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NRS 428 Topic 4 DQ 1

DQ 1 Describe the effect of health care reform on the U.S. health care system and its respective stakeholders.

Topic 4 DQ 1

Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article.

The U.S. has a decentralized healthcare system with various private and public access points. The public health system includes government entities and collaborative efforts with community nonprofit organizations and faith-based organizations. Government agencies include state and local health departments, providing care such as laboratory services, health screenings, treatment of disease, and epidemiology surveillance (Quentin & Busse, 2018). Private health care is delivered in inpatient, outpatient, or ambulatory care; long-term or residential; mental health; home care; wellness center; and alternative medicine settings. Private institutions are either for-profit private facilities or nonprofit private facilities, with the latter being the largest component. The U.S. has poor health outcomes, including low life expectancy and high suicide rates, compared to our peer nations.

A relatively higher chronic disease burden and incidence of obesity contribute to the problem, but the U.S. health care system is also not doing its part. The analysis shows that the U.S. has the highest rates of avoidable mortality because of people not receiving timely, high-quality care (Saenz, 2021). The healthcare system in U.S. is greatly influenced by the health insurance system which does not adequately support right to health which every person residing legally in United States should be able to enjoy their right.

In trying to promote effective healthcare for all U.S. population, healthcare should be focusing on the care that can be afforded by all

DQ 1 Describe the effect of health care reform on the U.S. health care system and its respective stakeholders.

DQ 1 Describe the effect of health care reform on the U.S. health care system and its respective stakeholders.

and strengthening the primary preventive care. The preventable diseases like diabetes, hypertension and cancers can be minimized by promoting access to effective and quality healthcare. For Americans to enjoy optimal health—as individuals and as a population—they must have the benefit of high-quality health care services that are effectively coordinated within a strong public health system (Colón, 2018). The greater attention should be placed on reducing health care costs. The U.S. could look to approaches taken by other industrialized nations to contain costs, including budgeting practices and using value-based pricing of new medical technologies. Approaches that aim to lower health care prices are likely to have the greatest impact, since previous research has indicated that higher prices are the primary reason why the U.S. spends more on health care than any other country.


Colón, K. A. (2018). Creating a Patient-Centered, Global, Decentralized Health System: Combining New Payment and Care Delivery Models with Telemedicine, AI, and Blockchain Technology. Blockchain in Healthcare Today, 1(9), 03-11. https://doi.org/10.30953/bhty.v1.30

Quentin, W., & Busse, R. (2018). The strongly decentralized Swiss health system achieves good results: Past research has addressed persisting challenges – but more is encouraged. Health Policy, 122(6), 565–567. https://doi.org/10.1016/j.healthpol.2018.06.002

Saenz, S. R. (2021). High-Level Disinfection in Ambulatory Care: Overcoming the Barriers of a Decentralized System through Auditing and Education. Antimicrobial Stewardship & Healthcare Epidemiology, 1(S1), s11–s11. https://doi.org/10.1017/ash.2021.21

I must mention that when evaluating the U.S. health care system and the effectiveness of it, it is important to evaluate what is affordable. The health care system in the U.S. is one of the best in the world to those who can afford it, for those who cannot afford the high prices of many treatments and medications the U.S. health care system is much less effective. The Affordable Care Act of 2010 sought to provide and improve care for those who previously could not afford it. Insurance companies in turn raised rates on those who had insurance to help offset the deficits that were created by providing benefits to those who could not afford to contribute. This system and the financial burden it has created on the government, the insurance companies, and even those who can afford to pay for their own insurance is not sustainable over the long term. The need for health care reform was prompted due to the fact that a large portion of the population was uninsured and thus could not afford health care. What could decrease the costs of health care in the U.S.?

Goldstein, A. (2015, October 27). 2016 Affordable Care Act Insurance Rates Are Climbing. The Washington Post. Retrieved October 6, 2016, from http://www.highbeam.com/doc/1P2-38905492.html?refid=easy_hf

Hello Shola, informative post you shared with us! I agree with the importance of US health care insurance should be lowered and more accessible to the community. We need to take into consideration many factors: physical/mental health, income, and environment that can put a person/community at risk of diseases. Just imagine a household of 5 trying to cover their insurance and this can be costly to afford, a surprising fact shared in our eBook, “The economic situation may cause families to consider whether they can afford to both heat and eat” (Grand Canyon, University, 2018). Meaning it can be hard for families to prioritize between basic resources such as food or health insurance. Hope one day everyone can afford this right of freedom and health.


Grand Canyon University (Ed). (2018). Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/

Read Also: DQ 2: What are the most important elements of the Affordable Care Act in relation to community and public health? 

There are many different types of medical professionals working in a variety of groups, networks, and individual practices, including doctors, nurses, hospitals, and other healthcare facilities. Healthcare is another industry that can’t function well without revenue, yet it also offers services to people who can’t pay for them but still need them (Royce, 2021). In the US, financing medical care is a significant issue. Although people may have free access to healthcare in a variety of contexts, healthcare organizations and providers need to be paid in order to stay in business. Healthcare professionals work together to deliver healthcare through prevention, health promotion, and patient care. Professionals in healthcare management supervise and organize all facets of healthcare (Park, & Look, 2019). These managers make sure that healthcare facilities run efficiently for everyone involved, whether they are managing hospital operations or organizing the activities in a small private practice.

The best care is given when a facility is properly managed, and the personnel are happy as well. When the equipment in the building, the building itself, the technology, and the staff, that promotes patient care are effective then a healthcare system is sustainable. Along with the expectation that all nurses incorporate theory, research, clinical competency, and leadership development to address the evolving requirements of healthcare, increasing the proportion of nurses having doctorates is one step toward advancing nursing leadership (Lepore, 2020). With more nursing in a leadership role and an understanding of what it takes to provide exceptional patient care by ensuring staffing is accurate, equipment is functional and financial budgets are in order.





Lepore, M. (2020). Learning Lessons From Long-Term Care Policy Financing Efforts in the United States. Innovation in Aging, 4(Supplement_1), 680–680. https://doi.org/10.1093/geroni/igaa057.2366

Park, J., & Look, K. A. (2019). Health Care Expenditure Burden of Cancer Care in the United States. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56(9), 61–69. https://doi.org/10.1177/0046958019880696

Royce, T. J. (2021). Financing of US Graduate Medical Education. JAMA, 325(6), 585–589. https://doi.org/10.1001/jama.2020.23979

Abigail Retana

Sep 21, 2022, 10:43 PM(edited)

Paying for health care insurance in the U.S can be complicated, growing up I remember my household didn’t have enough finances to cover health insurance, my parents applied for Arizona Health Care Cost Containment System (AHCCCS). AHCCS’s mission “reaches across Arizona to provide comprehensive, quality health care to those in need.” (AHCCCS, n.d.). Thanks to coverage of this government aid, helped my family greatly. “The Arizona Health Care Cost Containment System (AHCCCS), the State’s Medicaid Agency, uses federal state and county funds to provide health care coverage to eligible enrollees” (AHCCCS, 2022). This program is open to children and adults, offering services such as medical, vision, and dental care. It the importance for the community nurse to be informed and updated with the health care in the US the public and private access points are beneficial to the communities. Understanding how the public health system works will allow us to advocate for our patients, knowing how government entities and collaborative efforts with the community nonprofit organizations and faith-based organizations provide a better health outcome for the community (Grand Canyon University, 2018)



AHCCCS. (n.d.). About the Arizona Health Care Cost Containment System (AHCCCS). https://www.azahcccs.gov/AHCCCS/AboutUs/index.html. Retrieved September 21, 2022, from https://www.azahcccs.gov/AHCCCS/AboutUs/index.html

Arizona Health Care Cost Containment System. (2022, June 30). AHCCCS Fiscal Year 2023 Strategic Plan 2-pager. AHCCCS. Retrieved September 21, 2022, from https://www.azahcccs.gov/AHCCCS/Downloads/Plans/FY2023_2-Page_StrategicPlan.pdf


Grand Canyon University (Ed). (2018). Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/


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