The study investigated the impact of policy amendments on the medical coverage for young cancer patients. The authors observed that the United States healthcare reforms under the Patient Protection and Affordable Care Act (ACA) comprise a critical policy approach to the improvement of the quality of lives among young cancer adults. The researchers believe that the policy review to extend the eligibility age for dependents from 18 to 26 years resulted in a high proportion of the insured people with cancer (Parsons, Schmidt, Tenner, Bang, & Keegan, 2016).
The adjustment of medical policies to accommodate an expanded health care insurance is essential for improving the overall health status of a population (Siegel, Miller, & Jemal, 2017; Carrera, Kantarjian, & Blinde, 2018). The views of researchers on policy amendments are justifiable because the majority of individuals within the adjusted age group have experienced a low level of medical coverage.
The authors have clearly stated the research problem for they have highlighted the existence of a disparity in the accessibility of care between young people with and without cancer. Moreover, they have justified the need for an evaluation by citing evidence attributing this disparity to financial challenges. Cancer survivors continue to face some socio-economic challenges that involve access to job opportunities and care services (Nagai & Kim, 2017; Carrera et al., 2018). These challenges are significant as they form the basis of the research problem to investigate the relationship between policy amendments and improvement of cancer patients’ quality of life.
The objective of the study is to determine the influence of ACA policies on the health insurance coverage among young adults with cancer. By reviewing data from 18 credible cancer records in the United States, the authors hypothesized the extension of age limit increases insurance coverage. Certainly, the findings demonstrated that the extension of the age limit from 18 to 25 years considerably increases the proportion of people under insurance coverage for the eligible group when compared to the non-eligible category of 26 to 29 years (Parsons et al., 2016). To facilitate readers’ understanding of the research, the authors provided a list of key terms incorporated into the study.
The article lacks the literature review section to buttress the essence of the study. Besides, the authors failed to mention adequate evidence from relevant studies in the introduction section to provide existing contextual knowledge.
Research Materials and Methods
Research Design and Population
The case study, which is a research design, is consistent with the purpose of the research. The authors reviewed medical records from reliable government sources of 18 cancers registries in the United States under the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER). The utilization of an extensive data set positively influences the external validity of the findings and promotes the generalizability of the results to the population (Parsons et al., 2016).
The study recruited all young adults diagnosed with a malignant form of cancer for the period between 2007 and 2012. To avoid the effect of bias, the authors used purposive sampling to exclude patients who died and those diagnosed during the study. The sample size of 39,632 patients (N = 39,632) offers a sufficient and appropriate representation of the target population.
As the authors employed SEER’s data, they enhanced the internal validity of the findings for registries have accurate records on the insurance status of the target population. The systematic process of data management adopted by the National Program for Cancer Registries reduces errors, increases accuracy, and boosts the internal validity. Besides, the researchers only limited data review to insurance status of people with cancer in the dependent insurance coverage. By establishing how participants’ data changed during the period, the researchers obtained reliable and accurate findings. The overall systematic process of observation enhances the internal validity of the study.
The United States implemented ACA policy in 2010 that extended the age limit for the eligibility of dependents on the family coverage. The SEER records patient insurance status for both the pre-ACA period (2007-2010) and the post-ACA period (2010-2012). Two periods facilitated the authors’ evaluation of results for both the pre-ACA and post-ACA periods. Creating two data sets enabled comparison of the effects of implementation, determination of post-exposure changes, and accurate drawing of inferences. The post-implementation data were compared with the baseline data of the pre-amendment period to determine the effects of the policy change. Therefore, the application of these datasets to the study was crucial for hypothesis testing.
The SEER observes the standard protocol for medical practice in collecting data from cancer patients. The procedure categorizes data according to the patient demographic and disease characteristics. This information guided the research team to structure their data review along these patients’ variables. Therefore, researchers’ utilization of patient variables as a measurement instrument is essential for analyzing the impact of the policy change.
The study exploited appropriate statistical techniques in data analysis. The research team used descriptive analysis, chi-square test, and multivariate tools to calculate the quarterly insurance rates, examine the patient variables and compare the changes in insurance rates between the two age categories. Nagai and Kim (2017) hold that the adoption of systematic processes in data management is essential to maintain the accuracy of records and improve the validity of the findings. The researchers sought ethical clearance from the University of Texas Health Science Review Board before conducting the study. The board approval indicates that the research team complied with the value requirement of ethical research practices, making the study findings valid and reliable.
In the results section, the researchers have indicated their findings clearly by listing the difference in insurance coverage among Hispanic males. Specifically, insurance coverage for the eligible category aged 18 to 25 was higher than that for the non-eligible category of 26 to 29 years. Nevertheless, before the ACA implementation in 2010, researchers found no disparity in insurance rates for the two age groups in the overall population.
However, after the ACA policy implementation, the results depicted apparent changes in insurance rates for both eligible and non-eligible categories. In the eligible category, the research indicated a significant increase in insurance rates by 1.9% from 83.5% to 85.4% (p = 0.01) within the two-year period of post-policy study of 2010 to 2012. On the contrary, the study showed that the rates for the non-eligible category (26-29 years) dropped slightly by 0.5% from 83.4% to 82.9% (Parsons et al., 2016).
However, a multivariate analysis provided an average statistical increase of 3.1% for the eligible group and an insignificant decline in the non-eligible category. These test values imply that the implementation of the ACA policy had a positive influence on the proportion of the eligible category with no significant effect on the non-eligible group.
The authors have discussed the findings based on the objective of the study, research problem, purpose, hypothesis, and then related them to literature. Drawing from earlier studies, the researchers observed consistency in findings. Parsons et al. (2016) assert that the proportion of patients accessing care in medical facilities increases with the expansion of insurance policies. Given that the research problem indicated the existence of disparity in the access to medical services by young adults with and without cancer, the researchers have observed that the ACA did not influence any change in the proportion of the Medicaid coverage.
The findings demonstrate a significant positive relationship between family coverage and the percentage of insured young people with cancer (p = 0.01). In addressing the objective of the research and confirming the hypothesis, the research team identified an increase in overall insurance rates for the eligible group after the implementation of policy in 2010 but did not observe the presence of an apparent change in insurance rates for the non-eligible group.
The study has highlighted the lack of adequate research on the influence of policy-driven amendments on the use of healthcare services. Therefore, future trends discussed focus on the need to evaluate the relationship between increased eligibility for insurance coverage among young people with cancer and the overall health benefits (Siegel et al., 2017). Furthermore, the research proposes the need to investigate an appropriate process of expanding the dependent insurance coverage to incorporate lifetime policies for people with cancer under ACA initiatives and public programs.
Additionally, the article has highlighted the existence of different eligibility criteria for insurance coverage in different states. In this aspect, the study recommends future research to investigate the disparity in insurance rates among young people with cancer in various regions.
Implications for Healthcare
From the study, it is notable that the research findings dramatically influence the improvement of healthcare services. Since there is a consistency of findings between the study and previous research outcomes, the main implication is that a favorable positive adjustment of the eligibility criteria for medical coverage results in increased access to healthcare services and improvement of the patients’ quality of life. Furthermore, the results indicate that policy amendments in medical practice are indispensable since they enhance the proportion of people with cancer under insurance coverage. These findings are crucial in promoting access to medical services and reducing the effects of disease burden.
Opinion on the Article
In my opinion, the research is relevant to the healthcare needs of the modern society. The researchers used a comprehensive data obtained from 18 cancer registries for the period 2007 to 2012 in the United States. According to Carrera et al. (2018), cancer is a chronic disease that considerably adds burden to individual lives, increases country’s medical expenses, and undermines the overall quality of life of an individual.
The researchers have conducted the study under professional guidelines and ethical values, making their findings reliable and generalizable. Moreover, the authors have employed appropriate research methods and data analysis tools, which have significantly enhanced the validity of the results. Thus, the evaluation of the impact of the policy review on healthcare is appropriate in improving the quality of lives and facilitating socio-economic development of a country.
Summary of the Statistical Data
The statistical data show an insignificant disparity in the proportion of insurance rates before the implementation of policy with the eligible category scoring 83.0% compared to 82.7% of the non-eligible group. However, after the adoption of the policy, the proportion of insurance coverage for the eligible group before adjustment for patient variables increased from 83.0% to 85.4 %. On the contrary, for the non-eligible category, the data show a slight drop in the proportion by 0.5% from 83.4% to 82.9% after the implementation. These findings support the identified topic that the extension of eligibility criteria for dependent insurance leads to positive health outcome for young people with cancer.
Cancer is a chronic disease that poses a global threat to human existence and socioeconomic development. Despite the concerted efforts in the medical practice to improve the treatment of the illness, existing insurance agencies have restricted their coverage due to the expensive life-long treatment programs. Treatment programs seek to reduce the prevalence of cancer and improve management of its side effects. From the data, it is evident that current policies in medical plans limit access to healthcare services by cancer patients. However, the findings of the article point out the essence of policy-driven amendments in promoting access to healthcare services and improving the quality of life for people with cancer.
Carrera, P. M., Kantarjian, H. M., & Blinder, V.S. (2018). The financial burden and distress of patients with cancer: Understanding and stepping-up action on the financial toxicity of cancer treatment. CA: A Cancer Journal for Clinicians, 68(2), 153-165. Web.
Nagai, H., & Kim, Y. H. (2017). Cancer prevention from the perspective of global cancer burden patterns. Journal of Thoracic Disease, 9(3), 448-451. Web.
Parsons, H. M., Schmidt, S., Tenner, L. L., Bang, H., & Keegan, T. H. M. (2016). Early impact of the Patient Protection and Affordable Care Act on insurance among young adults with cancer: Analysis of the dependent insurance provision. Cancer, 122(11), 1766-1773. Web.
Siegel, R. L, Miller, K. D., & Jemal, A. (2017). Cancer statistics, 2017. CA: A Cancer Journal for Clinicians, 67(1), 7-30. Web.