The issue of accessibility to healthcare

Respond to 2 students 250 words each and include a reference with each about Electronic Medical Records now and in the year 2025…

 

Student#1

After reading all 4 scenarios for primary care, by 2025 and reading several articles.  I believe the U.S. healthcare system will represent scenarios 1 and scenarios 4 due to the rapid changes in technology.   With the electronic health records (EHR) and new technologies emerging this will improve quality of care, while reducing cost, and by allowing patients to monitor, record, and participate in their own preventive care, progress, and which will produce better outcome for each individual needs (Ginter, P.M.; Duncan, W.J.; Swayne, L.E. 2013). New technology will make it easier for patients to address their questions and concern by phone or online access to their physician directly.

Based on today’s issue due to cuts in the federal health care spending, Medicare restricting payments to hospitals that perform sufficient amount of surgical procedures where this is known to result in better outcomes, and the global debit crisis which has put the country in a recession with healthcare being hit the harder due to millions of Americans are still uninsured, employees are paying higher premium  and out of pocket for health care has contributed to the lack of affordable health insurance, and high quality of care (Ward, M.; Daniels, S.A.; Walker. G.J.; and Duckett, S. 2007).

Even though physicians are more likely to receive a financial incentive for improving on the quality of care while controlling the volume of service they provide and deliver (Ward, M.: Daniels, S.A.; Walker, G.J.; and Duckett, S. 2007).

In my scenarios in health care in 2025 will be due to people are starting to live, longer, and healthy lives due to becoming more involved in their own preventive care by changing their eating habits and exercising more. I believe within the next 10 to 15 years that majority of Americans will receive free preventive maintain services; safer hospitals; ability to access their own medical records; more affordable health care with lower increases in insurance premiums; more information about prices on diagnosis codes, procedures codes, and quality of care (Ezekiel, E. 2014).  With Electronic health records (EHR) and new technology emerging with be a major tool in helping patients  monitor their own blood pressure, glucose levels, and participate more in their own health care while increasing patient contact by phone, email, or online with their personal physicians without having to wait for hours for a response. There concerns can be addressed more quickly.

Student#2

Healthcare has come a long way in such a short period of time and will continue on this model of rapid growth within the next few years as well. This is not only to the medical breakthroughs and techniques which are utilized but also the health care field and client based experiences which patients rely on. These changes encompass accessibility through technology as well as government regulations in medicine.

After reading through the perspectives, perspectives 1 and 4 seem to not only be the most likely, but also can be reflected with our current healthcare systems we have in place. It is already possible for patients to receive care through the use of technology. A bad example of this would be the use of WebMD by patients to self diagnose their illnesses by searching through a poorly curated database (Funt, 2011) .The answer to this in recent years has been the ability, presented by some companies, to be able to live chat and even video conference with healthcare professionals in order to better diagnose minor illnesses. The issue with this is that at this point in time, these tools are only available to some based on either the company they work for and or the insurance plan that they have.

In the year 2025 it can be foreseen that the healthcare industry will have the ability to go paperless with the use of  electronic medical records and electronic health records as standard practice. “We have point-and-click instead of having to write long notes, which reduces the time it takes to chart and gives them more time with patients,” said Tammy S. Hogue, a registered nurse at the heart hospital (Paperless, 2004, 449) . This in conjunction with the use of these e doctors would allow for patients to become more involved with the healthcare process. This will allow those who have access or authorization such as health care professionals in different fields to view and share medical records  about mutual patients in order for them, as well as the patient, to better understand their medical standing.

 

The issue of accessibility to healthcare is not only addressed through the internet but also the government’s ability to provide affordable solutions to patients. As the population of the US gains access to affordable healthcare solutions, there will be an influx in patient care in doctors offices and emergency rooms even in the case of non emergencies. As stated in Journal of Biomedical Informatics, “This type of telemedicine system guarantees patient supervision while reducing costs (enabling more autonomous patient care and avoiding hospital overflows). Furthermore, patients’” quality of life and empowerment are improved” (Lasierra, N., Alesanco, A., Guillén, S., & García, J, 2013, pg 516). This can only be done if patients are educated correctly on preventative measures and health care practices. This will allow for a healthier population with greater accessibility to healthcare professionals.

American Government Unit V Article Critique

Unit V Article Critique 

 

 

 

 

 

 

 

 

 

Access the CSU Online Library. Within the database “Academic OneFile,” locate and read the following articles:

 

 

 

 

 

 

 

  • Gregg, G. L. (2011). “Unpopular vote: Enemies of the Electoral College aim to scrap the Founders’ design.” The American Conservative 10 (12), 33+.

 

 

 

  • Underhill, W. (2012). Changing up the Electoral College? State Legislatures38(1), 9.

 

 

 

 

 

 

 

Upon reading the two articles, write a response essay of at least 500 words. Your essay should address the Electoral College as it currently functions, as well as the proposed changes discussed in the two articles. Are you in support of the current Electoral College? Do you agree or disagree with the proposed changes? Is it right for states to circumvent the Constitution on this matter? Your essay should be well thought out and include direct references to the articles. Limited direct quotes are permitted. All references (paraphrased or quoted) should be correctly cited using APA format.

Unpopular vote: enemies of the Electoral College aim to scrap the Founders’ design

 

Full Text:

During the debates over the ratification of the Constitution, Alexander Hamilton remarked in Federalist 68 that the method of presidential selection was “almost the only part of the system, of any consequence, which has escaped without severe censure or which has received the slightest mark of approbation from its opponents.” If only we could say the same today.

From the problematic election of 1800, which resulted in tweaking the system with the Twelfth Amendment, to the Florida recount in 2000, the Electoral College has become the most maligned and least appreciated aspect of America’s constitutional order. Opponents have introduced hundreds of bills seeking to amend the Constitution to replace the college with some variation of a national popular vote.

Now its foes have given up trying to amend the Constitution through traditional methods. They have created a new scheme to get around the built-in impediments to electoral reform; they call their effort the “National Popular Vote Plan” (NPV), and they have been quietly making progress toward its adoption. One proponent, Washington Post columnist E.J. Dionne, has been so bold as to admit, “this is an effort to circumvent the cumbersome process of amending the Constitution. That’s the only practical way of moving toward a more democratic system.”

The NPV was first advanced by computer engineer John R. Koza, best known for co-inventing the rub-off instant lottery ticket. The plan asks state legislatures to pledge all of their state’s electoral votes to the winner of the national popular vote once NPV goes into effect, which will happen when enough states have enacted the legislation to control the 270 electoral votes necessary to elect a president.

Backers of the plan are carrying out a stealthy and disciplined state-by-state campaign. Over 2,100 state legislators are now on board, and the plan has already passed in eight states–Vermont, Maryland, Washington, Illinois, New Jersey, Massachusetts, California, and Hawaii–and the District of Columbia, which together control 132 electoral votes. It has recently cleared single legislative chambers in New York, Rhode Island, and Delaware. NPV activists are halfway to their goal of transforming presidential elections.

Though it would have radical implications for American politics, this revolution is being accomplished without a national discussion and largely without serious debate at the state level. This is just how Koza and NPV’s supporters want it. The lottery king would gamble our future on a clever scheme to void the delicate compromises created by our Founders.

The mode of selecting the chief executive was one of the most difficult problems to confront the men assembled at the Constitutional Convention during the hot Philadelphia summer of 1787. There had never been a similar office created and they returned to it throughout the convention.

Three basic and sometimes competing values were at stake. First, the system would need to be based upon the republican principles of the revolution, finding its legitimacy in a recognition that the people and their communities are the ultimate source of power. Second, the system should encourage the president to be sufficiently independent that he could act his part with vigor and resolve. Third, the method of selection would have to be designed to encourage the choice of a character fit for high executive office.

Various modes of electing the president were proposed during the Constitutional Convention, most attempting to achieve some balance between the three oft-competing goals. Each proposal can be placed into one of three general categories: popular election, election by the national legislature (or a part thereof), or selection by some version of a specially chosen body of electors or other non-national figures (such as state governors).

Direct popular election for president, as the proponents of NPV advocate today, was the subject of two explicit votes, and on both occasions it was overwhelmingly defeated. On July 17, 1787, Gouverneur Morris made a motion to have the president elected by the people, but only Morris’s own delegates from Pennsylvania voted in its favor. More than a month later, a popular-election plan was proposed by Mary-land’s Daniel Carroll. It was defeated without any discussion and with only two states supporting the idea.

The convention’s chief advocates of popular election were Pennsylvanians–Gouverneur Morris and James Wilson. Wilson first apprehensively raised the possibility on June 1, fearing “it might appear chimerical,” and no one responded to his thoughts until he rose for a second time, when George Mason–voicing some support but finding such a mode impractical–suggested postponing the discussion until Wilson “might have time to digest it into his own form.” Perhaps tellingly, Wilson the next day proposed something closer to the Electoral College than a direct popular vote: citizens would choose a representative from their district who would then serve as one of the electors for president.

What was on the minds of the Framers? A direct popular election would, of course, adhere to the requirement that the system to be republican. It would also encourage the president to be more independent than if he were elected by Congress. But would direct election by a national populace result in the selection of a president most fit for office? Would it be representative of the genius of the balanced political frame-work itself?

Here again, the convention record is complex. Some delegates anticipated good results from popular choice. Morris, for instance, said, “If the people should elect, they will never fail to prefer some man of distinguished character” and would choose someone of “continental reputation.” Others, such as Mason, were not so confident. But many of the Founders’ concerns about direct popular election were motivated more by electoral dynamics and constitutional balances than by animus toward the public. Fear of demagoguery, a concern about competing favorite sons from each state, the difficult logistics of a single national election, and a need to adhere to the tensions and balances of the political system all conspired against direct election as much as any concern about the public’s fitness to choose.

The Electoral College is a compromise. The executive would be selected from special representatives of the people in the states, a republican process. The president would not have an institutional rival within the government to which he would owe his election, so he would be a free and independent actor. The threat of demagogic and pandering candidates would be reduced. Finally, because of the select nature of the electors and their meetings in their respective states, where they might discuss the merits of the candidates before voting, the likelihood was that a person of outstanding moral and intellectual virtues would be chosen.

The system worked as planned in only its first two elections, with George Washington being unanimously chosen. By 1800, the development of political parties undermined the deliberative nature of the college, with discussion replaced by party loyalty as the basis for electoral voting. This change was institutionalized when the Twelfth Amendment permanently created national tickets of presidents and vice presidents within parties. Though not required to do so by the Constitution, every state now awards Electoral College votes to the popular winner chosen by its citizens. (Though two states, Nebraska and Maine, divide their electoral votes between the candidate who wins statewide and whoever wins each congressional district.) The race for the presidency today is in every way a democratic and popular election, although the elections are run and votes counted separately in the 50 states and the District of Columbia.

The modern Electoral College may not be exactly what the Founders intended, but it fits the spirit of their decentralized federal system, which treats states as more than just administrative arms of a national majority.

The de facto abolition of the Electoral College might make presidential selection easier for some to comprehend. It would be reducible to the formula, “he got the most votes.” But our Founders believed that only a rather complex structure would serve the needs of order without threatening the goal of liberty. Such a simplification of the system would radicalize our politics, undermine the rule of law, lengthen the political process, render small states irrelevant, and enthrone urban areas as undisputed kingmakers. Most importantly, there is no guarantee, or even likelihood, that it would result in what should be the key goal of any electoral reform–selecting better people for office.

Opponents of the Electoral College came closest to prevailing in Congress during the 1970s. In that debate, New York Senator Daniel Patrick Moynihan passionately recounted how he had once sat in the General Assembly Hall of the United Nations and stared at a board containing the names of the 143 nations then part of that assembly. He wondered how many of them had existed before 1914 and how many had not had their governments changed by force since then. Only seven, he discovered. Among the nations of the world, what could account for America’s remarkable political stability? The answer, Moynihan said, was the genius of the American Constitution–and at the heart of that document’s success he found the lowly Electoral College. He called the proposal to abolish the college “the most radical transformation in our political system that has ever been considered.” He added that it was “so radical and so ominous” as to require from the Senate “the most solemn, prolonged, and prayerful consideration, and in particular a consideration that will reach back to our beginnings, to learn how we built and how it came about that we built better than we knew.”

The Electoral College is “the basic institution that has given structure to American politics,” Moynihan said, and expresses the core American principle “that power is never installed, save when it is consented to by more than one majority.” This idea is seen everywhere in our system: federalism, the bicameralism of Congress, and the majority vote on the Supreme Court exercising judicial review. The establishment of a simple national plebiscite at the center of the constitutional order would undermine the delicate system of concurrent majorities, he ominously warned, and would leave us vulnerable to “the ever-present threat of an overwhelming issue, an over-powering person, and the end of liberty.”

Moving to a simple national vote would radicalize American politics in several ways. With states giving their electoral votes to whoever wins a national plurality, the more extreme elements of each party would be empowered. Under the prevailing system of winner-take-all, a candidate whose support is not localized within particular states has no incentive to run. Without this moderating system, the extremes of each party would be empowered to blackmail more prudent candidates: “Make me director of the EPA or I run and siphon enough votes to cost you the presidency!” In a divided nation, one candidate with the power to draw just a few percentage points of the vote nationally could completely change the outcome of the election. Corrupt bargains would be routine.

Our politics would also be moved out of the center, particularly in the Democratic Party, as the path to the presidency became one where smaller states and rural areas could be ignored with impunity. Currently, an urban politician seeking the highest office is forced to travel to rural areas and hear concerns that might otherwise be alien to him. By compelling candidates to mingle at state fairs, speak with coal miners, throw bowling balls, and visit small-town churches, the Electoral College system gives candidates some appreciation of the great diversity of the nation.

By contrast, under NPV an aspirant might be able to win the presidency by campaigning only in major metropolitan areas–recall the county-by-county electoral map of 2000 that showed how Al Gore won the national popular vote but could fly from Pittsburgh to Los Angeles without passing over a single county where he prevailed. A campaign waged to maximize voter turnout in and around urban areas would be divisive and lead to more radical public policy from the victor. Imagine a Barack Obama without the need to appeal to at least some voters clinging to guns or religion.

The proponents of NPV point to the election of 2000 as evidence of the need for reform. But the opposite lesson should be drawn. The recounts in Florida were ugly, yet because of the Electoral College they were concentrated in one state. Now imagine an election that close under a national system, with two candidates separated by only a few hundred thousand votes. Under NPV, lawyers would descend on every voting precinct in every county in every state of the nation. Recounts would be nationwide spectacles fought in county courthouses and in front of state and federal benches across the land.

NPV would eventually turn presidential elections into a version of a Jamaican limbo dance. A great advantage of the current Electoral College system of winner-take-all is that it funnels votes into two candidates with relatively broad bases of support and exaggerates the margin of victory for the winner, no matter how close the popular contest. With Ross Perot in the race in 1992, Bill Clinton won the presidency with just 43 percent of the popular vote, but with 68 percent of the Electoral College. Will Americans be satisfied if a president takes office after receiving only 40 percent of the national vote? How about 30 percent in a five-candidate race?

(Although it’s not part of the current NPV plan, we could eventually be driven to adopt a run-off election, allowing the top two candidates to face each other in a second round. Imagine the expense, the length of the campaigns, and the legal controversies of such an approach.)

The NPV would also be a blow to federalism and the dignity of the states. Small states like West Virginia or Colorado would never see a presidential candidate again. Large urban areas would grow in power and pull candidates to the left. A new national bureaucracy might eventually be empowered to certify an official national vote winner.

The supporters of the NPV are halfway to their goal. Only a vigilant and determined debate in the states will preserve the system that has served America since 1792. It is time for that debate to begin.

Gary L. Gregg is editor of Securing Democracy: Why We Have an Electoral College.

Gregg, Gary L.

 

 

Changing up the Electoral College?

Full Text:

Four presidents have been elected without winning the majority of popular votes. That’s because 48 states give all their Electoral College votes to the candidate who wins in their state. The 2000 election of President George W. Bush was the most recent example, and has sparked a renewed interest in changing the system.

Recently, in Pennsylvania and Wisconsin, legislators have suggested replacing the winner-take-all system with the model used in Nebraska and Maine. These two states allot two electoral votes to the statewide winner and the rest according to the winner in each congressional district.

California and Vermont this year joined Hawaii, Illinois, Maryland, Massachusetts, New Jersey, Washington and Washington, D.C., in supporting a different idea known as the “Agreement Among the States to Elect the President by National Popular Vote,” or the NPV compact. It would require electors to vote for the candidate who wins the most votes nationwide.

Both concepts preserve the Electoral College and do not require a constitutional amendment since the U.S. Constitution gives states exclusive control over how to award their electoral votes.

Proponents of the National Popular Vote point out that the state winner-take-all rule is not in the Constitution. They argue that it would give candidates a reason to campaign nationwide and not just in “battleground” states. The current system allows candidates to pay little attention to the concerns of voters in states where they are comfortably ahead or hopelessly behind.

They dispute that the change would broaden campaigns, suggesting instead that it would just alter their targets; candidates may focus on only their “base” voters (such as city dwellers) instead of on voters from a wide geographic cross-section. They dispute the change would broaden campaigns, suggesting instead that it would just alter their targets; candidates may focus on only their “base” voters (such as city dwellers) instead of on voters from a wide geographic cross-section. And a recount, opponents argue, could be a national nightmare because each state has its own set of procedures.

“The Electoral College is an important part in the system of constitutional checks and balances in our country,” says Allison Hayward, vice president of policy at the Center for Competitive Politics. “Modifying the way we elect the president to a system that increases the chances of electoral chaos and voter anger is not in the best interest of our country.”

The National Popular Vote compact would go into effect after states representing 270 electoral votes join. The tally is currently at 132 electors.

SL ONLINE

For more details, on the National Popular Vote go to www.ncsl.org/magazine.

Underhill, Wendy

The U.S. Health Care System

The health reform law of 2010 authorizes Medicare, beginning next year, to contract with accountable care organizations (ACOs) in a Medicare Shared Savings Program. ACOs provide financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs. But providers have raised red flags, saying the arrangements are burdensome and too hard to achieve. This briefing addresses questions raised by the law and the subsequent regulation implementing ACOs.

http://www.kff.org/ahr051311video.cfm

 

This article reviews the Clinton Health Plan lack of public support.

Blendon, R. J., Brodie, M., & Benson, J. (1995). What happened to Americans’ support for the Clinton health plan? Health Affairs, 14(2), 7–23.

Online manual: American Hospital Association. (n.d.).

Legislative Manual. Washington, DC: Author. Retrieved from http://www.aha.org/aha/content/2009/pdf/0901-legislative- manual.pdf

Question:

What have you learned that clarifies the positions and tools used by the various stakeholder groups to impact Health Care reform legislation?

 

175 word count

 

APA Format

American National Government 2

Worksheet below***

 

LEARNING ACTIVITY WORKSHEET – Week Two

Please review the full assignment prompt located within the classroom and in the POL 201 Course Guide before beginning this assignment.

Utilizing the worksheet below, develop detailed paragraphs that focus on the second main point for your final paper. For each section, a minimum of one fully-developed paragraph is required.  Each paragraph should include at least one in-text APA citation that provides support for the topic.

At least two scholarly sources from the Ashford University library (not including your textbook) with in-text citations utilized within your paragraphs are required.  Two new sources should be utilized each week to meet the minimum of eight required sources for the final paper.  By finding and supporting your material with these sources each week, you will have the research necessary to construct a strong final paper. For help with writing and citations, please review the handouts and tutorials provided by the Ashford Writing Center.

1. Federalism:

A. One advantage to a national policy that must be implemented by one agency of the federal bureaucracy.

(Use the space below to complete this section.)

 

 

B. One disadvantage to a national policy that must be implemented by one agency of the federal bureaucracy.

(Use the space below to complete this section.)

 

 

 

C. One option to maintain the advantage of the national policy discussed above.

(Use the space below to complete this section.)

 

 

 

 

D. One option to improve the disadvantage of the national policy discussed above.

(Use the space below to complete this section.)

 

 

2. Reference List (utilizing full APA citations)

(Use the space below to complete this section.)

 

 

Federalism

This week, we continue completing the worksheets in preparation for the Final Paper. It is recommended that you review the Learning Activity assignments and review the Final Paper prompt before beginning this assignment. Please be sure to review the feedback provided by your instructor on your Week One Learning Activity as well. A model POL201 Final Paper Guide is provided for you to download and utilize when completing your Final Paper. One of the most important structures in the national government is federalism. Understanding the relationship between local, state, and national level governments is critical in being able to understand all of the key features of our national government. Describe an advantage and a disadvantage to a national policy that an agency in the federal bureaucracy must implement. In addition, recommend an option to maintain the advantage and one to improve the disadvantage.

To complete the assignment, save the Week Two Learning Activity Worksheet to your computer, fill it out, and submit it via WayPoint.

 

 

 

Develop several detailed paragraphs regarding your second main point using the Week Two Learning Activity Worksheet.

Federal Policies
You are required to develop four paragraphs that explain one advantage and one disadvantage of a national policy that is implemented by one agency of the federal bureaucracy, as well as options to maintain the advantage and improve the disadvantage must also be addressed.

 

Scholarly Support
For assistance with your research, the Ashford University’s Library provides tutorials and recorded webinars on a variety of topics. To access these helpful resources look for the links located under the FindIt@AU search box on the library home page. For help with writing and citations, please review the handouts and tutorials provided by the Ashford Writing Center.