The Bystander Effect – Diffusion of Responsibility

Steps on Becoming a Grassroots Advocate for Health Care Policy Position on Affordable Healthcare Act 2017 The American Health Care Act, which was introduced by the U.S. Congress to partially repeal the Affordable Care Act, has attracted criticism across the divide besides being unpopular with healthcare experts. This paper presents the position of a nurse on the AHCA and calls on the representative to oppose the bill. 

Although most of the health enactments are introduced with the aim of helping to increase the access to care for the American populace, I feel that the AHCA has fallen short of that objective hence the bill should not be supported.

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Understandably, local laws and state legislation on health have a significant impact on access to and delivery of care to the people. It is, therefore, imperative to ensure that only health enactments that present maximum benefits to the people are implemented in place of potentially flawed legislation.

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Too often, legislators who intend the best for their constituents sponsor bills that may negatively affect the lives of many people because they are not aware of the consequences.

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I feel that the AHCA is largely based on political perspectives rather than on the health interest of the people.

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It is impractical to support a bill that would deny a huge number of people access to care by making insurance less available.

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Form a political perspective; the AHCA also appears to have fallen short of the campaign promises on health care made by President Donald Trump.

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The bill does not in any way fulfill the promise on affordable coverage for all people, let alone reduce health care costs or create the base for better care.

Rationale A critical assessment of the AHCA has revealed that it does not support the creation of a

universal platform that promotes access to care, provision of high-quality care and reduced healthcare costs (Collier, 2017). The components of the AHCA will have a negative impact on many Americans who benefited from the ACA Medicaid expansion. Significant proportions of the American populace comprise of low-income earners and fall below the 138% federal poverty level. Cancellation of the Medicaid expansion will leave many people without access to care thus contradicting the purpose for which the bill was intended (Himmelstein & Woolhandler, 2017).

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The AHCA retains most of the components of the Affordable Care Act. For instance, it has retained the coverage for young people under their parents' insurance until they reach 26 years as well as coverage availability for persons with pre-existing conditions (Wen, Behrle, & Tsai, 2017). This shows that there is no need to repeal the ACA which offers numerous benefits to the people and replace it with controversial legislation. The other reason why the AHCA act should not be supported is that it eliminates penalties for employers with more than fifty full-time employees, but do not offer health insurance (Himmelstein & Woolhandler, 2017). Elimination of penalties will reduce the commitment of the employers in supporting health initiatives aimed at benefiting the employees. The implementation of the AHCA will have a detrimental impact on the seniors (Collier, 2017). Seniors will be charged higher under the AHCA plan than younger people with pre-existing conditions. Even though tax credits have been cited as a potential solution in offsetting the high premiums, economists have pointed out that tax credits present a major challenge.

Summary of the Legislative Visit Was your member in support of or in opposition to the AHCA? The legislative visit was successful since the representative promised his support on campaigns to oppose the AHCA bill. The representative was informed that the call to oppose the proposed bill was not a position of a single nurse but a collective call from a huge proportion of health care professionals. The visit was typical of an interactive forum whereby ideas concerning the benefits of the ACA together with the potential disadvantages of the AHCA were exchanged.

The representative was aware of the main message of the meeting. He was also aware that the AHCA is a controversial bill that has attracted opposition across the political divide. The representative noted that this bill is also opposed by many healthcare specialists who believe that

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it will have a negative impact on different patient populations. He also argued that the ACA should not be repealed since it has benefited a large number of people who were previously uninsured. According to the legislator, the ACA, which the AHCA targets to repeal, have turned out to be nothing less of affordable. Even though many people have experienced premiums rise, many more have been able to receive the health care they needed desperately.

State Three Points that You Would Cover in Support of Your Representative's Position One of the issues that I would cover in support of the representative’s opinion is the age tax imposed by the AHCA. The new bill proposes to increase the rates of premiums charged on older enrollees by insurance companies in comparison to younger enrollees (Himmelstein & Woolhandler, 2017). The age-based rating means that older enrollees can be charged up to five times or more for health insurance than younger consumers. Furthermore, the bill proposes a reduction of tax credits which help older people afford their coverage. The implementation of this bill would, thus, penalize the oldest and most rural consumers.

The other issue that would need to be addressed in support of the representative’s position is the Repeal of Obamacare’s individual and employer mandates. There is a high likelihood that repealing the individual mandate will lead to over 13 million people becoming uninsured over the next few years (Collier, 2017). Many more will face a premium increase of over 10%. The individual mandate was aimed at ensuring that health insurance in the markets was being bought by all people and not just the sick.

The other point that would be addressed touches on repealing the Prevention and Public Health Fund. This fund was established under the ACA in an attempt to improve the nation’s public health system. Such a move would jeopardize a wide range of essential health benefits revolving around preventive care (Collier, 2017).

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How Nursing Experience Influences the Advocacy Position on the AHCA Nursing experience has the potential to influence the advocacy position on AHCA. For instance, nurses who witnessed the implementation of the ACA were worried that they would be flooded with patients presenting with chronic and preventable conditions. However, the implementation of the ACA had numerous benefits both to the patients and the care providers.

A large number of people were covered and hence were able to seek and receive care. Nurses, on the other hand, gave priority to wellness and prevention thus helping patients lead healthier lives.

A nurse with such an experience may be reluctant to support a bill that has the potential to leave a large number of people uninsured (Engel, 2018).

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References Collier, R., (2017). Why Trumpcare failed. CMAJ. 189(17), E645–E646. doi: 10.1503/cmaj.1095414 Engel, J. (2018). Unaffordable: American healthcare from Johnson to Trump. Madison, WI: The University of Wisconsin.

Himmelstein, D. U., & Woolhandler, S. (2017). Trumpcare or Transformation. American Journal of Public Health, 107(5), 660–661. doi: 10.2105/AJPH.2017.303729 Wen, L. S., Behrle, E. B., & Tsai, A. C., (2017). Evaluating the impact of the Affordable Care Act repeal on America's opioid epidemic. PLoS Med, 14(8), e1002380. https://doi.org/10.1371/journal.pmed.1002380