When politics and medical science intersect, there can be much debate.

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.




In simple terms, healthcare policy refers to plans, discussions, and actions that are established on to achieve specific goals of healthcare in any setting. One of the healthcare policies that have caused significant debate is the Affordable Care Act (ACA). ACA has faced a lot of opposition since Trump came into leadership (Congress.gov, 2019). Trump has always been fighting the ACA stating that it doesn’t meet the healthcare needs of the Americans. Trump is aiming at replacing the ACA with the Graham-Cassidy. Graham-Cassidy is supposed to permit the insurers to discriminate against the people with existing states and remarkably reduced insurance subsidies for the Americans in the middle and low-income classes.

Reliable research establishes that there is some logic in Trump’s decision. Dismantling the ACA is expected to provide an opportunity for the Americans to enjoy better healthcare services.  The ACA has various shortcomings which need to be addressed if it must meet the healthcare needs of all the Americans (McCarthy, 2018). Research establishes that ACA has led to increasing in the cost of care to many Americans. Diseases that had been ignored in the past started to be treated after the implementation of the ACA. Treatment of some chronic illnesses which had been ignored prior to the implementation of the ACA led to the increased cost of care due to the need to cater to them. The fact that the ACA requires Americans to cater to services that don’t benefit them shows that it is ineffective; such services include maternity care.  Moreover, ACA led to multiple losses to various insurance companies and Americans after it canceled insurances for over 30 million people as their policies didn’t meet the 10 essentials of the ACA.  It is worth noting that the move by the ACA in 2013 to increase the income taxes for the majority of Americans was much ravaging because it led to double taxation among many Americans, who had to pay for the Medicare (Amadeo, 2019).

It is worth noting that dismantling the ACA will lead to inefficiencies in healthcare. There are many Americans who rely on the ACA to meet their care needs; Such Americans include the poor and the middle-class individuals. Dismantling the ACA is, therefore, likely to result in significant problems for the poor. However, the Graham-Cassidy policy seems to be better as it advocates for the healthcare needs of both the poor and the rich. Equality should be the basis of medication in healthcare (McCarthy, 2018).


Amadeo, K. (2019). 10 Pros and Cons of Obamacare. Retrieved from https://www.thebalance.com/obamacare-pros-and-cons-3306059

Congress.gov. (2019). Congress.gov | Library of Congress. Retrieved from https://www.congress.gov/

McCarthy, M. (2018). Trump calls on Congress to replace “unsustainable” Affordable Care Act. BMJ, j1145. doi: 10.1136/bmj.j1145



You identify the ongoing challenges related to ACA and the current debate that continues about health care coverage. Related to the Graham-Cassidy plan, what are the key advantages and disadvantages that have been identified? What approach would you use to gain support of key stakeholders related to proposed changes and policy development to address the issues related to this or other policies that require change?


For this week’s discussion, we needed to find one proposed health policy. Going away from nursing and focusing on my other passion of being an EMT, I found a policy dealing with those who are first responders.

On 05/16/2019, a new policy named H.R.2812 or Protecting America’s First Responders Act was introduced. The sponsor of this bill is Representative Bill Pascrell JR a democrat out of New Jersey and Charles “Chuck” Grassley from Iowa (Congress n.d.). The goal is to provide payment of death and disability benefits for any first responder that becomes seriously injured or completely disabled in the line of duty.

The original version of this bill dated back to 1968 and was called the Omnibus Crime Control and Safe Streets Act of 1968 (Congress n.d.). As of May 2019, the bill has passed in the Senate and goes to the house next for consideration where there is a 98% chance of it being enacted on (Protecting America’s First Responders Act n.d.). 

As a first responder, I feel that this is a valuable bill and seems to have a larger amount of support to pass it into law. As a volunteer for my local rural Wisconsin town, we get up at all times of night, and from the moment I get in my vehicle till the time I get back into bed my life is in danger. We are a completely volunteer and give my time to help our local community. We don’t ask for anything in return but continue to serve our community. I feel strongly that this bill will pass as first responder compensation has been in the news lately. On June 11, 2019, former Daily Show host Jon Stewart went to capitol hill to rant about the need to protect our first responders from 9/11. Alongside him was a Luis Alvarez, a detective that spent six months digging through ground zero and later developed cancer. Luis died on 6/29/2019 18 days after sitting alongside Jon Stewart. The saying I live by, “if we don’t protect our first responders, who will protect us?”


Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Protecting America’s First Responders Act (S. 1208). (n.d.). Retrieved July 9, 2019. from https://www.gotrack.us/congress/bills/116/s1208


Main question post: Senate Bill 773: Telehealth Innovation and Improvement Act of 2019 is proposed legislation designed to require and facilitate the Center for Medicare and Medicaid Innovation (CMI) to initiate telehealth utilization policies and services into their healthcare reform model (U.S. Congress, n.d.). The proposed expanded telehealth services requirement would allow for participating hospitals to test the utilization of telehealth services under the direction of CMI. By evaluating the effectiveness of telehealth programs and the quality of care, Medicare could expand coverages of these services and further billing practices according to accountable care organizations and bundled payment programs (Burch, 2017). This bill was introduced in the Senate on March 13th, 2019 and is currently sponsored by Senator Cory Gardner (R-CO) and co-sponsored by Gary Peters (D-MI) (U.S. Congress, n.d.). The bill is in its initial stages and has not reached any formal committee activity level.

Telehealth can aid in providing access to healthcare services to many people across the country. With the Accountable Care Act’s expansion of healthcare coverage for millions of Americans, the increased demand on the healthcare system has not been fully accounted for which includes increased wait times to see primary care providers, impacted emergency departments and home health and mental health services. By utilizing telehealth technology to offset the burden of an impacted system; monitoring, follow-up, and preventable services may not only be a viable cost-saving solution but a profitable one as well. Data has shown that telehealth has decreased hospitalizations by the early detection and intervention of exacerbations of chronic disease such as hyperglycemia, hypertension, congestive heart failure, and respiratory distress syndromes. However, payor sources, including Medicare and Medicaid Services (CMS), have conflicting definitions of what telehealth is and how it should and could be reimbursed (Burch, 2017). By taking the lead in defining the parameters around telehealth reimbursement, CMS has an opportunity to improve access and evolve the healthcare model and control the narrative. CMI can be at the forefront of the future of healthcare by adopting organizational policies and supporting innovation and creating a culture of progression (Klein, 1996).

According to Burch (2017), practitioners should look beyond reimbursement to the actual value of telehealth; patient safety, chronic care management, access to care, and reduced hospital admissions. Medicare’s bundled payment plan makes the physicians or home health agencies responsible for episodic care for 60 to 90 days after a procedure, surgery, or hospitalization, and in some cases telehealth can reduce the number of visits to the provider and provide cost savings through monitoring and early intervention (Burch, 2017). Progressive, forward thinking is required to solve the current impacted, costly, and inefficient healthcare system we have in the United States. One way to accomplish this is through telehealth. Hospital systems and providers should start to familiarize themselves with telehealth and various other technologies to streamline their practice, unfortunately however, until there is an agreed upon reimbursement model for these services it is not likely to occur. Support for SB 773 is paramount in improving quality healthcare through telehealth and forcing CMS and their innovation department to lead the way into the future of healthcare.


Burch, S. G. (2017). The power and potential of telehealth what health systems should know. Healthcare Financial Management, 71(2), 46-49.

Klein, K. J. (1996). The challenge of innovation implementation. Academy of Management Review, 21(4), 1055-1080. doi:10.5465/AMR.1996.9704071863

U.S. Congress. (n.d.). Current Legislation. Retrieved July 8, 2019, from Congress.gov: https://www.congress.gov/bill/116th-congress/senate-bill/773/text?q=%7B%22search%22%3A%5B%22health+care%22%5D%7D&r=135&s=2


Expert Solution Preview

Hi Shannon,

You provide an interesting analysis of the Affordable Care Act (ACA) and the proposed Graham-Cassidy policy. However, it would be helpful if you could provide some more evidence-based information to support your claims. For example, you state that the ACA has led to an increase in the cost of care for many Americans, but could you provide some sources to back up this claim? Additionally, while it is true that the ACA requires Americans to pay for services that they may not necessarily need or want, such as maternity care, this is done to ensure that healthcare coverage is comprehensive and available to everyone. It may be helpful to explore this concept further and discuss the benefits and drawbacks of a comprehensive healthcare system.

Overall, your analysis provides a good starting point for the debate surrounding healthcare policies, and it would be interesting to see how stakeholders on both sides of the issue respond.

Best regards.


Amadeo, K. (2019). 10 Pros and Cons of Obamacare. Retrieved from https://www.thebalance.com/obamacare-pros-and-cons-3306059

Congress.gov. (2019). Congress.gov | Library of Congress. Retrieved from https://www.congress.gov/

McCarthy, M. (2018). Trump calls on Congress to replace “unsustainable” Affordable Care Act. BMJ, j1145. doi: 10.1136/bmj.j1145


As a fellow first responder, I agree with you that the Protecting America’s First Responders Act is an important piece of legislation. However, it may be helpful to explore the potential criticisms or drawbacks of this policy. For example, some may argue that providing death and disability benefits to all first responders could place an additional burden on taxpayers. Additionally, there may be concerns about the potential for fraud or abuse of these benefits. It would be interesting to see how proponents of the policy respond to these criticisms.

Best regards.


Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Protecting America’s First Responders Act (S. 1208). (n.d.). Retrieved July 9, 2019. from https://www.gotrack.us/congress/bills/116/s1208


Your analysis of the Telehealth Innovation and Improvement Act of 2019 is insightful. It may be useful to explore some of the potential benefits and drawbacks of telehealth as a healthcare delivery model. For example, while telehealth can increase access to care for individuals living in rural or remote areas, there may be concerns about the quality of care provided through telehealth compared to in-person care. Additionally, it is important to consider the potential for telehealth to exacerbate existing disparities in healthcare access and utilization. It would be interesting to see how stakeholders in the healthcare industry respond to the proposed legislation and these potential concerns.

Best regards.


Burch, S. (2017). Telehealth Reimbursement: Where Do We Stand Now? Journal of AHIMA, 88(2), 44-45.

U.S. Congress. (n.d.). Senate Bill 773: Telehealth Innovation and Improvement Act of 2019. Retrieved from https://www.congress.gov/bill/116th-congress/senate-bill/773.

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