NURS-FPX6218 Assessment 1 Proposing Evidence-Based Change

NURS-FPX6218 Assessment 1 Proposing Evidence-Based Change

A Sample Answer For the Assignment: NURS-FPX6218 Assessment 1 Proposing Evidence-Based Change

Title: NURS-FPX6218 Assessment 1 Proposing Evidence-Based Change

NURS-FPX6218 Assessment 1 Proposing Evidence-Based Change

The healthcare model used by a particular country determines how patient care services are offered; hence is a need to have an adequate understanding of the healthcare model applied in the country. Healthcare leaders also need to be familiar with various models and approaches to healthcare to enable them to identify aspects that are effective and that are not effective, hence forming the basis of a proposed change. Such proposals for change can be effected in local or regional healthcare systems to help improve patient outcomes (Smith-Bindman et al.,2019). Therefore, the purpose of this assignment is to propose a change to an aspect of the local or regional healthcare system. In addition, this assignment will focus on a comparative analysis of other non-U.S. healthcare systems focusing on the proposed change.

Executive Summary

Proposed Change

This paper will focus on the U.S. regional healthcare system and, specifically, U.S. healthcare insurance. The USA healthcare insurance has been a topic of debate for several years, with a substantial number of U.S. citizens not having insurance. The implication is that such a large number of individuals, therefore, may find it hard and complicated to access healthcare services due to their inability to pay the needed cash for the healthcare services. As such, they can even succumb to treatable diseases which could have otherwise been treated if they had health insurance. Currently, the U.S. health insurance system is, to a bigger percentage, a private insurance system that is supplemented by Medicaid and Medicare (Berchik et al.,2019). The proposed change is a modification of the current healthcare system to lean towards a universal health insurance coverage system. Therefore, it is expected that such a change would lead to a majority of the population accessing healthcare services. The evidence that supports my position regarding the change is that a substantial number of U.S. citizens remain uninsured even though the Affordable Care Act has improved the number of insured individuals.

Desired Outcomes

As pointed out earlier, the proposed change is to reform the USA healthcare insurance system; as such, one of the desirable outcomes of the proposed change is a change to a universal healthcare insurance system to offer coverage for every U.S. citizen so that each and every person can access the patient care services that they may need (Keisler-Starkey & Bunch, 2020). The implication is that every U.S. citizen would be able to access healthcare services since the costs will be reimbursed from the new initiative. The health coverage would include several basic healthcare needs and just leave out a handful of services that can be decided once a suitable framework has been put in place.

The new proposed universal healthcare insurance system will need to be funded, and so, as part of the proposal, the new system is to be paid for by every USA taxpayer. The payment rates for every those who pay will have to be regulated by suitable enacted laws. For example, every citizen would be required to contribute a part of their income to support the new health insurance system. Appropriate calculation of the percentages would ensure that the payments are fair to support the system as appropriate and that the payment system would ensure that everyone gets healthcare services.

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The proposal of the universal healthcare system can help solve the problem of inadequate access to healthcare services which has seen a substantial number of American citizens not being in a position to obtain the needed healthcare services. Nonetheless, there could be various limiting factors that can hinder the implementation and acceptance of the proposed universal healthcare insurance system. One such factor is the lack of political goodwill from the political class who make and implement laws. There is still a belief that the universal health instance is associated with socialist ideology and should not be accepted in countries that believe in capitalism as the USA. The other potential limiting factor is the strong presence and influence of the private insurance companies that have been engaging in offering coverage and have an influence on politics and government policies.

Health Care System Comparative Analysis

It is important for healthcare leaders to have appreciable knowledge regarding the healthcare systems of other nations so that they can make informed decisions regarding any potential changes to the existing system. As such, the Canadian and French healthcare insurance systems have been chosen for the comparative analysis. These two systems have substantial differences from the U.S. healthcare system, which is largely privatized. In the two counties, the health insurance systems put in place by each government offers health insurance coverage to almost all their citizens. Healthcare insurance in both Canada and France advocates for solidarity and equality in how healthcare should be obtained (Ranabhat et al.,2019). The two countries have their universal healthcare system hinged on the respect for human dignity principles. Hence individuals are able to seek healthcare services even though the costs may be high.

The universal healthcare systems offered by France and Canada give universal coverage to their citizens for better patient outcomes. However, they both have limits on health insurance coverage. For example, the French universal healthcare system excludes dental and eye care from coverage, implying that individuals have to use supplementary insurance when accessing such services (Ranabhat et al.,2019). Comparatively, the Canadian universal healthcare system excludes home healthcare and drugs from the coverage (Smith-Bindman et al.,2019).

In most cases, the Canadian and French universal healthcare systems have for a long time been viewed as superior to the healthcare system in the U.S. in terms of accessibility and focus on quality care. In various rankings, the two nations have always been ahead of the U.S. healthcare system and health insurance (Smith-Bindman et al.,2019). Such rankings are usually based on various outcomes. As such, the Canadian and French healthcare systems both support more access to healthcare. They also support healthcare equity as compared to the U.S. through the universal healthcare system.

The rationale for the Proposed Change

As discussed earlier, the current U.S. healthcare system is largely private and supported by Medicaid and Medicare. Therefore a proposal is here given for change to a universal healthcare system where American citizens will pay for the insurance using calculated percentages to help support a universal healthcare system (Berchick et al.,2019). Therefore, the rationale for choosing this change or approach is to ensure that all citizens have access to the needed healthcare service. The other rationale is to improve the quality of care offered to patients across all economic classes without the fear of having to pay extremely high bills.

Financial and Health Implications

The proposed universal healthcare system has great potential to improve access to care and the quality of patient care services offered to patients. However, the proposal has financial and health implications. One of the financial implications is that the working class paying taxes will have to pay to help the system work. For example, the new system may work as a tax system where individuals contribute depending on the value of their salary in the form of tax revenue (Berchick et al.,2019). The federal and state government will also have to sponsor part of the health care insurance. However, private medical insurance will also need to be in existence to cover the services not covered in the proposed universal healthcare system. In case no change is made, then then a notable number of citizens will continue not having adequate access to the healthcare services as they should.



This paper has focused on a change proposal to the U.S. healthcare system, focusing on healthcare insurance.   The nature of the current healthcare care system, where the insurance is largely managed privately, has locked many individuals from getting adequate access to healthcare. As such, a proposed change to a universal healthcare system that will improve access to care and quality of care has been explored. The rationale for change is to increase health insurance coverage for American citizens. Increased insurance coverage may impact the quality of care positively and lead to better population health.



Table 1: Health Care System Comparative Analysis

Table directions:

  1. Add the names of the two non-U.S. healthcare systems and the local or regional U.S. healthcare system to the applicable column headings.
  2. In the first column, list each outcome. Add rows to your table as needed.
  3. Add the relevant information pertaining to each outcome for each healthcare system in the second, third, and fourth columns.
Outcomes [Canadian Health care system] [French Health Care System,] [U.S. Health Care System]
Improve access to care Has better access to care Has better access to care Comparatively lower access
Improved patient outcomes. Patients have improved outcomes Patients have improved outcomes Patients have improved outcomes
Quality service at affordable costs The costs are relatively low compared to the USA The cost is relatively lower High costs due to privatization

(Papanicolas et al.,2018), (Smith-Bindman et al.,2019)



Berchick, E. R., Barnett, J. C., & Upton, R. D. (2019). Health Insurance Coverage in the United States, 2018 (pp. 60–267). U.S. Department of Commerce, U.S. Census Bureau.

Keisler-Starkey, K., & Bunch, L. N. (2020). Health insurance coverage in the United States: 2019. Washington, DC: U.S. Census Bureau.

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama319(10), 1024-1039. Doi: 10.1001/jama.2018.1150

Ranabhat, C. L., Kim, C. B., Singh, A., Acharya, D., Pathak, K., Sharma, B., & Mishra, S. R. (2019). Challenges and opportunities towards the road of universal health coverage (UHC) in Nepal: a systematic review. Archives of Public Health77(1), 1–10.

Smith-Bindman, R., Kwan, M. L., Marlow, E. C., Theis, M. K., Bolch, W., Cheng, S. Y., … & Miglioretti, D. L. (2019). Trends in the use of medical imaging in U.S. health care systems and in Ontario, Canada, 2000-2016. Jama322(9), 843-856. Doi: 10.1001/jama.2019.11456