NR 451 Week 7: Healthcare Policy: What You Need to Know About the Affordable Care Act
NR 451 Week 7: Healthcare Policy: What You Need to Know About the Affordable Care Act
NR 451 Week 7: Healthcare Policy: What You Need to Know About the Affordable Care Act
Ah, the Affordable Care Act! One of the most hotly debated changes in policy in decades. I deactivated my Facebook account over the hate spawned over the internet on this issue.
Some benefits prompted by the ACA is it is more female friendly. Women paid 80% more for health insurance than men (McDonald,2015). Insurers could deny a woman for healthcare coverage for pre-existing conditions, even pregnancy. ACA put an end to some discrimination in healthcare for women. It also outlawed caps on benefits when people needed health care the most. Another aspect of ACA that I applaud is coverage on mammograms, pap smears, annual well visits, drug counseling, and more access to preventative care that is part of our co-pay. Almost 30 million women now have access to these services when before they didn’t (McDonald,2015). I also like that my OBGYN can be my primary provider. I think the ACA helped women close the barrier another inch in equal rights for women, with better health care coverage, especially for minority women.
Knowing changes in healthcare policy can empower us to make changes in policy, advocate for our patients, and help us understand what effects our practice including how we document (Domrose,C., 2016). It is frustrating to carry out policy especially when it is written by a bunch of people in Washington that have no idea on how our industry really works. Being active in policy and understanding regulations helps us advocate for our patients.
We spend more on healthcare in our country but have the worst outcomes because we allow it. Healthcare is big business in the US, and with all of the red tape in the industry there is little room for healthy competition to make it a successful business. We all heard about the issue with Epi Pens. The pharmaceutical company started charging 500.00 per pen because it could, with no competition or “knock off” brands, they monopolized the market. Big Pharm companies have no initiative to produce life saving medications when they can make money off of medications like viagra. “High drug prices are the result of the approach the United States has taken to granting government-protected monopolies to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits”(Kesselheim,A. et al. 2016). Having more competition and creating more price negotiation is one way we could combat pricing hikes.
Other countries with better health insurance, my pick is France. Everyone must have health insurance and it is sold by several non-profits. Public insurance covers about 80% of cost and you can choose other insurance companies to cover the other 20%, voluntarily. About 95% of the population chooses to have the other 20% covered or most jobs cover the portion as a job perk.The cost is 11.8% G.D.P. but still cheaper than US insurance. France allows private hospitals and allows competition among drug companies and other health care essentials. France also has less problems getting access to care, doctors make some home visits, and provides almost all aspects of healthcare coverage (Carroll,A. & Frakt,A., 2017).
References
Carroll,A., & Frakt,A.,(2017).The best healthcare system in the world: Which one would you pick? -The New York Times. retrieved from www.nytimes.com
Domrose,C.,(2016). Health Policy Nursing: A Specialty With A View. retrieved from www.nurse.com/blog/author/cdomrose
Kesselhein,A., Avorn,A., & Sarpatwari,JD., (2016).JAMA. The High Cost of Prescription Drugs in the US:Origins and prospects for reform. 2016. 316(8):858-871.doi:10.1001/jama.2016.11237
McDonald,J.,(2015). The 5 Most Important OBamacare Benefits for Women. Retrieved from www.bankrate.com
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.
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. Louis, 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
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