NURS 8100 Week 1 Discussion: Health Care Reform

NURS 8100 Week 1 Discussion: Health Care Reform

Healthcare Reform

The U.S. Health Care System that is of Particular Interest to you

The critical feature of the United States (U.S.) health care system of interest is health equity. Health equity is defined as the attainment of the highest level of health for all people (Zimmerman & Anderson, 2019). Furthermore, health equity can only be accomplished when all individuals in the society are equally valued with focused and ongoing societal efforts to address avoidable inequalities, historical and current injustices, and the elimination of health and healthcare disparities (The Commonwealth Fund, 2021). Unfortunately, the goal of the U.S. public health system is to accomplish health equity for all individuals. The U.S. health care system is fraught with racial and ethnic disparities and other unique populations, including female gender, lesbian, gay, bisexual, transgender (LGBT) individuals or groups (National Academies of Sciences, Engineering, and Medicine et al. 2017). In addition, individuals with mental health conditions are also of grave concern related to health equity.

Significant in terms of Health Policy and Reform

Health inequity and inequality have been repeatedly explored in literature and reveal groups and individuals who experience poorer health and shorter lives. Literature has often shown that while the U.S. health care system is the most sophisticated globally, with the most educated providers and technology-capable facilities, everyone does not have a fair and just opportunity to be as healthy as possible. Zimmerman and Anderson (2019) pointed out that “health equity in particular, with improved population outcomes, are more broadly to depend on health care payment and delivery systems. Reforms that focus on holding the health care system accountable for addressing the impact of structural racism on health and social determinants of health through the use of stratified and equity-focused performance measures” (National Academies of Sciences, Engineering, and Medicine et al., 2017). Furthermore, pathways to policy and reform must also include the provision of greater flexibility, incentive, resources for health care providers, and plans to coordinate with social service providers. And community-based organizations (Zimmerman & Anderson, 2019), (“U.S. Health in International Perspective: Shorter Lives, Poorer Health,” 2016).

Challenges Related to the Passing of the PPACA

Challenges related to the 2010 Patient Protection and Affordable Care Act (PPACA) include higher insurance premiums, fines for failure to hold health insurance, increased taxes, and short enrollment periods despite technical challenges on the marketplace. Companies cut back on employee hours avoid insurance coverage for employees. The goal of the PPACA was to ensure health coverage for all Americans regardless of socioeconomic, health, or employment status. One of the most notable protective features of the PPACA is the policy that governs the actions of insurance companies. For example, insurance companies are prohibited from denying coverage or payments for preexisting conditions (Patel, 2021). The challenges to PPACA outlined above are at the root of political conversations, health care policy, and healthcare reform. The mandate to hold insurance and pharmaceutical companies accountable for affordable healthcare and prescriptions ultimately poses a problem to the very consumer the PPACA was designed to protect. Access to care remains a problem as many providers have limited services and practice personally. In addition, providers’ actions create a problem for the healthy population, who must now wait for weeks or months to address issues as the public system is strained. Policymakers have an important opportunity to center equity in the healthcare enterprise and improve the U.S. population’s health. Patel (2021) argued that policymakers should take action to develop bold and transformative plans. To hold the health care system accountable for health outcomes, reduce inequities, and work collaboratively with health equity and consumer health leaders to harness the current political moment for tangible, long-lasting change.

References

National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on Community-Based Solutions to Promote Health Equity in the United States, & Committee on Community-Based Solutions to Promote Health Equity in the United States. (2017). Communities in action: Pathways to health equity (urban planning and development) (Illustrated ed.). National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK425844/

Patel, K. K. (2021). Patient protections in the affordable care act. The affordable care act is a national experiment (pp. 15–21). Springer International Publishing. https://doi.org/10.1007/978-3-030-66726-9_3

The Commonwealth Fund. (2021, November). Achieving racial and ethnic equity in U.S. health care: A scorecard of State performance. Retrieved February 28, 2021, from https://www.commonwealthfund.org/publications/scorecard/2021/nov/achieving-racial-ethnic-equity-us-health-care-state-performance

U.S. health in international perspective: Shorter lives, poorer health. (2016). Military Medicine, 181(9), 945–946. https://doi.org/10.7205/milmed-d-16-00227

Zimmerman, F. J., & Anderson, N. W. (2019). Trends in health equity in the United States by race/ethnicity, sex, and income, 1993-2017. JAMA Network Open, 2(6), e196386. https://doi.org/10.1001/jamanetworkopen.2019.6386

After much public and political debate, in March 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. The PPACA is one of many health care reform efforts that have sought to correct key features of the U.S. health care system such as financing, service delivery, and care coordination. This week, you will examine the passage of PPACA as a milestone along the historical continuum of health care reform in the United States.

To prepare for NURS 8100 Week 1 Discussion: Health Care Reform:
Review this week’s Learning Resources and media presentation, reflecting on the evolution of health care in the United States and the public’s response to health care reform efforts historically and currently.
Consider: What principal features of the U.S. health care system helped or hindered the enactment of federal health reform in March 2010? What challenges were encountered?
How do these conditions and/or challenges reflect characteristics of the policy process and the political environment?
By Day 3 of Discussion: Health Care Reform
Post a cohesive response that addresses the following:

Analyze at least one important feature of the U.S. health care system that is of particular interest to you. Explain why you think this feature is significant in terms of health policy and reform.
Describe one or more conditions or challenges specifically related to the passing of the PPACA. Explain how this exemplifies the nature of the policy-making process, and evaluate how it could relate to the question of why health reform in the United States has been so difficult.
Read a selection of your colleagues’ postings.

ORDER NOW FOR ORIGINAL PAPER
By Day 6 of NURS 8100 Week 1 Discussion: Health Care Reform
Respond to at least two of your colleagues in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources. Discussion: Health Care Reform
NURS 8100 Week 1: The Health Care System, Part 1
The evolution of health care in the United States has been a roller-coaster story of good intentions that were often buffeted by economic and social change, compromised by special interests, and beset by passionate differences of opinion. The primary goals of health care reform have been fairly consistent: to increase access, lower costs, and improve quality. Many efforts to bring about change, however, have not resulted in policy. Why has this been such a challenge? What barriers have prevented reform efforts from being successful? Exactly how to fix the weaknesses of the current health care system continues to be an issue of public and political debate, and one which continues to be played out in the policy arena.

This week, you will examine the history and evolution of health care and consider how health care financing has been central in shaping the current system. You also will examine provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA)—a groundbreaking attempt at reforming the U.S. health care system by the enactment of new policy.

Looking Ahead
In Week 2, you will begin an assignment that requires you to interview a policy maker. Due to the time-sensitive nature of getting on the desired individual’s schedule, you may wish to review this assignment now to begin thinking about who you might like to contact.

Objectives
Students will:
Analyze principal features of the U.S. health care system
Evaluate the policy process in relation to challenges for health care reform
Access online learning resources for professional growth and development
Learning Resources
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.

Chapter 1, “Introduction: The Paradox of Excess and Deprivation”This chapter introduces the concept of “excess and deprivation”—p eople receiving either too little or too much health care, which contributes to the weakness of the health care system.
Chapter 2, “Paying for Health Care”This chapter discusses the evolution of health care financing, including out-of–pocket payments, individual private insurance, employment-based insurance, and government-financed insurance.
Chapter 3, “Access to Health Care”This chapter focuses on financial and nonfinancial barriers to health care and concludes with influences to one’s health status unrelated to health care.
Chapter 4,“Paying Health Care Providers”This chapter provides information on how physicians and hospitals are paid.

HealthCare.gov. (n.d.). Understanding the Affordable Care Act. Retrieved from http://www.hhs.gov/healthcare/rights/index.html

Posted by U.S. Department of Health & Human Services, this article provides an introduction to the Patient Protection and Affordable Care Act of 2010 (PPACA).

HealthCare.gov. (n.d.). Understanding the Affordable Care Act: About the law. Retrieved from http://www.hhs.gov/healthcare/rights/law/index.html

Also posted by U.S. Department of Health & Human Services, this article focuses on specific provisions of the law and outlines how it will increase access to affordable health coverage.

In Week 1 of this course, you are required to subscribe to one of the health information services listed below. In preparation, review these different sites:

Agency for Healthcare Research and Quality. (2010). AHRQ PSNet Patient Safety Network. Retrieved from http://psnet.ahrq.gov/

ModernHealthcare.com. (n.d.). Registration is free: The news is invaluable. Retrieved from https://home.modernhealthcare.com/clickshare/addAccountFree.do

Robert Wood Johnson Foundation. (2011). Publications and research. Retrieved from http://www.rwjf.org/?topicid=1318

The Commonwealth Fund. (2010). The Commonwealth Fund. Retrieved from http://www.commonwealthfund.org/

The Henry J. Kaiser Family Foundation. (2011). New & noteworthy. Retrieved from http://www.kff.org/

Required Media
Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: The policy process. Baltimore: Author.

Note: The approximate length of this media piece is 11 minutes.

In this media presentation, Dr. Kominski and Dr. Zelman discuss the policy process and provide an overview of the influence of policy on health care practices. Dr. Zelman also discusses the challenges of passing new policy and relates this to health care reform efforts.

Optional Resources
Hammer, D., Phillips, B., & Schmidt, T. L. (2010). The intended and unintended consequences of health care reform. Healthcare Financial Management, 64(10), 50–55.

Rettenmaier, A. J., & Saving, T. R. (2011, January 5). Reforming Medicare: The Affordable Care Act versus the Rivlin/Ryan proposal. National Center for Policy Analysis. Retrieved from http://www.ncpathinktank.org/pub/ba736

Stephens, J. H., & Ledlow, G. R. (2010). Real health care reform: focus on primary care access. Hospital Topics, 88(4), 98–106.

NURS 8100 Week 1 Assignment: Staying Current: Online Resources
Technology is providing increasingly rich and credible resources for staying abreast of the latest trends and issues in health care. Many recognized organizations provide regularly disseminated updates via their websites, and offer this information free to subscribers. As you proceed through the DNP program, you will find that receiving these updates will support your professional growth as a scholar practitioner.

To prepare:

Explore the following resources found inthis week’s Learning Resources:

AHRQ Patient Safety Network
Modern Healthcare Alerts
RWJ Nursing News Digest
The Commonwealth Fund
The Henry J. Kaiser Family Foundation
To complete:

Select one service and subscribe to receive e-mail alerts or updates.
Copy and paste your successful subscription notification into a Word document.
By Day 7
Submit the Assignment.

Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
Click the Week 1 Assignment link.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.