Week 1
Discussion: Presidential Agendas
Regardless of political affiliation, every citizen has a stake in healthcare policy
decisions. Hence, it is little wonder why healthcare items become such high-profile
components of presidential agendas. It is also little wonder why they become such hotly
debated agenda items.
Consider a topic that rises to the presidential level. How did each of the
presidents (Trump, Obama, and Bush) handle the problem? What would you do
differently?
To Prepare:
• Review the Resources and reflect on the importance of agenda setting.
• Consider how federal agendas promote healthcare issues and how these
healthcare issues become agenda priorities.
By Day 3 of Week 1
Post your response to the discussion question: Consider a topic that rises to the
presidential level. How did each of the presidents (Trump, Obama, and Bush) handle
the problem? What would you do differently?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days by expanding on
their response and providing an example that supports their explanation or respectfully
challenging their explanation and providing an example.
,NURS 6050N Week 1 Discussion: Presidential Agendas
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence,
it is little wonder why healthcare items become such high-profile components of presidential
agendas. It is also little wonder why they become such hotly debated agenda items.
Consider a topic that rises to the presidential level. How did each of the presidents (Trump,
Obama, and Bush) handle the problem? What would you do differently?
POST
The high costs of prescription drugs have become one of the major concern in the
U.S. In the article by Kesselheim, Avorn, & Sarpatwari, they note that spending on
prescription drug per capita in U.S exceeds that of all other countries: an average of $858
compared with an average of $400 for 19 other industrialized nations
(2016). Healthcare access has become a hot button issue in the U.S, and with this problem of
the high cost of prescription drugs, it is not surprising that this issue rises to the presidential
agenda. Here is how each of the U.S. presidents: Trump, Obama, and Bush have handled or
attempted to handle the problem:
According to the Whitehouse briefing, reducing drug prices is one of the highest
priorities of the Trump Whitehouse, by taking action to improve the affordability and
accessibility of life-saving prescription drugs (Whitehouse.gov., July 24, 2020). To this end,
President Trump signed four Executive Orders as follows: 1) direct federally qualified health
centers to pass along massive discounts on insulin and epinephrine received from drug
companies to certain low-income Americans, 2) allow State plans for safe importation of certain
drugs, authorize the re-importation of insulin products made in the U.S. and create a pathway for
widespread use of personal importation waivers at authorized pharmacies in the United States, 3)
prohibit secret deals between drug manufacturers and pharmacy benefit manager middlemen,
ensuring patients benefit directly from available discounts at the pharmacy counter, and 4) ensure
that the United States pays the lowest price available in economically comparable countries for
Medicare Part B drugs (Whitehouse.gov., July 24, 2020). Other cost-saving approaches by the
Trump Administration include the approval of generic drugs, and the signing of legislation to end
gag clauses that, according to the Administration, prevented pharmacists from informing patients
about the best prices for the medications they need (Whitehouse.gov., July 24, 2020).
The approach of the Obama White House, according to the fact sheet, was to fight price
gouging as a result of drugs scarcity (Obama Whitehouse, October 31,
2011). The Obama administration took action to reduce prescription drug shortages in the U.S.
, by using an Executive Order, which he signed on 10/31/2011(Obama Whitehouse, October
31, 2011). This Executive Order has the FDA and the Department of Justice working together to
identify illegal hoarding of medications or price gouging by secondary drug wholesalers or other
market participants (Obama Whitehouse, October 31, 2011). This action followed a
Premier healthcare alliance report released in August which estimates that the typical gray
market vendor marks up prices by an averaged 650 percent (Obama Whitehouse, October
31, 2011). By using an Executive order, President Obama indicated that the problem of
prescription drugs cost, which threatens the health and safety of consumers, is, in the
President's own words, “a problem we can’t wait to fix.” The Executive Order was signed into
action to immediately address the issue while leaving room for Congress and industry to keep
tackling the problem (Obama Whitehouse, October 31, 2011).
The agenda under the Bush White House was to empower Medicare Beneficiaries With
Affordable Options; by modernizing Medicare to improve access to prescription drugs to more
than 40 million Americans (The Bush Record, n.d.). According to The Bush Record, n.d., under
President Bush, Medicare Prescription Drug, Improvement, and Modernization Act of 2003,
which was considered historic, was passed by Congress (The Bush Record, n.d.). This act, in
part, provided seniors and people with disabilities better access to the prescription drugs they
need (The Bush Record, n.d.). Prescription drug coverage helps beneficiaries in four crucial
ways: 1) helps all beneficiaries pay for prescription drugs, no matter how they paid before, 2)
offers many choices for beneficiaries by providing beneficiaries ability to choose from a number
of private plans to find the one that best serves them, thereby, saving more and getting the
coverage they want, 3) Beneficiaries who have the highest drug costs receive extra help, and 4)
Medicare is providing extra help to low-income beneficiaries; on average, Medicare will pay for
more than 95 percent of the costs of prescription drugs for low-income beneficiaries (The Bush
Record, n.d.).
In conclusion, all three past and present presidents of the U.S., no doubt, had the agenda
to reduce the prescription drug cost as a priority. They addressed the agenda differently by
working with Congress to enact laws and by issuing Executive orders to address the problem.
The overall impact of the effectiveness of the method used to address the agenda can be
measured by the impact of health care costs to individuals. I would welcome any format that
would immediately yield the result of reducing cost by working with both Executive Orders and
Congress.
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