Rhetorical Analysis Of The Affordable Care Act And Emergency Care

“The Affordable Care Act and Emergency Care” is a public health policy brief authored by McClelland et al. The article highlights various implications of the Affordable Care Act especially on emergency care services via the emergency departments (EDs) of healthcare facilities. Based on the Affordable Care Act (ACA) of 2010 that was signed into law by President Obama, this policy brief discusses how emergency care will have to adapt or become ineffective due to the dynamics involved.

McClelland et al. posit that the ACA will bear significant effects on the design and delivery of healthcare; the authors highlight a number of elements in the Act that will have direct effects on both ED care demand and raised expectations on its roles regarding the provision of coordinated care (8).

Some of these elements include the need for hospitals to employ revised strategies aimed at reducing crowding in the EDs as the Act ensures expansive insurance coverage for Americans, and the re-evaluation of the respective roles of primary care physicians and the EDs regarding the provision of unscheduled acute care to patients. While the authors seem rather biased towards the ACA regarding its effects on effective emergency care in the first paragraphs of the brief, latter paragraphs highlight a balanced approach to how ACA can be effectively implemented to better healthcare outcomes despite the varied implications, thus making the article operative in detailing the ethical, logical, and emotive appeal used.

Ethos

In an attempt to appeal to ethics, i.e. convincing the users of the credibility and character of the argument, McClelland et al. begin by highlighting the main aims and intentions put forth by the ACA. This includes the emphasis on healthcare quality improvement and admission through long-drawn-out insurance coverage made possible by quality reportage reform approaches for payments. The authors also highlight a key healthcare reform that the ACA enforces; EDs are highlighted as places that should be “abridged and avoided” whenever possible (McClelland et al. 8). This means that the new system will still maintain old emergency department payment models.

By beginning with the key intimations of the ACA, the authors are able to base their arguments and recommendations on the basis of the ethical approach of the ACA, i.e. focusing on providing care to more affordable care to Americans through strategic insurance coverage. The appeal to ethics also helps the authors to frame their latter arguments in the policy brief, thus defining the logos and pathos of the article as well. For example, based on the ACA requirements, the authors argue that the promotion of value in ED care will need to be a superior focus for the policymakers in the process of ACA implementation. This is because emergency departments, as the main area for receiving accident patients and the critically ill, play a crucial role in healthcare delivery alongside being the readily-available medication resource for impromptu care.

Logos

McClelland et al. invariably imbue logic and persuasion in the policy brief by basing their arguments on definitive facts. The ACA will have some considerable implications on the EDs of healthcare facilities for several reasons discussed by the authors. First, physicians at the EDs make up of less than 5% of the entire United States medical physician workforce, and they are tasked with over 28% of all acute care situations (McClelland et al. 8). Adding to this current pressure on the EDs, insurance expansion, accountable care organization, bundled payments, and patient-focused medical homes under the ACA will increase the demand for ED-based care as well as its role in offering coordinated patient care. Also, as the American citizens increasingly gain health insurance via the ACA, there will be more emergency department cases. The forecast into the future demands especially on EDs is not highlighted in the brief, but some studies have shown state-wide growth regarding ED visits is concurrent among different states.

Weighting the implications of the ACA on emergency healthcare delivery is vital for the authors to develop a logic in which the approach to effective future implementation can be discoursed by the authors, which is also crucial in framing the pathos of the article. While the authors highlight a number of key implications on the delivery of healthcare through the new act, it presents them with the opportunity to detail some of the opportunities that the ACA brings to the American healthcare system.

Pathos

The appeal to emotion, i.e. pathos, is developed by the authors through their position on how the ACA can be used to ultimately benefit Americans in the long-term.

First, the authors indicate that there is a budding percentage of healthcare institutions that have successfully alleviated crowding in their EDs, thus refining patient flow via new admittance processes, thereby realizing bolstered healthcare efficiencies. As such, the brief underlines the need for hospitals to embrace such effective strategies.

Second, McClelland et al. assert that ACA can be used as a platform to increase healthcare integration; the ACA, through the changed payment methods, will provide incentives to healthcare entities including accountable care institutions, thus bolstering efficiency. For example, the act will foster better access to patient-focused remedial homes, thus realizing timely access to practitioners; this may also result in lower ED cases in some facilities.

Third, the authors argue that with the continual evolvement of the outpatient system under the ACA as a more central part of acute care, emergency departments can foster and support care coordination via community engagement for local practitioners to boost patient flow through the care continuum.

Finally, McClelland et al. report that the ACA could create critical connected rapid centers for effective diagnoses (9). Based on the core competence of EDs, i.e. the ability to deliver rapid diagnoses combined with 24-7 access to specialists and high technologies, ACA creates the capacity of supportive roles especially for populaces with high-acuity ailments. Further, under the rapid diagnoses approach, the authors report that alternatives to hospital admissions will foster significant cost savings for patients. One such disruptive innovation associated with the ACA is the “Hospital at Home” adopted from European healthcare institutions is reportedly highly effective for patient recovery while being less costly than in-hospital admission.

The policy brief captures a deep sense of pathos in analyzing the opportunities that feature in the Affordable Care Act. Notably, this in-depth focus on the pathos of the brief is crucial in showing the alternate aspect of the ACA, thus eliminating biases in the article. Bias is further eliminated by beginning with the statement of the key attributes of the Act, followed by its implications, and ultimately the opportunities and positive influences that the Act may have on the American healthcare system.

Conclusion

The authors of the policy brief “The Affordable Care Act and Emergency Care” are effective in providing a balanced assessment of the ACA. The authors begin by stating the main attributes of the Act, its far-reaching implications on the current healthcare system, and the current and future potential of the act in fostering a better healthcare system despite its implications; for example, the potential for EDs to be the centre of most of the ACA reforms through community-level engagements and widened outpatient care systems such as the “Hospital at Home” innovations. By looking into all aspects of the ACA pertaining emergency care delivery, the policy brief eliminates biases in its reporting. Also, the authors give an intricate correlation of the ethos, logos, and pathos elements in the policy brief, thus achieving its intended purpose; framing the ACA as an opportunity to achieve better healthcare outcomes in emergency and other patient-based care.