Social Insurance Programs (ANSWERED)

QUESTION

Required Resources

Read/review the following resources for this activity:

• Textbook: Chapter 17
• Lesson: Read this Week’s Lesson which is located in the Modules tab
• Initial Post: minimum of 2 scholarly sources (must include your textbook for one of the sources). Follow-Up Post: minimum of 1 scholarly source for your Follow-Up Post.

Initial Post Instructions

For the initial post, respond to one of the following options, and label the beginning of your post indicating either Option 1 or Option 2:

• Option 1: The main social insurance programs like Social Security, Medicare, and unemployment compensation are funded by a payroll tax on the earnings of individuals who may receive benefits. Do you think the social insurance programs are effective? How are social insurance programs affected by the socioeconomic and political forces? Explain your answers.
• Option 2: Research government regulations on a particular area of your choice, such as food, drugs, product safety, fracking, environment, etc. Do you think the government regulations go too far? Do you think the government needs to add more regulations? How are lobbyists involved concerning regulations on food and drug safety, and our environment concerning fracking? Explain your answers.

Be sure to make connections between your ideas and conclusions and the research, concepts, terms, and theory we are discussing this week.

ANSWER

Government Regulations and Social Insurance Programs

Option 1: Effectiveness of social insurance programs

Ben-Shalom et al. (2011) examined the effectiveness of social insurance programs in the US. The authors found that the benefits system (e.g., Medicaid, Temporary Assistance for Needy Families, Supplemental Security Income, the Supplemental Nutrition Assistance Program, etc.) has significantly reduced the poverty rate from 29% to 13.5%. However, the aggregate impact of the insurance program is small because it does not cover all those in need. Ben-Shalom and associates (2011) found that the insurance programs primarily benefit the elderly, the disabled, and those with higher incomes. The low-income individuals benefit the least from these programs.

For example, Medicare has successfully provided a wide range of healthcare coverage for various populations in the country, but it does not cover all services. Its beneficiaries must purchase additional insurance or co-pay for the uncovered services (e.g., outpatient drugs, routine physical examination for the elderly, hearing devices, dental services, etc.)  Tarazi et al. (2022) reveal that most Medicare beneficiaries have supplemental insurance plans to fill the Medigap. The unemployed or low-income individuals may not afford to buy these additional insurance programs, explaining why they are the country’s largest uninsured and underinsured population (Tarazi et al., 2022). Social insurance programs have successfully improved the quality of life of some populations, but they have excluded other vulnerable groups, making them ineffective.

Social insurance programs are affected by socioeconomic and political forces because most are funded by taxpayers and administered by the government. For example, the government takes a specific percentage of employers’ and employees’ total wages to sustain the Medicare program. Each political leader has specific tax policies, which, in turn, affect the size and design of the programs. Also, some state actors may use social insurance programs as an extraction instrument to advance economic interests instead of covering the programs’ costs, explaining why the programs are affected by the socioeconomic and political environment.

Option 2: Government Regulations

Do you think the government regulations go too far?

I don’t think FDA’s regulations go too far and are ideal for consumers. Fleming et al. (2017) indicate that it would be treacherous for the government to reduce FDA’s regulatory authority. Doing this would lower the standards required for drug approval, forcing healthcare practitioners to rely on post-marketing observational studies to understand drug safety and efficacy (Fleming et al., 2017). Drugs such as encainide and flecainide illustrate the dangers of using this post-market approach. Hundreds of thousands of patients received these medications until a randomized controlled study later established that their use tripled death rates (Fleming et al., 2017). Other medications such as rofecoxib and valdecoxib had similar adverse events due to weak regulatory standards. These examples demonstrate the importance of having stringent drug regulatory standards. Therefore, I support the current FDA drug regulations standards.

Do you think the government needs to add more regulations?

Increasing regulations does not automatically translate into higher drug safety. The agency can have many regulation standards but fail to achieve its mission if the standards are ineffective. Instead of adding more regulations, the agency should pursue creative approaches to accelerate approval without compromising quality standards (Fleming et al., 2017). For example, artificial intelligence and machine learning provide vast opportunities in pharmacovigilance due to their automatic task execution capabilities. The agency can also use digital therapeutics (use of technologies to deliver evidence-based medical interventions directly to patients) or large-scale distributed database networks for pharmacoepidemiological studies (Trifirò & Crisafulli, 2022). These creative approaches ensure a timely and reliable assessment of drugs and medical interventions without compromising quality standards, speeding the approval process.

How are lobbyists involved concerning regulations on food and drug safety?

Lobbyists help to campaign for increased federal funding to the FDA. Lobbyists also use various tactics, including attacking the agency’s integrity, to influence its decision-making. Typically, the agency bases most of its decision on scientific research, but there are times when they approve drugs due to political pressure and lobbying influence. Kim et al. (2016) reveal that pharmaceutical firms spend billions on lobbying, and 67% of the lobbying firms have higher chances of receiving FDA approval than non-lobbying firms. Lobbyists influence food and drug safety by influencing the FDA’s decision-making process.

References

Ben-Shalom, Y., Moffitt, R. A., & Scholz, J. K. (2011). An assessment of the effectiveness of anti-poverty programs in the United States (No. w17042). National Bureau of Economic Research.

Fleming, T. R., Demets, D. L., & McShane, L. M. (2017). Discussion: The role, position, and function of the FDA—The past, present, and future. Biostatistics, 18(3), 417-421. https://pubmed.ncbi.nlm.nih.gov/28633307/

Gornick, M. E., Warren, J. L., Eggers, P. W., Lubitz, J. D., De Lew, N., Davis, M. H., & Cooper, B. S. (1996). Thirty years of Medicare: impact on the covered population. Health care financing review, 18(2), 179.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193632/

Trifirò, G., & Crisafulli, S. (2022). A new Era of Pharmacovigilance: future challenges and opportunities. Frontiers in Drug Safety and Regulation, 1.

Kim, D., Kim, 1., & Unsal, O. (2020). Two faces of corporate lobbying: Evidence from the pharmaceutical industry. The North American Journal of Economics and Finance, 51, 100858. https://scholarworks.merrimack.edu/cgi/viewcontent.cgi?article=1003&context=fin_facpub

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