Healthcare Policy - Republican vs. Democrat: Contrary to what the newsreels out of Washington dep...

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Healthcare Policy - Republican vs. Democrat: Contrary to what the newsreels out of Washington depict, there are many common concerns and issues between the two parties. The major differences and passionate disputes come with how to address those issues. The major principle that underlies the Democrat's proposals is based on their belief that it is the Federal government's ability and responsibility to provide and ensure that every individual is able to realize their individual RIGHT to healthcare. The Republican guiding principle is that the individual, not the federal government should have the right to make all decisions regarding their healthcare, and that it is a benefit, not a personal inalienable right. In this mindmap, we look at the shared beliefs, and then dive deeper into how each party differs on the path to resolution. by Mind Map: Healthcare Policy - Republican vs. Democrat: Contrary to what the newsreels out of Washington depict, there are many common concerns and issues between the two parties. The major differences and passionate disputes come with how to address those issues. The major principle that underlies the Democrat's proposals is based on their belief that it is the Federal government's ability and responsibility to provide and ensure that every individual is able to realize their individual RIGHT to healthcare. The Republican guiding principle is that the individual, not the federal government should have the right to make all decisions regarding their healthcare, and that it is a benefit, not a personal inalienable right. In this mindmap, we look at the shared beliefs, and then dive deeper into how each party differs on the path to resolution.

1. Shared Belief - All individuals should have better access to care, including those with PRE-EXISTING conditions.

1.1. Democrat

1.1.1. Have create a system through the ACA where discrimination based on pre-existing conditions is now illegal (House Democrats, 2013).

1.2. Republican

1.2.1. Believe that individuals with pre-existing conditions who maintain continuous insurance coverage should be protected from discrimination (Republican Platform, 2012).

2. Shared Belief - Medicare and Medicaid are important and should be maintained.

2.1. Democrat

2.1.1. In favor of strengthening Medicare and Medicaid by providing free preventative care and lower drug costs (House Democrats, 2013).

2.1.2. Adamantly appose and privatizing of Medicare, and any voucher program to create alternatives to CMS (House Democrats, 2013).

2.1.3. Believe that Medicare will remain solvent due to the reduced costs projected to come from the Affordable Care Act (House Democrats, 2013).

2.2. Republican

2.2.1. Believe that cuts that were previously made should be restored to bring it more in line with the budget (Republican Platform, 2012).

2.2.2. Believe that Medicare and Medicaid must be able to assure that every participant receives the amount of care they need at the time they need it. If there are no reforms, "these two programs are headed for bankruptcy that will endanger care for seniors and the poor" (Republican Platform, 2012).

2.2.3. Believe that the best way to keep CMS slovent is, "to move the two programs away from their current unsustainable defined-benefit entitlement model to a fiscally sound defined-contribution model. This is the only way to limit costs and restore consumer choice for patients and introduce competition; for in healthcare, as in any other sector of the economy, genuine competition is the best guarantee of better care at lower cost" (Republican Platform, 2012).

3. Shared Belief - The private medical system is broken. All Americans should have better access to low cost private insurance.

3.1. Democrat

3.1.1. Every single individual has a right to quality Healthcare. To ensure that everyone can sign up, private insurance plans are subsidized dependent upon income in healthcare marketplaces (House Democrats, 2013).

3.1.2. Young Americans entering the workforce can stay on their parents' plans. This will increase the accessibility of healthcare to those that have not fully entered the work force.

3.1.3. Believe that in order to keep healthcare costs low, the pool of insured individuals must be generally more healthy. this results in lower premiums. In order to have more healthy individuals enroll, the tax code is used to mandate enrollment (House Democrats, 2013).

3.2. Republican

3.2.1. Believe that in order to lower private insurance cost, a free market in healthcare and ensured competition must be achieved. This will, "promote price transparency so that consumers will know the actual cost of treatments before they undergo them" (Republican Platform, 2012).

3.2.2. • Individuals with pre-existing conditions who maintain continuous insurance coverage should be protected from discrimination. 

3.2.3. Believe that tax discrimination against the individual purchase of insurance should be ended, and that consumers should be allowed to purchase insurance across State lines. While promoting “co-insurance” products and alternatives to “fee for service,” government must promote Health Savings Accounts and Health Reimbursement Accounts to be used for insurance premiums and should encourage the private sector to rate competing insurance plans.

3.2.4. Believe that cost can also be reduced by promoting “co-insurance” products and alternatives to “fee for service,” HSA's and HRA's should be encouraged more, and a more direct form of consumer rating of the private carrier should be in place (Republican Platform, 2012) .

3.2.5. (Freedom of choice)No healthcare professional or organization should ever be required to perform, provide for, withhold, or refer for a medical service against their conscience. Especially religious organizations

4. Shared Belief - Healthcare is an important part of government policy- it is a big agenda item with many stakeholders, proponents and opponents

4.1. Democrat

4.1.1. Proponents

4.1.1.1. Individuals with preexisting conditions

4.1.1.2. Individuals who could not afford insurance previously

4.1.1.3. Supporters of strong central government

4.1.2. Opponents

4.1.2.1. Conservative groups apposed to stem cell research

4.1.2.2. Private Insurance companies who have profits capped, and are pressured to reduce premiums.

4.1.2.3. Upper middle class individuals who do not benefit from the subsidies, but are subject to the same medical restrictions of care.

4.1.2.4. Religious groups who feel they may be forced to provide coverage for specifically mandated procedures/care.

4.1.2.5. Mid sized company owners due to the mandate to provide health insurance

4.1.2.6. Healthy individuals who do not want health insurance and are penalized through tax penalties.

4.1.3. Stakeholders

4.1.3.1. Litigation lawyers who would be hurt if Republican Tort Reform was pursued

4.1.3.2. Stem cell and other major medical researchers

4.1.3.3. American Medical Association (Cafasso, 2011)

4.1.3.4. Private Insurers - In theory, these groups stand to gain substantially from teh larger pools of participants in their programs, although this trend may be reversing with with UHC's recent announcement to withdraw from the ACA marketplace (Cafasso, 2011), (Matthews & Armour, 2015).

4.1.3.5. Abortion and planned parenthood clinics

4.2. Republican

4.2.1. Proponents

4.2.1.1. Private insurance companies who are in favor of more market freedom, and privatizing Medicare

4.2.1.2. Wealthy individuals who had no issues with insurance, but are now limited by the rules that apply to all plans because of the ACA.

4.2.1.3. Religious groups who want freedom to provide the healthcare options that are in line with their values and beliefs.

4.2.2. Opponents

4.2.2.1. Individuals under the age of 55 who are afraid that Medicare will be changed and not be beneficial for them once. They may also be afraid that the age for enrollment will be raised.

4.2.2.2. Individuals with pre-existing conditions.

4.2.3. Stakeholders

4.2.3.1. Hospitals - Hospitals have seen huge losses as the ACA reform has taken place. They would stand to gain some of their control and profits back under a republican plan (Cafasso, 2011).

4.2.3.2. Grass roots physicians - Unlike thier representative body, the AMA, polls show that everyday physicians felt that they were ignored in creating the ACA. They have seen unprecedented controls and unfair cuts to the way they receive reimbursement. -6 They also would benefit from the reduced malpractice insurance premiums and fewer unnecessary protective lab tests that could be possible with Tort reforms proposed by the GOP (Republican Platform, 2012).

4.2.3.3. Employers - For companies that

5. Main underlying principle - my take

5.1. Democrat

5.1.1. "We believe accessible, affordable, high quality health care is part of the American promise" (House Democrats, 2013).

5.2. Republican

5.2.1. "Putting the patient at the center of policy decisions will increase choice and reduce costs while ensuring that services provide what Americans actually want" (Republican Platform, 2012).

5.2.2. When approximately 80 percent of healthcare costs are related to lifestyle -smoking, obesity, substance abuse-far greater emphasis has to be put upon personal responsibility for health maintenance.

5.3. My view

5.3.1. One quote resonated with me, and formed a basis for my opinion. "When approximately 80 percent of healthcare costs are related to lifestyle -smoking, obesity, substance abuse-far greater emphasis has to be put upon personal responsibility for health maintenance"(Republican Platform, 2012). Being a father of five small kids, I have come to appreciate the importance of personal responsibility and accountability. I believe that this is something that should be focused on in order to reduce overall cost, which would improve the availability of insurance plans. This problem of personal responsibility should be treated like a disease in need of treatment options. Focus money on teaching patients how to be responsible for their health care. One example of this is "Motivational Interviewing." This is a method taught at my work, which has shown the ability to transform a patients compliance. But this methodology is not reimbursable through insurance. The need is for policy that will focus on treating this ailment of a lack of personal accountability, and I believe that will make a great change in our healthcare system.

6. Shared Belief - Healthcare Financing needs to change and is a major economic component

6.1. Democrat

6.1.1. Believe that because of the high percentage that healthcare is of our budget, the ACA can help improve the economy by stabilizing the budget. These savings are achieved by eliminating waste, fraud, and abuse (House Democrats, 2013) The projected savings to Medicare from the ACA is $104 million for the next ten years (Congressional Budget Office, 2014)

6.1.2. The ACA is projected to cost $1.2 trillion over the next nine years (Obamacare Facts, 2015).

6.1.3. The cost of the ACA is paid for by tax penalties, additional taxes, spending cuts, and reforms to the healthcare industry (Obamacare Facts, 2015).

6.2. Republican

6.2.1. Believe that Medicare has $37 trillion in unfunded obligations, and will go bankrupt in 9 years if the system is not reformed (Republican Platform, 2012).

6.2.2. Costs must be cut in order for the program to be sustained. These cuts can come from...

6.2.2.1. Raising the age of medicare elligibility

6.2.2.2. privatizing the Medicare program and encourage competition in these private plans (Republican Platform, 2012).

6.2.2.3. Re-implimenting former Medicare cuts (Republican Platform, 2012)

7. References: