World Day of Social Justice

“Social justice is an underlying principle for peaceful and prosperous coexistence within and among nations. We uphold the principles of social justice when we promote gender equality or the rights of indigenous peoples and migrants. We advance social justice when we remove barriers that people face because of gender, age, race, ethnicity, religion, culture or disability.” -United Nations, WDSJ webpage (1)

In 2007, the United Nations General Assembly declared that February 20th be celebrated annually as World Day of Social Justice. A product of rising globalization, World Day of Social Justice encourages nations to devote the day towards the eradication of poverty, inequity, exclusion, and unemployment. While we know these goals cannot be achieved in a day, World Day of Social Justice provides us with a chance to look around our community, locally and globally, with extra purpose and passion. GlobeMed at Tufts and PHASE Nepal share a drive to collaborate and eliminate global health inequity, and we find inspiration in the action taken by the international community in support of global health equity. February 20th has become a day to rally, to dream, to energize, to learn, to grow, and to come together. Especially in the current national climate, it is increasingly important every single day to take action and to create hope.

This February 23rd, GlobeMed at Tufts will be hosting a film screening of Vessel, an award-winning documentary following the work of Rebecca Gomperts, founder of Women on Waves. Dr. Gomperts, a Dutch physician, activist, and artist, made it her life’s work to end the health risks associated with illegal abortions. Dr. Gomperts and her organization work on a ship-turned-clinic that sails to areas where women cannot access legal and safe abortion. Once in international waters, Dr. Gomperts and her crew are trained and authorized to administer abortions and provide contraceptives. They also train local women to administer safe abortions using non-surgical WHO-researched protocols. Through a network of empowerment, Women on Waves has given countless women access to safe abortions, birth control, and invaluable knowledge.

We find this documentary especially relevant after the reenactment of the U.S. Mexico City Policy, also known as the Global Gag. First enacted by President Reagan and most recently reenacted by President Trump, this policy blocks federal funding to NGOs that provide abortion services or counseling as well as those that advocate for the decriminalization or expansion of abortion services.

GlobeMed at Tufts is devoted to social justice, nationally and abroad, and aims to emphasize the importance of self-education and community discussion. Please join us on February 23rd at 6 PM in Tisch 304 for a free screening of Vessel with snacks, discussion, and good company! We hope to foster an open dialogue about the film and World Day of Social Justice, so all thoughts, feelings, and opinions are welcome.

Vessel trailer: https://vimeo.com/106489346

Women on Waves website: http://www.womenonwaves.org/

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(1) http://www.un.org/en/events/socialjusticeday/

Rebuilding Nepal: Reflections from a GlobeMed Alumnus

Nick James Macaluso, an alumnus of GlobeMed at Tufts, is currently working with our partner organization, Practical Help Achieving Self-Empowerment (PHASE) Nepal at their headquarters in Bhaktapur. He answered some questions about his experience over email.

PHASE’s new office building

Nick James (NJ) Macaluso graduated from Tufts last year and was a GlobeMed member during his time as an undergraduate. He served as GlobeMed at Tufts’ Grassroots Onsite Work (GROW) Coordinator on our executive board. The GROW team organizes our summer internship projects; NJ was able to visit PHASE Nepal during the summer of 2014 as a GROW intern. He is currently working with PHASE Nepal at their headquarters in Bhaktapur. He works under the Communications Manager, and has been helping with PHASE’s website, including creating graphics and generating future website content, among other projects.

NJ’s biggest project with PHASE so far has been creating a summary sheet for each Village Development Committee (VDC) where PHASE works; he described a VDC as “kind of like the subgroup of each district—for example, Rayale is a VDC of Kavre.”  These summary sheets include project information, donors, and demographic information.

NJ is also helping plan the 2016 GROW trip. His history with GROW and previous role as GlobeMed at Tufts’ GROW Coordinator has informed his work with PHASE in this aspect. He wrote, “As coordinator last year, a big part of my job was figuring out how to make the trip unique from the previous year, and I’ll continue to do that here on the ground in Nepal.” NJ will be traveling to Rayale, where this year’s team will be placed, to evaluate their needs and help next year’s team develop a project that will benefit PHASE.

The view from where NJ is living in Nepal

Earthquake Damage

The massive earthquakes in Nepal on April 25th and May 12th of 2015 and their aftershocks left thousands of families without homes or livelihoods; the earthquake on April 25th was of 7.8 magnitude; the two major aftershocks on May 12th were of 7.3 and 6.8 magnitude. On NJ’s first night, there was another earthquake of 5.3 magnitude. He wrote, “It was absolutely terrifying, but such aftershocks have become the norm for most people in Nepal.” NJ was in Kathmandu at the time, relatively far from the epicenter in Sindhupalchowk, so he was unharmed.

NJ stated that since his arrival in Nepal, he has seen countless construction projects. However, Bhaktapur and Kathmandu, the two areas he has visited so far, were not among the areas that were severely damaged by the earthquake. According to NJ, many popular tourist sites were damaged; tourism is a large contributor to Nepal’s economy. For example, two of the sites he visited on his first trip to Nepal—Bhaktapur’s Durbar Square and Basantapur—have been significantly damaged by the earthquakes.

Damage in Bhaktapur from the earthquakes

PHASE Nepal’s Relief Efforts

Like the organization’s name suggests, self-empowerment is central to PHASE’s mission. As stated on their website, PHASE Nepal’s vision is “A self-empowered and self-sustained society, where all kinds of discrimination are absent.” PHASE Nepal is a non-profit, non-governmental, nonpolitical, social development organization founded in 2006. PHASE Nepal’s core programming includes health, education, and livelihood projects for disadvantaged populations in the Himalayan regions of Nepal. PHASE strives to break the cycle of poverty in these regions by helping communities achieve a self-sufficient future.  

In addition to these core projects, PHASE has implemented an Emergency Relief Program for VDCs of Gorkha, Sindhupalchowk, and other districts. NJ wrote, “These projects include distribution of shelter materials and other necessary items, construction of school TLCs (Temporary Learning Centers), roof reconstruction, winterization projects, and WASH [Water And Sanitation for Health] projects. PHASE attracted many new donors around the world after the earthquake who have been responsible for these projects.”

Students celebrating Saraswati, a school holiday devoted to the Goddess of Education/Knowledge

GlobeMed After College

NJ said, “My involvement in GlobeMed definitely made this all 100% possible!” He also stated that things our chapter discussed during our weekly Global Health University (ghU) lessons have informed his volunteer work. For example, one of his projects is updating PHASE’s donors on Nepal’s progress in the Millennium Development Goals, a topic we covered in ghU last semester. He added, “GlobeMed is definitely a great tool for those who would like to work with NGOs or have a career in public health. Even the structure of GlobeMed is similar to the office structure of PHASE, and it’s nice to feel comfortable in this setting, delegating work within teams and sub-committees.”

NJ with some students of Shankhadhar Memorial School, which is located right near the PHASE office, during their Parents Day program. The students did performances, such as dancing, singing, playing musical instruments, karate, gymnastics. 

Learn more about PHASE Nepal through their website and 2014-2015 Annual Report.

Learn more about GlobeMed at Tufts through our Facebook page.

Consider donating to PHASE through GlobeMed at Tufts’ current project to support the work that Nick James Macaluso and countless others are doing to help rebuild Nepal.

Please contact tufts@globemed.org if you have further questions about GlobeMed at Tufts or about our partner organization, PHASE Nepal.

 

Taylor Kennedy is a senior majoring in Child Study & Human Development and Clinical Psychology. She served as GlobeMed at Tufts’ Director of Communications from 2013-2015.

Samantha Nutt: Global Health Icon

In high school, I first heard about Dr. Samantha Nutt when she came to speak to my school about global health in war torn regions, the talk she gave was one of the most inspiring and eloquent speeches I have ever heard and since then I have been inspired by her career and her work around the world. I thought I would share a bit of what she has done to the GlobeMed community!

Dr. Nutt is the founder and president of War Child Canada, a charity that works in regions that have been torn apart by conflict. She focuses on helping women and children in these regions, providing health care, education and vocational training in order to get their lives back on track. She has worked in regions such as Afghanistan, Sierra Leone, Uganda, and The Democratic Republic of the Congo to name a few. In addition to her work with War Child she is a physician at the Women’s College Hospital in Toronto and is a Professor at the University of Toronto. In 2011, she was appointed the Order of Canada – the most prestigious honor bestowed by the Canadian Federal government for “for her contributions to improving the plight of young people in the world’s worst conflict zones, notably as a founder of War Child Canada.” How she ever has time to sleep, I am not sure!

Her recent book “Damned Nations: Greed, Guns, Armies and Aid”- a national bestseller – is a comprehensive look back on her career and her experience in the foreign aid industry. An excellent read that I highly recommend everyone check out as it mixes her personal narrative and experiences with facts about foreign aid, and its failures and successes.

She is someone who has inspired me and taught me a lot about foreign aid, and the challenges of effective distribution of health throughout war-torn regions. I find that her methods and philosophies about global health are very similar to GlobeMed’s! Everyone should check out her book, or even go on youtube and check out a couple speeches she has made to learn a bit more about her and War Child Canada!

Here are some I have found really interesting:

Future of Aid – Dr. Samantha Nutt Keynote

https://www.youtube.com/watch?v=ALCScV_CoA0 (starting at 5 minutes)

CBC News Our World: Africa’s Killing Field

https://www.youtube.com/watch?v=YCbdfMWZL54

Adrienne Caldwell is a sophomore majoring in Biology and Psychology.  She is a member of the Communications team.  

Article 25 Speakers

On Sunday, Tufts GlobeMed chapter will be travelling down to the Boston Common to be a part of the Rally For the Right To health, a very exciting event that many of our members have been tirelessly working on for the past several months! At the rally there will be several exciting and prestigious speakers including Professor Brook Baker and Don Berwick. Some highlights of their decorated careers are as follows:

Brook Baker is a professor at Northeastern University teaching courses in Global HIV/AIDS Policy seminar, and disability discrimination law. The focus of his work is on movements that advocate for universal access to treatment, prevention and care for people living with HIV and AIDS. In addition, he is a senior analyst Health GAP (Global Access Project).

Don Berwick has had an extensive and meaningful career in public health including being the Administrator of the Centers for Medicare and Medicaid, President and Chief Executive officer for Institute for Healthcare improvement and worked directly on both the Massachusetts health care reform and the Affordable Care act. He has worked tirelessly to bring equality to the American health care system and improve access to health care for all.

So on Sunday, cancel whatever you may have planned, grab a friend, and head down to the Boston Common for a day of advocacy, action and incredible speakers! (Plus, I hear the weather is supposed to be beautiful!)

Adrienne Caldwell is a sophomore majoring in Biology and Psychology.  She is a member of the Communications team.  

Why You Should Rally for the Right to Health with Us This Sunday

Since the start of the semester there has been a lot of hubbub surrounding “Article 25” and a “Global Day of Action” and something about a rally? Just to clear up any confusion and get everyone on the same page here’s some basic background about what we’re trying to do.

“Article 25” refers to a specific statement in the United Nation’s Declaration of Human Rights which states that:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

Although it is not explicitly stated that medical care itself is a human right, having access to both health care and sick care regardless of geographic location or socioeconomic status is certainly an integral aspect of “security in the event of… sickness” and “a standard of living adequate for the health” of the individual.  The Millenium Development Goals (MDGs) have had a huge impact on the international move towards a healthier world, focusing on issues like poverty, hunger, HIV/AIDS, child mortality, and maternal health, and though a lot of progress has definitely been made, we still have a ways to go.  The UN is currently meeting to discuss post-2015 MDGs and other aspects of development that should be prioritized in the coming years and the aim of the Global Day of Action is to make sure health is on the top of their agenda.

The focus of the campaign in Boston is on erasing health inequities here in Boston as well as abroad, and in a timely manner. For this rally, we will be advocating for a Single-Payer Health System in Massachusetts and a $20 billion emergency fund for epidemics, so that catastrophes such as Ebola are never repeated. For us, Ebola is a case study for the need of health-systems strengthening around the world, and Article 25 demonstrates that we made that commitment long ago, but have a long way to act.

Please join us at the Boston event, a rally on the Common, on October 26th. It is one of the loudest ways we as students can make a splash in the fight for global health and equality and help choose the direction the international development effort is headed in for years to come.  It is absolutely essential that you all lend us your voices and make yourselves heard.

So, grab your friends, your peers, that random person you kind of recognize in the dining hall and say “hi” to in passing even though you don’t actually recall their name or where you know them from, and come together on October 26th on the Boston Common and make a stand for change and the right of human beings everywhere to live healthy lives.

Alex Boden is a junior majoring in Anthropology and Biology.  She is a member of the Policy team.

A Bhalcandra School Update from Binod

It’s been just over 3 months since the GROW team returned from Nepal, and we’ve been anxious to check in on life in Rayale. When working with the child clubs at the Bhalchandra School and Shree Shanti Niketan, one of our main focuses was designing goals with the children that they could work towards and accomplish even after we had left. Sustainable solutions are a fundamental part of PHASE Nepal’s mission, and therefore the GROW team hoped to brainstorm self-sufficient yet attainable projects for the students to tackle this year. Because we were working with such incredibly driven and creative kids, we were never worried about the fate of the child clubs after our departure!

Thanks to Facebook, receiving updates on the latest happenings at Bhalchandra School is just a click away. Binod, an English teacher and the adult coordinator for the school’s child club, was more than happy to share both stories and photographs of some of the great work the Bhalchandra School Creative Child Club has completed in the short time since we’ve been gone. He told me how proud he was of their work, and it’s easy to see why! Here are some of the inspiring and innovative programs that the students have organized:

• A quiz competition, in which the winner received a small prize paid for by the Bhalchandra School teachers and staff
• A “week of sport” that included running activities for all students as well as a football (soccer) tournament for those interested

Bhalchandra School football tournament participants, (photo provided by Binod, in center).

• Activities for Children’s Day, a widely celebrated holiday in Nepal. While it was already customary for Bhalchandra School to host a special event, the child club volunteered to aid the adults. They managed crowds and materials, supervised the younger children, and provided water, tea, and biscuits to the rest of their classmates. Binod was also excited to share with us that they won 2^nd and 3^rd prizes in singing, dancing, and oratory competitions against 13 schools!
• Maintenance of the vegetable garden started with the help of Nick and Morgan during the GROW trip. This was a special program that we were able to bring to fruition during our time in Rayale, so it was really cool to hear that the child club is still taking care of it, and that the vegetables are doing well!

Bitter gourd from the Bhalchandra School vegetable garden (photo provided by Binod).

We’re so lucky to be working with schools in Rayale that have such passionate children and adults, like Binod, supporting both GlobeMed and PHASE Nepal’s missions even when we aren’t able to be there with them. It’s great that we are able to keep in touch over Facebook and share in their success. Binod also described his hopes to implement a special management committee for the child club that would provide funding and adult assistance with programming, so we’re sure that we will only hear of bigger and better things from the Bhalchandra School Creative Child Club in the future!

Nick James Macaluso is a senior majoring in Biology and Environmental Studies.  He is a member of the Campaigns team.

“You’re Putting Him on a Motorcycle?”

It was Wednesday, and I was sitting under the merciless Nepali sun, my pasty Irish complexion slowly roasting to a crisp red, chatting with the ladies of grade eight by the football field. Just as I started to contribute to the turning of the Bhalchandra School rumor mill by inquiring about a hush-hush puppy love courtship among two of the eighth graders, one of the younger players howled; I turned to see him stumble toward the edge of the field,  a limp hand dangling awkwardly from an outstretched arm. Nick, stopping the play to address the wailing, sat him down on a shady stone and asked what had happened. He continued to moan, the slack hand was becoming more apparent. The sleeve of the sweater (yes, he was wearing a sweater playing soccer as I sit on the sideline sweltering) was sheared to expose the damage: a grotesquely apparent, shouldn’t-be-there kink contorted his frail forearm.

Pre-Break: Ominous walk to the soccer field.

I turned and trotted down the main/only village road, looking into all the local tea houses hoping that I would stumble upon Kriti, the closest medical care provider. Kriti is a 21-year-old Auxiliary Nurse Midwife (ANM) in training, completing her On-the-Job training of five months under PHASE while living in the village. We had shadowed her days before at a nearby outreach clinic that she mans on a weekly basis, a sparse but clean and efficient one room medical office in which she saw patient after patient, most of them older men and women who came for follow-up visits to refill medication and track symptoms. No emergencies to be seen that day. We later learned that some of them had to walk significant distances to reach the outreach clinic, despite their age and ailments. The outpost is of great value, as the next provider, a larger medical post, is about a half hour walk up the road. Stumble upon Kriti I did, discovering her in the canopy of a tree off the side of the road about a third of a mile away from the incident. She was hacking away at the highest branches.

“KRITI, SOMEONE BROKE THEIR ARM IN HALF.” My rushed and slapdash-shouted English was hard to follow (even more so than my usual quick diction).
“Okay.”
She continued to lop off branches.
“KRITI,” more slowly this time. “SOMEONE BROKE THEIR ARM IN HALF.”
“Ooo.”

I pivoted and ran back, with Kriti (I assumed) following. It was her last day in the village, as she had just completed her training, and was set to return to Kathmandu the next morning. I arrived back at the scene to find that a crowd had gathered around the broken boy. Several of the onlookers decided to take a more hands-on role in the situation, and one woman (who we later found out to be the aunt of the boy) was massaging the break. As Nick and I tried to disperse the crowd and prevent any more fracture-kneading, I asked if anyone had called an ambulance. There were a few confused nods, confirming my suspicion that no, no one had called an ambulance. While in the states, there would be no question as to whether an ambulance would have been called, or at least a car prepared to take the boy to the hospital, it was a question without any definite answer in Rayale.

This, upon reflection, sheds light on the true meaning of the frequently discussed community health buzzword of accessibility. In places even as rural as the small village of Manadhova, which, thanks to it’s proximity to Kathmandu and the frequent buses to the nearby city of Panauti, is not considered very rural by many standards, accessibility is simply too limited to ensure quick care for real medical emergencies. We were in luck to be close to the main road and within a 5-minute walking distance of Kriti and her house full of supplies. While the boy was soon whisked away by motorcycle to a hospital about an hour away, the time elapsed between fall and arriving at the hospital was, as precisely as I can remember, a very, very long time. While there is an ambulance that services the area, it takes, at minimum, half an hour to arrive. Having traveled to some of the students’ homes higher in the hills of neighboring villages, it’s clear that a more immediate medical emergency in a harder to reach area (of which there are very many) could not be handled as straight forwardly and as quickly.

Before the boy was tossed atop the bike, Kriti soon arrived, looked at the arm with a empathetic mien of pain upon her face (precisely the same face as Nick displayed upon seeing the arm) and took a (painfully) bumpy walk with the boy to her nearby place of residence as she held a make-shift notebook-and-string splint. There, she quickly addressed the arm with a expertly-applied sturdy cardboard splint and a gauze sling.

The broken-arm incident naturally made the idea of the lack of healthcare accessibility a very clear one. While, in places like the U.S., financial barriers are often the ones preventing needed care from being received, we witnessed a situation where the geographical obstacles were the more immediate concern. Even without a single thought to the financial aspect of care, the boy probably could not have received care any more quickly. Of course, in places like this, both financial and geographical barriers are hinderances to receiving proper and needed care.

Nick, what do you got there?

A few days later, Nick and I trudged up a steep and rocky hill not without difficulty a ways away from the football field to the home of the boy; it was certainly not an easy walk. His hand and fingers were shades darker and clearly very swollen on the broken side than on the non-broken side, and he told us he didn’t feel any better and that the pain hadn’t subsided. He would be out of school for two months due to the injury (it was his writing hand, and, moreover, the walk to school was not a short one). In the same room, his incredibly petite and very elderly grandmother lay bedridden and unexpectedly talkative, a outmoded-looking green tank providing her oxygen through a nasal cannula. As I sat on the bed by her, I wondered how they got the tank, and her, down and up the steeply rugged path to the house; yet another medical concern exacerbated by the hard journey to the closest provider.

Morgan Jordan is a junior majoring in Biology and International Relations.  She is the Director of the Finance team.

Overprescription of Opioids Epidemic

Starting at the turn of the century, an increased amount of data has shown, over an array of studies, that deaths by caused by drug overdose have increased for the fourteenth consecutive year, mostly due to opioid analgesics, which are “derived from the poppy and used for pain relief,” and include Hydrocodone, Morphine, and Oxycodone. Opioids are more readily being prescribed in the past decade than ever previously before by doctors to patients, often without consideration of the severity of their condition, their state of mental health, and alternative medications and options.Though providing therapeutic pain relief to millions of Americans, this staggering number of drug overdoses is now higher than the number of deaths from motor vehicle accidents.

Additionally, a logical presumption would be that the rise in opioid prescriptions would correlate with a decline in chronic pain and even illnesses; however, this is not the case. The Center for Disease Control went on to state that there are noticeably “clear correlations between national trends for prescription opioid sales, admissions for substance abuse treatment, and deaths.”   According to a 2012 JAMA article, the specific amount of overdose deaths attributable to prescription opioids exceeds those attributable to cocaine and heroin combined. This rapidly-emerging and pervasive epidemic is gaining visibility, yet despite this increased awareness of the problem there is not much action being done towards beginning to solve it.

The lack of change and continual abuse of prescription opioids, is largely due to a higher demand from patients, particularly those with mental disorders and a history of substance abuse, to treat chronic pain that has fostered a powerful industry that grosses in billions of dollars each year. The increase in opioid overdoses correlates with the increase in opioid prescriptions, highlighting the leniency on the care provider level with prescribing opioid analgesics, a lack of regulation of patients prescribed to opioids, as well as proper education and warning being provided to these specific patients. Cross-prescribing and pill mills also play a vital role in the easy access to opioids and the increase in abuse. The number of overdoses due to opioids is especially high among individuals with mental diseases and those with a history of substance abuse, meaning that increased precautions must be taken when prescribing these individuals to opioids.

As stated by JAMA’s 2012 article, “Patients with mental health or substance use disorders are at increased risk for nonmedical use and overdose from prescription painkillers as well as being prescribed high doses of these drugs.” One of the primary causes of the heightened susceptibility is that the process is cyclical: chronic pain can cause depression, as well as a multitude of other mental health disorders, and depression and other mental health disorders can cause pain. This community is also exposed to a high vulnerability due to a lack of specialized regulation—which includes intricately keeping track of the medical and behavioral backgrounds of each patient and using that information when determining the dosage, level of precautionary information, and amount of follow-up visits—in the amount and level of opioids they are prescribed, frequent hospital visits with multiple doctors, multiple prescriptions, and a higher accessibility to prescriptions as a remedy for their disorders including depression, anxiety, and posttraumatic stress disorder. Also, because opioids suppress pain and can create a euphoric relaxed sensation, they can provide a release from stress which is particularly higher in individuals with mental health disorders or a history in substance abuse.

Action against this epidemic could include an increase in repercussions for mal-practicing physicians, the implementation of mandatory online databases across the nation to regulate what doctors are prescribing opioids to which patients, and an option for alternative pain treatments. With these implementations there will be less of an incentive to inappropriately prescribe opioids and, consequently, a decreased amount of unqualified patients who have access to prescription opioids. Social determinants are impactful, particularly for the population I described including the genetics they were born with, the families in which they were born into, as well as their conditions in which they live. However, even if they are unable to modify their situation, the regulation of patients on a care provider level can aid in decreasing opioid abuse and, in turn, the health of patients in spite of these outside influences.

Sources:

http://www.cdc.gov/homeandrecreationalsafety/rxbrief/

httpp://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/oxycontin/Pages/opioids_dyk.aspx

http://www.ncbi.nlm.nih.gov/pubmed/24211157

http://www.ncbi.nlm.nih.gov/pubmed/21668754

ACA Individual Mandate: Why You Should Stop Criticizing and Start Caring

Though the Patient Protection and Affordable Care Act, commonly referred to as simply the ACA and Obamacare, is approximately 2,400 pages long in total length, there are key components of the act that spark a significant amount of controversy and debate. Enough debate to have the nation essentially split directly, and ultimately to have been a key factor in the recent government shutdown effective as of October 1st. Coincidentally and ironically, it was because of this government shutdown pertaining to the ACA that I could not obtain access to some documents on it. Fortunately there are many other non-government affiliated documents on the subject, and I’d like to hone on one major factor of the ACA, a contentious component that I feel is one of the most imperative, known as the individual mandate. The definition of the individual mandate, to go into effect with the anticipated implementation of Obamacare, is defined by kaiserhealthnews.org as “…a provision of the federal health law that requires you, your children and anyone else that you claim as a dependent on your taxes to have health insurance in 2014 or pay a penalty. That coverage can be supplied through your job, public programs such as Medicare or Medicaid, or an individual policy that you purchase. The health law is setting up online health insurance marketplaces, also known as exchanges, to help you shop for plans.”

Republicans see it as a power-hungry move by the government for control and an infringement on their rights; however, if the end goal is of benefit to society as a whole, and literally promote the general welfare, that view cannot truly be upheld. On the side of Democrats, though in favor of the act, one of the controversial views regarding this mandate is that although its goal is aiming to close the disparity in those who can afford health insurance and those who cannot, it isn’t fully solving the problem in providing a universal health care system for all members of society in the United States. What I feel people are neglecting to remember, however, is that it is a step in the right direction, and if there are enough current issues between the two parties on simply obtaining this first victory, delving straight into the ultimate goal is inefficient and unrealistic. In addition, it is always positive to have two varying views on an issue in order to keep it in perspective.

The mandate of health insurance for all American citizens will additionally aid in eliminating the rising problem of individuals and families being denied health insurance, or charged higher, for preexisting health conditions, whether minor or not. Currently insurance companies have the power to dictate who gets what type of insurance in an attempt to ensure that they have the healthiest clients, in turn resulting in a vicious cycle of less fortunate citizens, monetarily and health-wise, continually receiving less care and a higher probability of health problems. Though it is easy to criticize new initiatives, the important thing is that it is still just that: new, progressive, an idea. And as Cardinal Mahony stated, “Any society, any nation, is judged on the basis of how it treats its weakest members ; the last, the least, the littlest.”