4 postsRe: Topic 4 DQ 2

The Affordable Care Act (ACA) was signed into law by President Barack Obama in March 2010, or the Patient Protection and Affordable Care Act (PPACA), is the healthcare reform legislation, the regulatory rebuild of the U.S. healthcare system, mostly known for the expansion of coverage.

States gane the authority to expand eligibility for Medicaid to persons under the age of 65 if the family income is below 133% of the federal poverty level (Falkner, 2018). Also, health insurance companies cannot deny the health care coverage because of pre-existing conditions and keeping them at the same rate as for others. The plans must include coverage for 10 essential health benefits, such as outpatient/inpatient, ER, prescription drugs, labs, mental health and more (https://www.healthcare.org).

The objectives set in the SEC. 2402, of Affordable Care Act, Removal of Barriers to Providing Home and Community-Based Services, are aimed to the improvement of the community care. The Federal Human Services to promulgate regulations to ensure that all States develop service systems that are designed to – allocate resources, provide strategies, provide the support and coordination (https://www.hhs.gov).

As the whole health care system attention shifting towards outpatient and community care, following the ACA, the number of new community health centers expanding, more nursing jobs are opening up in this area of services. The demand for nurses, is growing nationwide in the rate that faster than average for all occupations, especially for nurses in home care, case management and community health care. Affordable Care Act authorizes funding for nursing development programs and loan repayment programs for nurses to help with preparation of the nursing workforce to meet the demand.

ACA’s grants are given to develop Nurse-Managed Health Clinic, which are nurse-managed, by advanced practice nurses, health clinic that provides comprehensive primary care or wellness services to underserved or vulnerable populations (https://www.hhs.gov).

The nurses’ role in the implementing this law is in achieving higher education, expanding the scope of practice, and extension the primary and community care to nurses while improving the quality of services at the lower cost.

 

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The Affordable Care Act (ACA) otherwise known as Obamacare, is a legislative health care provider that aims to improve the financial burdens that communities face. It creates an incentive for employers to provide health insurance and requires that nearly all people not covered by their employer or a government insurance program, enroll in Medicare or Medicaid, or purchase private health insurance (Schrek 2016).

      The most important element regarding this Act is the pre-existing condition coverage. It means that Health insurers can no longer deny coverage or charge more for services, once the insurance is bought and there’s a pre-existing condition like cancer or diabetes (U.S Department of Health & Human Services, 2017). This Act also aims to provide health insurance for those who would not have otherwise had the money. The role of the community and public health is to offer pre-screening for diseases, preventative care, and low-cost services that will benefit all the people.

      The role of the nurse in implementing this law is to advocate for patients to seek accessible health care and to seek preventative care even if they are healthy. For example, holding Fairs and Health information sessions to help with educating the community about vaccinations for the flu virus during the flu season, pre-screening for high blood pressure and annual health checks. Nurses play a role in the mission of the ACA, nationally and globally, provide equitable health care and the reduction of health disparities (Green 2018). The nursing profession is crucial in educating and taking care of the public. The American Nurses Association (ANA), is very supportive of the Affordable Care Act and upholds any court decisions. The ANA is “actively engaging with federal policymakers and regulators to advocate for system transformation” (ANA 2014).

 

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1 postsRe: Topic 4 DQ 1

The U.S. health care system has many weaknesses with the primary issue being the extremely high cost of care. Individuals have access to care in many different settings however issues with transportation, restrictions regarding eligibility for certain services and ability to pay providers for services rendered are barriers to care for many Americans (Green, 2018). As health care evolves, there is an increased need for reform in the U.S. public health policies and for advancement of proposals to improve the health of the population. In the last century, the cost of high-quality medical care has risen to extraordinary rates, resulting in out of pocket payment and self-payment for services. Even minor illness or injury can incur high costs for health care consumers and the majority of Americans do not have the ability to pay for services (Green, 2018). The ability to pay medical bills often comes from health insurance coverage, either government based or through private companies to guarantee payment for health care services. Establishing costs within the health care system for procedures can help patients, employers, insurers and government officials identify the elusive value of health care services provided (Daniels & Ritter, 2018). Cost management tools can improve cost effectiveness of care such as cost information for services being available to consumers to make informed decisions about where to seek care.

References

Daniels, D. J., & R

 

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Isleidy Alvarez 1 postsRe: Topic 4 DQ 1

The methods used to finance health care service is a major concern in America and it plays a major role in shaping a country’s health care system. Health care services include such as hospital care, physician care, dental services, and drugs that are provided directly to individuals.

The question of how to sustain, finance and manage healthcare involves a deeply ideological and political question, who is going to pay for it and how? Green (2018) discusses how the health profession continues to evolve, including various reforms in the United States public health policies, and the need for the development of plans to improve public health.

When evaluating healthcare and insurance companies’ clinical effectiveness, compared to their financial sustainability, one can see that as far as the stakeholder/patient is concerned, companies do not want you to know about the practice of “covert rationing”. This practice by insurance companies, often limits availability of treatments, as a cost savings measure, and to preserve profits or raise salaries to company staff (Torrey,2018).

These issues of cost-effectiveness and rationed care can directly affect the quality and availability of care needed to obtain positive patient outcomes. I believe a reform solution to improve effectiveness in this area of concern, would be the greater need for transparency of coverage on the healthcare providers side, and increasing competitiveness among provider companies.

I believe that plans for universal healthcare need careful reconsideration. Also, I feel that the influx of millions of immigrants to the united states does nothing to improve this healthcare crisis. Again, who is going to pay for it, and how? This raises the concerns that reliance on taxation may be associated with higher private payments, especially during economic downturns (Evans,2002). It is all about freedom of choice, personal responsibility and required political and social involvement.

References

Evans RG. Financing health care: taxation and the alternatives. In: Mossialos EDA, Figueras J, Kutzin J,

 

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Bias, it’s in all of us, whether subtle or outright it is there. How we display our feelings is indicative on the receiving party. It is a multifaceted negative evaluation of one group and its members relative to another. Stereotype is a way of categorizing people without giving ourselves the opportunity to interact with them and the world around us. Implicit bias is an unconscious association, belief or attitude toward any social group, (Bucknor-Ferron 2016).

       In order for the community health nurse to recognize bias, stereotypes and implicit bias within the community, she/he has to understand her biases. She/he has to be careful not to prejudge or view members of the community negatively based on race, nationality, religion, gender, age etcetera. In order for the nurse to make sure she/he promotes activities that are culturally competent, a survey should be done to assess the needs of the community.

       Strategies I can use to reduce cultural dissonance and bias is first to understand what my biases are and not to compare myself with others. Being open with myself about my conscious awareness so that I will not negatively evaluate another person through irrelevant characteristics. Do not allow my decisions to affect the level of care and quality of treatment I give to my patients. See people as individuals and make a conscious effort to adjust my response to them, try seeing things from their point of view.

       Stereotyping and prejudice are difficult to measure because people are often unwilling to admit negative attitudes and beliefs. Additionally, people may sometimes be unable to accurately report on these topics because of how they feel or think, (Sekaquaptewa et. al 2003).  Bias in the real world is negative, troubling and challenging. Although a person can consciously make adjustments and strive to eliminate these stereotypes, it will take time and being aware of the existence of these biases is a good place to start to make changes.

 

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