Implications of the Patient Protection and Affordable Care Act on the Healthcare Environment

The Patient Protection and Affordable Care Act is one of the most important policy initiatives of the American government in the contemporary world. The first of its aims to ensure that there is collaboration between government, individuals, and employers in order to achieve near-universal healthcare coverage. The second aim is to ensure that al of those individuals who receive health insurance coverage are able to achieve a high level of fairness, affordability, and quality. Another aim is to ensure that individuals who have coverage are able to receive a high quality of care without wasteful spending through the improvement of efficiency and accountability to patients. This policy also aims at promoting the development of a situation where there is a strengthening of primary care with the objective of easier access to preventative healthcare; essentially encouraging the reduction of healthcare costs. The final objective of this policy is to ensure that there is investment in needed healthcare facilities in so that it can be possible to bring about the expansion of clinical preventative care that is useful in the creation of a stable healthcare system. Patient Protection and Affordable Care is essential in the fixing the healthcare system so that a majority of the population can have access to quality care.

One of the most fundamental aspects of the American healthcare system is that it is one of the most expensive in the world. Unlike in European countries, where there are strong social welfare systems that ensure universal healthcare, in the United States, prior to Affordable Care, it was quite difficult for individuals to access quality healthcare. Furthermore, there was a situation where very few individuals had health insurance; meaning that some treatable health conditions ended up becoming a burden on patients. Therefore, the move by government to ensure that there was the expansion of healthcare insurance as well as an increase in investment in medical facilities to cater for the needs of individuals in need of them. This legislation had considerable support from the Obama administration, which promoted it by proposing that it was not only a matter of government policy, but also a moral issue that could not be ignored. In addition, while there was an attempt by the Democratic majority in Congress to take on a bipartisan approach, this ended up not being the case because the policy faced considerable opposition from conservative elements in the Republican Party such as the Tea Party. Moreover, some lobby groups associated with the healthcare complex were also involved in pushing their agendas in the development of the policy.

Among the considerations that were made during the development of Patient Protection and Affordable Care Act was the establishment of a single-payer Medicare for All Act. However, this option was discarded because of the belief that it would not be able to acquire support within the Senate that was filibuster-proof. The Medicare for All Act would have been one of the most progressive accomplishments of the policy because it would have ensured that all individuals were able to have health insurance. However, this alternative was not considered because it would have met with considerable opposition, especially from the conservative elements in the Republican Party. Furthermore, there was the fear that if such an act was passed by Congress, it would encourage freeloading among those individuals who were not willing to pay their fair share of insurance premiums. Therefore, the most progressive aspects of the Affordable Care Act were discarded because of the potential of considerable opposition to it. Furthermore, the need to ensure that the bipartisan concerns were addressed so that the act could be passed meant that compromises had to be made in order to create a situation where it was possible for majority support to be comfortably obtained.

The implementation of the Affordable Care Act was conducted at the state level. However, it was not implemented according to its original design because of considerable resistance that the legislation received from its opponents. A consequence was that states were given the option of making the decision of whether or not to expand their Medicaid programs. Since the objective of promoting the full adoption of Affordable Care in the whole of the United States was not achieved, it has remained a considerable point of contention on both sides of the political divide. However, a number of states ended up expanding their Medicaid to such an extent that a large number of individuals who previously did not have the means to have quality healthcare currently have access to it. This situation shows that if there had been proper bipartisan support for the policy, it would have led to universal healthcare coverage in the country to such an extent that it would have promoted the health of all Americans while reducing costs. Those states that opted not to expand their Medicaid created a situation where the federal government had to revise its estimates concerning how Affordable Care would work. This meant that it was essential to reduce the expectations concerning the savings that would have been made following implementation in all states.

While the policy started with good intentions for the healthcare system, it ended up not being able to achieve its intended goals because of resistance towards it both at the political and state levels. However, it was able to solve a considerable part of the original problem because it allowed individuals who could not previously afford it to have healthcare coverage. The progress of this policy was interrupted because some states opted not to adopt it because of the belief that it would increase their Medicaid costs. The lack of bipartisan support for this policy, especially considering Republican resistance, meant that its chances of success were limited to those states that adopted it. A consequence was that because some states opted not to adopt Affordable Care, the cost savings ended up being much less than was originally projected. Thus, this policy can be considered to have been neither a success nor a failure because while it was able to achieve its objectives in some states, in others, it had a hard time gaining acceptance.

Teenagers and Plastic Surgery

Over the past few years, statistics have shown that there has been an increase in the number of teenagers opting to go for cosmetic surgery. The most popular of the non-surgical cosmetic procedures among teenagers include laser hair removal and chemical peels, which have grown in popularity especially over the last two years. It has been stated that the most popular cosmetic surgery among teenagers has been cosmetic ear surgery, also known as otoplasty. Some experts in cosmetic surgery state that for some teenage patients, plastic surgery could have a very positive effect in their lives not only physically, but also in their emotional development. Moreover, cosmetic surgery has become so popular among teenagers that their parents are now bestowing them to their children as gifts for their birthdays or even graduations. Many surgeons state that they are seeing more teenagers than ever coming to their practices for the various cosmetic surgery procedures available to them. Despite the fact that many parents and their teenage children have been advised against turning to major surgical procedures as a fix for the teenagers’ self-confidence, the number of teenagers who have undergone these procedures has continued to rise. For example, the number of teenage girls under the age of 18 years who undergo breast augmentation procedures has nearly tripled from one year to the next. Teenagers undergoing cosmetic surgery have become a common phenomenon and it is no longer a procedure reserved for the rich as it has previously been.

In the initial stages before a surgeon can put a teenage patient in the cosmetic surgery procedure, he must assess whether this patient is suited for the procedure, otherwise, the entire procedure would be unethical because the surgeon will only be interested in the patient’s money and not their well-being. The most important thing that a surgeon must consider is whether the patient is physically mature this is because performing an operation on a physical feature, which has not fully developed could interfere with its growth and lead to or could have a negative impact on the surgery in the future. Secondly, the surgeon has to consider the emotional maturity of his patient and not only should he inform the teenager of the benefits of the procedure, but also its limitations and he should make sure that the patient is ready to live with the consequences of the procedure whether it meets their expectations or not. Lastly, teenagers and their parents should be made to understand the risks of undergoing the cosmetic surgery as well as the time it takes to recover from the procedure.

In addition, there has been a growing trend among teenagers towards undergoing cosmetic surgery to improve their appearance. From a handful of these procedures that were done some two decades ago on teenagers, today, a large number of teenagers in their hundreds of thousands, undergo cosmetic surgery. This number has kept on growing over the last ten years and it is actually becoming quite common. For example, the number of lipoplasty procedures for teenagers under the age of 18 years has continued to increase over the years and this has continued to be so despite the very careful selection by surgeons of the patients in this group. Furthermore, of the women who underwent breast augmentation procedures in the year 2010, about two percent of them were under the age of eighteen and this is quite a significant number. The reasons why teenagers go for cosmetic surgery to reduce or increase the size of their breasts, correct the balance between a pair of body parts and in this case mostly breasts and ears, correct the severe underdevelopment of some body parts and finally the need to increase their self-confidence in an environment where they feel insecure.

Many teenagers who wish to undergo plastic surgery are motivated by factors, which are very different from those that influence adults to do the same. Most of them want to improve the physical characteristics, which make them feel and look awkward; moreover, they believe that this awkwardness may pursue them for the rest of their lives. In fact, teenagers are always motivated by the current trends of the time and many undergo surgery just so that they can look similar to their friends or their favorite celebrities. This motivation is quite different from that of adults because they tend to undergo the cosmetic procedure not only to look different from their peers, but also to stand out. The most common physical characteristics, which teenagers often want to change for the better through cosmetic surgery include misshapen noses, protruding ears and either small or overly large breasts. After a successful procedure, many teenagers often regain their confidence because their perceived physical deformities have been corrected. In fact, this procedure if successful tends to make teenagers more confident in their social skills and this ensures that the social withdrawal, which had haunted them before is gone.

There are very strict procedures, which have been put in place to ensure that all teenagers who undergo cosmetic are well suited for it. The most common procedure that is supposed to be undertaken is to establish whether the teenager is mature enough emotionally and that this teenager understands the limitations of the surgical procedure which he is to undergo. Teenagers, and their parents, whose consent they need in order to have cosmetic surgery, have to understand that the effects of the surgical procedure on their bodies will be permanent and cannot be reversed and that they should therefore be very realistic in their expectations about what it will do for them. Moreover, the body of a teenager is more often than not fully developed and those perceived deformities that a teenager may have could be outgrown in time without the need for any surgery.

Many people believe that the increase in the number of teenagers undergoing plastic surgery is not a trend but an evolution, which has led to a new way of life. It is stated that one of the main reasons for this growth is the visibility of the procedure considering the fact that most teenagers are today growing up with parents who have undergone cosmetic surgery and they therefore have more knowledge about it. Media of all types has also made teenagers more aware of the procedures that one has to go through in a plastic surgery procedure and this awareness has ensured that their interest in it is whetted and it has become an acceptable thing among them (Janet, 2004). Teenagers have come to realize that plastic surgery does not only repair their physical appearance but it also boosts their self-confidence, something that they tend to require in the very competitive environment in which they live today. Plastic surgeons are also aware of the problems that teenagers’ face, which leads them to come to the decision to undergo the procedure and the surgeons, therefore, assess their psychological condition before putting them under the knife. Surgeons also recognize the fact that the surgical procedure may not do anything to help a teenager make an advance in their self-confidence and this is as a result of their prior experiences with celebrities who have remained very insecure despite undergoing so many cosmetic surgery procedures. Teenagers should be made to understand that although it is their right to have cosmetic surgery, they should be very careful in their consideration of whether to have it or not. They should realize that their wish to have the surgery should not be expressed lightly because the effects of this procedure will stay with them for the rest of their lives. Whether it is a trend or not, it has to be recognized that teenagers undergoing plastic surgery is something that is here to stay and that it should no longer be a surprising thing.

Review: Wasted: A Memoir of Anorexia and Bulimia

The need to succeed and to excel in every aspect of their lives leads many women, especially in the upper classes of society, to develop the problem of anorexia or bulimia. The drive for these women to succeed is so great and what is expected of them by both their families and the society tends to affect them negatively as they try to fulfill these expectations. The mothers of these women tend to be perfectionists and are very demanding of their children setting such unreasonable goals for them to achieve that this pressure becomes overwhelming for them. The fathers of these women tend to always be busy and have not enough time to get to know their families better and are often busy. Such situations always lead young women into living a life which is not fulfilling to them and in the process; the void which has not been filled by doing what they would have loved to do is often filled by an obsession with food or the lack of it. These matters are dealt with extensively in this book as Marya Hornbacher tells the story of her personal experience when dealing with eating disorders as well as her road to regaining what can be considered as a normal life.

One of the lessons learnt from this book is the fact that anorexia and bulimia are disorders which are more prevalent in upper class families than in the working class ones. The main reason for this is most likely because of the higher expectations expected from the members of such families and their feeling of inadequacy due to the fact that they are not able to fulfill these expectations. It is therefore necessary for parents to read this book so that they can get a hint of what really goes on with their children and to also ensure that they raise their children in a considerate environment where they do not feel too pressured to succeed. Furthermore, it is imperative that parents pay close attention to their children and talk to them often so that they can gauge their mood and feelings. In this way, the psychological problems which bring about anorexia will be prevented.

Anorexia and bulimia are psychological disorders which affect a large percentage of people in the world today and it is most rampant in the United States. It is necessary for these disorders to be studied as psychological problems and this book is a chronology of experiences related to these problems. This book can be used as a guide on how the people affected by anorexia and bulimia behave as well as how to find ways of curing them from these disorders. I believe that this book is an eye opener in many matters concerning eating disorders and their causes and it can be used in generalized terms to determine how most of the people affected by these disorders can be helped to regain their self esteem. It can be argued that this book is a credible psychological book since it is based on the real life experiences of somebody who was affected by these psychological disorders and managed to pull herself out of these problems and make something out of herself. It is for this very reason that this book should be considered as a psychological book.

Reference

Hornbacher, M. (1999). Wasted: A Memoir of Anorexia and Bulimia. New York: Harper Perennial.