NURS 8100 Discussion Health Care Reform

A Sample Answer For the Assignment: NURS 8100 Discussion Health Care Reform

This is an exceptional work on health care reform. I concur with you that cost of care is an important feature of health care system that has great influence on the health policy and reforms.  Other than the cost, the other important feature of the US health care system is politics. Politics play a crucial role in the health care affairs, particularly health policy and reforms (Tuohy, 2018). The health care reform discussion in the US has been a political issue centered on reduction of cost, funding, increasing medical coverage, insurance reform, government involvement, and philosophy of its provision. 

Health care reforms have been highly contentious among law makers (Haeder, 2020). For instance, President Obama enacted the Patient Protection and Affordable Care Act (PPACA) to increase health coverage to all Americans.  However, the Trump administration consistently made efforts to repeal the ACA and adopt alternative policy called repeal and replace approach.  This effort to repeal the ACA has been a controversial political topic among the Democrats and Republicans in the Congress (Michener, 2020).

References

Haeder, S. F. (2020). Political science and US health policy in the era of the affordable care act. Policy Studies Journal, 48, S14-S32. https://doi.org/10.1111/psj.12385

Michener, J. (2020). Race, politics, and the affordable care act. Journal of Health Politics, Policy and Law, 45(4), 547-566. https://doi.org/10.1215/03616878-8255481

Tuohy, C. H. (2018). Remaking policy: scale, pace, and political strategy in Health care reform (Vol. 54). University of Toronto Press.

The enactment of the Affordable Care Act in 2010 heralded reforms in health care that led to more Americans, about 25 million, who did not have health insurance coverage, getting insured. While the reforms from the passage of ACA 2010 led to increased access and quality of affordable care, they did not create universal health coverage to guarantee all Americans, irrespective of their socioeconomic status, access to quality care (Wilensky et al., 2020).

The recent COVID-19 pandemic has illustrated the need for in-depth reforms in the healthcare sector to be spearheaded by state and federal governments. The pandemic demonstrated the importance of having universal healthcare coverage to enhance access to all Americans. The U.S. recorded the highest caseload and fatalities from the COVID-19 pandemic because of the current health system despite being a developed country and spending over $4 trillion or about 12% of its gross domestic product (GDP) on healthcare (Auener et al., 2021).

Several studies have demonstrated that having universal health coverage would have enabled the U.S. to handle the pandemic better than it did (King, 2020). The purpose of this paper is to present a health reform plan that focuses on the implementation of universal health coverage with a single-payer model.

Conflict Between Federal and State Policies on Healthcare

Federal and state governments have different roles and responsibilities in healthcare provision. As such, there is no uniformity concerning policies between the federal and state governments. The existence of policy variations between these governments can lead to conflicts that require solutions to improve accessibility, reduce costs, and enhance the quality of care. State and federal governments jointly fund health care provision based on existing policies like Medicaid under the ACA 2010 (Wilensky et al., 2022).

Under this policy, states are free to take Medicaid and increase resources by developing their provisions. Such provisions may conflict with the federal mandates on Medicaid since the federal government hopes to offer access to care through the program (McClellan et al., 2021). However, due to differences in state laws and rules based on their legislations, some states do not have Medicaid programs implying that in such states, Americans cannot access healthcare services under the policy.

According to the Kaiser Family Foundation (KFF), ten states have not expanded Medicaid, implying that over 2.1 million people belong to the “coverage gap” or income level that makes them eligible for the program yet cannot access it due to their state policies (Tolbert et al., 2022). Such a conflict in policies implies that Americans in the ten states have limited options to access healthcare services. Again, it means that state and federal governments cannot implement a universal healthcare model that will address the coverage and access gaps.

Currently, the federal government funds fully the Medicare program that caters to older Americans, those 65 years and above as well as Americans living with disabilities. Under the program, all state policies align with the provision since they do not fund costs, including prescription drugs. As such, these conflicts can only be solved through one healthcare plan as demonstrated by the Medicare program or the Veterans Administration (VA) healthcare plan.

Conflicting policies as demonstrated by the Medicaid program lead to limited access to health care and reduced resources to fight pandemics when they occur like the recent COVID-19 pandemic and other health emergencies (Hiam et al., 2021). Therefore, both state and federal governments should embrace a universal model like other developed countries with a single public-payer system where the federal government provides resources based on the state population’s healthcare needs.

Health Preparedness

The proposed health reform plan of having a universal health coverage plan that emphasizes primary care implies that more resources are allocated to the local health facilities within states and counties. Under this proposed plan, states will work with the federal government on the current model of both Medicaid and Medicare services based on the targeted population (Galvani et al., 2022).

The plan will entail having Medicaid-like coverage where all people get insured based on the resources that the federal government offers, and the state matches the same amount. For instance, based on the population levels, states will have different allocations and match half of that by evaluating their demand.

The plan will expand access and ensure that populations and individuals previously not eligible become eligible in all states. The policy will ensure that states align their healthcare mandates with the federal government’s direction to improve access and quality of care.

The policy will entail allocating more resources to preventive and primary care interventions in the communities. These resources include investing in healthy food options, physical activities and exercising, giving nutritional information, expanding maternal care, and ensuring that all consultation services and physician visits are free (Wilensky et al., 2022).

Imperatively, the plan is to ensure that Americans can access not just emergency care as provided under the EMTALA provisions but also physician visits and annual routine reviews. The plan will seek to reimburse physicians for value provided and not quantity.

Through these provisions, the proposed plan will enhance health preparedness, especially during public health emergencies as witnessed recently due to the COVID-19 pandemic. Since the plan will focus on primary care, it enhances the level of preparedness as it means that the entire public can access information and emergency services (McClellan et al., 2021). States would increase their allocation and build more facilities that prepare adequately for any health emergencies.

The new plan will ensure seamless sharing of health information, effective coordination, and teamwork based on the expertise and number of healthcare workers who will be deployed in communities. According to the American Public Health Association (2022), nations that had a universal healthcare system leveraged their models to mobilize resources and ensure the testing and care of their citizens and residents during the COVID pandemic.

Universal health coverage would reduce disparities and support vulnerable populations’ access to care. These two factors can help reduce the impacts of pandemics as demonstrated in the country since a majority of those who succumbed to the disease were vulnerable and experienced health disparities.

Percentage of GDP for Health Care

Investing in and rolling out a universal healthcare system would be a critical part of attaining accessibility, reducing overall costs, and improving the quality of care. Currently, models like value-based purchase (VBP) emphasize quality as opposed to quantity implying that the plan does not have to spend more on the GDP but will deploy international best practice standards.

For instance, Canada spends about $9,000 per person on universal healthcare (Geyman, 2021). With a higher GDP than Canada’s, the U.S. can spend about $10,000 per person using this model implying that it will only be about 10% of the nation’s GDP. This figure will allow the federal and state governments to provide comprehensive care to all people who require care throughout the year. States will match the funding by half to close any gaps and reduce bureaucratic aspects that affect the implementation of the program.

Conclusion

Reforming the health system entails developing models that will leverage the limited resources but guarantee high-quality care to Americans and residents. Evidence demonstrates that embracing a universal healthcare model will allow more Americans to access quality care and reduce wastage and additional spending that make it difficult for many to get services.

The proposed plan will ensure that more Americans, especially those experiencing disparities and vulnerability, access care and prepare adequately for public health emergencies like the COVID-19 pandemic and other epidemics like the current opioid crisis.   

References

Auener, S., Kroon, D., Wackers, E., Van Dulmen, S., & Jeurissen, P. (2020). COVID-19: a

a window of opportunity for positive healthcare reforms. International Journal of Health Policy and Management, 9(10), 419-422. DOI: 10.34172/ijhpm.2020.66

American Public Health Association (APHA) (2022). Lessons from the COVID-19 Pandemic:

The Importance of Universal Health Care in Addressing Health Care Inequities. https://www.apha.org/Policies-and-Advocacy/Public-Health-Policy-Statements/Policy-Database/2022/01/07/Lessons

Galvani, A. P., Parpia, A. S., Pandey, A., Sah, P., Colón, K., Friedman, G., … & Fitzpatrick, M.

C. (2022). Universal healthcare as pandemic preparedness: the lives and costs that could have been saved during the COVID-19 pandemic. Proceedings of the National Academy of Sciences, 119(25), e2200536119. https://doi.org/10.1073/pnas.2200536119

Geyman, J. (2021). COVID-19 has revealed America’s broken healthcare system: What can we

learn? International Journal of Health Services, 51(2), 188-194. https://doi.org/10.1177/0020731420985640

Hiam, L., & Yates, R. (2021). Will the COVID-19 crisis catalyze universal health reforms? The

            Lancet, 398(10301), 646-648. DOI:https://doi.org/10.1016/S0140-6736(21)01650-0

King, J. S. (2020). Covid-19 and the need for health care reform. New England Journal of

            Medicine, 382(26), e104. DOI: 10.1056/NEJMp2000821

McClellan, M., Rajkumar, R., Couch, M., Holder, D., Pham, M., Long, P., … & Smith, M.

(2021). Health care payers COVID-19 impact assessment: Lessons learned and compelling needs. NAM Perspectives, 2021. https://nam.edu/health-care-payers-covid-19-impact-assessment-lessons-learned-and-compelling-needs/

Tolbert, J. & Drake, P. (2022). Key Facts about the Uninsured Population.

Key Facts about the Uninsured Population

Wilensky, S. E., & Tietelbaum, J. B., (2020). Essentials of health policy and law (4th ed.).

            Burlington, MA: Jones & Bartlett Learning.

Wilensky, G. R. (2022, January). The COVID-19 pandemic and the US healthcare workforce.

JAMA Health Forum, 3(1) pp. e220001-e220001. DOI:10.1001/jamahealthforum.2022.0001

The United States’ health-care system differs from that of other developed countries in that it lacks a standardized health-care system and universal health-care coverage. Other developed countries have a single-payer national health insurance system, a national health service, or a multi-payer universal health insurance fund, whereas the United States has a hybrid healthcare system (Papanicolas et al., 2018).

I am particularly interested in the disparities in health insurance coverage in the United States health care system. Many Americans lack access to health care because it is limited to: people with health insurance; people covered by government insurance programs; people who can afford to buy private health insurance; and people who can get health services through safety net providers (Papanicolas et al., 2018).

The feature is important in terms of health policy and reform because policies and reforms are required to improve Americans’ access to healthcare. Examples of approaches to addressing the issue include developing policies that provide health insurance coverage to low-income Americans (Papanicolas et al., 2018). Health insurance policies must also be changed to allow the disproportionately uninsured Americans to access quality healthcare.

The Patient Protection and Affordable Care Act (PPACA) was passed with provisions that provoked legal and political controversy. It included a requirement requiring Americans to buy health insurance or face penalties, with certain exclusions for low-income Americans who couldn’t afford insurance (Talbert et al., 2018). In order to cover healthcare costs in the United States, the condition was deemed necessary.

The dispute produced by this condition hampered policy development. Opponents of the proposal said that the condition violated Congress’s commerce clause jurisdiction (McIntyre & Song, 2019). This explains why health-care reform has been so difficult in the United States, as some policymakers contend that proposed reforms are illegal.References

McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2), e1002752. https://doi.org/10.1371/journal.pmed.1002752

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS:NURS 8100 Discussion Health Care Reform

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039. https://doi.org/10.1001/jama.2018.1150

Talbert, P. Y., Martin, L. F., Frazier, M., & Byas, D. (2018). Benefits and Challenges of the Affordable Care Act: What should be the Future of the ACA in 2018? Acta Scientific Medical Sciences 2.5, 09-16.

Discussion: Health Care Reform

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:

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

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.

NURS 8100 Discussion Health Care Reform

Read a selection of your colleagues’ postings.

Your work on health care reform is insightful and interesting. Indeed, politics is playing an important role in the US health care reforms and PPACA has remained controversial issue due to political differences.  The other challenge related to the passing of the PPACA is healthcare inequalities, which has disproportionately impacted the minority groups such as African Americans and marginalized groups (Yue et al., 2018). 

While the PPACA coverage increased the progress towards universal coverage, the persistent high cost of various coverage options implies limited access to affordable health care among many Americans, especially the minority and marginalized groups (Gaffney & McCormick, 2017). These disparities lead to the gaps in health insurance coverage, poor health outcomes among minority and marginalized groups, and unequal access to services (Dickman et al., 2017).

The issue of healthcare inequalities and other challenges portray why health care reforms in the US have been difficult.  They characterize systematic health care challenges that indicate that the US health care reforms are not comprehensive and fail to capture the health care needs of all Americans.

References

Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet, 389(10077), 1431-1441. https://doi.org/10.1016/S0140-6736(17)30398-7

Gaffney, A., & McCormick, D. (2017). The Affordable Care Act: implications for health-care equity. The Lancet, 389(10077), 1442-1452. https://doi.org/10.1016/S0140-6736(17)30786-9

By Day 6

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.

The U.S. health care system is different from other developed countries in that it does not have a standardized health system or universal health care coverage. The U.S. has a hybrid healthcare system, while other developed nations have a single-payer national health insurance system, a national health service, or a multi-payer universal health insurance fund (Papanicolas et al., 2018).

The uneven health insurance coverage in the U.S. health system is an important feature of interest to me. Many Americans do not have access to health care since it is restricted to: Persons with health insurance; Americans covered under government insurance programs; Persons who can afford to purchase private health insurance; Individuals who can get health services through safety net providers (Papanicolas et al., 2018).

The feature is significant in relation to health policy and reform since policies and reforms are needed to increase Americans’ access to healthcare. Examples of approaches to address the issue include formulating policies that provide health insurance coverage to Americans from low-income families (Papanicolas et al., 2018). Policies on health insurance also need to be modified to allow the disproportionately uninsured Americans to access quality healthcare.  

The passing of the Patient Protection and Affordable Care Act (PPACA) came with conditions that triggered legal and political controversy. It had a mandate requiring Americans to obtain health insurance or get penalties, with some exceptions, especially for low-income Americans who cannot afford insurance (Talbert et al., 2018). The condition was viewed as necessary to cover healthcare costs in the U.S.

The controversy brought by this condition led to delays in the policy-making process. Policymakers challenging the policy argued that the condition overstretched Congress’s commerce clause power (McIntyre & Song, 2019). This explains why health reforms in the U.S. have been complicated since some policymakers argue that proposed reforms are unconstitutional.

References

McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2), e1002752. https://doi.org/10.1371/journal.pmed.1002752

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039. https://doi.org/10.1001/jama.2018.1150

Talbert, P. Y., Martin, L. F., Frazier, M., & Byas, D. (2018). Benefits and Challenges of the Affordable Care Act: What should be the Future of the ACA in 2018? Acta Scientific Medical Sciences 2.5, 09-16.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 1 Discussion

Name: NURS_8100_Week1_Discussi