NURS 8200 Discussion: Starting the Research Process

NURS 8200 Discussion: Starting the Research Process

NURS 8200 Discussion: Starting the Research Process

The affordability of a health plan depends greatly on the money an individual makes, and this expense, based on raising premiums and deductibles, is beyond reach for many considered middle class (Fehr et al., 2019). The current situation is detrimental to most unsubsidized middle-class income America (Collins & Blumenthal, 2019), and thus to prevention in primary care. Let us look at the typical family of four in Miami Dade, Florida. According to PEW Research Center, a nonpartisan fact tank that conducts public opinion polling, and demographic research, middle-income households are considered those with an income that is two-thirds to double the U.S. median household income (2020). In 2018, that meant $48,500 to $145,500 annually, and thus, 49% of people meeting this criterion in this area are considered middle income families (Pew Research Center, 2020). As per the U.S. Centers for Medicare & Medicaid Services, (2021), a family of four is considered lower income when the annual income is $26500 annually. Tax breaks in the Marketplace apply to low-income families and not to middle income families. Yet, it is common knowledge most in this latter bracket forgo insurance and primary preventive care primarily because they cannot afford it.

It is a testable idea that one could level the playing field by cutting out the existing third-party payor system. The PICO inquiry would

NURS 8200 Discussion Starting the Research Process
NURS 8200 Discussion Starting the Research Process

be: How would a primary care prevention plan featuring a direct monetary relation between provider and patient fare against a traditional third-party payor plan in terms of affordability for middle class income households? This topic warrants attention because as ACA itself concedes, subsidies are available (only) to people whose net income is between 100% and 400% of the Federal Poverty Line (American Council on Aging, 2021).

The hypothesis is that a flat fee option/plan (the independent variable), regardless of income, would allow affordability (the dependent variable), permit clinicians and patients to focus on healthcare. Conglomerating disciplines around this concept may deliver this goal. In fact, if I may, the concept is not new, I invite you to research “Turntable Health”.

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American Council on Aging. (2021, January 13). Federal poverty guidelines / Levels for 2021 & their relevance to Medicaid eligibility. Medicaid Planning Assistance – Helping Americans obtain the Medicaid long term care they require.

Collins, S., & Blumenthal, D. (2019, November 21). New state-by-state report: Health insurance costs taking larger share of middle-class incomes as premium contributions and deductibles grow faster than wages. Commonwealth Fund.

Fehr, R., Cox, C., Levitt, L., & Claxton, G. (2019, March 15). How affordable are 2019 ACA premiums for middle-income people? KFF.

Pew Research Center. (2020, July 30). Are you in the American middle class? Retrieved June 6, 2021, from

U.S. Centers for Medicare & Medicaid Services. (2021). Health insurance plans & prices.