As a result of the Affordable Care Act (ACA) and private insurance exchanges, there are fewer uninsured in the U.S. now compared to 2010. In 2022, the national uninsured rate reached a new low of only 8% of the population (HHS, 2022). In addition, under the ACA, 39 states have expanded Medicaid coverage to nearly all adults up to 138% of the Federal Poverty Level (Kaiser Family Foundation, 2022).
Assume you are the administrator of a health care organization that accepts Medicaid as a payor, but in a state that has not expanded Medicaid coverage. Recent Medicaid policies and discounting have contributed to the organization’s failing bottom line. Many of your clients are on Medicaid or uninsured.
You have been asked to prepare an executive summary to present to the board of directors detailing how Medicaid discounting causes hardships on your organization’s finances and the health populations you serve.
Write a 700- to 1,050-word executive summary.
Include the following in your executive summary:
• Clearly identify the type of facility that you are leading.
• Explain specific cuts that Medicaid has made in recent years.
• Describe how Medicaid discounting causes hardships on your organization.
• Evaluate the impact of federal or state health care policies are having on consumers’ costs. Explore both positive and negative effects.
• Recommend changes you propose to help decrease the deficit from the perspective of your organization.
• Recommend actions the organization can take to alleviate the negative effects of these changes but still meet the needs of various populations.
Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).
Format your assignment according to APA guidelines.
Part 2: Resource: Ch. 8 to 14 of The Spirit Catches You and You Fall Down.
Respond to the following in a minimum of 175 words:
• Define the term social contract.
• Within this context, should cultures within the United States be expected to set aside some traditions or beliefs and integrate under a united social contract?
• How does this impact or influence health care delivery within this country?
Please include sources/references to support your perspective.
Classmates response: respond to both in 50 words minimum.
R1
To my understanding, a social contract is a living agreement (like a living document) among people in a society. This agreement is forever evolving in parallel with new technology, medical advancements, migration, etc. It is the invisible contract that sets expectations and common grounds that guides interactions between individuals.
With that said, I don’t believe that cultures be forgotten. Nor do I believe that it is suitable for individuals never to assimilate. I think both can exist, and focusing on one or the other can lead to extremist ideologies. For example, the rules we have at home for ourselves and our families are not entirely the same as those at work. We live with both, speak one language in the house and another when we are out. So, some form of integration is essential, especially in health care. Care providers should respect a patient culture to an extent, “patient’s body, patient’s choice.” Decision-making adults should have a say in their care and how its administered. As pointed out in The Spirit Catches You and You Fall Down, most Hmong patients were comfortable with the doctor who “did not cut.” Removing a patient’s fear, I believe, will promote quality care and help to increase patient health. Contrary to that point, patients are not old enough to make their own decisions, their health should trump all beliefs.
R2
Social contract is an agreement, either implicit or explicit, governing the behavior of individuals and organizations within a certain context such as a workplace, culture, a nation. Meaning people live together on society in accordance with an agreement that establishes moral and political rules of behavior. I think what makes this country great is its diversity, cultures and traditions from other countries are the elements that contribute to the success of this country. Therefore no one should be asked to set aside some traditions or beliefs and integrate under a untied social contract. People can live according to a social contract and can live morally by their own choice while they still have their tradition and belief.
Doctors enter medicine as well as enter into the social contract as an agreement with society, but they must navigate the realities of the racial contract and inequality in ways that have yet to be recognized. If a patient is asked to set aside their traditions and belief to receive health care, it diminishes the trust that the patients have in their doctors. No one should be asked to surrender their beliefs and fully submit to the authority or decision of a majority on exchange for protection of their remaining rights. This is the case with the Lee’s family, not understanding their belief and disregarding their tradition the doctors were unable to fully gain the trust and support of the parent which affected the treatment of their daugter. This is one example of how social contract and influence or impact healthcare delivery in the United States.
Social Contract Theory
https://ethicsunwrapped.utexas.edu/glossary/social-contract-theory
