Senator Marco Rubio and His Proposal
Senator Marco Rubio (R-FL) was chosen based on the state and his ideas about reforms in the healthcare sector. In the post-Obamacare era, no legislator has introduced a well-planned healthcare proposal to address some shortcomings noted in the current healthcare system. Rubio has been vocal about reforms and given his 2016 presidential ambitions, the legislator’s proposals should be reviewed keenly to understand their feasibility. New thoughts could be risky, but the senator has proposed a fresh three-part plan to reform the healthcare sector.
Volunteering roles included reviewing the available healthcare policies formulated for the State of Florida. Most importantly, the review concentrated on various comments and contributions made by the Senator regarding healthcare issues. These included a review of the affordable health insurance, which aimed to provide flexible, quality healthcare at affordable prices. The volunteering opportunity was a great way of gaining experiences in policy formulation, support and implementation processes. It was also an opportunity to build interpersonal relations and communication skills.
Affordable health insurance has been a major policy issue for Marco Rubio. Many Americans continue to experience rising costs of healthcare as the rate of different chronic diseases continues to rise. The Senator believes that Obamacare has eroded the system and as a result, many Americans have lost access to their physicians, insurance plans, pay high deductibles or high premiums. In addition, the Senator asserts that perhaps some people have lost their jobs or increased hours at work to cover for additional costs.
Marco Rubio’s values are guided by strong Republican ideologies on healthcare system. Rubio holds the view that conservative solutions can fix the healthcare issue in the US. The Senator believes that all Americans should be able to purchase health insurance of their choices with the increasing value every year. That is, there should be a marketplace of affordable health insurance for all Americans.
Healthcare insurance has a long history in the US. President Lyndon B. Johnson introduced both Medicare (a social insurance program) and Medicaid (social welfare program) in 1965 through changes in the Social Security Act. These social insurance and protection programs serve low-income families, but may also meet other requirements such as age, citizenship among others. The recently enacted Obamacare has resulted into widespread access to healthcare services, but its implementation has faced many challenges. Senator Rubio seeks to repeal and replace the current healthcare insurance.
While wealthy Americans can meet their healthcare costs, many middle and lower class Americans require federal government’s interventions in terms of insurance and support programs.
The proposals target specific groups of people in the United States, specifically families with low incomes and few resources, and individuals may qualify based on the citizenship, age, disabilities and pregnancy status. The affected individuals are mainly marginalized with little influence on affairs on the federal government and thus their representatives must promote their healthcare agendas.
While most Americans have insurance coverage, healthcare access for a small percentage of marginalized individuals without coverage has often raised ethical, social, economic, cultural and health implications (Hoffman, 2007). The implications have raised the issue of fair and just allocation of healthcare resources to ensure equal distribution, widespread coverage and access to all Americans. The uninsured Americans reflect challenges in healthcare coverage and distribution (Trotochaud, 2006).
Healthcare stakeholders have strived to improve the quality of healthcare and coverage for most Americans. Today, for instance, Obamacare has ensured that millions of Americans who previously could not access medical care can now get it and have coverage (Oberlander, 2012). Legislators have continued to push for more resources to be allocated for the healthcare sector. At the same time, other providers have adopted various technologies to deliver quality, affordable healthcare.
Marco Rubio has outlined a fresh post-Obamacare plan with three parts to repeal and replace Obamacare. First, he proposes “an advanceable, refundable tax credit that all Americans can use to purchase health insurance with increasing credit value every year and set the tax preference for employer-sponsored insurance on a glide path” (Rubio, 2015). Second, Rubio wants to “reform insurance regulations to encourage innovation, ensure that Americans with pre-existing conditions should be able to find coverage through their state’s federally-supported, actuarially-sound high risk pools” (Rubio, 2015). Finally, the legislator wants to save Medicare (change to a premium support system) and Medicaid (transform to a per-capita cap system) by placing them on fiscally sustainable paths.
The proposed policy strives to repeal and replace Obamacare. This will not be easy for the legislator. The public may resist the changes because the lower class may not get insurance due to lack of tax credits while Democrats will obviously not support the proposal (Oberlander, 2012). Besides, this is a completely new idea that no one understands its feasibility. Others could argue that the proposal is a mere rhetoric to seek for presidency by condemning Obamacare for no apparent reasons.
The proposal is still at a nascent stage. Nevertheless, Rubio delivered its three-plan reform to repeal and replace Obamacare and provide affordable health insurance. It is yet to be scrutinized and criticized.
Rubio’s Three-Part Plan for the Post-Obamacare Era
An Advanceable, Refundable Tax Credit
Action
Reviewing current distortions in the tax systems associated with the current healthcare policy. The review is meant to identify loopholes in the existing model and demonstrate how the proposed credit system will address them. The system must demonstrate how it will prevent large-scale distortion of the tax system, increase credit value every year and provide tax preference for employer-sponsored insurance.
Responsible persons
The Senator will establish a sub-committee consisting of tax consultants, nurses, employers and employees. Senator Ben Sasse and Congressman Paul Ryan will head the sub-committee. While the entire committee will work toward achieving the three-part plan goals, this sub-committee will focus on critical areas of tax distortions and complexity and provide a detailed report on improving the system and exactly how the advanceable, refundable tax credit will work and benefit the public. Jill and Jack will be responsible for finding the available information and getting relevant information, including evidence-based outcomes.
Time
The sub-committee must collect and review all available data, make and present a report within six weeks after the plan of action has been implemented. The action plan will be implemented on 1 April 2015.
Resources
Senator Marco Rubio must organize for funding to facilitate the work of the sub-committee. In addition, the sub-committee will seek for funds from the business community, healthcare organizations and the Republican Party. Individuals with conservative views will also be encouraged to contribute.
Communication
Senator Marco Rubio will be releasing the necessary information to all committee members on healthcare reform, all stakeholders and the public. Meanwhile Jack must coordinate communication affairs among the sub-committee and committee members.
Reform Insurance Regulations
Action
- The sub-committee members will evaluate the current health insurance regulations to initiate reforms. The reforms should ensure that citizens with pre-existing conditions get coverage through state’s federally supported programs. In addition, determine how wealthy Americans can purchase their insurance covers within state lines. Consumers should have a larger marketplace for coverage products such as health savings accounts. In addition, the community should establish clearly that taxpayers should bail no insurance firm once they become bankrupt.
- It is expected that these reforms will introduce a marketplace of affordable health insurance for Americans, expand provision of healthcare cover, enhance accountability and increase choices for consumers. Overall, it would offer quality healthcare at affordable costs. These reforms will continue as new realities emerge.
Responsible persons
The Senator will establish a sub-committee consisting of regulators, consultants, nurses, employers and employees. Senator Ben Sasse and Congressman Paul Ryan will head this group. The group will work toward finding the current challenges to affordable healthcare insurance. James and Anne will be responsible for establishing factors that have contributed to rising costs of cover, how to establish one-stop shop for healthcare insurance information and ensure accountability and use of technology to enhance efficiency and reduce errors.
Time
The sub-committee must collect and review all available data, make and present a report within six weeks after the plan of action has been implemented. The action plan will be implemented on 1 April 2015.
Resources
Senator Marco Rubio must organize for funding to facilitate the work of the sub-committee. In addition, the sub-committee will seek for funds from the business community, healthcare organizations and the Republican Party. Individuals with conservative views will also be encouraged to contribute.
Communication
Senator Marco Rubio will be releasing the necessary information to all committee members on healthcare reform, all stakeholders and the public. In addition, he will be ready to defend the proposal using various means of communications to reach different stakeholders. Meanwhile, James must coordinate communication affairs among the sub-committee and committee members.
Saving Medicare and Medicaid
Action
Study the current Medicare and Medicaid to determine their long-term financial sustainability. The programs require reforms to sustain them. The sub-committee will review the possibility of Medicaid under a per-capita cap model and Medicare under the premium support model. This would result into a marketplace with choices for Americans.
Responsible Persons
Senator Ben Sasse and Congressman Paul Ryan will head this group. Henry and Magnum will work toward reviewing the current state of Medicaid and Medicare, evaluate potential challenges and provide new recommendations.
Time
The sub-committee must collect and review all available data, make and present a report within six weeks after the plan of action has been implemented. The action plan will be implemented on 1 April 2015.
Resources
Senator Marco Rubio must organize for funding to facilitate the work of the sub-committee. In addition, the sub-committee will seek for funds from the business community, healthcare organizations and the Republican Party. Individuals with conservative views will also be encouraged to contribute.
Communication
Senator Marco Rubio will be releasing the necessary information to all committee members on healthcare reform, all stakeholders and the public. In addition, he will be ready to defend the proposal using various means of communications to reach different stakeholders. Meanwhile, Magnum will coordinate communication affairs among the sub-committee and committee members.
Nursing’s Role/Implications in This Process
The role of a nurse in this process of health policy change is advocacy. Advocacy is a key pillar of nursing under nurse roles. Effective advocacy, however, requires nurses to be knowledgeable of policymaking processes, policymakers and understand health issues.
The nurse must understand the proposed policy, Rubio’s three-part plan for the post-Obamacare era, its objectives and potential outcomes.
The most vital role for a nurse is to establish support for the proposed policy. The nurse may use different methods to achieve this advocacy goal. The nurse will rely on collaborative processes to engage internal stakeholders in all processes. Hence, it shall account for health needs of the immediate beneficiaries and engage decisively with politics in policymaking processes.
The policy shall use best practices and successful programs of the past based on data to influence policymakers. For instance, a study established that advocacy programs reduced health care disparities significantly among the medically uninsured and underserved populations (Rosenbaum, Jones, Shin, & Ku, 2009). It will also identify weaknesses in the current policy in order to improve on them, such as uninsured and underinsured, lack accessibility to healthcare facilities and financial support. The nurse can adopt health care provision for change and long-term outcomes by addressing the immediate concerns and long-term issues with health insurance. On this note, the nurse will use multidimensional approach, collaborative processes, monitoring and evaluating, financial support and management and other supports systems to advocate for the policy.
The proposed policy seeks to modify the existing Obamacare based on its weaknesses and inadequacy to serve all Americans. Hence, the nurse must have reliable data to support the three-part plan of Rubio.
It is vital for the nurse advocate to understand that the law protects Obamacare. It is a public health policy issue. Hence, it is under the current laws and regulations that guide the provision of health care services to all Americans through Medicaid, Medicare and other forms of healthcare insurance. Therefore, the advocacy and public policy must work collaboratively in order to identify and set forth the required changes so that they can address these needs. There should be no competition because advocacy will act as a factor for facilitating or influencing public policies for change. Exchange of information will be effective for the proposal.
Heath care provisions should not be apolitical because inputs and supports from legislators and policymakers are crucial for the success of the program. Politicians must understand that they make policies, which determine behaviors, choices, and the provision of health care services among Americans. The major role of advocacy is to change such policies that politicians and policymakers make. In this case, the health care resources are in the hands of few. This has led to poor provisions and distribution of health care service to the racial minorities in remote locations.
Advocacy for modification of the current laws would ensure that the medically underserved groups gain recognition for their health challenges. In addition, the effort would also influence lawmakers to ensure equitable distribution of health care resources in order to solve immediate and long-term health challenges among Americans (Milstead, 2011). The nurse advocate will do the following to support the process:
- Identifying key decision-makers, policies they implement, the level of consultation, accountability, and responsiveness
- Understanding how public policies are implemented and enforced
- Persuasion with facts on health care disparities and their negative effects on Americans
- Gaining direct access to key decision-makers on public health issues
- In case the responses are poor from lawmakers, the disruption and litigation may influence lawmakers and other policymakers
Summary of the Nursing Practicum
The Nursing Practicum Legislative Report focused on health policy reform proposed by Senator Marco Rubio during a nurse volunteering opportunity. Volunteering roles included reviewing the available healthcare policies formulated for the State of Florida.
The first section of the report focused on the choice of the legislator and the proposed policy. Marco Rubio has outlined a fresh post-Obamacare plan with three parts to repeal and replace Obamacare. First, he proposes “an advanceable, refundable tax credit that all Americans can use to purchase health insurance with increasing credit value every year and set the tax preference for employer-sponsored insurance on a glide path” (Rubio, 2015). Second, Rubio wants to “reform insurance regulations to encourage innovation, ensure that Americans with pre-existing conditions should be able to find coverage through their state’s federally-supported, actuarially-sound high risk pools” (Rubio, 2015). Finally, the legislator wants to save Medicare (change to a premium support system) and Medicaid (transform to a per-capita cap system) by placing them on fiscally sustainable paths.
The second section of the report has highlighted the Legislative Initiative Action Plan. It has covered Rubio’s three-part plan for the post-Obamacare era by showing required actions, expected outcomes, persons responsible, time, resources required for the policy change and communication processes.
The last section shows the role of the nurse as an advocate for healthcare policy change. The nurse advocate should engage all stakeholders to support the policy.
References
Hoffman, C. B. (2007). Simple Truths About America’s Uninsured: Many common beliefs are incorrect. American Journal of Nursing, 107(1), 40-47.
Milstead, J. A. (2011). Health Policy and Politics: A Nurse’s Guide (4th ed.). Burlington, MA: Jones and Bartlett.
Oberlander, J. (2012). The Future of Obamacare. New England Journal of Medicine, 367, 2165-2167.
Rosenbaum, S., Jones, E., Shin, P., & Ku, L. (2009). National Health Reform: How Will Medically Underserved Communities Fare? Web.
Rubio, M. (2015). My three part plan for the post-ObamaCare era. Web.
Trotochaud, K. (2006). Ethical Issues and Access to Healthcare. Journal of Infusion Nursing, 29(3), 165-170.