The Affordable Care Act Of 2010 An Inquiry To Address Challenges Of The Uninsured

Running Head: THE AFFORDABLE CARE ACT 1

The Affordable Care Act of 2010: An Inquiry to Address Challenges of the Uninsured

Name

Institution

THE AFFORDABLE CARE ACT 2

The Affordable Care Act of 2010: An Inquiry to Address Challenges of the Uninsured

The Affordable Care Act (ACA) of 2010 was a monumental change in the US healthcare

policy since the passage of Medicaid and Medicare in 1965. According to Manchikanti, Helm,

Benyamin, and Hirsch (2017), the ACA has had its successes and failures since its enactment.

However, it is already evident that the Trump’s administration has capitalized on the ACA’s

failures to abolish it, with an agenda of replacing it with American Health Care Act. Since the

enactment of ACA, there has been a decline in the number of uninsured Americans, which has

facilitated the ease of access to health care services to all Americans (Kantarjian, 2017).

However, the impetus for reform, as the pro-AHCA could argue relates to costs. They are of the

opinion that the premiums are way too high to accommodate the low-class citizens. The aim of

the essay presents information to address the challenges of the uninsured in a manner that

advances a position favorable with the National Association of Social Work (NASW) Code of

Ethics.

Part I: Defining the Role of Social Work in Health Context

The history of medical social work is proof for the ever-increasing role of medical social

workers in health care. In fact, in the near future, it will be impossible for health care

organizations to provide services in the absence of medical social workers. Through Cabot’s

thoughts, it is evident that all professions are interdependent because they have something unique

that is of value to the other (Cited in Gehlert, 2011). The role of social workers in health care to

“treat the whole person by taking a biopsychosocial approach to outreach, assessment,

intervention and care” (Browne, 2011 pp. 20). Connecting this role to Cabot’s thoughts is among

the reasons for the successful historical journey to incorporate and accommodate the medical

social work profession in health care. The history of medical social work further depicts the

THE AFFORDABLE CARE ACT 3

current efforts towards social justice, and according to Martin Luther King, Jr., Social work helps

the arc of the moral universe bend towards justice. To get to a current state where justice is

served on a platter, medical social workers have had to fight for civil rights and equality in the

health care, with the hope of ending health care disparities.

The struggle for equality and justice has seen social workers occupy a position of

privilege and earn the title of advocacy. Therefore, they are in that position to advocate for the

needs of those marginalized in a society like the poor and minority ethnic groups. In their

advocacy positions, they contribute to policy making, which defines the course of health care

service administration. Through this position, social workers have contributed not only to policy

administration of the public social security systems (Carvalho, 2014) but also took center stage

in the construction of social facilities at the community level, including Day and Social Centers,

homes and residential homes, and support services. All these efforts have been towards ensuring

authentic service delivery. The Institute of Medicine (IOM), having realized the importance of

social work and the ignored patients’ social and psychological needs, recommended the

establishment of a committee to study the delivery of psychosocial services according to patient

needs (Ganz, 2008). Findings from such studies depict how social workers have the power to

influence the implementation of changes in the health care system. Upon the implementation of

the ACA in 2010, social workers were swift in pushing the government to reduce insurance costs

so that those marginalized in society have a chance benefit.

The social worker’s advocacy role relies on the biopsychosocial approach (Browne,

2011) to address all psychosocial-related aspects of illness. Unfortunately, it does not come with

limitations amidst its strengths. One strength of the biopsychosocial approach is its ability to

incorporate the nonmedical determinants of the disease (Browne, 2011). These determinants

THE AFFORDABLE CARE ACT 4

include the patient’s financial capabilities to purchase a specific medicine as per the doctor’s

recommendations. Through such an approach, social workers can craft the most appropriate

treatment plan for the patient after diagnosis of the disease. More so, this approach offers a

platform for transdisciplinary team interaction. Efficiency in healthcare is dependent on the

collaborative efforts by different professionals who provide different viewpoints with the aim of

improving patient outcomes. The limitations of this medical approach can be traced to an

individual level. Even though the main purpose of the approach is to provide psychosocial

services, some people are illiterate to comprehend the suggested interventions and how to

implement them in the social workers’ absence.

Part II: Ethical Considerations

According to NASW, the social work profession is guided by these six core values:

service, social justice, dignity and worth of the person, importance of human relationships,

integrity, and competence (Cited in Sparks, 2011). Of these core values, service is the most

important because it summarizes the primary goal for social workers. Their purpose is to offer

public service for the benefit of the need, minority groups, and everyone who requires their

services related to social problems. Bent-Goodley (2017) is of the opinion that the value of

service is a reminder of the commitment to turn the theorized policies into practice. Therefore,

that means that service is more of an opportunity than obligation since it involves contributing to

the wellbeing of a society. The most comfortable role as a social worker is taking part in the

design of health care (Browne, 2011). Social workers understand social systems and problems,

which makes them the best to serve in community settings. People are afraid to seek help for

psychosocial problems in health institutions because of fear and stigmatization. If social workers

go to where the victims are, it is much easier to solve, stop and prevent any future occurrences of

THE AFFORDABLE CARE ACT 5

the social problem. A social setting like schools is a great place to interact with adolescents, who

shy off from seeking help in hospitals because of fear and being shy. That means that the area

with the most opportunity for growth of social workers is in public health social work. Public

health setting provides social workers with a platform for assessment, policy development, and

assurance (Sable, Schild & Hipp, 2011). A focus on public health will ensure that the needy in

society get medical attention, affordable medical insurances, and encourage healthcare to

become patient-based. Therefore, it is necessary to have more people in macro or clinical roles to

meet needs. Social workers cannot work in isolation, and thus need to collaborate with other

physicians to improve patient outcomes. Their presence in the macro level setting is critical in

“designing and implementing community health programs and initiatives” (Browne, 2011 pp.

27). Browne’s statement means social workers are a voice for change and thus cannot be

ignored. The clinical level approach provides social workers with a platform to implement

biopsychosocial models.

The readings have prompted me to reflect on the twists of government policies and the

journey of social work as a profession. Through this thinking, the readings have challenged me

to be open-minded. More so, the readings have guided me in understanding what it means to be

truly professional in the field of social work through the roles as discussed by Browne (2011).

For instance, by reading through Mildred Williamson’s profile (Browne, 2011, pp. 23), I am

challenged to think beyond the static health care policies. Coming up with policies based on

patient needs will go a long way in creating new career opportunities for social workers. Infants,

adolescents, and adults may have different needs, and thus the need to have policies that best

respond to these need without generalization.

THE AFFORDABLE CARE ACT 6

Part III: Theoretical Framework

Theories of health behavior provide a conceptual framework for reference whenever

social workers need to gain an understanding of how people behave under certain conditions

(Gehlert & Bollinger, 2011). Specifically, these theories provide insights on patient situations

and guide social workers in selecting the most reliable interventions that suites the patient needs.

The major theories of health behavior according to Gehlert and Bollinger (2011) are the Health

Belief Model and the Theory of Reasoned Action. Of the two, the Health Belief Model (HBM) is

the most important because it validates the assertion that people’s behaviors and intentions about

healthy behaviors depend on their beliefs, values, and knowledge about the issue

(Morowatisharifabad, Momayyezi & Ghaneian, 2012). HBM is tied on an attitudinal construct

that helps people to predict perceived benefits of an intervention. For instance, when advising

people to use condoms during sexual intercourse, the perceived benefits would be to prevent

unwanted pregnancies and sexually transmitted infections. At the same time, others can perceive

condom use as inappropriate basically because they cannot achieve maximum pleasure.

Therefore, before suggesting an intervention or policy in a population of interest, it is advisable

to look at the belief systems and how they influence their behavior. HBM is critical since it lays

the foundation for understanding other theories like the Theory of Reasoned Action.

Furthermore, the model guides social workers to understand the social factors that contribute to

inequalities in health care and reasons as to why people shy off from health improvement or

protection opportunities.

Building on understanding for theories of health behavior, Kondrat (2002)’s perspective

where she argued that the environment does not necessarily influence human behavior. Human

beings create and control environmental outcomes in their favor. Kondrat (2002) reinforces her

THE AFFORDABLE CARE ACT 7

arguments with the structuration theory to inform a pro-social work position for health care

reforms by affirming that human agents have the advantage of monitoring the performance and

outcomes. Hence, it is simple to initiate change because human beings are the active agents who

can recreate social structures to meet their needs. Kondrat (2002) also uses the ecosystem

perspective, which can favor the anti-social work position to exclude people from access to

healthcare. In her argument, this perspective does not prioritize knowledge on social change,

which means people cannot get the needed information to access health service. The moment

humans are displaced as agents in a transformation process, it always becomes impossible to

realize any outcomes because they tend to wait for the suggested intervention to work as they

watch. Health care service delivery systems require human efforts, commitment, knowledge, and

interaction to realize any change.

Part IV: Turning Theory into Practice

Health, psychosocial well-being, and ecological factors impact the provision of social

work services in a health care context because they influence quality, price, and timeliness of the

service. All these aspects form part of an individual’s social circumstances that dictate the

quality of service they get. For instance, people living in poor environments may not get the

quality social work services as expected because the areas are inaccessible, they do not have the

required documents to initiate government support or lack the money to request for the services.

More so, the experiences in these macro and microenvironments may cause trauma that may

affect the mental health. Health and psychosocial well-being also impact the provision of these

services. Engstrom (2011) established that there is a relationship between psychosocial

conditions and health complications. For instance, someone with stress is likely to suffer from

depression and worse can be hostility, which may make it difficult for social workers to

THE AFFORDABLE CARE ACT 8

administer the services. It is impossible counselling a hostile person because they can cause

unintended harm.

The fact that social work is socially sensitive, culturally oriented, and takes a critical

approach to issues, a social worker must consider the code of ethics. Instances of ethical

dilemmas have been reported by social workers especially when they find themselves in

controversial situations. For instance, a patient may try convincing a social worker not to admit

them in a rehabilitation program since they prefer their way of life or do not want to leave their

families and friends. However, the goal is to help the patient in the best way possible to prevent a

repetition in future. Remaining ethical while interacting with clients is the preferred at both

micro- and macro-levels.

Turning theory into practice requires more than a casual understanding of a text. The

most intriguing and intervention models that can best help social work advance healthful

outcomes are cognitive-behavioral therapy (CBT) and crisis intervention models. Cognitive-

behavioral therapy deals with human thoughts, beliefs, and attitudes (Engstrom, 2011), which is

an essential prerequisite to psychosocial treatment. Social workers rely on this model when

treating persons with stress. The best part of this model is its capability to trace and understand

the patient’s reaction to the problem and identify the problem itself. Another intervention model

is the crisis intervention model (Brashler, 2011), which emphasizes disruptions and emotions that

are a threat to one’s life. Social workers can use this model to create a positive outcome since

they encourage the client to cope up with others and attain the same level of outcome. A social

worker can use this model on people who are bereaved, those who have experienced domestic

violence or had suicidal thoughts.

THE AFFORDABLE CARE ACT 9

Conclusion

The abandonment of the ACA of 2010 is unwelcomed. It is far much better to amend and

improve on its provisions rather than abolish it all together. Throughout the discussion, it is

evident that social workers are the idea behind influential policies in health care. Part I defines

the role of a social worker. The primary role of a social worker is a biopsychosocial approach in

treating patients and advocate for quality patient services. Part II discusses the ethical

considerations in social work. Professionals have a code of ethics that must guide them as they

execute their duties. The most important core value of ethics is service because it defines the

primary objective of social work. Part III provides a theoretical framework. Theories guide social

workers in understanding human behavior and help predict the outcomes and their interventions.

Through Kondrat’s arguments, it is evident that there exist ideologies that pro- and anti-social

work reforms. Part IV explains the possible ways of turning theory into practice. The process is

only possible if social workers can understand the relationship between health care service

provision and ecological, psychosocial well-being, and health.

THE AFFORDABLE CARE ACT

References

Bent-Goodley, T. B. (2017). Living our core values. Social Work, 62(4), 293-295.

Brashler, R. (2011). Social work practice and disability issues. In S. Gehlert & T. A. Browne

(Eds.), Handbook of health social work (pp. 23-42). New Jersey: John Wiley & Sons.

Browne T. (2011). Social work roles and health care settings. In S. Gehlert & T. A. Browne

(Eds.), Handbook of health social work (pp. 23-42). New Jersey: John Wiley & Sons.

Carvalho, M. I. (2014). Social work and intervention with older people in Portugal: A critical

point of view. European Journal of Social Work, 17(3), 336-352.

Engstrom, M. (2011). Physical and mental health: Interactions, assessment, and interventions. In

S. Gehlert & T. A. Browne (Eds.), Handbook of health social work (pp. 23-42). New

Jersey: John Wiley & Sons.

Ganz, P. (2008). Institute of Medicine Report: Recognizing psychosocial health needs to treat the

whole patient. Journal of Oncology Practice, 4(3), 128-130.

Gehlert, S. & Bollinger, S. E. (2011). Theories of health behavior. In S. Gehlert & T. A. Browne

(Eds.), Handbook of health social work (pp. 23-42). New Jersey: John Wiley & Sons.

Kantarjian, H. A. (2017). The Affordable Care Act, or Obamacare, 3 years later: A reality check.

Cancer, 2(1), 25-28.

Kondrat, M. E. (2002). Actor-centered social work: Re-visioning “Person-in-Environment”

through a critical theory lens. Social Work, 47(4), 435-448.

THE AFFORDABLE CARE ACT

Manchikanti, L., Helm, S., Benyamin, R. M., & Hirsch, J. A. (2017). A critical analysis of

Obamacare: Affordable care or insurance for many and coverage for few? Pain

Physician, 20, 111-138.

Morowatisharifabad, M. A., Momayyezi, M., & Ghaneian, M. T. (2012). Health belief model

and reasoned action theory in predicting water saving behaviors in Yazd, Iran. Health

Promotion Perspectives, 2(2), 136-144.

Sable, M. R., Schild, D., R., & Hipp, J. A. In S. Gehlert & T. A. Browne (Eds.), Handbook of

health social work (pp. 23-42). New Jersey: John Wiley & Sons.

Sparks, J. (2011). Ethics and social work in health care. In S. Gehlert & T. A. Browne (Eds.),

Handbook of health social work (pp. 23-42). New Jersey: John Wiley & Sons.

Place new order. It's free, fast and safe

Paper type

Deadline

Page count

550 words

Total price: $ 15.00

Our customers say

Jeff Curtis

USA, Student

"I'm fully satisfied with the essay I've just received. When I read it, I felt like it was exactly what I wanted to say, but couldn’t find the necessary words. Thank you!"

Ian McGregor

UK, Student

"I don’t know what I would do without your assistance! With your help, I met my deadline just in time and the work was very professional. I will be back in several days with another assignment!"

Shannon Williams

Canada, Student

"It was the perfect experience! I enjoyed working with my writer, he delivered my work on time and followed all the guidelines about the referencing and contents."

The Affordable Care Act of 2010 An Inquiry to Address Challenges of the Uninsured

Place new order. It's free, fast and safe

Our customers say

Jeff Curtis

Ian McGregor

Shannon Williams