scholarly journals Faith, Politics, and the Parable of the Kosher Deli: Explorations of Narrative in a Congressional Hearing

2016 ◽  
Vol 3 (1) ◽  
pp. 110
Author(s):  
Joshua Kraut
Keyword(s):  
Affordable Care Act ◽  
Effective Means ◽  
Political Conflict ◽  
Analytic Approach ◽  
Individual Experience ◽  
Patient Protection ◽  
Congressional Hearing ◽  
The Government ◽  
Short Narrative

This paper takes a discourse analytic approach in exploring how a short narrative, delivered in the testimony of a panel-witness during a 2011 US congressional hearing investigating potential violations of religious liberty in the Patient Protection and Affordable Care Act (commonly known as “Obamacare”), shapes and reflects the larger political conflict over the legislation.  Exploring the so-called “parable of the kosher deli” from a structuralist, functionalist, and post-structuralist perspective reveals several key elements of how narratives can function in such a context.  The choice of genre not only facilitates communication via a culturally familiar structure, but also positions the communicator reflexively, and in strategic fashion.  This choice also provides an efficient means for glossing over the adversary’s most significant concerns: because parables are abstractions meant to reflect back on real situations, one can choose which elements to incorporate, and which to ignore about those situations in one’s interpretation.            Additionally, I observe how the parable is an effective means for positioning an opposing side (Davies and Harré, 1990), as the narrative takes aim at not only the government, positioned as an illegitimate disciplinarian, and an inappropriate judge, but also at advocates of the legislation generally, characterized as “off-topic” or else blind to the most important issue.  Finally, from a post-structuralist perspective, I note that the narrative, reflecting the general stance of the majority members of committee overseeing the hearing, construes the opposing side as a “generalized other” (Benhabib, 1992), ignoring the role of individual experience, needs, motivations, and desires in the attempt to make a case for broader exemptions to the proposed legislation.  Such a move short-circuited any possibility of “elaboration” (Cobb, 2006) in which both sides might have worked toward a mutually agreeable narrative which contained both of the moral perspectives presented.   ACKNOWLEDGEMENTS:I would like to thank Sara Cobb as well as the editor and two anonymous reviewers for their constructive comments on earlier versions of this manuscript.  

scholarly journals Access to Gynecologic Oncologists in Ohio: The Role of Insurance Marketplaces and the Patient Protection and Affordable Care Act

2020 ◽  
Vol I (1) ◽  
pp. 22-25
Author(s):  
Bogna N. Brzezinska
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Gynecologic Oncology ◽  
Gynecologic Oncologist ◽  
Patient Protection ◽  
Access To Health ◽  
The Affordable Care Act ◽  
Improve Access

Background The Affordable Care Act was passed in 2010, which provided a platform for states to develop insurance marketplaces. The goal of this legislation was to improve insurance coverage by providing more affordable options to patients. One metric of the Affordable Care Act was to improve access to comprehensive cancer care. Objective To identify to the effect of the Affordable Care Act on access to Gynecologic Oncologists in Ohio. Study design The Patient Protection and Affordable Health Care Act increased access to health insurance in Ohio, through Medicaid expansion and creation of a healthcare marketplace. We accessed information on access and usage of the healthcare marketplace in Ohio through Healthinsurance.org. We identified Gynecologic Oncology practices in Ohio through the Society of Gynecologic Oncology, and confirmed these practices by telephone. We communicated with each practice and identified which practices took marketplace health insurance. We also gathered information on changes in usage from 2014-2018. We then used descriptive statistics to identify access to a Gynecologic Oncologist though these exchanges. Results In 2017, there were 238,843 people enrolled in marketplace insurance (2% of the Ohio population). We identified 11 practices in Ohio with 39 Gynecologic Oncologists, and 11 marketplace insurance providers. Of these insurers, 7 could be clearly identified as providing access to 5 different Gynecologic Oncology practices. Of the 11 practices, 5 were confirmed to accept marketplace insurance (46%). Interestingly, 3 practices were unsure whether they took patients on marketplace insurance (27%), and 3 definitively did not take patients on marketplace insurance (27%). Each practice varied with how many exchanges they accepted, with 4 out of 5 accepting insurance through more than one insurer. Conclusions About half of the Gynecologic Oncology practices in Ohio accepted insurance through the insurance marketplace, which may limit patient access to a Gynecologic Oncologist.

Partisan Politics and Congressional Election Prospects: Evidence from the Iowa Electronic Markets

2015 ◽  
Vol 48 (04) ◽  
pp. 573-578
Author(s):  
Joyce E. Berg ◽  
Christopher E. Penney ◽  
Thomas A. Rietz
Keyword(s):  
Affordable Care Act ◽  
Negative Impact ◽  
Electronic Markets ◽  
Partisan Politics ◽  
Patient Protection ◽  
The Us ◽  
Political Impact ◽  
Us Government ◽  
The Status ◽  
The Government

ABSTRACTUsing the Iowa Electronic Markets (IEM), this article assesses the political impact of several important events during the fall of 2013: the US government shutdown, the Senate elimination of filibusters for presidential nominations (i.e., the “nuclear option”), and the implementation of the Patient Protection and Affordable Care Act (i.e., ObamaCare). Did these events have meaningful effects on congressional control prospects in the 2014 election? According to IEM price changes, Republican chances fell dramatically when the government shut down, and they did not recover on resolution. Eliminating filibusters had a negative impact on Democratic chances. Various aspects of the ObamaCare rollout and reporting, as well as new announcements that incumbents would not run for reelection, had little effect. In contrast, the budget resolution reinforced the status quo. Overall, political rhetoric does not appear to affect congressional control prospects. Instead, actions matter: deliberate partisan actions of Congress adversely affect the initiating party’s prospects, whereas bipartisan initiatives help the party that initiates the bipartisan effort.

The Role of Community Health Needs Assessments in Medicalizing Poverty

2018 ◽  
Vol 46 (3) ◽  
pp. 615-621 ◽  
Author(s):  
Arden Caffrey ◽  
Carolyn Pointer ◽  
David Steward ◽  
Sameer Vohra
Keyword(s):  
Affordable Care Act ◽  
Social Inequalities ◽  
Risk Exposure ◽  
Community Benefit ◽  
Non Profit ◽  
Needs Assessments ◽  
Patient Protection ◽  
History Of ◽  
The 1960S

The Patient Protection and Affordable Care Act (ACA), passed in 2010, is considered by many to be the most significant healthcare overhaul since the 1960s, but part of its promise — improvement of population health through requirements for non-profit hospitals to provide “community benefit” — has not been met. This paper examines the history of community benefit legislation, how community benefit dollars are allocated, and innovative practices by a few hospitals and communities that are addressing primarily non-medical factors that influence health such as social disadvantage, attitudes, beliefs, risk exposure, and social inequalities.

scholarly journals What is the Meaning of Health? Constitutional Implications of Defining “Medical Necessity” and “Essential Health Benefits” under the Affordable Care Act

2012 ◽  
Vol 38 (2-3) ◽  
pp. 445-470 ◽  
Author(s):  
B. Jessie Hill
Keyword(s):  
Affordable Care Act ◽  
Human Services ◽  
Health Benefits ◽  
Medical Necessity ◽  
Health And Human Services ◽  
Patient Protection ◽  
The Affordable Care Act ◽  
The Government ◽  
The Individual ◽  
Essential Health Benefits

When the government decides to assume a major role in providing and paying for healthcare, the government also has to decide exactly what constitutes appropriate, reasonable, or essential healthcare under its program. Congress, of course, recognized this necessity when it passed the Patient Protection and Affordable Care Act (ACA), and the statute itself provides authority to the Secretary of Health and Human Services (HHS) to determine the “essential health benefits” that must be covered under the ACA beginning in 2014, both by insurers offering plans within governmentally sponsored exchanges and on the individual and smallemployer markets outside the exchanges. In a decision that was hailed as both “politically astute” and problematic for the goals that the ACA itself was supposed to accomplish, HHS shunted off the task of defining the term “essential health benefits” to the individual states.

scholarly journals Affordable Care Act: A review and discussion of its impact on healthcare today, and a primer for pharmacists

2013 ◽  
Vol 4 (1) ◽  
Author(s):  
Leo Lai Ho Lui ◽  
Albert Wertheimer
Keyword(s):  
United States ◽  
Patient Care ◽  
Affordable Care Act ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
The United States ◽  
Patient Protection ◽  
The Future ◽  
The Impact

In the midst of countless healthcare debates, the Patient Protection and Affordable Care Act is written into legislation as a possible solution to the United States's rising healthcare costs. Individualized into nine titles, the act sought to provide additional coverage to millions of Americans while cutting down healthcare costs through numerous provisions effective into 2020. While the act has been challenged publicly and privately by the states, many healthcare professionals today, let alone the average American, are unaware and uneducated of what comprises the act, as well as the impact in which it has on the future of healthcare in the United States. With an increasing role of patient care placed upon pharmacists today, an understanding of the PPACA allows us to provide extensive answers to questions in which our patients may have.   Type: Student Project

scholarly journals Unraveling from Within? The Affordable Care Act and Self-Undermining Policy Feedbacks

The Forum ◽  
2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Jonathan Oberlander ◽  
R. Kent Weaver
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Public Support ◽  
Partisan Polarization ◽  
Patient Protection ◽  
Political Impact ◽  
Mediating Factor ◽  
Political Foundations ◽  
To Receive

AbstractThe 2010 Patient Protection and Affordable Care Act (ACA) passed through Congress on partisan lines and with only lukewarm public support. The Obama administration and Congressional Democrats, though, had reason to expect that the ACA’s political fortunes would substantially improve as the acrimonious debate over its enactment faded and millions of Americans came to receive significant benefits from health care reform. But 5 years after its passage, the ACA’s political foundations remain shaky. We suggest that one reason for the ACA’s unsettled fate is the role of policy feedbacks that undermine public support for and opponents’ acceptance of the program. The ACA experience highlights how policy feedbacks can vary widely in their political impact, and suggests that some policies are in fact self-undermining. We also emphasize the crucial role of partisan polarization as a mediating factor in shaping policy feedbacks.

scholarly journals A network-based model to explore the role of testing in the epidemiological control of the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yapeng Cui ◽  
Shunjiang Ni ◽  
Shifei Shen
Keyword(s):  
Infectious Diseases ◽  
Close Contact ◽  
Effective Means ◽  
Social Contact ◽  
Working Hours ◽  
Transmission Model ◽  
Epidemic Control ◽  
Start Time ◽  
The Government

Abstract Background Testing is one of the most effective means to manage the COVID-19 pandemic. However, there is an upper bound on daily testing volume because of limited healthcare staff and working hours, as well as different testing methods, such as random testing and contact-tracking testing. In this study, a network-based epidemic transmission model combined with a testing mechanism was proposed to study the role of testing in epidemic control. The aim of this study was to determine how testing affects the spread of epidemics and the daily testing volume needed to control infectious diseases. Methods We simulated the epidemic spread process on complex networks and introduced testing preferences to describe different testing strategies. Different networks were generated to represent social contact between individuals. An extended susceptible-exposed-infected-recovered (SEIR) epidemic model was adopted to simulate the spread of epidemics in these networks. The model establishes a testing preference of between 0 and 1; the larger the testing preference, the higher the testing priority for people in close contact with confirmed cases. Results The numerical simulations revealed that the higher the priority for testing individuals in close contact with confirmed cases, the smaller the infection scale. In addition, the infection peak decreased with an increase in daily testing volume and increased as the testing start time was delayed. We also discovered that when testing and other measures were adopted, the daily testing volume required to keep the infection scale below 5% was reduced by more than 40% even if other measures only reduced individuals’ infection probability by 10%. The proposed model was validated using COVID-19 testing data. Conclusions Although testing could effectively inhibit the spread of infectious diseases and epidemics, our results indicated that it requires a huge daily testing volume. Thus, it is highly recommended that testing be adopted in combination with measures such as wearing masks and social distancing to better manage infectious diseases. Our research contributes to understanding the role of testing in epidemic control and provides useful suggestions for the government and individuals in responding to epidemics.

scholarly journals People Love Their Religion: Political Conflict on Religion in Early Independent Mexico

Religions ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 60
Author(s):  
Silke Hensel
Keyword(s):  
Political Conflict ◽  
Religious Conflict ◽  
First Republic ◽  
History Of ◽  
The Government ◽  
Cristero Revolt ◽  
Role Of Religion ◽  
The Church ◽  
Large Sections

Global histories commonly attribute the secularization of the state exclusively to Europe. However, the church state conflict over these issues has been an important thread in much of Latin America. In Mexico, questions about the role of religion and the church in society became a major political conflict after independence. Best known for the Mexican case are the disputes over the constitution of 1857, which laid down the freedom of religion, and the Cristero Revolt in the 1920s. However, the history of struggles over secularization goes back further. In 1835, the First Republic ultimately failed, because of the massive protests against the anticlerical laws of the government. In the paper, this failure is understood as a genuine religious conflict over the question of the proper social and political order, in which large sections of the population were involved. Beginning with the anticlerical laws of 1833, political and religious reaction in Mexico often began with a pronunciamiento (a mixture of rebellion and petitioning the authorities) and evolved into conflicts over federalism vs. centralism.

scholarly journals Obamacare 2012: Prognosis Unclear for Interventional Pain Management

2012 ◽  
Vol 5;15 (5;9) ◽  
pp. E629-E640
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
United States ◽  
Pain Management ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Patient Protection ◽  
Medical Education And Training ◽  
Interventional Pain Management

The Patient Protection and Affordable Care Act (ACA), informally referred to as ObamaCare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. ACA has substantially changed the landscape of medical practice in the United States and continues to influence all sectors, in particular evolving specialties such as interventional pain management. ObamaCare has been signed into law amidst major political fallouts, has sustained a Supreme Court challenge and emerged bruised, but still very much alive. While proponents argue that ObamaCare will provide insurance for almost everyone, with an improvement in the quality of and reduction in the cost of health care, opponents criticize it as being a massive bureaucracy laden with penalties and taxes, that will ultimately eliminate personal medicine and individual practices. Based on the 2 years since the passage of ACA in 2010, the prognosis for interventional pain management is unclear. The damage sustained to interventional pain management and the majority of medicine practices is irreparable. ObamaCare may provide insurance for all, but with cuts in Medicare to fund ObamaCare, a limited expansion of Medicaid, the inadequate funding of exchanges, declining employer health insurance coverage and skyrocketing disability claims, the coverage will be practically nonexistent. ObamaCare is composed of numerous organizations and bureaucracies charged with controlling the practice of medicine through the extension of regulations. Apart from cutting reimbursements and reducing access to interventional pain management, administration officials are determined to increase the role of midlevel practitioners and reduce the role of individual physicians by liberalizing the scope of practice regulations and introducing proposals to reduce medical education and training. Key words: Patient Protection and Affordable Care Act, ObamaCare, interventional pain management, Patient-Centered Outcomes Research Institute, Independent Payment Advisory Board, Centers for Medicare and Medicaid Services, Accountable Care Organizations, Medicare, Medicaid

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