Political science Unit

Political science Unit





To:Governor Kasich



Healthcare issues to be addressed

Mattersof national health insurance have dominated presidential campaignsfor a long the history of the US. This is not just a randomoccurrence but rather a result of Americans’ interest in theirhealth and how the government manages this prerogative. Currently,things are far from what they ought to be. The current affordablecare act faces some major issues. Therefore, there is need to reformthe act to fit with reality and the needs of the people. As embark onyour presidential campaigns, I do hereby recommend some policy issueson healthcare that you can address in your campaigns and also once inoffice.


  • Repealing the current provision in the affordable care act (ACA) that calls for businesses with at least 50 employees to provide coverage for their full-time employees. I would suggest that the cap be placed on businesses with a least 100 full time employees.

  • More freedom for state governments in Medicaid and health-exchange programs.

  • Improved funding for disease prevention activities

  • Design a separate healthcare program for patients with long-term care needs.


Thecurrent requirement under Affordable Healthcare Plan Act (APA) has amandatory requirement that all businesses with more than 50 full timeemployees to provide full health cover for the employees. Thisrequirement directly stifles upcoming small businesses. This defeatsthe larger goal of the federal and state government of addressingunemployment. This is because mandatory healthcare insuranceprovision to employees drastically increases costs to thesebusinesses and makes them uncompetitive locally and globally. Whileyou have indicated that you would scrap this requirement in whole, itis highly suggested that the minimum requirements for businesses beraised to 100 full time employees. This ensures that the law appliesto small businesses with significant financial foothold and canwithstand such additional costs.

Recently,some state governments such as Indian have challenged the federalgovernment’s stringent control of Medicaid. This has seen the stategovernment pass on health responsibility to low income earners bycharging them a monthly premium set at a minimum $1.

Diseaseprevention activities should be well funded. This pertains torewarding patients in disease prevention activities to keep awaydiseases, which is more cost efficient compared to treating diseases.This is very relevant given that the US has in the last few decadesexperienced a significant surge in lifestyle diseases.

Aseparate program is necessary to cater to patients with long-termcare needs. The reason why such patients need a different program ismainly because of two reasons. The first is because of the differentcosts structure that is required in managing long term healthcareneeds especially where chronic illnesses such as diabetes areinvolved. The second is the type and intensity of healthcare servicesneeded by patients of long term care is significantly different.Ideally, the new program shall adequately respond to these majorneeds without affecting the quality of care.


Healthcareis politically sensitive issue. I believe that each of these issuesraised are not only important in improving the healthcare servicesbut also critical in managing the public healthcare budget. Previousgovernments and political leaders have been judged and rated based onthe healthcare policies. Each of these issues suggested here hasconsiderable political significance and if raised in yourpresidential campaigns, I believe they will garner public support andprovide you with competitive edge over other candidates.

Takefor instance the issue of small businesses and the provision ofhealthcare insurance to full time employees. There is need for thegovernment to nurture small businesses. Reports indicate that thesesmall and medium enterprises provide 60-70% of all employment in OECDcountries. What this means is that for any political regime that iskeen to address current unemployment concerns in the US, the regimemust be ready to embrace SMEs and provide a favorable environment forthem to flourish. Furthermore, the SME filed registers faster growththan other established firms. However, less than half of start-upslive beyond five years. To ensure a larger number of these firmslive beyond five years, those with less than 100 permanent employeesshould be spared from providing full health insurance cover for theiremployees. Instead, the government should create a health insuranceprogram for employees in new established SMEs.

Tolower the healthcare wage bill in the government, the federalgovernment in conjunction with state governments should developappropriate programs that seek to promote disease prevention programsand reward participants such as through special tax rebates foradults and other reward programs for school children. This way, thegovernment will promote healthy living alongside other mechanisms andat the same time manage the ballooning healthcare budget and improveservice. A good example would be providing incentive to children tovisit recreational parks as opposed to staying indoors and playingindoors.

Onprevious occasions, Mr. Governor, you have expressed your views onthe current healthcare plan. I stand to be corrected when I say thatwhat I have understood in your speeches is that you would repeal oreven replace the ACA with something better. On one hand, there arethe positive elements of the current plan that should be retained.However, there are some other areas of the current plan that requireto be addressed. I would like to suggest that repealing the ACA willallow you to win conservatives, moderate democrats and the undecidedvoters.

Additionally,states governments should be given more freedom when it comes toimplementing Medicaid. Some states such as Indiana have petitionedthe federal government on this and they have improved healthcareservices. As it, states have little maneuvering space to applyMedicaid in a manner that the program addresses local challengeswell. As a presidential candidate, I am a stern believe that reformsin the Medicaid in manner that allows individual states to expand andmodify Medicaid in ways that they deem appropriate. Such a move willallow you to appeal to those democrats who support Medicaid and thoseConservatives who are of the view that the ACA should be repealed.

Itis my strong believe that the issues raised above carry a lot ofpolitical weight. These are policy issues affecting ordinary peopleand are likely to affect voting patterns. As such, they are veryrelevant in pushing campaigns at the moment and also can work towardsboosting your rating on popularity polls. Furthermore, these issuesgreatly improve efficiency and effectiveness in government. It is mybelief that it you adopt the suggested positions in health, you willenjoy better public political supports and the issues are likely toenact once in government with support of the majority in both thecongress and senate.


PNHP(2012). A brief history: universal health care efforts in the US.Retrieved from