Maroc - EURASIAREVIEW.COM - A la une - 14/Sep 23:01

Public Healthcare Debates In US Presidential Election: Harris Vs Trump Vision – OpEd

The US Presidential Election 2024 brings two distinct healthcare visions from Kamala Harris and Donald Trump, reflecting broader ideological differences between their parties. The US Presidential Election 2024 going to be held on November 5, 2024. Joe Biden, the incumbent president, withdrew due to concerns about his health and age, and endorsed Vice President Kamala Harris nominated a presidential candidate prudential candidate. Donald Trump, the Republican nominee, is running for re-election. Leading campaign issues include abortion, border security, immigration, climate change, democracy, economy, education, foreign policy, healthcare, and LGBT rights. Major Health Challenges The United States faces multiple public healthcare challenges, including a large population without health insurance, high healthcare costs, widespread chronic diseases, inequalities in health outcomes, mental health issues, an increasing elderly demographic, and a shortage of healthcare professionals. In 2022, the percentage of uninsured Americans was 8.6%, and those living in rural areas faced significant challenges in accessing healthcare. Geographic disparities also play a role in these issues, with around 15% of the U.S. population being rural Americans. The United States is confronted with a significant challenge regarding high medical costs, highlighted by its healthcare spending of $4.3 trillion in 2021, which stands as the highest among OECD countries. The per capita health expenditure reached approximately $12,530, exceedingly more than double the average of other developed countries. The administrative costs in the United States are almost four times higher than those of comparable countries, totaling around $937 billion annually. Chronic illnesses, including cardiovascular disease, cancer, and diabetes, are the leading causes of death and disability, accounting for 90% of the nation's annual healthcare costs, which total $4.1 trillion. Fewer than half of adults living with chronic illnesses access preventive healthcare that is based on solid evidence. Health disparities involve differences in access to healthcare and health outcomes, especially concerning race and ethnicity. It is important to highlight that Black and Hispanic communities show higher rates of being uninsured when compared to white populations. Socioeconomic disparities exist, with individuals from lower income brackets being more likely to face poorer health outcomes. Mental health presents a significant challenge, with around 20% of adults in the United States experiencing a mental illness. Nevertheless, only 46.2% of these individuals utilized mental health services in the past year. The presence of stigma and a general lack of awareness play significant roles in exacerbating mental health disorders, leading to decreased reporting and a reluctance to seek treatment. The topic of an aging population holds considerable importance, with projections indicating that the number of individuals aged 85 and older is expected to triple by 2060. This will lead to a significant increase in the demand for long-term care services. The Medicare and Social Security programs are under significant pressure, and the COVID-19 pandemic has highlighted important weaknesses in the public health infrastructure of the United States. The lack of healthcare professionals is a significant issue, as indicated by projections from the Association of American Medical Colleges (AAMC). By 2033, we may face a shortage of as many as 139,000 physicians, and by 2030, the deficit in nursing could reach around 1.1 million. Addressing workforce challenges can be effectively achieved by implementing training and retention programs. The healthcare system in the United States exhibits considerable fragmentation, incorporating a mix of private insurance, Medicare, Medicaid, and a range of other public programs. The inconsistencies led to gaps in insurance coverage, confusion in billing, and inefficiencies. The Trust for America's Health highlights a continuous shortfall in public health funding, noting that the per capita expenditure was only $86 in 2019. The integration of data and technology presents a significant challenge, as fragmented systems hinder the effectiveness of public health responses. The insights derived from data highlight the complicated challenges confronting the U.S. healthcare system today. To tackle these challenges, it is essential to implement coordinated policy efforts and make strategic investments aimed at improving access, affordability, and outcomes for every American citizen. Harris vs Trump: Vision for Public Healthcare The evolution of public health policy and reform in the United States has been ongoing from 1900 to the present day. The journey starts with Teddy Roosevelt's endorsement of social insurance in 1912, which encompassed health insurance and the establishment of regulatory frameworks. The Sheppard-Towner Act of 1921 represented a crucial step forward in the funding of maternal and child health, although it came to an end in 1929. The Great Depression resulted in the 1935 Social Security Act, which encompassed grants aimed at maternal and child health. The 1960s saw the introduction of Medicare and Medicaid, which expanded coverage for the elderly and those with low incomes. During the 1970s and 1980s, a series of reforms were introduced to manage healthcare costs and expand coverage, notably with the creation of the Health Care Financing Administration and the implementation of the Emergency Medical Treatment and Active Labor Act. During the 1990s, there were efforts for comprehensive reform led by President Clinton, but these ultimately did not succeed. The 2000s saw the introduction of the Medicare Drug Benefit alongside state-level reforms aimed at universal coverage. A significant turning point occurred in 2010 with the Patient Protection and Kamala Harris Kamala Harris has consistently championed healthcare reform since her political career began. Her advocacy for healthcare began in 2016 when she co-sponsored Bernie Sanders' "Medicare for All" bill, demonstrating her commitment to expanding healthcare access. In 2018, she introduced the Choose Medicare Act, which aimed to enhance the Affordable Care Act (ACA) by increasing subsidies and extending assistance to higher-income individuals. Additionally, she proposed the Maternal Care Access and Reducing Emergencies (CARE) Act to address racial disparities in maternal health outcomes. Harris has been vocal about her concerns regarding the Trump administration's handling of the ACA, particularly its use of Section 1332, which she argued could lead to higher healthcare costs and jeopardize protections for those with pre-existing conditions. In 2019, she co-introduced the State Public Option Act, allowing states to create Medicaid buy-in programs, further advocating for accessible healthcare options. Her commitment to health equity continued with the Territories Health Equity Act, which sought to increase federal Medicaid funding for territories and proposed a gradual transition to a Medicare for All system. During the COVID-19 pandemic, Harris urged the reopening of the ACA marketplace to help uninsured Americans secure health coverage, emphasizing the importance of stable leadership in public health.  Over time, Harris has shifted her focus from a full Medicare for All approach to a more gradual expansion of Medicare, while still supporting private insurance options. Her current healthcare agenda includes enhancing the ACA, negotiating lower drug prices, and ensuring transparency in drug pricing. She has also advocated for reforms to alleviate the burden of medical debt and protect individuals from aggressive debt collection practices. In addition to her healthcare initiatives, Harris is a strong advocate for reproductive rights, opposing the Dobbs ruling and sponsoring legislation to protect abortion access. She has played a significant role in gun violence prevention, supporting universal background checks and "red flag" laws through her leadership in the White House Office of Gun Violence Prevention. Furthermore, she has been active in pandemic response efforts, promoting free testing and vaccination initiatives, and addressing long COVID challenges. Harris also supports comprehensive paid leave policies and has endorsed Biden’s American Families Plan, which aims to enhance tax credits for low-income families. Overall, her legislative efforts reflect a commitment to improving healthcare access, promoting reproductive rights, and addressing social equity issues. Trump Presidential candidate Donald Trump's healthcare policies and public health strategies, demonstrated inconsistencies and complexities in his public healthcare approach. Trump has pledged to replace the Affordable Care Act (ACA), a move supported by some Republican senators, but this has historically led to increased uninsured rates and higher premiums for those who remained insured. His administration's efforts to repeal the ACA included removing the penalty for non-insurance and promoting short-term health plans that often lack essential coverage, complicating the healthcare landscape further. Recently, Trump has indicated a potential shift towards enhancing the ACA, reflecting growing public support for the program. In terms of entitlement programs, Trump has proposed reducing them, including Social Security and Medicare, although his campaign later clarified that this would focus on "cutting waste" rather than direct cuts to benefits. His administration's approach to civil rights has also raised concerns, with intentions to reinterpret protections for minorities to address what he describes as "anti-white racism," potentially undermining existing anti-discrimination efforts. Trump's record on medical debt is marked by a lack of prioritization, despite implementing the No Surprises Act and price transparency measures aimed at protecting patients from unexpected medical expenses. His stance on reproductive health has been inconsistent, initially supporting strict abortion restrictions but later softening his position in response to electoral outcomes, while also supporting in-vitro fertilization (IVF). On gun violence, Trump's policies are being criticized for inaction, particularly his reversal of regulations that prevented individuals with mental illnesses from purchasing firearms, indicating a preference for Second Amendment rights over public health concerns. His handling of the COVID-19 pandemic faced significant criticism for not adhering to scientific guidance and promoting unproven treatments, despite the success of Operation Warp Speed in vaccine development. However, his current campaign does not adequately address ongoing public health issues related to the pandemic. Lastly, while Trump has shown some support for paid leave for federal employees, his proposals lack comprehensive coverage for non-federal workers and are criticized for insufficient federal funding. Overall, Trump's healthcare policies reflect a blend of initiatives aimed at cost reduction and access improvement, often resulting in unintended negative consequences. Conclusion At last, it is concluded that the public health visions of Kamala Harris and Donald Trump, both have differing approaches to healthcare reform. Kamala Harris advocates for a gradual expansion of Medicare and the enhancement of the Affordable Care Act (ACA), emphasizing the importance of reproductive rights, gun violence prevention, and addressing healthcare disparities, including medical debt relief. Her vision aims for comprehensive healthcare reform that prioritizes equitable and accessible care for all Americans. In contrast, Donald Trump has focused on repealing the ACA and promoting short-term health plans, while also advocating for Second Amendment protections. However, his healthcare policies have led to inconsistent outcomes, such as increased uninsured rates and higher premiums, which undermine access to care and public health. To improve healthcare in the U.S., it is suggested that expanding the ACA, empowering the government to negotiate drug prices, and addressing healthcare disparities are crucial steps grey arears.