NR 451 Week 7: Healthcare Policy: What You Need to Know About the Affordable Care Act
The healthcare reform has benefited millions of people in the United States. The Affordable Care Act has allowed many people especially those of low -income to have access to affordable health insurance, as it regulates insurance company by setting rules that put a ban these company that denies coverage to those people with pre-existing medical conditions. Not only does it allow people from getting preventive care and immunization for children at no cost but small business owners can purchase health coverage for their employees and get a break on tax credit in doing so. Dependent teens and young adult up to 26 years of age are covered under their parent’s insurance. The government set rules and regulation that healthcare providers must follow which focuses on preventive care and improving health.
“By understanding how government works, how bills become laws, and how legislators make decisions, nurses can influence policy decisions through individual efforts such as electronic letter writing, social networking, participation in political campaigns, and selection of candidates who support policies conducive to improving the health and welfare of all citizens.” (McEwen, pg.184)
It is very important for nurses to be aware of changes in healthcare policy to have the knowledge basic, and insight on government rules and regulations that will help in making decisions and educating our patients, families and the community. Not only do changes in healthcare policy affect we way we deliver care, but it also directs the care we deliver. Nurses play a great role in being active in lobbying and do have a word in the development of some health care policies that are written by the government. We are in the forefront of this delivery system and do have a voice on issues that affect patient care this allows us to advocate on our patient’s behalf on certain practices that are recommended and regulated by the government.
In 2015, the healthcare cost in the U.S far exceed cost as compared to countries like Switzerland, Australia, and Canada, yet their life expectancy rate is lower. Data from the Organization for Economic Cooperation and Development (OECD) shows that there is a higher percentage of people who do not have healthcare insurance comparison to 12 other countries and ranks the highest when it comes to the number of death from preventive diseases and complications.
In my opinion, There is an uneven distribution of spending that causes health care to be so costly. Some providers, insurances companies, and the drug companies want to make great profit at the cost of the sick and helpless. The drug companies are one of the reasons the cost of healthcare is so high, they charge what they want for medication to make a huge profit, not to mention some providers, they create fraud to get more money from the insurances companies, and some insurance companies want to get as much from the public as they can. It is just a dog-eat-dog system.
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References:
New York. (2014). Is the Affordable Care Act Working? Retrieved from https://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html#/ (Links to an external site.)
McEwen. (2015). Community/Public Health Nursing: Promoting the Health of Populations (6thed.). St. L
ouis, Mo. Retrieved from https://online.vitalsource.com/#/books/9780323188197/cfi/8/4!/4/2/38/10@0:16.1 (Links to an external site.)
Los Angeles Times. (2017). The U.S spends more in Healthcare than any other country- But not with better Health Outcomes Retrieved from
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I enjoyed reading your post. Great post! I actually like the “dog-eat-dog” expression you used to describe the healthcare cost system. Personally, I think the government should intervene and regulate the cost of health care especially in the area of insurance premium and prescription drug cost. One thing that baffles in the healthcare business is the uneven charges based on patient’s insurance policy. I don’t understand why some patient must pay a higher cost for a similar condition that would cost lower charge. I remember visiting the Emergency Room (ER) without any insurance and it only cost approximately $1000 for treatment. However, another visit to the ER with Blue Cross Blue Shield insurance card with a similar issue attracted over $12,000.
According to Kane (2012), the United States health care is more costly than countries like France, Sweden, and the United Kingdom. I think that America government should strengthen the system already in place to protect patients from exploitation. I understand that the healthcare professionals are working hard to provide the best care, however, the sick and helpless as you mentioned should not be taken advantage of for self-benefit. I also believe that nurses have roles as advocates by creating awareness and protecting the patients. Thanks for sharing.
Reference:
Kane, J., (2012). Health Costs: How the U.S. Compares With Other Countries. Retrieved from http://www.pbs.org/newshour/rundown/health-costs-how-the-us-compares-with-other-countries/
I have never been a proponent of The Affordable Care Act. The federal government has had “a hand” in healthcare for quite some time. The news stations constantly inform of the problems with the Veterans Administration. Knowing that the government-run “health insurance” for Veterans is done so poorly, why would anyone believe that additional government-run insurance would truly work? In looking through the healthcare Marketplace, I found very few perks. My premium for my family of 4 would be between $13,712 yearly ($867.51/month) and $23,375 yearly ($1744.33/month). There were no subsidies available for my income bracket so, I would be responsible for the total amount. In addition, there was a deductible and copays for services and prescriptions. How is this affordable care?
The only benefits that I have seen stem from The Affordable Care Act are related to hospital accountability. “A central feature of the ACA has been the accountable care organization (ACO), the goals of which were to reduce fragmentation and inefficiency by encouraging the innovative redesign of primary health care, measuring health outcomes, and relying on physician-led expert systems and treatment pathways (Skinner and Amitabh, 2016). Healthcare facilities now face more accountability than before. Ratings of facilities are public knowledge and insurance companies can withhold claim’s payments if certain criteria are not met.
Many facets of The Affordable Care Act are concerning. Healthcare for everyone sounds like a good idea and other countries have made it work. U.S. Health Care from a Global Perspective compares the U.S. to 12 countries that have universal healthcare. The results are astounding. Despite spending more on health care than any other nation, the United States ranks 23 out of 30 industrialized countries in life expectancy (American Nurses Association, 2015, p. 45). The U.S. has the lowest life expectancy and highest infant mortality rates. We have the highest percentage of people over 65 years of age with two or more chronic conditions. We also have the highest obesity rate. The U.S. does have the lowest percentage of daily smokers, though. “The U.S. also had high rates of adverse outcomes from diabetes, with 17.1 lower extremity amputations per 100,000 population in 2011. Rates in Sweden, Australia and the U.K. were less than one-third as high” (Squires & Anderson, 2015). To have a more productive system in the U.S., more research needs to be done about policies and procedures of the countries that have made it work.
“Influence on social and public policy to promote social justice reflect[s] the definition of nursing and illustrate[s] the essential features of contemporary nursing practice” (American Nurses Association, 2015, p. 49). Knowing which new policies and laws are being considered gives nurses a voice. By staying up-to-date on new policies and laws, we can be advocates of the patient’s needs. We can also advocate for our own rights and contact our state representatives about passing bills that create safer work environments. “From 2002 to 2013, incidents of serious workplace violence (those requiring days off for the injured worker to recuperate) were four times more common in healthcare than in private industry on average. [Also,] 12 percent of emergency department nurses experienced physical violence—and 59 percent experienced verbal abuse—during a seven-day period, 2009–2011 Emergency Nurses Association survey of 7,169 nurses, [and] 13 percent of employees in Veterans Health Administration hospitals reported being assaulted in a year,2002 survey of 72,349 workers at 142 facilities” (Workplace Violence in Healthcare: Understanding the Challenge, 2015). Being an Emergency Department Registered Nurse at a Veterans Health Administration hospital, I find these statistics to be lower than what I would have thought. I have been attacked by a patient and my life has been forever changed. Only by standing up for ourselves will we ever be able to stop the violence against healthcare workers. We must know the laws and policies that protect us and fight for enforcement of those laws.
References:
American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.
Skinner, J., & Amitabh, C. (2016). The past and future of the Affordable Care Act. JAMA, 316(5), 497-499. doi:10.1001/jama.2016.10158. http://jamanetwork.com/journals/jama/fullarticle/2533697.
Squires, D., & Anderson, C. (2015, October 08). U.S. Health Care from a Global Perspective. Retrieved June 14, 2017, from http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective
Workplace Violence in Healthcare: Understanding the Challenge. (2015, December). Retrieved October 4, 2017, from https://www.osha.gov/Publications/OSHA3826 .pdf