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NURS 8100 Discussion: Nursing and Health Policy in Other Nations

NURS 8100 Discussion: Nursing and Health Policy in Other Nations

Think for a moment about nurses who relocate because of professional opportunities. How could such a seemingly personal decision have a detrimental impact on global health care? As presented in this week’s Learning Resources, nurse migration is of
global concern. In response to this issue, international health care organizations such as the World Health Organization (WHO) and the International Council of Nurses (ICN) have positioned themselves to craft related policy as a solution. This is just one example of a global nursing policy effort.

The dysfunctional state of North America’s healthcare system continues to make headlines among academicians, researchers, policymakers, patients, and business investors alike. These stakeholders are faced with a multitude of challenges which seem to be deeply embedded in the system. Some of the commonly stated issues include exorbitant costs of care, resource wastage, fragmentation, low quality outcomes, and fraudulent activities. Of course, each of these problems is attributable to a broad range of causes, but one cannot ignore the fact that toxic social policies, myopic political courses, and unfair economic programs are largely responsible for most if not all systemic challenges faced in the United States healthcare sector. This argument places immense emphasis on the unscrupulous third-party healthcare reimbursement framework which has done more harm than good. It suffices to state that the uninsured and underinsured are not the root cause of the problems facing this sector. For this reason, a direct payment system would be instrumental in addressing the current challenge facing the United States.

Third-Party Reimbursement as the Root Cause of US Healthcare System Dysfunctionality

Before delving deep into this matter, Haeffele, Hall, and Millsap (2019) highlight an interesting trend which acquits underinsured and uninsured citizens from the ongoing superficial blame game. According to their report, overall costs of care have increased by 50 percent within roughly half a century. This retrogressive trend has remained at large regardless of the government’s decision to shoulder the financial burden of care rather than placing it on individuals. When viewed from this point, it is obvious that the lack of insurance is not the problem. As a matter of fact, the government’s seemingly misguided decision to place all financial responsibilities on third-party actors is the main reason behind this persistent problem.

Former President Barrack Obama’s Affordable Care Act (ACA, 2009) offers an illustrious case of the ultimate factor behind most of the challenges that plague this system. Inasmuch as ACA was implemented to reduce financial burden bore by all citizens during care delivery processes, it gave third-party insurance organizations a golden opportunity to control the costs of care (McConnell, 2018). This factor appears problematic, especially since these corporate actors prioritize profitability in all their actions. Such a sentiment explains why the government’s per capita spending on healthcare has doubled initial costs covered by individuals on a private bases. McConnell (2018) attributes this upsurge to corporate fraud and retrogressive politics in the policymaking processes.

Why Political Schisms Trigger System Dysfunctionality

Since third-party reimbursement framework is largely responsible for healthcare system challenges, it can be resolved through political discourse. Unfortunately, the United States harbors a negative political climate, which is characterized by huge rifts, particularly in policymaking matters. When reflecting on this matter, it appears fair to highlight the ongoing Republican war against the previous regime’s Affordable Care Act.  As much as the system failed to work, repealing and replacing it with a new third-party model does not resolve the issue. President Donald Trump’s administration’s approach to this problem shows just how detrimental bad politics can be on the healthcare industry: it prevents the regime from focusing on the key issues such as the unwarranted role of third-party reimbursement programs in healthcare delivery (McConnell, 2018). Perhaps, cooperation between the two extreme political factions will allow leaders to seek alternative ways of improving care. For instance, healthcare costs can be subsidized for individuals to pay out-of-pocket without great difficulties.

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Additional Data for Further Research

At the moment, insufficient emphasis has been placed on the role of ineffective policies on healthcare outcomes. As controversial as the preceding sentiment sounds, it is rightly ingrained on the multiple investigations done on factors such as technology integration, system fragmentation, and other process dynamics that determine the quality of care delivered to patients (Gordon, 2016). On this note, further research on the policymaking aspects of the industry is recommended so as to enhance stakeholders’ grasp of the root cause of this underlying problem. So far, it should be understood that the United States has implemented various strategies to help reduce clinical costs. Some of these initiatives include Health Savings Accounts, High Deductible Health Plans, and the Affordable Care Act (Gordon, 2016). These policy measures demonstrate the value of policymaking in the transformation of care processes and outcomes. When perceived from this lens, it is fair to assert that additional research is warranted on policymaking to show how detrimental policies contribute to the current problem facing the United States healthcare system.

Privatization and Subsidization should replace the Third-Party Healthcare Reimbursement Model

This paper’s author believes that third-party healthcare reimbursement is responsible for most problems evidenced in the United States healthcare system, so resolution of this issue calls for disbandment of the framework. However, removing insurers from the picture is bound to increase financial burdens shouldered by Americans on an individual basis. Such a scenario implies that the government needs to reduce this burden in a more efficient and feasible manner. Once healthcare services are funded privately, the government should place subsidies of between 40 and 70 percent of the total costs (Gordon, 2016). When placed into perspective, this approach will prevent fraud since the government’s expenditure will be based on affirmable factors including patient income and treatment costs (recorded by individual organizations). Of course, the proposed framework is not perfect since it stills capitalizes on measures utilized by insurers to reimburse clinical expenditure, but, it removes third-party providers from the equation by giving patients more knowledge and power over their healthcare experience.

NURS 8100 Discussion: Nursing and Health Policy in Other Nations

The Federal Government’s Role in this Problem

The federal government is best placed to address this problem compared to state and local governments. Such a bold claim is founded on the fact that all United States citizens are affected by the same. Apart from that, the federal government is quite instrumental in advancing policy matters that require national attention. This process will impact various stakeholders including insurance companies, Department of Finance, pharmaceutical brands, patients, and healthcare providers, mainly organizations.

Anticipated Debate

Considering the disruptive nature of the proposed solution, it is bound to trigger opposition from stakeholders, especially the ones that are benefiting from the present third-party reimbursement framework. These opponents are likely to argue that the privatization and subsidization of care will not only place immense burden on consumers but also enhance government control over the industry. When viewed from such a point, it is apparent that a powerful government grip on healthcare industry jeopardizes patients’ say on their health. While such a claim holds some level of truth, it disregards the fact that insurers have been misusing the same authority. Perhaps, the key benefit of this proposed solution is its capacity to reduce resource wastage on underutilized services.

Conclusion

After a thorough exploration of the United States healthcare system, it is apparent that this sector is negatively affected by the third-party reimbursement framework. The use of insurers has resulted in overspending and ineffectual service delivery. On that note, it is fair to introduce a privatized system which assumes a share of the financial burden shouldered by individuals throughout their interaction with the system.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Gordon, P. R. (2016). How can physicians educate patients about health care policy issues?. Academic Medicine, 91(10), 1333-1336. Retrieved from https://journals.lww.com/academicmedicine/fulltext/2016/10000/How_Can_Physicians_Educate_Patients_About_Health.9.aspx

Haeffele, S., Hall, A. R., & Millsap, A. (Eds.). (2019). Informing Public Policy: Analyzing Contemporary US and International Policy Issues through the Lens of Market Process Economics. Rowman & Littlefield International.

McConnell, A. (2018). Rethinking wicked problems as political problems and policy problems. Policy & Politics, 46(1), 165-180. Retrieved from https://www.ingentaconnect.com/content/tpp/pap/2018/00000046/00000001/art00009

This course has equipped me with knowledge of healthcare systems, politics, and health policy. I have learned that healthcare systems direct healthcare financing, organization, and delivery of care, and it deals with accessibility, resources, and expenditures in healthcare (Turale & Kunaviktikul, 2019). I have also learned that politics play a major role in healthcare since they dictate the formulation of health policies and the budget that will be allocated to healthcare. Politicians are involved in passing policies into laws, and for healthcare policies to be enacted, politicians need to be enlightened on the benefits of the policy in improving health outcomes (Turale & Kunaviktikul, 2019). Furthermore, health policies significantly determine the health outcomes of a population and healthcare providers need to be actively involved in the formulation of policies since they are directly affected.

Making informed decisions on nursing practice and patient outcomes requires that nurses research the impact of the specific health issue on the global economy (Ding et al., 2016). The first thing should be to calculate the relative risk as a result of the health issue and quantifying the prevalence of the health issue in each country (Ding et al., 2016). The average annual expenses of the health issue should be estimated in each country and calculated to determine the total global cost. By identifying the impact of the health issue on the global economy, nurses can make an informed choice on the amount the resources that should be directed towards preventing, controlling, or eliminating the problem (Ding et al., 2016). Consequently, patient outcomes can be improved by adding more resources to control and manage the health issue.

I will apply the knowledge acquired in this course in the upcoming practicum experience by taking part in the formulation of health policies. I will identify a major challenge encountered in the delivery of care and enquire from health providers how it affects them and how it can be addressed. I will then write a proposal that will explain the issue, including how it affects the delivery of health services and health outcomes and how it can be addressed. I will present the proposal to an elected legislator, and convince the legislator to present the proposal as a bill for debate and enactment. Moreover, I will apply the knowledge on advocacy to enlighten people of their rights and encourage them to give opinions on issues that affect their health.

References

Ding, D., Lawson, K. D., Kolbe-Alexander, T. L., Finkelstein, E. A., Katzmarzyk, P. T., Van Mechelen, W., Pratt, M., & Lancet Physical Activity Series 2 Executive Committee. (2016). The economic burden of physical inactivity: a global analysis of major non-communicable diseases. The Lancet388(10051), 1311-1324.

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. International nursing review66(3), 302-304.

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