Q&A: Experts discuss health care and the 2024 presidential election

Health care has often played a central role in political campaigns, and the 2024 presidential election is no different. But the debate over health care is not just policy. Issues at risk—such as health care delivery and affordability, reproductive health and substance use disorders—affect individuals and families in Pennsylvania and across the nation, which make it a priority among voters.

Penn State News spoke with four education experts about the pressing issues and how they can affect voters and their families.

How has political polarization changed the way government approaches policymaking, especially when it comes to important issues like health care?

Daniel Mallinson, assistant professor of policy and public administration at Penn State Harrisburg, studies why countries adopt new policies and what we can learn from individual and contextual policy approaches. is a senior and takes a keen interest in Pennsylvania state politics.

Mallinson says, «Our recent research has shown that polarization overstates the policymaking power of Congress. By that I mean there are long periods of relative stasis, where nothing gets done or things are change incrementally, but when change occurs it tends to be larger.

«Health care, specifically the Affordable Care Act (ACA), is a good example. Changes in national health care policy took a long time, but when the political process was right, it resulted in major policy change. We also see that those major changes tend to be less bipartisan, which helps explain the extremes for many policy areas.»

How has the Affordable Care Act affected health care coverage and access? If the ACA is repealed, how does that affect me and my family?

Dennis Scanlon, distinguished professor of health policy and management, studies health policy and change and can talk about health care efficiency and efforts to distribute funds equitably by manufacturers and opioid distributors.

Scanlon explains, «Overall, the Affordable Care Act has helped people get health insurance and increased the number of people who have health insurance in the United States.

«It is very unlikely that the ACA will be repealed. If anything were to be repealed, it would likely be the pieces of the ACA that are being dismantled. The impact would depend on which pieces If someone is currently receiving subsidies from the health care exchange and if those subsidies are broken, that may affect their choice of whether or not to switch. stay insured.»

The Dobbs decision—the landmark Supreme Court decision in June 2022 that struck down the constitutional right to abortion—changed reproductive health care as much as access to care. how is the patient?

Sarah Horvath, assistant professor of obstetrics and gynecology at Penn State College of Medicine, is available to discuss reproductive health care, including access to reproductive health services, contraceptive counseling, management of miscarriage and the safety of mifepristone, one of the two drugs used in medicine. abortion.

Horvath says, «The effects of the Dobbs decision are geographic. Most of the full bans and early abortion bans are concentrated across much of the South. What we’ve seen is that in those states, there have been and a big drop in total abortion care provided but if you look at the data from across the country, we’ve seen an increase in the number of abortion care.

«What that means is that people have to walk for care. It’s really exacerbated the inequity of access to care because those who have mobility equipment will walk with people who can’t.

«It also affects access to continued prenatal care because these policies have had a devastating effect on providers. Take Idaho for example. It’s a state that already had very few obstetricians and antenatal care specialists, who care for high-risk pregnant women.There has been an influx of government providers, meaning people towards the end of their pregnancy are now traveling to neighboring countries for routine prenatal care. ”

Have more restrictive health policies had surprising effects?

«We see a lot of limited results. I provide care for complicated miscarriages, stillbirths, ectopic pregnancies and other conditions, and we see that the drugs and procedures used to treat these conditions also it’s involved,» says Horvath. . «There are countries where the medication mifepristone is not available for the management of miscarriage, although we know that it improves outcomes. It makes care more efficient, safer and better for the mother, but we don’t give people access to these drugs because of it. In the same way that abortion, other drugs to treat cancer or conditions like tuberculosis are difficult to access because of the relationship. their history and abortion care Women can no longer get these drugs, but men can.

«We’re also seeing brain damage in the workplace. It’s not just OBGYNs, it’s also affecting family medicine doctors and, in one study, even psychiatrists were considering leaving the country because of lack the ability to provide comprehensive care to their patients.. Even among medical students, there has been a decline in residency programs in countries with abortion restrictions across all specialties. »

How has the increase in drug use problems, especially opioid use, affected our nation and our communities?

Abeena Jones, Ann Atherton Hertzler Associate Professor of health and human development and assistant professor of human development and family studies, has expertise in social and structural issues of substance abuse. among vulnerable people.

Jones says, «Drug abuse continues to be a national concern as the number of drug overdose deaths continues to rise. Drug abuse affects communities and societies by the breakdown of families, especially when the criminal justice system and the welfare of children are involved, increasing health care costs and loss of productivity, affecting access to education and the increase of infectious diseases such as HIV and Hepatitis C.

Are there people disproportionately affected by substance use problems?

«The most affected populations include vulnerable and marginalized groups who face a disproportionate burden of poverty and limited social welfare systems, and who live in under-resourced areas, such as rural areas or low-income cities,» explains Jones.

«Furthermore, available data suggest that the increase in the number of homicides among racial/ethnic minorities is primarily due to low-quality drugs and fentanyl contamination often found in areas lack of resources and lack of access to quality substance use treatment, substance abuse and harm reduction services.»