Tutor profile: Gabrielle B.
Subject: Public Health
What action can Senator Lamar Alexander take to mitigate surprise medical billing for health consumers?
Option 1: Cap reimbursement rates based on Medicare rates. This option caps reimbursement rates for services provided by out-of-network providers up to 125% of Medicare reimbursement rates. This option will apply to all out-of-network ED providers and ancillary providers. This option applies to all plans, including those under the jurisdiction of ERISA. Political feasibility is tempered because the option involves federal intervention in setting service rates. Implementation will be feasible because Medicare rates are already standardized. In terms of effectiveness, this option does not directly abolish surprise medical billing, but rather, focuses on preventing surprise medical billing. Further, this option targets ED and ancillary providers, which are largely responsible for surprise medical bills. Option 2: Mandate that all patients be notified that they are receiving out-of-network care. This option mandates that all individuals who receive emergency or ambulatory care are notified that they are receiving out-of-network care once they are medically stable. Providers must also tell patients their expected out-of-network cost-sharing responsibility. Political feasibility is high because this option is low-cost and does not directly change market dynamics. Implementation will be simple because facilities would give patients an additional consent form to sign acknowledging the out-of-network care. However, the effectiveness of this option is low because patients will not forego care in dire circumstances, even if the care is out-of-network. Option 3: Use binding arbitration to determine reimbursement rates. This option establishes a binding arbitration process to determine service fees via an arbiter contracted by the federal government. Both the insurer and the provider propose a price for medical services and the arbiter will select the most reasonable price based on local in-network rates. This option applies to all plans, including those under the jurisdiction of ERISA. Insurers and facilities will be dissuaded from bringing disputes to arbitration because they will be forced to split the fee for arbitration. This option eliminates direct governmental involvement, so political feasibility is practicable for Republicans. Implementation will require compromise in the private sector; however, the federal government will be able to model implementation after New York’s law, making implementation achievable. This option is highly effective because insurers would be forced to pay the entire service fee determined by the arbiter, eliminating the ability of the provider to balance bill. Policy Recommendation: Option 3 is the most viable solution for Senator Alexander. The bill would have bipartisan support, effectively reduce surprise medical bills, and hold insurers, practitioners, and hospitals accountable for health billing. Further, this option has proven successful in New York. Health prices would steadily fall, and prices would be based on current contracts, health outcomes, and local markets. Binding arbitration will hold both insurers and practitioners accountable for medical costs.
Subject: US History
Please discuss the history of abortion politics between the two major political parties.
In the United States, abortion is a major social issue that both major political parties have contemplated for decades. Democrats and Republicans cite moral objections, freedom of choice, and the meaning of life in the abortion debate. Further, these disagreements exist on the federal, state, and local levels. Before Roe v. Wade, illegal abortions were the norm; without regulation and legalization, some patients experienced sepsis, multiorgan failure, or death (Ingelfinger, 2018, p.708). Then, in the early 1970s, Roe v. Wade decriminalized abortion in the United States. Roe v. Wade established a framework for the termination of a pregnancy, with three distinct phases of legality. In the first trimester, the state cannot regulate abortion. In the second trimester, the state can regulate abortion related to the woman’s health. In the final trimester, once the fetus is viable, a state can actively restrict, or prohibit, abortion (Cornell Law School, 2020). After the 1970s, the two major political parties established party platforms on the legality of abortion. On the national level, the Republican Party platform fundamentally opposes abortion, federal funding towards abortion, and cites a moral argument in its opposition. According to the Republican’s 2016 platform, federal dollars should exclusively fund healthcare not related to abortion procedures. The Republican Party is against “acquir[ing], transfer[ing], or sell[ing] fetal tissues from elective abortions for research” (RNC, 2016, p.13). The Republican Party actively supports the U.S. House of Representatives for the Born-Alive Infant Protection Act, which makes providers care for fetuses that survive abortions (RNC, 2016, p.14). The Republican Party also applauds the twelve states that have passed a series of Pain-Capable Unborn Child Protection Acts, which ban abortion after twenty weeks; the Party encourages Congress to pass a federal version of the legislation. The Party is against sex-selection abortions and disability-related abortions (RNC, 2016, p.14). The Party uses moral arguments to justify its position, citing sources that state that fetuses can feel pain after twenty weeks. In terms of children, the Party believes schools should not provide referrals to abortion clinics (RNC, 2016, p.34). Additionally, the Party maintains that minors need parental approval to cross state lines to get an abortion (RNC, 2016, p.37). The platform emphasizes a state-based approach to regulating abortion, which highlights that the Party favors regional-based approaches over federal interventions. The Republican Party platform underscores the “extremist” tendencies of the Democratic Party (RNC, 2016, p.14). According to the Republican’s 2016 platform, the Democratic Party’s “opposition to simple abortion clinic safety procedures, support for taxpayer-funded abortion, and rejection of pregnancy resource centers that provide abortion alternatives” supports abortion to excess (RNC, 2016, p.14). The Democratic Party platform supports safe and legal abortion, the expansion of women’s rights to choose, and also cites a moral argument in its opposition. The Democratic Party platform for 2016 emphasizes that the Party will appoint judges who will “protect a woman’s right to safe and legal abortion” (DNC, 2016, p.23). As opposed to the Republican Party, the Democratic Party affirms that abortion is a form of healthcare. The Party sustains that abortion should be accessible to any woman regardless of her income, insurance, or geographic location. The platform also criticizes the Hyde Amendment, which bans the use of federal dollars to pay for elective abortions (DNC, 2016, p.33). This demonstrates that the platform fundamentally opposes all efforts that limit a woman’s ability to access an abortion. The platform encourages federal and state funding for evidence-based sex education and comprehensive healthcare. The Democratic Party states that comprehensive maternal and women’s healthcare must include abortion services. When justifying its stance, the Party highlights the right to choose solely belongs to the woman. Further, the Party supports options for those who do not want an abortion. The Democratic Party denounces the Republican Party’s efforts to defund Planned Parenthood health centers. Similarly, the Democratic platform combats acts of “violence, harassment, and intimidation of reproductive health providers, patients, and staff” (DNC, 2016, p.33). Nationally, the Republican Party and the Democratic Party have drastically different views of the legality of abortion. The Republican Party focuses on the fetus in its moral objections, while the Democratic Party focuses on the mother in its moral objections. Depending on the electorate, the Republican Party and the Democratic Party may alter future platforms. When forming platforms, parties generally account for varying constituencies and party factions that may have a particular stance on an issue. These constituencies and factions inform the national platform; in turn, these groups will support the party.
Consider Irish (and global) history from 1914 until 1923. At what point was an Irish Free State a foregone conclusion? Put slightly differently, at what point was Irish independence a question of not if but when? Defend your argument.
At the beginning of the 1900s, Ireland experienced political and cultural upheaval. Further, Catholics gained ownership of land, which translated to more autonomy. By 1913, the Irish Volunteers made up of members from the Gaelic League, Ancient Order of Hibernians, Sinn Fein, and Fianna Eireann. The growth of the Irish volunteers demonstrated that there was going to be an inevitable push for Irish independence. Patrick Pearse and James Connolly both supported an offensive strategy. Because Connolly wanted to create a Socialist Workers Republic, he believed that independence was crucial to forming the Party. As political and civil unrest continued both domestically and globally, Irish independence was inevitable. I believe that an Irish Free State a foregone conclusion after the 1916 Easter Rising. It was unavoidable because this was one of the first instances where individuals from every group formed a collective movement to contribute to the 1916 Easter Rising. The group was made up of the Irish Citizen Army, Irish Volunteers, Cumann na mBan, and the Irish boy scouts. To attack when the British would be at their weakest point, the group chose to attack during Easter week. Further, the group solicited support from Germany, which helped them secure weapons. Pearse also publicly read the Proclamation of the Irish Republic, which was a sign that an Irish Free State was a foregone conclusion given the persistence of the Irish, as well as Britain’s weakened position. Although there is little popular support and the Brits ultimately win, Easter Rising was a symbolic turning point in Irish history that pushed for independence. After the Brits execute leadership from Easter Rising, the Irish public ultimately feels nationalistic, bitter, and anti-British, which pushed independence ideology forward.
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