NURS 8100 Assignment 1: Issues in Health Care Reform (Interview)
According to the AACN (2006), “Political activism and commitment to policy development are central elements of professional nursing practice” (p. 13). Throughout this course, you will hone the skills and competencies required for this type of
involvement in policy. Research is an essential step in the process of acquiring the skills and competencies,
and interviews are one form of research that can serve as a valuable source of information. As such, this Assignment (which you will start this week, and submit by the end of Week 9) provides an opportunity for you to identify a health reform issue of
interest and discuss the issue with a state or national politician (or their aide).
Significant transformations in healthcare have been witnessed in the US over the past one decade. The transformations mainly target at improving the health and wellbeing of the America citizens irrespective of their backgrounds. The reforms aim to achieve this by increasing the populations covered by different health insurance schemes, which will improve access and utilization of healthcare services by the diverse populations (Jones, 2017). Despite these benefits, significant challenges surround the transformations. For instance, concerns have been raised on whether the reforms will be of importance in the long-term. Therefore, this paper expounds on these issues based on the interview I conducted with the director of health in our state.
Summary and Analysis of the Interview
The interview was conducted on 5 January 2020 at the director’s office. In my view, the interview was a success since the director explored a wide range of issues on healthcare reforms. The director was keen on ensuring that all the questions asked were tactfully addressed. The main areas of focus in the interview included achievements of healthcare reforms, opportunities for healthcare institutions, challenges with the reforms and ways of addressing them. According to the director, significant successes have been reported with the adoption of healthcare reforms in the US. The success can be seen in the percentage of American citizens who have access to their needed care in the modern world. As reported by her, the healthcare reforms have not only increased healthcare access for the ethnic minorities but also individuals from non-minority communities that are unemployed. The consequences of these improvements are a significant rise in the utilization of healthcare services and healthier populations.
The director also reported that the adoption of healthcare reforms has led to a significant improvement in the quality of care offered to the American citizens. Accordingly, it has shifted the payment system for healthcare services where hospitals that meet the goals of value-based purchasing system receive higher numeration than those that does not. There has also a significant improvement in the protection of data of the patients since institutions have to abide by regulations guiding its use. Health organizations have also embraced new technologies that have enhanced the safety, efficiency, and quality of care (Thompson, 2015). Therefore, she was optimistic that the achievements reported with the adoption of healthcare reforms are expected to transform the healthcare system of the US in the future.
Moreover, the director was keen to note that there exist opportunities that can be explored to enhance the efficiency of the healthcare reforms. She expressed the increased need for healthcare stakeholders to focus on upholding the principle of doing no harm to others. In this case, she expressed that while most people have criticized the use of single-payer system to be unsustainable; it should not be disbanded but be fixed. The imperfections in the Affordable Care Act need to be fixed with the aim of increasing insurance coverage to the Americans who are not insured. The director gave four ways in which this can be achieved. Firstly, the legislators should consider expanding the eligibility for tax credit offsets. This will raise the number of poor individuals who can afford the premiums. Secondly, there is a need for the states to provide citizens with enhanced tax credit offsets. This will specifically benefit the young adults with low income (Shaw, 2017). Lastly, the Medicaid eligibility should be expanded to a level that ensures that a majority of the poor can afford the cost of premiums in the state insurance cover. Through these interventions, the goals of healthcare reforms can be achieved.
The director expressed concerns that despite the success in healthcare reforms, the implementation process has experienced significant challenges. Firstly, there has been considerable resistance from healthcare institutions in the implementation of some provisions. Successful implementation of the healthcare reforms demands the restructuring of most processes of health care organizations. The restructuring require the use of financial resources to acquire new technologies and train staffs on its use (Shaw, 2017). As a result, the adoption process must consider the needs and concerns of healthcare institutions, hence, the challenge.
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In addition, the director also expressed that the implementation process could be affected adversely by the rising costs of healthcare in the US. According to evidence, the cost of healthcare in the US is higher than any other developed state in Europe and the rest of the world. The high cost is expected to rise further with the adoption of the reforms. The rise is attributed to a decline in the population covered by the employers in the state (Jones, 2017). The consequence of such change will be an increase in consumer spending on healthcare, hence, the rise in healthcare cost and unaffordability of care to a majority of the citizens.
The last part of the interview was on the ways in which the above challenges can be addressed. According to the director, there is a need for the expansion of federal coverage to solve the cost-related issues affecting the reforms. The coverage should be nationwide with states having complete responsibility for the vulnerable in the society. The second recommendation is retaining the Medicaid expansion for individuals with income level below 138% of the poverty levels to increase affordability and coverage (Thompson, 2015). Lastly, coverage should be comprehensive to cover all the healthcare needs of the diverse populations.
In summary, the interview revealed that the adoption of healthcare reforms in the US have achieved significant milestones in promoting the health of the American citizens. There has been an increase in healthcare access, affordability, and utilization among the population. Despite these achievements, the adoption process has faced challenges related to financial implications it has on health care organizations. Therefore, it is important that a focus be placed on ensuring that the challenges are addressed to realize the full benefits of the reforms.
Jones, D. K. (2017). Exchange politics: Opposing Obamacare in battleground states. New York, NY: Oxford University Press.
Shaw, G. M. (2017). The dysfunctional politics of the Affordable Care Act. Santa Barbara, CA: California Praeger.
Thompson, T. (2015). The Affordable Care Act. Farmington Hills, MI: Greenhaven Press.