The Patient Protection and Affordable Care Act
Healthcare policies play an instrumental role of informing the public about government intentions and initiatives in the health sector. The directives of these legal instruments guide decision making, legal action, and oversee important operations in healthcare. The propositions of the Patient Protection and Affordable Care Act detail the transformations that the government wishes to implement in the sector. After underscoring the rationale for the changes, this paper explicitly explores its provisions. Then, it proceeds to provide an in depth critical analysis of the provisions. As it will come out from the study, the policy has various shortcomings that can compromise its fundamental goal of reducing costs and improving accessibility and affordability. The government should prepare itself to deal with these limitations in order to ensure effectiveness.
Key Words: Policy, healthcare, Patient Protection and Affordable Care Act, critical analysis
Good health is an important aspect that enables individuals to perform well at all times. Governments are responsible for ensuring that populations access quality and affordable health services. They recognize that sound health contributes positively to the economic wellbeing of their nations. The provisions of an excellent health policy govern decisions and oversee operations within this sector. A comprehensive health policy ensures that all facets of the population access quality healthcare services. America’s Patient Protection and Affordable Care Act (PPACA) provides insightful provisions that aim at reforming healthcare. It recognized that the healthcare costs were rising at a higher rate than the nation’s income. Statistical evidence shows that in 2007, they constituted a significant 17.4 percent of the gross domestic product (Reid, 2010). Yet irrespective of this increased spending, the health of the populations did not improve.
The PPACA seeks to address the problem of increasing government expenditure on alternate health programs like Medicare and Medicaid. Due to the fact that the elderly population is likely to increase exponentially in future, these programs are not financially sustainable. Coupled with related challenges like fraud and waste, Pipes (2010) believes that these medical programs are counterproductive. Notably, there is a glaring challenge between health insurance and employment. The conditional nature of the relationship discourages employees from exploring other job opportunities. In addition, it makes it difficult for individuals who lose employment to retain and benefit fully from health insurance coverage.
Proponents of this policy instrument also realize that a significant percentage of the American population does not afford healthcare and lacks essential insurance. Notably, the number of individuals that do not have insurance increased to a worrying level. This implies that they have the responsibility of paying for their medical services from their pockets. Research evidence points out that in most instances; the uninsured individuals lack access to critical health care (Barr, 2011). Besides failing to access essential preventive care, they seldom get quality treatment for injuries and illnesses. The undesirable state of affairs is inconsistent with the provisions of the universal health policy that America holds in high regard. Undoubtedly, the preceding concerns have far-reaching implications on the health and general wellbeing of the American population. The PPACA seeks to address these issues and thus safeguard the health of this nation. However, there are challenges that compromise its effectiveness. It is against this background that the paper provides a critical review of this policy.
Provisions of the Policy
Generally, this policy aims at enhancing the accessibility as well as affordability of medical services. Its objective is to ensure that all persons from the high, middle, and low-income groups access quality health services at all times, irrespective of their employment status. To meet this goal, it begins by according individuals a personal mandate to attain health coverage (Davidson, 2013). This requires legal American residents to acquire health insurance and pay for the same or risk facing penalties. In order to ensure that populations comply fully with this provision, the policy provides guidelines and options with regard to accessibility to coverage. Relative efforts aim at ensuring that by the time the policy comes in effect; all persons have full medical coverage.
With respect to private health insurance coverage, the policy provides certain requirements that planners and insurers need to adhere to. In addition to preventing employees from losing coverage in certain instances, the changes ensure affordable coverage for all facets of the population. These modifications are wide and varied and include guaranteeing availability of coverage to employees, removal of pre existing exclusions, conditions, and refusals on the basis of an individual’s health status, expansion of depended coverage to include children up to the age of twenty six years, removal of unreasonable yearly limits, coverage of various other preventive health services like immunizations without requiring cost sharing, and provision of health insurance premiums (Long, Stockley, & Nordahl, 2012).
By establishing the American Health Benefit Exchanges, this legal instrument directly improves coverage. This provision allows small businesses and populations who lack access to employer coverage to acquire coverage. In addition to availing coverage to citizens, the exchange simplifies the very process of obtaining the coverage. According to Rashford (2007), the purpose of the exchanges will be to undertake premium reviews in a bid to establish their viability, accredit health plans, ease client access to important information, and undertake outreach functions. Further, the policy provides subsidies to individuals from the low-income category in order to ensure that they obtain coverage accordingly.
This Federal Law also expands the Medicaid program to include individuals who were not beneficiaries previously. Before the effect of this policy, Medicaid beneficiaries needed to be individuals from the low-income class or from other specific categories such as the disabled and pregnant. Currently, this policy requires coverage for individuals that are less than sixty-five years and expands to include childless adults. Furthermore, it accords states the alternative of establishing basic health plans (Rashford, 2007; Staff of Washington Post, 2010). Arguably, this will benefit immigrants whose incomes disqualify them for the Medicaid program. Besides the preceding policy provisions, the government provides various other incentives in an effort to improve healthcare. These benefit researchers, health providers, and states amongst others.
The intention of the government’s implementation of this law is to ensure that its population has access to affordable medical services. While some of the consequences may be beneficial to certain populations, others will probably disadvantage different facets in significant ways. Bodenheimer and Grumbach (2012) cite that one of the problems that the sector struggles with pertains to underuse of medical resources. Notably, effective treatments that are likely to improve patient outcomes are seldom used because physicians and other medical professionals lack adequate relevant information. The PPACA advocates for use of sophisticated information systems by all healthcare professionals during the execution of duties. Undoubtedly, this will have a positive impact on the quality of healthcare because it encourages increased use of effective treatment. However, it is worth noting that use of this system may not motivate providers to improve performance. In such a case, McCaughey (2012) recommends that employment of other types of incentives will enhance the quality of health care. Besides using subsidies, the government can directly offer other forms of financial incentives to these personnel.
Ideally, provisions of this instrument increase the percentage of the population that benefits from health insurance exchanges facility; a measure that has positive impacts on quality competition conception. The US government and The Department of Health and Human Services (2010) assert that quality competition increases accessibility and affordability without compromising effectiveness. In order to reap optimal rewards, it is important for the exchanges to provide consumers with sufficient vital information regarding health insurance to ensure that they make informed choices. Because the policy offers insurance administrators a host of subsidies, it is likely that they will devote a significant percentage of their time to managing the respective subsidies and enforcing related mandates. The administrative tasks that are associated with estimating tax credits are complex and demanding. For this reason, they are most likely to raise costs and limit the amount of time that the administrators commit to providing invaluable information to the consumer base. This is unsustainable in the sense that it prevents clients from making informed decisions and choices.
In his review, Tate (2012) indicates that the effects of the policy on health costs will be varied. By requiring health insurance companies to extend coverage to all individuals and refrain from increasing charges for persons with poor health, the policy raises the costs of providing quality medical services. Companies will most likely grapple incidences of adverse selection that stem from individuals of poor health paying less for what their health problems actually cost. Further, the policy requires insurance companies to set premiums that cover the health costs of an average person. Healthier individuals are unlikely to purchase the premiums because of the fact that they may not make medical visits, and thus are unlikely to incur related costs. Persons with poor health may consider the premiums a bargain and resort to purchasing insurance. This state may lead to an increase in the cost of premiums as well as insurance.
This policy increases the percentage of the population that benefits from insurance from private companies as well as the government. This will increase the cost of healthcare especially considering that very few individuals put in consideration the cost of their medical services. The fact that third parties pay for these costs discourages them from assuming any form of responsibility. As such, they do not undertake important research regarding the implications of their choices. The findings of the research undertaken by The Staff of the Washington Post (2010) ascertain that individuals who pay for their medical expenses spend less than those who do not assume financial responsibility for the medical costs.
The policy makes it difficult for insurance companies to participate actively in controlling medical costs. In his report, Reid (2010) reveals that insurance companies focus on developing ways through which they can limit consumption of healthcare especially by the insured. Some of the notable ways through which they attain this includes providing incentives and increasing out-of-pockets costs. Currently, the PPACA requires insurance plans to cover up to sixty percent of the healthcare and medical costs (Reid, 2010). Although the provision benefits consumers, it undermines the ability of the insurance companies to control costs and function profitably. In addition, it encourages wasteful spending within the sector and ultimately increases the cumulative costs.
According to the directives of the policy, insurance companies assume the responsibility of paying for the entire cost of preventive care. Medical literature indicates that various preventive measures are not cost effective (Davidson, 2013). Undoubtedly, they ensure that the health of the affected population improves. However, the health improvements do not have a direct positive impact on cost reduction and enhancement of economic productivity. Further, the government’s decisions with regard to the preventive care to incorporate in the costs are greatly influenced by politics. This makes it difficult for the relevant stakeholders to make credible choices with respect to the most beneficial preventive measures. Seemingly, health care providers pressurize the government to focus more on saving financial resources than on providing quality and sustainable packages. At this point, it is worth noting that cost effectiveness is a function of various factors including the health history, age of the clients, and patient characteristics (Kocher, Emanuel & DeParle, 2010). Including these in critical decision-making can make the insurance policies to determine the percentage of the cost that the patients should assume. Since insurance companies have this information, they are in a better position to make informed decisions than the government.
By requiring all individuals to purchase insurance, the policy aims at addressing the problem of adverse selection (McCaughey, 2012). However, it is unlikely to address the issue because the related penalties are very low and thus, individuals will prefer to pay the penalties as opposed to purchase the premiums. Currently, for an individual to purchase health insurance premiums, s/he requires an average of $4000 dollars. According to McCaughey (2012), this is lower than the $695 penalty that an uninsured individual requires to pay. Particularly, healthy individuals will prefer to face the penalty than pay for the insurance that may not benefit them in any way. Davidson (2013) agrees that indeed, there are facets of the population that will remain uninsured regardless of implementation of this policy. The immigrants and persons that do not qualify for Medicaid will thus find it difficult to access quality healthcare. The fact that the provisions prevent them from purchasing insurance exchanges implies that their medical coverage is at stake. In this respect, the government faces the challenge of determining ways through which these individuals will access healthcare and remain productive members of the society.
One of the objectives of this policy is to ensure that all individuals access healthcare. By providing subsidies in this sector, the policy seeks to make sure that the low-income groups access health care services at all times. Although it will ensure increased access, it may limit the ability of certain groups within the population to attain important medical services. From an economic point of view, Goodson (2010) indicates that this is a consequence of scarcity that requires rationing in order to ensure availability of services. Ideally, providing affordable healthcare increases the demand for healthcare professionals such as nurses, pharmacists, and physicians. This will increase provider charges in the short run and compel the government to enforce rules for rationing and price controls. Coupled with existing shortages, The US Government and The Department of Health and Human Services (2010) assert that increased access is likely to worsen the scenario. Put differently, it will raise the medical costs by increasing expenses.
Another vital goal of the policy is to reduce Medicaid as well as Medicare fraud. In this respect, Altman and Shactman (2011) point out that fraud occurs naturally in systems where a significant percentage of payments are made by third parties. Stringent regulations and tight rules regarding insurance and government reimbursements exacerbate the problem and promote fraud. For instance, such scenarios force physicians to make inaccurate diagnosis in order to receive specific reimbursements. The fact that healthcare professionals often deceive the government and insurance companies is indisputable. Patients encourage this practice because they equally benefit from the deception. A study undertaken by Weissert and Weissert (2012) established that an estimated forty percent of physicians exaggerate the severity of patient symptoms, report symptoms and signs that patients do not have, alter the patients’ diagnoses, tamper with billing procedures, and engage in other deceptive acts on the premise of helping patients to secure medical coverage.
Currently, the provisions of this policy intend to reduce and or curb the practice. Specific guidelines related to required compliance to certain programs by providers and stringent entry requirements for individuals that might bill the government for medical services will enable the later to meet its goal in this respect. However, increasing the percentage of the medical costs that the government needs to pay might generate opportunities for fraud (Long et al, 2012). Notably, incidences of fraud within the sector emanate from patient’s mentality that they spend other people’s financial resources and not their own. For this reason, they tend to be extravagant and pay minimal attention to accountability. The carefree attitude encourages pursuit of the abovementioned vices by both the health professionals and the patients. Ultimately, it increases the costs of healthcare and compromises effective implementation of the proposed reforms.
Expansion of healthcare entitlements by this policy has direct negative effects on the economic wellbeing of low-income populations. According to Altman and Shactman (2011), the reforms discourage employment and compromise economic growth. In this regard, uncertainties surrounding its mandates and tax increases discourage companies and firms from employing more staffs and expanding operations. Certain provisions like tax incentives for small companies and subsidies to households encourage hiring and employment. However, higher taxes and the costs that the government will incur during implementation discourage private capital investment. Since the provisions favor employees, some of them may assume counterproductive tendencies such as dropping out employment or working for few hours. Resultantly, companies and firms might resort to limiting hiring.
Governments formulate, implement and enforce health policies that govern healthcare and oversee operations in related fields. America’s Patient Protection and Affordable Care Act details various reforms and transformations that the nation seeks to enforce in its health sector. The underlying goal of this policy is to ensure universal access to medical services and ensure that all nationals access affordable healthcare. Increasing health care costs, depreciating health conditions of populations, and an increasing percentage of uninsured population inform decision making in this regard. The objective of the policy is to ensure that all populations from varied economic backgrounds access healthcare services at all times. Besides directing individuals to assume responsibility for insurance, the policy provides incentives for healthcare providers, researchers and states, expands Medicaid, addresses incidences of fraud, transforms the private insurance coverage, and establishes health benefit exchanges. However, effective implementation and enforcement of its provisions faces various challenges. As identified in the preceding evaluation, the government needs to develop alternative options to address the current loopholes that undermine effective implementation. Only then will it be able to achieve its goal with regard to reducing medical costs and enhancing affordability and accessibility.
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Goodson, J. (2010). Patient Protection and Affordable care Act: Promise and peril for primary care. Annals of Internal Medicine, 152 (11), 742-744.
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Kocher, R., Emanuel, E. & DeParle, N. (2010). The Affordable Care Act and the future of clinical medicine: The opportunities and challenges. Annals of Internal Medicine, 153 (8), 536-539.
Long, S., Stockley, K. & Nordahl, K. (2012). Coverage, access, and affordability under health reform: learning from the Massachusetts model. Winter, 49 (4), 303-316.
McCaughey, B. (2012). Decoding the Obama health law: What you need to know. New York: Paperless Publishing.
Pipes. S. (2010). The truth about Obamacare. New York: Regnery Publishing.
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Reid, T. (2010). The healing of America: A global quest for better, cheaper, and fairer healthcare. USA: Penguin Books.
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Tate, N. (2012). Obamacare survival guide. New York: Humanix Publishing.
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Weissert, W. & Weissert, C. (2012). Governing health: The politics of health policy. New York: John Hopkins University Press.
Storytelling in Leadership
Ready (2002), in his research study indicates that globally, the quest to develop effective next generation leaders is a paramount challenge to majority of chief executives and organization leaders. The reasons for this limitation is mainly embedded in the growing phenomena of globalization as the executives only believed in the urgency of sustainable core competition (Ready, 2002, p. 63).
In mid 1990s, improvement in technology and high demographic changes revealed to most of the organizations on the need of effective leadership to occupy a competitive edge. In recent years, dynamic changes have occurred with most organizations drifting from consultants and external faculty to dialogue and storytelling with the aim of gaining control to execute organization processes effectively (Ready, 2002, p. 65).
Currently, effective Storytelling has formed a central component in leadership strategies, aimed at providing competing edge. The executive may effectively use storytelling mechanism to relate the culture of the company and its strategic move. This may be done by creatively framing a story that relates to the culture of the organization. The developed stories should be effectively framed by the leaders to develop their experience while in similar position of their juniors. The stories that have been designed by the leaders must also portray a positive relationship based on the “students” and their mentors. This necessitates the storyteller to be someone with high standing value and can command leadership codes (Ready, 2002, p. 67).
telling when used effectively has a positive impact on the individuals and
organization teams since they possess high learning values that are able to
produce behavioral changes. This may also help to build and maintain a cadre of
leaders who effectively understand the value of strengthening the organization’s
character and strategic competence.
Ready, D. A. (2002). How storytelling builds next-generation leaders. MIT Sloan Management Review, 43(4), 63-69. Retrieved from http://search.proquest.com/docview/224966860?accountid=1611
I have no place to turn. I am always alone…I mean I have a lot of friends but I’m not sure they are real friends. We get together every weekend but sometimes when they don’t call I get all paranoid and feel like…. I don’t know. I just wish that sometimes I could be a fly on the wall, but I can’t so it makes me…. uh um…. uncomfortable. I guess.
Paraphrase:this person most probably feels lonely and is a bit distrustful of his/her friends. As a therapist who is an active listener, one should restate these ideas as follows: “Let’s see if I am clear about this, you feel lonely at times, even though you have a lot of friends. Could it be that you find it hard to trust your friends? ”
Clarify: this is done to get more information from the client regarding what they have said earlier. “You have said that you sometimes feel like you would like to be the fly on the wall. Does that mean that you do not wish to get noticed and yet want to witness the occasion? Tell me more about that…”
Validate: this is done to acknowledge the problems and feelings of the speaker. It makes them feel worthy. “I understand how uncomfortable that can feel…” or “I appreciate your courage and willingness to talk about such a difficult issue…”
Identify:This expresses a deeper understanding of the situation that the client is going through. A sample statement may include: “I understand how awful it is to be in a room full of people and yet feel lonely…”
I have this problem. My family is crazy. My parents are like two big kids. I feel like I always have to tell them what the right thing to do is… and then they get mad at me. I know I can’t take care of them but it’s like they mess around and are irresponsible and then they want to complain to me about how everyone else is messed up. I feel like when I call them there is always some issue they are not telling me about. Is it me? Am I the one who’s crazy here?
Summarize:This is done to put together ideas facts and feelings in order to have basis for continuation of the discussion. “What I hear you saying is that you feel like your parents are immature and irresponsible, right…?”
Clarify:to get deeper understanding and more information from the client. “I have heard you say that your parents mess around. Could you please tell me more about that?”
Validate:to acknowledge the feeling and sentiments of the client. “I think I understand how disappointed you feel by your family, especially your parents.”or “I appreciate your willingness to discuss such a sensitive issue with me.”
Identify:to show the client that you can relate to how they feel. “I can relate to how disappointing and frustrating it is to not know what the real problem is. I know you feel unappreciated by your parents when they get mad at you after you have just suggested the right thing to do…”
We have been married for just under a year. It is a second marriage for both of us. I have no children and she does and they are grown. Since I have been married I feel like I have to cater to her children. I can respect that I realize she’s their mother but come on already. I don’t want her to fight with her kids but I just can see how they take advantage of her. Then I get dragged into it. It upsets me to watch her give so much and get very little in return.
Paraphrase: “let me see if I am clear about this, you have said that your spouse’s children are grown, and therefore capable of taking care of themselves…is that correct?”
Summarize:“These seem to be the issues you have expressed: The children from your spouse’s previous marriage are taking advantage of her affection for them. You don’t know how to point it out to her without causing a rift between you and them, and it frustrates you to get dragged into catering for them. Am I right?”
Question: leading questions could be used-“Could you tell me more about how you met your current wife? Do you have any other unresolved issues apart from her children?” or close-ended questions-“Have you considered telling your wife exactly how you feel?”
Identify: “I understand how annoying it is to witness your wife get taken advantage of by grown children…”
(From a child) I don’t want to go on the bus anymore. How come my parents can’t drive me? I don’t like school. I just want to stay home.
Question: “How comes you do not want to go on the bus anymore?”or “Have you asked your parents to drive you? What was their response?”
Summarize: “So, it seems to me as if the problem is the school and not really the bus, as you have mentioned that you just want to remain at home, is that right?”
Build: helps continue the discussion and suggest solutions-“Have you considered discussing this issue with your parents?” “If you are left at home, don’t you think you will be very lonely, as every other kid will be at school?”
Identify: “I fully understand how confused and frustrated you feel. I was once in the same situation. Do not worry, you will be alright”
Mental Health: Bipolar Disorder
Bipolar disorder is a mental illness that affects the abnormal functioning of the brain. This makes individuals to experience extreme shift in mood activity level, energy, and the capacity to carry out daily activities. Individuals may also experience psychosis in the maniac and depression phase. There are distinct types of bipolar disorder: bipolar 1 disorder, which is characterized by one or more mixed episodes, bipolar 2 disorder that is characterized by one or more major depressive episodes followed by not less than one hypomanic episode, and cyclothymic disorder that is characterized by at least two years of frequent hypomanic symptoms (Peacock, 2000, p. 4). Bipolar disorder runs in families and it is believed to be a genetic disease. Children with siblings or parents who have bipolar disorder may develop the illness four times their colleagues that do not have history of the disease. Bipolar disorder is enduring and recurrent illness. Individuals with the disorder need a long-term treatment in order to control symptoms of the disease. Effective maintenance treatment plan of bipolar disorder includes psychotherapy and medication. This prevents relapse and reduces symptoms severity (Peacock, 2000, p. 5).
Bipolar disorder is one of the oldest known mental illnesses. It was noticed as early as the second century. Aretaeus of Cappadocia came up with some symptoms of depression and mania and felt they could be linked to one another. The findings were substantiated in 1650 when Richard Burton wrote a book that focused on depression. In 1854, Jules Falret established the link between suicide and depression. His work led to the term bipolar disorder because he was able to differentiate between heightened moods and moments of depression (Meisel, 2011).
In 1875, Jules recorded findings that were termed as Manic-Depressive Psychosis. Francois Baillarger was able to characterize the depressive phase of bipolar disorder. His achievement permitted bipolar disorder to obtain its own classification from other mental disorder. In 1913, another scientist Emil Krapelin came up with the term manic-depressive, which highlights the effects of depression. This approach was accepted and it became the prevailing theory for bipolar disorder. Manic-depressive disorder was replaced by the term bipolar disorder in 1980. The 1980 research was able to make a clear distinction between childhood and adult disorder. The research is ongoing on how to treat the illness (Meisel, 2011).
Types of bipolar disorder
According to Sorento (2013), bipolar disorder can be classified into bipolar 1 disorder, bipolar 2 disorder, and cyclothymic disorder.
Bipolar 1 disorder. An individual suffering from this illness has at least one manic episode. A manic episode is a period of abnormally elevated mood that is usually accompanied by abnormal behavior that disrupts life. There is always a pattern of cycling between depression and mania.
Bipolar 2 disorder. Patients suffering from bipolar 2 disorder suffers from at least one hypomanic episode and episodes of depression. The moods cycles between high and low over time. The up moods do not reach full on mania.
Cyclothymic disorder. It causes emotional vicissitudes but they never reach the severity of mania. The mood swings from mild depression to hypomania.
The mania symptoms of bipolar disorder are delusions and hallucinations, increased mental and physical activity, and reckless behavior. In addition, the mania symptoms are aggressive behavior, excessive irritability, decreased need for sleep, grandiose delusions, poor judgment, and impulsiveness (Hukic et al. 2013).
Even though hypomania or mania are the defining characteristics of bipolar disorder, right through the course of the disease depressive symptoms are more pronounced than manic symptoms. Individuals suffering from bipolar disorder spend a good amount of their time suffering from syndromal depressive symptoms. Major depressive episodes in bipolar disorder are the same as those experienced in unipolar major depression. In most cases, patients suffer from depressed mood. They experience profound loss of interest in activities. This is usually coupled with symptoms such as weight loss or gain, fatigue, excessive guilt, suicidal thoughts, feelings of worthlessness, psychomotor slowing, and difficulty in sleeping (Hukic et al. 2013).
Treatments for Bipolar Disorder
The treatments for bipolar disorder are aimed at reducing the severity and frequency of the episodes of mania and depression in order to allow the patient to live a normal life. The most common treatments are medication and psychotherapy.
A number of people with bipolar disorder are in need of medication in order to keep their symptoms under control. Continuous medication reduces the severity and frequency of mood episode. In some cases, it can prevent mood episodes completely. A number of medications that can help to stabilize mood swings for individuals suffering from bipolar disorder exist. The most common ones are antipsychotic medicines, anticonvulsant medicines, and lithium carbonate. The episodes of depression in bipolar disorder are treated just like clinical depressions.
Lithium carbonate. It is the most common medication for treating bipolar disorder. Lithium is the long lasting technique for treating depression, mania, and hypomania. It is prescribed for a minimum period of six months. For this medication to be effective, the dosage has to be correct. Incorrect dosage has a numerous side effects.
Anticonvusalant medicines. They include lamotrigine, carbamazepine, and valproate. They are long-term mood stabilizers. Valproate is a genetic term that is used to describe different formulations of valproic acid. It is a mood stabilizer and helps to treat manic or mixed phases. Carmazepine is only prescribed after permission from the doctor. Patients start with low dose before it is gradually increased. Lamotrigine is administered to prevent recurrences of either depressions or manias.
Antipsychotic medicines. They are prescribed to treat episodes of mania or hypomania; they include olanzapine, risperidone, airipiprazole, and questiapine. Mania can develop very fast and give rise to risks that harmful to the patient and others around. When mania is in its severe form, Antipsychotic medicines are used because they are antimatic.
It is the most essential part of treatment for a number of people severing from bipolar disorder. When the depression is classified as mild to moderate, psychotherapy can work alone. A good therapist can help individuals with bipolar disorder to modify emotional or behavioral patterns that are contributing to the illness. The most common therapies that can be used to treat bipolar disorder are Prodrome Detection, Psychoeducation, Cognitive therapy, and Play therapy
Prodrome Detection. It was developed by Dr. Perry and can be used to avert and reduce the number of manic episodes. The therapy begins by asking patients to identify early warning signs in the previous episodes. Prodrome detection involves ruminating thoughts and sporadic sleep. After the prodromes are identified, they are written on laminated card. The patient is required to carry it all the time. A copy provided to the treatment team. A plan action is instituted and contractual agreement is made to implement the plan the emergence of prodrome symptoms. A journal is kept with increased writing assignments around the time that lead to the first signs. This form of treatment may not be effective because episodes occur with little or no warnings. What is more, patients abandon the therapy once they feel better.
Psychoeducation. Clinicians assert that patients with bipolar disorder need to be given accurate information regarding their diagnosis, prognosis, and treatment. Psychoeducational intrusions can be offered in various ways. This can be to individuals, families, or group of professionals. Media devices such as radio, television, and online delivery can be used to maximize the impact. This can also be done to increase the retention of material. In individual psychoedcuation therapy, participants are subjected to between 7 and 12 sessions that involve teaching them how to identify prodromal symptoms of manic relapse and depression. Family-focused psychoeducation involves putting patients on a 21 one-hour session that is delivered over nine months. The therapy comprises of three consecutive models.
The first step involves 7 sessions that focuses on signs and symptoms of the disease or illness, the aetiology of the disease, and the growth of strategies to prevent relapses. The second step is communication improvement training. There are between 7 and 10 sessions administered using role-play. Between sessions, patients are thought active listening skills. The last step is problem-solving training. It comprises of between 4 and 5 sessions. Participants are required to specify family problems that may be part of the relapse. They are encouraged to develop effective skills for that enable them come up with solutions to their problems.
Cognitive therapy. The goal of this therapy is to help patients with bipolar disorder to gain a new outlook on their condition by challenging fears and negative thoughts. A short-term therapy focuses on eliminating specific problems. Both the patient and the therapist contribute. Normally, thoughts influence feelings. Distorted thoughts lead to problematic moods, emotions, and behaviors. Patients are thought how to get rid of these thoughts. They are also offered with strategies that can promote effective problem solving. Cognitive therapy presents mindlessness technique, which allows patients to gain some distance from negative thinking.
In the cognitive therapy patients are taught how to re-enter some situations that they may been avoiding for a long time. Any activity that offers pleasure or mastery is planned. Patients are also trained on new skills such as assertiveness and social interaction. In order to contain they feelings, patients are thoughts how to tolerate or accept painful emotions. In addition, they are taught strategies for managing extreme emotional reactions (Sorrento, 2013).
Play therapy. This form of therapy is common for children suffering from bipolar disorder. Young patients are allowed to express their emotions, desires, and fears in play. Therapists help children to enhance their skills in perception, interpersonal relationships, mood, and attention. Many tools can be used in play therapy. The most common one is floor-time therapy. In this therapy, structure play sessions are created for parents to play with their children. It helps to overcome deficits in relatedness and attention (Sorento, 2013).
The most preferred treatment for treating bipolar disorder is psychotherapy.This is because it has few physiological side effects. This makes the treatment essential for older adults who are already taking other medications.In addition, Psychotherapy provides the prospect of effective treatment for patients that have responded slowly to medications. Psychotherapy enhances family and interpersonal relationships affected by illness. It also promotes higher functional achievement. Psychotherapy offers a more effective identification and management of adverse effects of medication that may tend to limit its acceptance. With psychotherapy, it is very easy to detect early signs of impending illness. Psychotherapy offers improved skills that are aimed at minimizing stressors that contribute to recurrence risk. In contrast, psychotherapy takes very long time to produce the intended benefits when compared to drug therapy. In addition, it is not effective for patients with severe depression.
is mental illness that is characterized by depressed mood most of the day. This
can be indicated by subjective report or observation made by others. it is also
characterized by markedly diminished interest or pleasure in all or almost all
activities of the day indicated by either subjective account or observation
made by others and significant weight loss even when not dieting or weight
gain. This is indicated by decrease in appetite nearly every day. The other
signs are insomnia or hypersomnia every day, psychomotor agitation or
retardation every day, fatigue or loss of energy nearly every day, feelings of
worthlessness or excessive guilt, diminished ability to think or concentrate,
and recurrent thoughts of death. The most preferred treatment of bipolar
disorder is psychotherapy. The most common therapies that can be used to treat
bipolar disorder are Prodrome Detection, Psychoeducation, Cognitive therapy,
and Play therapy. Psychotherapy has some few side effects.
Hukic, D., Frisén, L., Backlund, L., Lavebratt, C., Landén, M., Träskman-Bendz, L., & … Ösby, U. (2013). Cognitive Manic Symptoms in Bipolar Disorder Associated with Polymorphisms in the DAOA and COMT Genes. Plos ONE, 8(7), 1-7. doi:10.1371/journal.pone.0067450.
Meisel, A. (2011). Investigating depression and bipolar disorder: Real facts for real lives. Berkeley Heights, NJ: Enslow Publishers.
Peacock, J. (2000). Bipolar disorder. Minnetonka, MN: Life Matters.
Sorento, M. (2013). Bipolar Disorder: Everything You Need to Know about Bipolar Disorder. Bloomington, IN: Booktango.
Community Service Reflection
Community service, also known as volunteering, can be defined as the voluntary provision of service by an individual, with the aim of benefiting the wider community. In the provision of community service, emphasis is placed on doing away with the expectation of monetary gain. Over the years, governments around the world have put in place interventions aimed at promoting community service considering its value to the community. First, I think community service is a key player in the growth of the community from an economic perspective; a role it plays alongside employers and service providers whose primary focus is to add on the global economic output. In this line, community service creates conditions that allow economic flourishment through boosting skills, training, and aiding in the employability of personnel. Second, community service plays an integral role in the growth of the community from a social viewpoint. Through community service, several people who might not be frequently in contact come together. Hence, community service helps strengthen social connections among people in the community, build strong, safe, and cohesive communities, enhance civic engagement, and provide opportunities for the delivery of public goods and services. Third, people involved in community service have the opportunity to enhance their personal knowledge, grow and embracing new experiences, and develop better interpersonal communication skills, which are valuable to the community. However, I believe community service can be counterproductive to a considerable extent. I support opponents of community service in their argument that the fact that students are the primary participants in it provides an opportunity of interference with learning the basics as well as holding part-time job opportunities. Also, I agree with the argument that community service is an unfair burden to youthful members of the community, especially in situations where it is considered mandatory. Many proponents and supporters of community service believe that it shapes and helps people to develop morally and ethically. In disagreement, I am of the view that the responsibility of ensuring the moral and ethical development of children lies with parents and not community service as alleged. The counterproductivity of community service is also evident in the fact that it is similar to slave-labor. I cannot agree more that mandatory community service provides a platform where people are forced into the provision of free service, and this could create a generation of people who are strongly against the practice.
From a personal standpoint, community service remains an integral part of the community’s social growth. Currently, the community is dealing with contentious social issues such as drug use and abuse and increased crime rates, discrimination, racism, and others. These social issues are the backbone of the community’s growth in economic, political, and religious contexts. To start with, selected parts of the global community have struggled economically due to the existence of social issues such as racism and gender discrimination. The developed world cannot be excluded when it comes to examining the adverse effects of social issues on economic growth and development. I cannot refute the argument that some of the slow economic challenges faced in the US are because of racism. With my experience on the significance of community service on the social development of the community, I believe that social malpractices such as racism would have no place in society if everyone embraced community service. As already mentioned, community service helps build strong connections among members of the community as well as building strong and safe communities. I firmly believe that cohesive and connected communities, enabled by community service, will eradicate runaway racist practices witnessed in society today. Similarly, crime remains one of the greatest social challenges in contemporary society, which can be attributed to harsh social conditions that exist. However, an emphasis on community service will ensure increased civic engagement and opportunities for the delivery of public goods and services thereby reducing the possibility of people’s involvement in criminal activities. Youths are the primary participants in community service in society today, a perspective that has been crucial to the reduction of youth involvement in practices such as drug abuse. In light of the highlighted benefits of community service, interventions ought to be put in place to ensure a mandatory embrace of community service for youths.
Other than being valuable to the community, I agree that community service is valuable to personable development. My involvement in community service has enabled me to learn my personal strengths and weaknesses. It has also seen me develop skills in areas such as communication, leadership, teamwork, and finding solutions to problems. My personal development in terms of communication, skills acquisition, and finding solutions to problems has been largely dependent on my role of serving the community in numerous ways that have been part of my life so far. One of the ways in which I have served my community is visiting hospitals on numerous occasions where I delivered gifts to patients, helped nurses and other health experts to stock medical supplies, and interacted and played with young patients. I believe that hospitals are among several public places in dire need of volunteers for a variety of activities, and like myself, several people could volunteer in hospitals near them to be of service to the community. Also, I serve my community by visiting preschools such as kindergartens frequently. Preschool teachers face numerous challenges when it comes to dealing with young students, and this is one of the factors that have motivated me to offer community service to the institutions. On several occasions, I have helped tutor young learners in preschool, create school murals, help them across busy highways, and supervise after-school programs. Moreover, I have been of service to my community through regular visits to food banks and helping with sorting food donations, delivering meals to people in need, and organizing food drives and food security campaigns.
There is no doubt that community service makes a difference, especially to community members who lack basic amenities such as food, shelter, and clothing. Additionally, I think that community service is important to people who live in areas that are prone to natural disasters such as floods, earthquakes, and tsunamis. Organizations such as Red Cross often work alongside community service providers to help people affected by natural disasters. Moreover, it should be noted that community service is of benefit to both those who provide service and those who receive the service. The service providers benefit from the opportunity to develop their skills in communication, leadership, and teamwork. On the other hand, those who receive the service benefit from access to basic amenities and resources. Also, they are granted the opportunity to interact with others as well as learn their strengths and weaknesses.
Creation of Employment
Social Welfare Policy
Social welfare policies refer to the guidelines and principles that affect the living conditions of people. They are aimed at improving the quality of people’s lives and solving the social problems that are prevalent in the society. Examples of social problems are; poverty, poor health, unemployment and education among others. Poverty has been an urgent problem for the world. The primary cause of poverty is the low income earning by the poor Poverty is defined in terms the amount of revenue that people receive, problems of physical health, living conditions, and living locations (Blank, 2017). Thus, the best way to reduce poverty is through the increase of the income of the poor through creation of new jobs. The poor should be considered as the producers and emphasis should be put on buying from them. Developing countries seek for foreign aid to trigger economic development by creation of more industries, which create more jobs.
Employment has grown disproportionately over the years. Traditional low paying services industries have grown and employed more employees who are paid above median wages. The labor market has grown to offer more opportunities and policies to workers to deal with job transitions. The economies are creating more jobs as an indicator of the rapid economic transformations that reduce poverty levels. Statistics by Bureau of Labor have shown that employment levels have grown by 7.8% since 1993. Additionally, the unemployment levels had reduced from 7% to 5.6% since 1993. Employment is expanding at a consistent pace and the poverty levels reducing at the same pace.
Other policies such as progressive taxes and increment of the benefits for the poor should be considered to eradicate poverty. For example, through the increase of income tax from 40% to 50% will take more tax from the high-income earners. The amount of income saved through progressive taxation can be used in other ways like purchasing of food, paying school fees among others (Prasad, 2017). Additionally, the increment of the welfare benefits to those who earn low income will help eradicate poverty. This ensures that money is given to those who need it most through either pension credit or family tax credit. Most governments use universal benefits because it makes people feel they benefit from the tax that they pay. However, selective provision of benefits ensures that those who do not require them do not waste resources.
There have been political debates over progressive taxation. Most of the political leaders argue that it leads to income inequality in a country. This is because the tax is used to fund government sending’s such as social safety nets and transfer payments. They argue that income inequality may lead to class conflict and adverse effects on long-term economic growth. On the other hand, they claim that increment of benefits for the poor creates a disincentive to earn a higher income (EUR-Lex. 2017). This is because if you get a high salary job, you will pay higher tax and lose some of your benefits. A vicious cycle develops because of this, and the country ends up being underdeveloped. Furthermore, they argue that the policy will lead to wastage of resources by those who do not need them.
In conclusion, creation of employment, progressive taxation, and increment of benefits for the poor reduces of poverty levels. However, these policies face political ramifications from the leaders. They discourage progressive taxation because they create a disincentive to search for well-paying jobs. Additionally, the increment of the benefits for the poor lead to wastage of resources by those who do not need them.
Blank, R. (2017). Welfare and the Economy. Brookings. Retrieved 28 July 2017, from https://www.brookings.edu/research/welfare-and-the-economy/
Employment and social policy – EUR-Lex. (2017). Eur-lex.europa.eu. Retrieved 28 July 2017, from http://eurlex.europa.eu/summary/chapter/employment_and_social_policy.html?root_default=SUM_1_CODED%3D17,SUM_2_CODED%3D1704&locale=en
Prasad, N. (2017). Policies for redistribution: The use of taxes and social transfers. Retrieved 28 July 2017, from http://www.oit.org/wcmsp5/groups/public/—dgreports/—inst/…/wcms_193159.pdf
Affordable Care Act Policy Analysis
III. Social Analysis
- Problem description
1. How complete is our knowledge of the problem?
2. Are our efforts to deal with the problem in accord with research findings?
3. What population is affected by the problem?
b. Defining characteristics
4. What theory or theories of human behavior are explicit or, more likely, implicit in the policy?
5. What are the major social values related to the problem and what value conflicts exist?
6. What are the goals of the policy under analysis?
a. Manifest (stated) goals
b. Latent (unstated) goals
c. Degree of consensus regarding goals
7. What are the hypotheses implicit or explicit in the statement of the problem and goals?
Political Analysis Outline
D. Choice analysis (i.e., what is the design of programs created by a policy and what are the alternatives to this design?)
Purpose To synthesize and demonstrate a policy analysis related to a policy topic. This assignment will develop skills in research, writing and policy analysis. Since this project is rather large, this will be a group assignment and done as a brochure instead of a paper…I know, I know. You will be working in groups and with people in social work and this group project will take this large assignment and make it more manageable for all students. You will also have the opportunity to give input on your group member’s grades if there are group issues, so those who slack will lose points. This is also a way to get to know other students in this class and the program.
Groups Groups and policy topics will be assigned by the instructor and posted on noodle after exam 1 and after you have read the first few chapters of the policy book. Each group will have access to a group email in moodle to discuss topics. The instructor will monitor the progress. You may use google hangout or other chat rooms to do your work. There will be 3-5 members in each group. The Brochure This brochure is like a policy analysis paper and will take several weeks to research, write and analyze. It is not a paper to be done in a day. It will be overwhelming. Each group will prepare an analysis of a national, state or local policy regarding a social problem assigned by the instructor. This will be a law or policy or one in the proposal stages. This policy is one that has a direct impact on the health and social services in the US. This brochure should be of professional quality that the group could distribute to policymakers.
Use the outline in the Popple & Leighninger book on pages 31-33. (this is also a great idea for work division). Analyze the policy giving an overview of the policy, a historical analysis, social analysis, economic analysis and political analysis (read the following chapters to understand the content of these areas). You need to discuss each section addressing each point in the outline. IF your policy does have some of this information, explain that in your paper; do not skip a section. The brochure should be 10 pages MAX. The last page of your brochure will include your references with a minimum of 8-10 academic references in APA format.