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Government in Healthcare

Government in Healthcare

The Affordable Care Act (ACA) brought about several notable changes that considerably impacted healthcare in the United States. One of the most prominent aspects was the expansion of health insurance coverage. The ACA allowed individuals to stay on their parents’ insurance plans until age 26 (Blascack et al., 2023). This prevented young adults from losing coverage when transitioning into the workforce. Additionally, it prohibited insurance companies from denying coverage on the grounds of pre-existing diseases. This ensured that individuals with prior health issues could also access insurance. The Act also established health insurance marketplaces (Rasmussen & Taylor, 2021). It provided a platform for individuals and small businesses to compare and purchase affordable plans. Furthermore, it offered subsidies to lower-income families to make insurance more accessible. Overall, the goal of the ACA was to improve the quality of care, enhance preventive services, and control healthcare costs.

Subsequently, I agree with Shi & Singh’s assertion that health coverage is often viewed as a privilege rather than a right. The United States healthcare system has historically been heavily reliant on employer-sponsored insurance (Tumialan, 2019). This leaves those without such coverage in a vulnerable position. As a nurse, I’ve witnessed the consequences of this system firsthand. Patients without insurance or with limited coverage often delay seeking medical care. They then get more severe health issues and higher healthcare costs in the long run. This highlights the inequities that happen within the system. The role of the government, as described by Shi & Singh, is indeed to fill the gaps for the most vulnerable. However, this approach falls short of ensuring comprehensive, equitable healthcare for all. The ongoing debate on healthcare as a right versus a privilege underscores the need for systemic reforms. There is a need to ensure that every individual can access essential medical services without financial barriers.


Blascak, Nathan, and Vyacheslav Mikhed. “Health Insurance and Young Adult Financial Distress.” Journal of Policy Analysis and Management 42, no. 2 (2023): 393-423.

Rasmussen, P. W., & Taylor, E. A. (2021, November). What can the federal government learn from states about health insurance plan standardization? In JAMA Health Forum (Vol. 2, No. 11, pp. e213478-e213478). American Medical Association.

Tumialán, L. M. (2019). Healthcare systems in the United States. Quality Spine Care: Healthcare Systems, Quality Reporting, and Risk Adjustment, 155-169.


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Government in Healthcare

Government in Healthcare

The role of government in healthcare has evolved over time. In 1798, President John Adams signed the Act for the Relief of Sick and Disabled Seamen, imposing a twenty-cent per month tax on sailors to be used to pay for care at various American ports. This was America’s first federal “insurance mandate” and the first socialized medical program. The program was a small but impactful step on the part of the federal government, and it gradually led to the building of federal hospitals and then ultimately to the development of the U.S. Public Health Service (USPHS), which still exists today. There have been numerous developments since then, including the creation of Medicare and Medicaid programs in 1965 and, more recently, the Patient Protection and Affordable Care Act, commonly referred to as the Affordable Care Act (ACA).

Healthcare as a “right” is a widely debated topic. Shi & Singh (2019) state it well: Health coverage in the U.S. “is considered a privilege for those offered insurance through employers, and the government is left to take on a gap-filling role for the most vulnerable of the uninsured population” (p. 311).

Step 2 Post a response to the discussion board.

In your post, respond to the following questions and, if it’s relevant, include your own personal experience:

Based on your research, what beneficial changes came from the Affordable Care Act (ACA)?
Do you agree with Shi & Singh’s above statement? Why or why not?
Step 3 Read and respond to two other students’ posts

Read other students’ posts and respond to at least two of them. Use your personal experience, if relevant, to help support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support your opinions.

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