Irrespective of the political affiliations, there is always an increasing concern among individuals when they consider the perceived competing interests of the government and how they impact topics that are of interest to them. Generally, a policy that is created and implemented for healthcare purposes mostly impacts the nurses and patients. However, speaking of who benefits the most from the developed policies, it all boils down to the person-in-charge of the legislation.
According to Milstead and Short (2019), “…policymakers do not necessarily focus on how the changes will affect the people, but rather on how they will affect their chances of re-election.” An example is President Donald Trump who began his term with the Republican house immediately bringing up a repeal to Medicare/Medicaid and the ACA. They described it as a “… a law that has long been a thorn in their sides” despite the estimated 20 million people who have gained health coverage courtesy of the Affordable Care Act (Milstead and Short, 2019). In this case, repealing this Act will leave so many people without health coverage. However, the act of making this as his first decision as to the president, for all the people that voted in his favor, and were strongly in support of this law, would in a strong way hold onto this moment and later vote for him again when his term elapses. Spending by the outside groups constituted 14.9% as of 2019, which was an increase of about 5% compared to 2010 (Milstead and Short, 2019). On the other hand, the individuals who are part of the large corporations or belong to organizations that belief in the new ACA reforms will supply more funds into this campaign.
Legislators are rational and make cost-benefit calculations in light of demanded legislation (Feldstein, 2006). Moreover, the cost-benefits calculations being made are not to the society, but to the additional political support that the legislator may receive from supporting that particular legislation when compared to the lost political support that they may incur from their actions (Feldstein, 2006). If the benefit (positive political support) outweighs the cost (negative political support), they will support the legislation.
The voters’ views can also affect the decision by legislators to recommend or position national policies as evident from the repeal of the ACA which has been passed without any republican signatures and is now being challenged (Laureate Education, 2018). Such impacts on ACA provisions affect adults with Medicaid coverage under the ACA rules due to the legislators. Re-election for expanding Medicaid includes the elimination of Medicaid funding, subsidies, and a loss of consumer protection. The result is a repeal of the legislation to makeover the gap brought by congressional effects and government preferences.
The analysis of votes helps to reveal issues and help the legislators when making policy choices. The outcome is for the public to limit their options once a leader’s policies are adopted. This is evident when comparing the potential loss of coverage, the associated benefits of repealing the provisions of financial assistance, and the Medicaid coverage that opposed the repeal. This affects the decisions that Congress has to make and how they impact Medicare and Medicaid coverage policies. There is always a method behind how all the decisions are made and I believe a strong consideration is made on how the decisions will impact the future votes.
References
Feldstein, P. (2006). The Politics of Health Legislation: An Economic Perspective. Chicago, IL: Health Administration Press.
Laureate Education (2018). Introduction to Health Policy and Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author
Milstead, J., & Short, N. (2019). Health Policy and Politics: A Nurse’s Guide. Burlington, MA: Jones & Bartlett Learning.
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