Beronio, K., Glied, S., & Frank, R. (2014). How the Affordable Care Act and Mental Health Parity and Addiction Equity Act greatly expand coverage of behavioral health care. Journal of Behavioral Health Services & Research, 41(4), 410-428.
In this article, the researchers reflect on the topic of the Patient Protection and Affordable Care Act’s expansion of the coverage for mental health benefits. Additionally, diverse aspects regarding this coverage such as its limits, uninsurance, incompleteness, and overall benefits are depicted in the study. The authors analyze various criteria of enhancing the expansions in coverage in the ACA and define the main ways of its affection on mental health and substance use treatment. Attention is paid to MHPAEA and its intersection with the Affordable Care Act as well. In this case, the health benefits and health plans of both MHPAEA and ACA are compared to one another and the discrepancies or differences are defined. Moreover, in this research article, the authors estimate the additional provisions that aim to provide the implementation of parity. Therefore, diverse perspectives of the issue concerning the impact of such requirements, their adequacy, risk adjustment, reinsurance, and coverage provision for small groups make a considerable part of the study.
Le Cook, B., Flores, M., Zuvekas, S. H., Newhouse, J. P., Hsu, J., Sonik, R., Lee, E., & Fung, V. (2020). The impact of Medicare’s mental health cost-sharing parity on use of mental health care services. Health Affairs, 39(5), 819-827.
The article consists of information about the impact of Medicare’s mental health cost-sharing parity on the use of mental health care services. The authors conduct the research utilizing diverse methods of analysis to draw conclusions about the increase or decrease of mental health services’ usage depending on the cost-sharing parity, consider the issue from a historical perspective. The list of authors includes representatives of diverse professions: economists, mental health providers, managers, and directors of various departments; therefore, the study on economic Medicare beneficiaries can be conducted on a top-notch level. In addition to the main topic of interest, the study provides the readers with data on the impact of cost-sharing activities on the quality of mental health services. The definition of the strength and weaknesses of those qualities make a considerable part of the study. Moreover, the researchers explain the specifics of central methods and strategies utilized in the study, their results, as well as limitations and traverses faced during the fulfillment of the research.
Nathenson, R. A. (2020). Coverage mandates and market dynamics: employer, insurer and patient responses to parity laws. Health Economics, Policy and Law, 15(2), 173-195.
The article is concentrated on mental health as a considerable feature of the Affordable Care Act. However, the author being a researcher in the field of policy attracts attention generally to the Employee Retirement Income Security Act and looks at the parity in coverage from its perspective. In addition, he compares the levels of mental health care services utilization before and after the implementation of new parity laws and concludes the laws’ benefits depending on the context. A considerable part of the article is provided to the background of those parity laws on both state and federal levels. Moreover, the author conducts his research by utilizing an empirical strategy, fully depicts his action plan and research methods in the corresponding subsections of the article. One of the most important examination outcomes depicted in the reading is the utilization of mental health services among self-insured and fully insured populations, the division of such populations based on the geographic factor as well.
Reference
Beronio, K., Glied, S., & Frank, R. (2014). How the Affordable Care Act and Mental Health Parity and Addiction Equity Act greatly expand coverage of behavioral health care. Journal of Behavioral Health Services & Research, 41(4), 410-428.
Le Cook, B., Flores, M., Zuvekas, S. H., Newhouse, J. P., Hsu, J., Sonik, R., Lee, E., & Fung, V. (2020). The impact of Medicare’s mental health cost-sharing parity on use of mental health care services. Health Affairs, 39(5), 819-827.
Nathenson, R. A. (2020). Coverage mandates and market dynamics: employer, insurer and patient responses to parity laws. Health Economics, Policy and Law, 15(2), 173-195.
Changes In Definition Of Family
Introduction
The progressive social and cultural organization has led to changes in the structure and concept. A family is the backbone of any society, and therefore, it is a society’s basic structure. The traditional definition of a family, the basic structure of a community, is too narrow to give modern families their wholesome purpose. Social factors such as divorce, intermarriages, and re-marriages have led to the change of family definition. Furthermore, while traditionally a family comprises members with blood-relations, modern families constitute members without blood relations. Step-families, blended families, and adopted family members lack blood relations with their family members. The law has also come in forming a family, and it does not restrict divorce, re-marriages, and children adoption. Therefore, the family definition has changed over time due to social factors such as re-marriages, inter-marriages, divorces, and adoption of other members into the family.
Traditional Families
Blood relation is a common feature among traditional family members. A traditional family consists of a man, a woman, and their biological children, also referred to as a nuclear family (Wanting, 2021). Further, traditional families consist of extended members such as uncles, aunts, and others. Adopted children are also part of a conventional family, though not related by blood. However, blood relation was a common feature of a traditional family. An extended family consists of more than one nuclear family related by blood. Uncles, aunts, cousins, grandparents, and other blood relatives form an extended family. Traditional family members are related by blood except for adopted members.
Same-family members’ marriages were restricted among societies with strict moral codes. Therefore, there was no family formation between members from the same family. Furthermore, some communities had strict rules against divorce, which would result in severe consequences (Caroll, 2021). Therefore, divorce was uncommon in traditional marriages resulting in less dissolved families. As society shifts towards social issues such as equality and freedom of expression, many modern families have come up.
Modern Families
Factors such as civilization, urbanization, and laws suiting existing society have led to the rise of modern families. Many laws, including international humanitarian laws, allow freedom of expression and other human rights. Consequently, many couples have divorced marriages that encumber their enjoyment of such rights. The courts have been at the frontline in supporting divorce cases backed up with inequality during the marriage. Furthermore, many countries have enacted laws allowing homosexuality and freedom of sexual expression. There is a rise in the number of same sex-marriages. Adoption of children has led to the formation of children homes, which recognize themselves as families. Divorce and the dynamic laws have led to the formation of modern families.
Divorce and Modern Families Formation
Divorce involves a legal marriage dissolution presiding over a court or any competent body. Divorces result from various factors such as lack of commitment, extramarital affairs, substance abuse, domestic abuse, among others. Furthermore, urbanization has necessitated divorce cases due to distance between couples. The consequences of divorce include the formation of new types of families. Divorced couples may decide, after divorce, to either get married or stay single. Reconstituted and single-parent families are a result of divorce among couples.
Reconstituted Families
Divorced couples may decide to enter another marriage and move to a new union with their children. Reconstituted families are formed when newly married individuals carry their children to the new marriage (Goss, 2019). Reconstituted families are also referred to as blended families or stepfamilies. The majority of American families have shifted from their original marriages to new marriages. Over fifty percent of the American families are either remarried or re-coupled (The Stepfamily Foundation Inc., n.d). The formation of blended families shifts the traditional definition of a family since it involves children who may not be biological to married couples.
Single-Parent Families
Some couples opt to stay single after divorce and raise their children. A family headed by one divorced parent is called a sing-parent family. The family can also result from extramarital affairs among unmarried couples. In 2020, about 15 million children lived with a single mother, while about 3.3 million children lived with a single father (Shipe, Ayer and Guastaferro, 2022). In the traditional nuclear families, which had both parents, a single-parent is overwhelmed with taking all the family responsibilities. However, the courts have intervened in a divorce, and often the duties would be equitably shared among the divorcing couples. Unlike the traditional nuclear family definition, a single-parent family negates one parent’s presence.
Homosexuality Families Formation
Homosexualism was considered a moral issue in the past, but recent research indicates that sexual orientation is caused by complex genetic interplay environmental and hormonal influences. Many societies and religions reject same-sex relationships and advocate legislation banning such relationships. For instance, Ghana voted for legislation restricting gay and transgender people from same-sex marriages. The legislation punished the “crime” with a five-year sentence (Jjuuko and Tabengwa, 2018). Despite the restrictions against same-sex relationships in various countries, countries like the United States have laws generous to homosexuals. Consequently, homosexuals can get married and form families in the United States. The same-sex family definition does not include biological children and is difficult to distinguish between a wife and husband in such marriage.
Problems of Modern Families
The dynamic shift in definition and concept of family, over time, has led to problems affecting the family members. Since the traditional family identifies a family composed of parents with their biological parents, modern families have been stigmatized. Some societies are scornful against same-sex, step-parents, and single-parent families. Therefore, many modern families lack happiness and free interaction, which are family formation. Furthermore, stepfamilies have been subject to violence leading to psychological disorders among children and other family members. Some single-parents are overwhelmed with their families’ financial needs if their divorced partners are not responsible. As the definition of a family changes over time, social and physical problems are associated with the changes.
Conclusion
While a family is described as parents and their biological children, the changing societal interactions have changed the definition. Civilization has led to new interactions and new social problems such as divorce. Divorce results in disagreement between the married couple and are presided over in a court of law. Divorced couples may decide to remit, leading to blended and step-parent families. The couples may also choose to remain single, leading to single-parent families. Same-sex relationships are permitted in various countries leading to the formation of similar-sex families. The dynamic family concept has led to social problems such as violence, financial burdens, family dissolutions, and psychological disorders. Defining a family is an arduous task, given the changing perceptions on family formation and family members.
References
Carroll, M.M., 2021. SIX. Iniquitous Partners. In Homesteads Ungovernable (pp. 133-162). University of Texas Press. Web.
Goss, R.E., 2019. Queering procreative privilege: Coming out as families. In Our Families, Our Values (pp. 3-20). Routledge.
Jjuuko, A. and Tabengwa, M., 2018. Expanded criminalisation of consensual same-sex relations in Africa: contextualising recent developments. Envisioning global LGBT human rights:(Neo) colonialism, neoliberalism, resistance and hope, pp.63-96. Web.
Shipe, S.L., Ayer, L. and Guastaferro, K., 2022. American Single Father Homes: A Growing Public Health Priority. American journal of public health, 112(1), pp.21-23. Web.
The Stepfamily Foundation Inc. (n.d.). Stepfamily Statistics. Web.
Wanting, S.H.I., 2021. Characteristics of Time-space Utilization and Its Gender Differences in Traditional Family Model: A Case Study of Stem Family and Nuclear Family. Journal of Landscape Research, 13(4).
Essay Voice-over
Should Free Healthcare Be A Right In America?
Introduction
Nothing exposes the inequalities prevalent in America more than the existing unequal healthcare system. It is a mix of healthcare providers and public and private insurers responsible for creating barriers to accessing quality services for a large portion of the population. Access to lifesaving medical treatment usually depends on employment and income status. This is a mixed private-public approach to healthcare where wealthy citizens buy health insurance from private insurance companies, while underprivileged people qualify for government-subsidized health insurance programs under the Affordable Care Act (ACA). Although ACA brought America closer to providing Universal Healthcare Coverage (UHC) through subsidized health care, inequalities still exist because not every citizen has medical coverage and access to the same needed treatments. A report shows that the American health system is still not universal because only 91% of the population is covered by insurance (“Health at a Glance”). Due to the inefficient healthcare system, there has been contention on whether or not healthcare should be a right or a privilege in America. The right to health implies that every citizen should have access to quality medical services regardless of their ability to pay.
Free Healthcare Should Be a Right in America
There is a common consensus that recognizes the right to universal healthcare globally. For instance, the United Nations Declaration of Human Rights (UDHR) supports unrestricted access to care. In 2005, America and all other member states of the United Nations (UN) endorsed resolution WHA58.33. This standard urges every nation to provide UHC to guarantee that all citizens have access to adequate and quality medical care while ensuring those services do not subject them to financial hardship. From this perspective, citizens who struggle to secure decent employment or cannot work due to their age or disabilities should have a right to free healthcare.
Under WHA58.33, the federal and states governments’ responsibility is to ascertain that the conditions that safeguard the rights to health are attainable, regardless of people’s race, age, gender, and income. In 2020, there were 9.3% of uninsured youths under the age of 19, while 66.7% of those who worked less than full-time annually were less likely to be covered by private insurance (“Health at a Glance”). Based on the UDHR’s ethical view, America has a duty to provide universal healthcare to eliminate inequitable systems where income status and access to medical services are intrinsically linked, preventing the underprivileged from accessing better healthcare. This can help all those for who the private-public insurance healthcare system imposes an undue burden.
The United States is a major industrialized nation and has vast resources to deliver free healthcare for every citizen. Since the endorsement of the UDHR, most developed countries worldwide have implemented universal healthcare systems. In this case, only America lacks a uniform health system and has not enacted legislation mandating UHC. The nation is the founding member of Economic Co-operation and Development (OECD) and the top contributor, funding about a quarter of its annual budget. In addition, despite America having the largest economy and a high Gross Domestic Product (GDP) than any other high-income nation, such as the United Kingdom, Italy, and France, it does not have universal healthcare. For this reason, free access to medical services should be a right in the United States.
The United States has a high level of healthcare spending and should be able to offer free healthcare services to every citizen. The federal government spends an average of $9 892 per person on healthcare annually (“Health at a Glance”). This figure is almost two-and-a-half times the average of other OECD members that only use $4003 per person. On the other hand, compared with the other G7 countries, America spends more than twice as much on healthcare per person as Japan, France, and Canada and almost 80% more than Germany. The nation’s healthcare expenditure accounts for 17.2% of GDP, which is more than 8% above the OECD average (“Health at a Glance”). Despite the country’s massive spending in the healthcare sector, it has the lowest life expectancy. This is attributed to the highly fragmented financing and healthcare delivery, creating coordination issues and inefficiencies that are less common in nations with more centralized national health systems.
American policymakers have an obligation to ensure that every citizen has coverage and access to the same needed medical services. The ACA has been sabotaged since it was implemented in 2010 under President Barack Obama. However, the head of state, Joe Biden, affirmed his commitment to protect and rebuild the ACA by making the country’s healthcare system less complex to navigate and reducing healthcare costs. Biden’s campaign platform states, “Every American has a right to the peace of mind that comes with knowing they have access to affordable and quality healthcare.” The statement indicates a political will to change the system founded after World War II when companies started offering insurance to their employees instead of higher wages. Therefore, by allowing big corporations to continue profiting from healthcare as a commodity, the American government has improved free access to care for all citizens instead of improving.
The United States already spends enough money to provide every American with free and better healthcare globally. A report shows that 48% of federal tax dollars are spent on the industry. It further illustrates that if a taxpayer earns $52,000 annually, they contribute $22,474, nearly half of their wages, to healthcare (Makary). This means that it is time to reduce the misallocation of resources by enacting new legislation to shift the direction of the country’s healthcare sector toward a single-payer system. This can guarantee that care is well-coordinated and the government delivers free medical services to every American. A study shows that the current healthcare structure results in high administrative costs and inefficiencies. In this case, medical resources are probably not devoted where they may affect patient outcomes, such as allocating excess resources to insurance marketing, billing, and administration. This indicates that UHC can save millions of dollars and provide Americans with free medical services.
Arguments Against Free Healthcare As a Right in America
Free healthcare for all would considerably augment the government’s spending leading to tax increments. A report shows that the country uses almost half of its GDP on healthcare expenses (Makary). Yet, most of its funding is only directly to major programs such as Medicare, Children’s Health Insurance Program (CHIP), and Medicaid. Providing free healthcare for every American would raise federal spending because it would entail providing full medical coverage to a vast number of the previously uninsured population. Additionally, UHC would require changes in infrastructures and healthcare facilities at the local, state, and national levels. These elevated healthcare expenses would be financed through federal taxes. A proposal for UHC in America pushed for a 7.5% payroll tax and a 4% income tax on all citizens, with the higher-income earners and middle class being subjected to more levies (Zieff et al. 2). Therefore, making free healthcare a right would cause a surge in government spending, resulting in more charges for the citizens.
The ballooning costs linked with UHC may expand the régime’s debt and deficit. Research shows that adopting a national single-payer healthcare system would immensely elevate the federal budget. For example, the proposed Medicare for All was estimated to augment the government’s spending by $32.6 trillion in its first ten years of implementation (“Medicare For All”). It was also estimated that doubling the individual and corporate income tax would not be enough to finance the Medicare for All plan. Alternatively, the UHC plan is expected to cost between $32 and $44 trillion in ten years, while deficit estimations range from 1.1 to 2.1 trillion dollars annually (Zieff et al. 2). Therefore, raising taxes may not be sufficient in funding universal healthcare. This would necessitate the administration to increase its borrowing, causing a spike in its debt level. A study shows that supporting UHC through government borrowing would shrink the economy by 24% by 2060 (“Medicare For All”). Thus, free healthcare is costly and may not be sufficiently funded through taxes; this may force the government to increase its borrowing, adversely affecting the economy.
Universal care may create tremendous inefficiencies within the healthcare system. This system has been linked to longer wait times for patients. Research indicates that countries with UHC, such as Canada and the United Kingdom, have exceedingly prolonged wait times. For example, the average wait time for arthroplasty surgery in Canada was between 20 to 52 weeks in 2017, while other patients were on waiting lists for approximately 1,040, 791 procedures. Similarly, in the United Kingdom, the median waiting time for optional hospital-based care was 46 days, with some patients waiting for over a year (Zieff et al. 3). In addition, the administration has been linked to promoting a “one-size-fits-all” approach which is likely to threaten innovations in the medical field, which are critical in discovering more effective healthcare plans. Due to many patients in need of care, UHC may result in the rationing of medical supplies and resources. A study has also linked UHC to reduced physician wages, provision of low-quality services, and higher out-of-pocket costs for patients. Therefore, making free healthcare a right in the United States may increase wait times and lower healthcare quality.
Conclusion
The international consensus that America and other UN member states endorsed supports the right to UHC. This implies that every citizen should access adequate, quality medical care services regardless of age, race, and financial status. Although ACA stirred the United States towards providing universal healthcare through subsidized insurance coverage, millions of Americans are still uninsured and underinsured. This is because ACA is highly fragmented, creating inefficiencies and misallocations of resources that are less common in other OECD nations with a single-payer healthcare system. The country already spends about half of the federal tax on the healthcare sector, and there is a need to enact new legislation to coordinate the industry better. On the other hand, adopting universal healthcare may be costly, necessitating tax increments and massive government borrowing, negatively affecting the nation’s economy. UHC may also create disorganizations within the healthcare system in regard to waiting times and the rationing of medical resources. However, since the government already spends a vast portion of taxpayers’ money on the healthcare sector, free healthcare should be a right in America.
Works Cited
“Health at a Glance 2017: OECD Indicators-How Does the United States Compare?” OECD, Web.
Makary, Marty. “We Spend About Half of Our Federal Tax Dollars on Healthcare. That’s Ridiculous.” Ustoday, 2019, Web.
“Medicare for All Could ‘Decimate’ the Economy.” Partnership for America’s Healthcare Future, Web.
Zieff, Gabriel, et al. “Universal Healthcare in the United States of America: A Healthy Debate.” Medicina, vol. 56, no. 11, 2020, pp. 1-7.