACA, Democrats feel that the party is addressing the concern that the private health insurance industry unethically profits off patients needing medical care. According to Eric Schansberg, the ACA imposes a burden on those with private insurance and will lead to higher costs for many taxpayers (2011). Individuals who fall within a specified income bracket who purchase private plans are issued government sanctioned subsidies to help cover expenses. Impacted Population As employers are faced with higher health care related costs, these expenses trickle down to the employees. According to Wikipedia, "The percentage of non-elderly workers with employer-sponsored coverage has been falling, from 68% in 2000 to 61% in 2009" (2014). Employers are responsible for sponsored programs as well as group programs College students Federal employees receiving health benefits Individuals with portability of group coverage Individuals with association group coverage Individuals who independently purchase plans Stakeholders Proponents Opponents Financing Program Costs Financing Plans

2.2.2. Affordable Care Act - Pharmaceutical Companies Historical Development Medicare Part D is the prescription drug benefit prior to the implementation of the ACA Prior to the implementation of the ACA, Medicare patients were often faced with a coverage gap known as the "doughnut hole" in which there is a temporary limit on what the drug plan will cover for drugs. This is eliminated with the ACA. According to an article printed in Forbes Magazine, "Despite expiring patents on blockbuster drugs and a wave of new regulation from the Affordable Care Act that will cost drug makers, the pharmaceutical industry will reap between “$10 billion and $35 billion in additional profits over the next decade,” (Japsen, 2013). Implementation According to the Medicare Rights Center, health reform phases out the doughnut hole by decreasing the beneficiary’s share of drug costs during the doughnut hole until it reaches 25 percent in 2020 for both brand-name and generic drugs (2014). Pharmaceutical companies are working collaboratively with the government on managing expensive prescription drug costs by issuing rebates to patients to shift costs from patients to the distributors. Impacted Population Medicare Part D recipients Newly insured patients who now have access to prescription medications. Stakeholders Proponents Opponents Financing Program Costs Financing Plans

3. Conclusion

3.1. Use this map as a one year overview of your subject's curriculum.

3.2. Note the topics you want to cover and the educational goals of each semester

3.3. Add exam dates and materials

3.4. Add dates and links to excursions and projects you are planning

3.5. You can share this map with your students to provide them with an overview of the class

3.6. Link the topic overview with a second mind map, where you give a more detailed outline of the contents. You can then turn that map into a presentation to visually aid your lectures

4. References