Creating and implementing the Affordable Health Care Act has been instrumental in impacting and comparing the “Sick around America/ Word” stories in the United States and internationally. On the documentaries in the United States there were citizens who were unemployed or underemployed, or had pre-existing medical conditions and were denied medical coverage. That loss of coverage led to numerous unnecessary deaths or health problems for individuals. With the new ACA being available individuals in the United States can now have access to medical coverage who were previously rejected for coverage. The ACA is finally trying to take the lead of providing universal health care as other countries have been providing helpful and affordable coverage to their citizens for decades. The Commonwealth Fund site exemplified the severity and issue of the United States being one of the wealthiest countries and having the worst rate health coverage for its citizens.

http://www.commonwealthfund.org/Publications/In-the-Literature/2013/Nov/Access-Affordability-and-Insurance.aspx

The site states “In 2013, more than one-third (37%) of U.S. adults went without recommended care, did not see a doctor when they were sick, or failed to fill prescriptions because of costs, compared with as few as 4 percent to 6 percent in the United Kingdom and Sweden”. That lack of coverage results in too many deaths and preventable medical diseases. In the America video, the only people who were able to maintain adequate care where those who had full coverage with their employer. If their employment ended then health coverage would cease for that person or their family and they are left with a debt balance. I think the ACA will change that feature in the future, because unemployed individuals won’t be penalized for being uninsured if they meet specific income specifications. I do think the ACA may work, but additional reform is necessary. For example, in southern states Medicaid expansion is blocked. That blockage is preventing low income individuals from receiving affordable coverage and ultimately killing people like the woman who had lupus in the video.  New measures have to occur for state legislatures and governors to stop blocking Medicaid and for people to receive health coverage.

I am skeptical of the longevity of the ACA in the future because in the United States the insurance market is based solely on revenue versus the wellness of a person in comparison to other countries. If this United States market ever reforms the health coverage putting a individual’s health before making a profit, than universal health coverage may began. According to the films and articles, United States doctors, facilities, administrative costs and Pharmaceutical companies make more money in providing health coverage compared to other companies who provide complete coverage for their residents at affordable rates. That support proves that the United States can implement the ACA , but political control is the exception to the Affordable Care Act functioning. John Cannon’s Affordable Care Act expressed how congress can implement or blocks legislation as if it is a game. Walter Oleszek of the  Congressional Research Service has chronicled the evolution of the modern congressional process and describes it this way: “Members find new uses for old rules, employ innovative devices, or bypass traditional procedures and processes altogether to achieve their political and policy objectives.”

The intersection of race, gender, and class

The DeParle reading did not change my perception with the ability of social policy combating poverty.  The history of how minorities have been treated in the United States post slavery exemplifies some of the discrimination, segregation, and continuous cycles of abuse that leads to present day poverty and inequality for individuals.  DeParle, 95 writes “Three centuries of exploitation from slavery to industrial unemployment is the reason for welfare policy” (Deparle, 2004). That quotes supports that social policy can be framed to support and aid citizens, but in reality it can have a hidden agenda that does not provide additional liberties for people and opportunities for better lives. For example, during the Clinton Administration, House Speaker Gingrich had his own political agenda. He attempted to “End welfare as We Know It” in his own controlling way. He wanted to allow state governors to control the welfare system oppose to the Federal government. Instead of providing helpful ways to reduce the welfare recipients with job training or daycare cost for children Gingrich choose to blame the victims who were teen parents or contracted AIDS by reducing the funding for the recipients and taking opportunities for growth from their lives ( DeParle 117).

Deparle’s book with Stone’s book  described the Liberty- welfare trade off as the recipients not truly having liberties because they were dependent on the government for  providing their shelter, food, and other necessities that could not provide. On one hand I felt that the women in DeParle did exemplify the welfare- trade off listed in the book, because they typically did not work for some of their resources, but on the other hand equal opportunity of obtaining those resources were often difficult to receive, resulting in the women finding other ways for survival. Ultimately, I think there is a trade off with the control and power of the underclass individuals. If a small window of opportunity presents itself for a person to improve their lifestyle and they take that opportunity, that results in that person improving their life. That can then result in that person helping someone else in the future, because all people rely on each other for survival and the advancement of life in society.