Healthcare Policy

Insurance access, hospital reforms, medical innovation, COVID-19 and more. Assessing the policies affecting the health of us all.

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Background memo

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder most commonly diagnosed in children (Rommelse, 2016). ADHD was first considered a defect of moral control, then a result of brain damage. Further research revealed its basis in the brain, and a genetic link between family members. Today, we still don’t know the exact causes of ADHD, but studies suggest three main factor: genetics, environmental factors, or a disruption of development, like a brain injury. In 1902, the first core symptoms were identified by a pediatrician named George Frederick. He conducted observations based on 20 kids who were easily distracted by such minor things. George noted that this was most common among boys and had nothing to do with intelligence. Then in 1922, Alfred F. Tredgold, who was an expert on mental impairment, noted that it was more of a psychological issue. Before this time people came up with conclusions that it was a result of poor behavior. During Alfred’s discovery, he concluded that it was based on brain activity rather than poor behavior.


Rommelse, N., Buitelaar, J., & Hartman, C. (2016). Structural brain imaging correlates of ASD and ADHD across the lifespan: a hypothesis-generating review on developmental ASD–ADHD subtypes. Journal of Neural Transmission124(2), 259–271.

Edwin Ayala

Findings memo 

In 1936, everything changed for the better as there was medication available to treat the symptoms. Benzedrine was approved by the FDA to provide treatment for ADHD. The medicine proved to improve school performance and interest by the kids taking it, while also decreasing disruptive behavior. ADHD became to skyrocket in cases with a multitude of people being diagnosed more than ever in the mid 1990’s leading up to the mid 2000’s. Researchers discovered that this disease in linked to genetics (Rommelse, 2016). There are a good variety of ways to get treated for this now via medication and therapy. This disease started to be diagnosed in kids, but can also have an affect in their adult hood as well. Anyone can have moments of being inattentive, impulsive, or hyperactive. Adults with ADHD, however, experience these symptoms repeatedly and in a way that is severe enough to have an impact at home, at school/work, or in social situations. People from all over the world can be affected by this disease, which estimated to be around 17 million people (Rommelse, 2016). People often think that ADHD is just one disease, when in reality its divided into 3 types of ADHD. The first one being predominantly inattentive, predominantly hyperactive, and it can be having both of these. Oddly enough the exact causes of ADHD are still unclear to this very day.


Rommelse, N., Buitelaar, J., & Hartman, C. (2016). Structural brain imaging correlates of ASD and ADHD across the lifespan: a hypothesis-generating review on developmental ASD–ADHD subtypes. Journal of Neural Transmission124(2), 259–271.

Edwin Ayala

Options memo

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood, affecting more than 6.4 million US children aged 4–17 years (Volkow, 2009). ADHD is a serious public health concern because of its high prevalence, chronic nature, significant impact on school performance, family life, and peer relationships. An estimated annual cross-sector costs of $38–72 billion. ADHD cannot be cured, but many treatment options exist, including parent training, school accommodations and interventions, medications, and behavioral intervention strategies (Volkow, 2009). State law and public , Medicare and Medicaid and private health insurance reimbursement, are policies that are often designed to guide physicians toward best practices for ADHD treatment while also affecting a patient’s access to these treatment options. For kids, its best to notice the symptoms arise from school work and other tasks that require an abundant amount of attention. For children its best to receive medication rather than psychological services, that include therapy. For adults medication can be prescribed but therapy can be a better alternative. Medications that are prescribed usually go to the most severe and serious cases.


Volkow, N., Wang, G., Kollins, S., Wigal, T., Newcorn, J., Telang, F., Fowler, J., Zhu, W., Logan, J., Ma, Y., Pradhan, K., Wong, C., & Swanson, J. (2009). Evaluating Dopamine Reward Pathway in ADHD: Clinical Implications. JAMA : the Journal of the American Medical Association302(10), 1084–1091.

Edwin Ayala

Decisions memo

I would strongly encourage people to see a doctor for a proper diagnostics. I know I few people who say they have it but aren’t properly diagnosed. The only way to do so is by seeing a specialist who is licensed. I myself, have ADHD and it has been taking a toll as I’m writing this blog for example. I have it more controlled more than ever now, due to medications. Everyone is different but for me I found that therapy doesn’t seem to work. I did find medications are very expensive. I would like for other people to have access to insurance because there are still people who don’t. With proper healthcare access to all will make this healthcare system we have now more advanced.

Edwin Ayala


Roughly 37% of Americans don’t have access to services to diagnose or treatment for ADHD. That’s still a big number, to take into account of how many people are in the U.S. As mentioned before the medication is expensive even with insurance. Even with co-pays, prices are very aggressive. A plan would be to minimize co-payments, no premiums, and no surprised bills. Pharmaceutical companies rips off many hard working Americans. A persons health shouldn’t be labeled as a commodity. Medication bills are the number one reason why people file for bankruptcy.

Edwin Ayala

Legislative memo

There have been several methods for trying to find the proper cure for ADHD. One of them being therapy, which concentrates on patients who lack the proper sleep schedule due to ADHD. A few experimenters were conducted in the patients with severe cases, tend to have irregular sleep schedules (Konofall, 2010). These would be patients who have the both combine forms of ADHD. George Frederick conducted experiments on patients with severe cases. I his experiment he noted that patients would wake up more earlier than usual and have difficulties falling asleep. About 55% of cases are linked to having sleeping problems (Konofall, 2020). Advances in this field may also have a tremendous impact on day-to-day clinical practice. A common practice used is to fix the sleep schedule in order to start seeing positive results. Studies have shown some particular drugs are linked to sleep deprivation. Depending on who takes it, it can have negative side affects. That’s why most doctors seek therapy for a solution at first. Drugs would be the last option due to the side affects it has, causing sleeping problems. It is also possible that the difficulties reported as significantly higher in children with ADHD, also refer to inappropriate behavior in the context of interactions with adults and other kids (Konofall, 2010). Linked with this would be restless leg syndrome (RLS). A condition that is linked with ADHD and incontrollable movements with ones legs. The legs would be moving, fiddling, and moving unintentionally becoming uncontrollable. This was discovered to be involved with ADHD patients who lack sleep, about 44% of cases (Konofall, 2010). Still both are under investigation with no inkling on any positive results. Later, the erratically sleep patterns were linked to insomnia. Both patients who are medication-free and taking medications, have higher levels of melatonin levels (Konofall, 2010). Studies also shown that an underlying issue would be the discomfort of ones bed adding to the issue, having a secondary resistance to go to bed. Considering that a delayed evening increase in endogenous melatonin levels , investigators have also assessed that the effect of light therapy (Konofall, 2010). The last key point discovered with these experiments would be the effect of sleep-disordered breathing linked with ADHD. SDB is an irregular breathing pattern that occurs with patients who have ADHD who have insomnia. This could be prove to be border line fatal, as it can lead to serious health problems. Most of these illnesses are related to ADHD in some way. All of them are still under investigation with little positive outlook on finding a cure. A lot of insurance companies require prior authorization in order to receive the medications. By everyone having access to healthcare, we should at least minimize the co-payments that are an outstanding amount. The therapy sessions are also a lot of money as well. As cases seem to gradually expand, this should be a major focus for insurance companies. Although it may not seem fatal, it does have potential consequences. Take a look a COVID-19 and how its been taking now compared to when we first heard about it. The most severe cases of ADHD causes damage to relationships, incapability to learn and be dedicated, and get proper sleep (Konofall, 2010). There needs to be a higher concentration on the younger children that suffer from sleep disorders because of this disease. It could lead to a prevention on having ADHD in their adult years to come.


Konofal, E., Lecendreux, M., & Cortese, S. (2010). Sleep and ADHD. Sleep Medicine11(7), 652–658.

Edwin Ayala

Facts sheet post

An issue I would like to focus on is the affordability and coverage the insurance companies offer for ADHD related treatments. Roughly around 44% of Americans have trouble accessing services to diagnose or treatment for ADHD. 95% of people taking a survey have a health insurance policy that includes coverage for themselves or a family member with ADHD. (Fluegge, 2016). A lot of companies are charging an inconvenient amount for the medications provided. Most of the times the coverage doesn’t cover the entire cost of the medication. There are several organizations that exists with professionals working with insurances, to handle the coverage needed. One of them being “Additude” , an organization that allows people to join to find strategies that help getting that coverage. The provide laws to look at and present to any insurance denying you the medication. This club is designed to be a shortcut for people having trouble access to their insurance company. Although they may not help you directly with your finances, there are many informative articles to read from others encountering such troubles. The club suggests that people give up easily when it comes to investigating as to why they were denied access. Many people simply don’t have the patience or time to pursue a claim no matter how legitimate it may be (Fluegge, 2016). Additude suggest that if you file a claim, you may get turned down the first time. If you pursue after that and you appeal, your chances of winning would be 44%. The main key points that Additude suggests would be knowing the law, provided evidence, keep good records on whom you speak with, and start as soon as possible. Knowing the law and each states requirements for granted access to medications. Providing written documentation on usually can be done with a doctor, with proper diagnoses. Keeping good records of whom you speak to and what transpired in that conversation. It’s best to keep the names of the individuals and contact information as well. Last but not least would be starting early diagnoses. The earlier the better, being observant for symptoms with your child. These key factors are here to increase the likely-hood to surpass the first denial of the claim. The trick here is that most insurance companies don’t tell you that, in order to save money. Mental health benefits related to ADHD treatment, are disorganized because they have a cap on the money they spend per year. It would be wise to read the policy but that would be time consuming. Companies are making hard for us to access mental health related disease. There are far too many loop-holes involved just to seek something that may not be guaranteed. To know that you have a 44% chance to get approval for any treatment is ridiculous. Imagine for people who don’t even have insurance, how much will the payments be? The healthcare system isn’t too concerned with mental health related issues, which is scary to think about. There needs to be a program with affordable medication for everyone.


Fluegge, K., & Fluegge, K. (2016). Glyphosate Use Predicts Healthcare Utilization for ADHD in the Healthcare Cost and Utilization Project net (HCUPnet): A Two-Way Fixed-Effects Analysis. Polish Journal of Environmental Studies, 25(4), 1489–1503.

Edwin Ayala

Citizen Activism & Covid-19: White Paper

By: Andrew Koh            The Covid-19 pandemic has proven to be the most significant and universally destructive dilemma the world has faced in the early 21st century. Affecting all aspects of American life like politics, societal behaviors, education, economy, public policy, etc., the multidimensional challenges faced with this pandemic have been debilitating to our current understandingContinue reading “Citizen Activism & Covid-19: White Paper”

Covid-19: Federal Mask Mandate Policy Brief

By: Andrew Koh              The Covid-19 pandemic has been a relentless and catastrophic assault to domestic and global healthcare. Its stranglehold on all aspects of American life, freedoms, politics, education, societal behaviors, economy, and public policy has been debilitating as the pandemic has affected the lives of millions across the country and the world.            Continue reading “Covid-19: Federal Mask Mandate Policy Brief”

The Importance of Face Masks: Fact Sheet

By: Andrew Koh Wearing protective face masks have been shown to reduce the amount of respiratory droplets in the air that could spread Covid-19 According to a study conducted by the New England Journal of Medicine (2020), “respiratory aerosols and droplets generated from speech have been shown to transmit Covid-19.” By conducting an experiment “usingContinue reading “The Importance of Face Masks: Fact Sheet”

The Action of Federally Mandating Masks to Prevent Covid-19

By: Andrew Koh            After declaring what public policy option the United States should go towards to further prevent the transmission of Covid-19, the decision to issue a federal mandate to wear protective face masks became clear after considering “Congress’ enumerated powers provided by the Constitution and how applicable the Spending Clause was to help issueContinue reading “The Action of Federally Mandating Masks to Prevent Covid-19”

The Policy Decisions Needed to Reduce the Rate of Covid-19 Transmission

By: Andrew Koh            Despite all of the scientific data and evidence given to support the CDC and WHO’s guidance and recommendations to wear protective face masks to prevent the further transmission of Covid-19, there is still a stark polarization and politicization of a public policy measure that should be championed by all citizens in itsContinue reading “The Policy Decisions Needed to Reduce the Rate of Covid-19 Transmission”

What Options Do We Have to Encourage the Use of Face Masks?

By: Andrew Koh            As the scientific evidence behind wearing protective face masks and mask mandates grows stronger, the sharp partisan divide between being for or against the CDC and WHO’s guidelines has primarily boiled down to one’s definitions of protecting the community during this Covid-19 pandemic versus the right to protect one’s personal freedoms againstContinue reading “What Options Do We Have to Encourage the Use of Face Masks?”

Protective Masks Stop the Spread of Covid-19? Prove It! – The Findings

By: Andrew Koh            The CDC and WHO guidance and recommendation on wearing protective masks to prevent the spread of Covid-19 has triggered a polarizing debate depending on where one fits in the political spectrum. While some agree and support the medical organizations’ guidelines of wearing PPE and masks to protect themselves and the people aroundContinue reading “Protective Masks Stop the Spread of Covid-19? Prove It! – The Findings”

Covid-19: A Historical Background – How Did We Get Here?

By: Andrew Koh            The Covid-19 pandemic has proven to be an arduous global dilemma that has severely challenged our current understanding of domestic and international healthcare. The magnitude of the pandemic has altered and impacted every facet of our lives from politics, education, societal behaviors, economics, and public policy. The following etches a timeline summarizingContinue reading “Covid-19: A Historical Background – How Did We Get Here?”

From I to III: Change the Classification of Marijuana Federally

By: Brandon Lancaster Executive Summary             The citizens of the county want to change the classification of marijuana in America. Marijuana is considered a Schedule I drug and the citizens want it to be considered a Schedule III drug. Marijuana in the United States is evaluated based on racial social context rather than the objectiveContinue reading “From I to III: Change the Classification of Marijuana Federally”

A Change to Federal Marijuana: Policy Brief

By: Brandon Lancaster Introduction             Cannabis within the United States is a controversial subject. Many religious groups condemn the substance as evil, and this belief is further aided by the classification of marijuana on the federal level. This brief seeks to breakdown the current policy surrounding marijuana in the United States. In addition, it alsoContinue reading “A Change to Federal Marijuana: Policy Brief”

Racism or Science: The Current Alternatives to Federal Medical Marijuana Policy

By: Brandon Lancaster The current federal policy within America is marijuana is an illegal, harmful drug. It yields no benefits to the medical realm and it gives the user a high risk of substance abuse. The issue on the table is many state governments ignore this classification and even deem marijuana and its businesses essentialContinue reading “Racism or Science: The Current Alternatives to Federal Medical Marijuana Policy”

How do Medical Marijuana Proponents feel about the Current Narrative?

By: Brandon Lancaster Over the past decade, marijuana legalization has become an extremely interesting topic within the medical field. The narrative and medicinal effects that were so wrongly constructed are beginning to unravel. As the truth begins to come forth, one must truly understand where the lies hide. On February 24th, Alvin Powell (2020) publishedContinue reading “How do Medical Marijuana Proponents feel about the Current Narrative?”

The Keystone Act: Act 16 and Pennsylvania

By: Brandon Lancaster As the entire focus of these memos deals with marijuana, it would only seem logical to understand the process at which medical marijuana is legalized. This memo shall explore the history of how a state legislative branch passed a bill permitting medical marijuana. Pennsylvania’s passing of Senate Bill 3 of 2015-2016 sessionContinue reading “The Keystone Act: Act 16 and Pennsylvania”

The Narrative Must Change: An Implementation of Federal Medical Marijuana

By: Brandon Lancaster Allowing medical use of marijuana and decriminalizing it (along with sufficient regulation) is the most practical recommendation considered from the alternative policy solutions. This memo seeks to explain a plausible federal policy which could be implemented within the United States. The first concern about medical marijuana is the amount of federal control.Continue reading “The Narrative Must Change: An Implementation of Federal Medical Marijuana”

The Most Practical Policy: Where should Marijuana Stand in the United States?

By: Brandon Lancaster According to the Options Memo, there are five alternative policy solutions to the current federal marijuana policy. They are: 1) Enforce marijuana as illegal, 2) Make marijuana medically allowed, but not decriminalized, 3) Decriminalize marijuana, but do not allow for medial use, 4) Make marijuana medically allowed and decriminalized, and finally 5)Continue reading “The Most Practical Policy: Where should Marijuana Stand in the United States?”

The Case for Medicare for All

Legislative History of Universal Health Care Coverage

Written by Adam Knopsnyder Achieving universal health care coverage in the United States of America has consisted of a long history of public policy initiatives starting just after World War II and continuing through to the 21st Century. Along with the goal of providing universal coverage, there has been a great deal of thought putContinue reading “Legislative History of Universal Health Care Coverage”

Action Memo on Universal Health Care Coverage

Written by Adam Knopsnyder In order to implement a single payer healthcare system in the United States, a bill must be passed in both houses of Congress and then signed into law by the sitting president. Currently, under the 116th Congress, Representative Pramila Jayapal introduced bill H.R. 1384 on February 27, 2019, which has comeContinue reading “Action Memo on Universal Health Care Coverage”

Decisions Memo on Universal Health Care Coverage

Written by Adam Knopsnyder The single largest issue in US healthcare policy right now is the incredibly high number of Americans who go either uninsured or underinsured. After examining the inadequacies of the current healthcare system and the Affordable Care Act, as well as evaluating the two most popular proposals for healthcare reform, there isContinue reading “Decisions Memo on Universal Health Care Coverage”

Options Memo on Universal Health Care Coverage

Written by Adam Knopsnyder Reaching universal health care coverage in the United States has been a longtime goal for many presidential administrations and has come in the form of many different public policy options. However, given the current healthcare laws and programs that exist, there are two basic ideas that are being considered to achieveContinue reading “Options Memo on Universal Health Care Coverage”

Findings Memo on Universal Health Care Coverage

Written by Adam Knopsnyder In order to determine the most effective public policy to ensure that all Americans have affordable healthcare access, it is key to have a comprehensive understanding of the facts surrounding the issue. When trying to obtain universal health care in a country, there are two main obstacles in doing so: anContinue reading “Findings Memo on Universal Health Care Coverage”

Background Memo on Universal Health Care Coverage

Written by Adam Knopsnyder Since the start of the 20th Century, there have been multiple attempts of public policy initiatives to ensure access to health care for all in the United States of America. Throughout this time, the federal government has enacted a variety of policies that have created and expanded programs that try toContinue reading “Background Memo on Universal Health Care Coverage”

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