Assignment Nurs 6050 Week 1 Paper

The Role of Government in the U.S. Health Care System

As stated in the course text, Health Care Delivery in the United States, “the health care enterprise is one of the most important parts of the U.S. social system and of our economic system as well” (Kovner and Knickman, 2011, p. 4); however, with millions of citizens uninsured, rising costs, massive health disparities, and the need to improve quality and access, many view health care as a broken system. As such, it continues to be a significant political issue in the United States. Most agree that something needs to be done to fix the health care system, but the methods and solutions for addressing problems vary greatly, particularly with respect to the role government should play. Proponents of varying approaches often have strong, emotional opinions, making compromise difficult.

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In this Discussion, you will consider the role of government in health care, and you will examine the impact of a social, economic, technological, ethical, or legal issue on health care delivery.

To prepare:

With this week’s Learning Resources in mind, consider this question: Is health care a right or a privilege?
Review the media presentation for this week, focusing on the role of the government in health care including Affordable Care Act.
Pinpoint a social, economic, technological, ethical, or legal issue that could, or has, affected health care delivery in the United States.
Locate a current article from the popular press (within the past 6 months) related to the health care issue you identified. How does this article inform your understanding of the influence of your selected issue in the health care debate?

By Day 3

Post your position on whether health care in the United States is a right or a privilege, and explain what you believe to be the proper role of government in health care. Justify your position. Explain how the social, economic, technological, ethical, or legal issue you selected is impacting health care delivery and whether this issue should be addressed by the government or by private entities. Identify the article you selected, and explain how this article informs your stance.

The Role of Government in the U.S. Health Care System

The question of: Is health care a right or a privilege, can be debated forever. According to the text, “our nation is built on the idea that society should ensure an opportunity for ‘life, liberty, and the pursuit of happiness’” (Knickman & Kovner, 2015, p. 4). Life being the key word in this statement. Health care is an important role in ensuring life. The statement “life, liberty, and the pursuit of happiness” is taken directly from our Declaration of Independence. Is not the role of the government to protect its citizens? The Patient Protection and Affordable Health Care Act 2010 (ACA) expanded the role of the government in health care. The ACA was designed to protect patient rights and make health insurance more available to the people. The theory was to make health care more available and affordable to the public. As this week’s video stated, the U.S. provides some of the best health care in the world as far as technology to deliver. The video also goes on to explain how on average, people in the U.S. end up pay more for health care in comparison to other countries (Laureate Education (Producer), 2012d). Assignment Nurs 6050 Week 1 Paper

We are a pivotal place, waiting and watching, to see which direction our nation will go. We have two candidates debating on issues, and we will have to choose which person to lead our nation in the coming years. This is vitally important to myself and the state I live, much like others across this country. New Hampshire finds itself in a crisis with opiate abuse. According to a local newspaper, the issue is “More Americans are dying from opioids than at any time in recent history, with overdose deaths hitting a peak of 28,000 in 2014” (Ronayne, 2016). When speaking of ensuring life, this statistic is going in the wrong direction. Internationally, the BBC wrote an article about the heroin and opiate crisis in the U.S., writing “The US is in the throes of a heroin and opioid epidemic – drug overdose has become the leading cause of accidental death, overtaking traffic accidents” (Pressly, 2016). While one candidate is electing to stop drugs via policing and tackling the issue through the judicial system, the other is electing to put money toward health care. According to the Concord Monitor (Ronayne, 2016), the candidates plan “would send more money to states to expand drug treatment and mental health services, promote greater availability of the overdose reversal drug naloxone and support better prevention programs in schools, among other things.” In NH, we find ourselves with one of the worse rankings in opiate abuse and death rates. Even worse we rank in the bottom for resources for those suffering from addiction. As a nurse working in the busiest emergency departments in the state, we see the effects of having few resources available for our patients.

The U.S. Constitution states that life is a right given to all citizens of the U.S. Providing health care to those citizens helps protect the same right.

Angela S.

RE: Discussion – Week 1

COLLAPSE

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The Role of Government in the U.S. Health Care System

Angela S.

Walden University

Policy and Advocacy for Improving Population Health

NURS-6050N

Dr. Linda Robertson

May 31,

The Role of Government in the U.S. Health Care System

Is health care a right or a privilege? Many have been debating about this for years. Even today people are still fighting for health care. Health care is not a right or privilege if you view them from each words definition. A right is defined as that which is due to anyone by just claim; Freedom of speech is a right of all Americans (Dictionary, 2012a, para.2). A right is something you are born with, and you will die with, granted to you by your “Creator” (whatever you imagine She/He/It/Them to be). A right something that is naturally yours. Something that no one can take away from you unless you give your rights away legally. A privilege is defined as any of the rights common to all citizens under modern constitutional government; we enjoy the privileges of a free people (Dictionary, 2012b, para.2). A privilege is granted to you by the King, General, Church, or the State, and may be revoked at any time, if one loses favor. It is a privilege to be able to have nice cars, clothes, and homes. Is health care a right? Health care is a product. It is a purchasable item. Assignment Nurs 6050 Week 1 Paper. The rise of the health care is affecting everyone and trying to reform a failing health care system would be a good idea. Insurance rates are rising and impacting Americans, many working class cannot afford insurance. A lot of Americans do not have insurance for themselves or their families because of the high cost of their insurance premiums. The more government involves itself in medicine, the worse health care will get. It has a cost which must be paid and has a very large economic affect when treated as a right or privilege. The theory that we as Americans are entitled to claim health care as a right/privilege is unrealistic. Quality of health care will diminish as the system struggles to contain rising cost, while shortages and long waiting times for treatment will become more and more common place.

Many Americans avoid medical care due to the high cost of treatment. The cost of a yearly health care insurance annual premium for an average family could be extremely high. There is a separation among American citizens related to health care. The first group in general, pays for their health care coverage through insurance plans, deductibles, copays, and remaining bill payments (Kovner & Knickman, 2011). The other group lacks insurance and therefore receives healthcare through a government program or obtains treatment without pay for the most part. There are smaller subgroups with variation to the above but for the purpose of this discussion I am simplifying the groups. Laws in the United States protect patients regardless of type of insurance, lack of insurance, or even proof of citizenship when seeking emergency medical care. In this aspect the government has made access to medical care available to all who are in the boarders both citizen and noncitizen. This is the only right to health care.

The working class should not have to carry the financial burden of non-emergent care for all of America. We all must have some responsibility in the maintenance of the health care provided for us. Social Security and Medicare are not entitlements; Americans pay into these programs and earn these benefits by spending years in the work force. How can we justify giving away another person’s earned benefits? Why should someone’s insurance cost increase to pay for those who opt not to carry insurance and obtain government aid? There are exceptions related to inability to obtain insurance such as the disabled, children, and elderly. But these should be the only exceptions. We should not be giving free healthcare to an abled body adult at the cost of another taxpayer. This increase in taxes to the working Americans has placed a financial burden which continues to destroy our economy. Hospitals are not reimbursed for losses due to the nonpaying population and budgets are flexed to the breaking point. Layoffs occur, increases in employee out of pocket cost, decreases in coverage, when the cost is greater than return.

If the government continues to encourage the enrollment of aid programs and not focus on improving the number of workers, this system will collapse. Eventually there will not be enough tax payers to carry the burden of these programs. Assignment Nurs 6050 Week 1 Paper. Health care and insurance cost do need some restructuring but just giving all Americans the “right” to health care does not improve the situation we have right now. I don’t have a single patient turned away for inability to pay at my hospital. They all receive care. What we need to improve is the ability for adults to work and pay for their medical care. This in turn places money into Social Security and Medicare for their future possibility of disability, aging, and possible loss of parents for children. Therefore, relieving the taxpayer of some of the burden and allowing those moneys collected by taxes to be allocated to the exception groups mentioned previously. According to The New York Times, “costly American health care system must find ways to slow the rate of spending while delivering quality care “(“Formula”. 2012. Para.1). They found a health care system which has shown improved results in the patients of a healthcare system owned and managed by Alaska’s residents while decreasing the cost of care. By providing outpatient care which was once care allocated by the federal government’s Indian Health Services, not only was there a decrease in government involvement but decreased cost of care and improved outcomes (“Formula”,2012). The Patient Protection and Affordable Care Act or Obamacare was a change in the U.S. medical system since Medicare and Medicaid reform. The Affordable Care Act is designed to ensure that all Americans have medical coverage. It gives those that were uninsured a means to now have health insurance, offers a more affordable coverage to those who couldn’t afford their premiums, expand the limitations on public insurance and subsidize private insurance coverage.

I feel that we can explore programs such as the one used in Alaska and find ways to decrease federal/government involvement and increase resident/patient involvement in their own health care. By using the program as a template there could be gains to future programs. Development of a similar program with such positive outcomes could move not only the underinsured but the private insured to become champions in their healthcare ultimately improving their outcomes and decreasing out of pocket costs. This will help promote and initiate social change. Health care is indeed a human right; all people deserve to have it.

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References

Dictonary. (2012). Retrieved from http://dictonary.reference.com/browse/right

Dictonary. (2012). Retrieved from http://dictonary.reference.com/browser/privilege

Kovner, A.R. &Knickman, J.R. (2012). The Current U.S. Health Care System. In A. R.

Koverner, & J.R. Knickman (Eds.), Health Care Delivery in the United States (10th ed., pp3-24). New York, New York: Springer Publishing Company, LLC.

Heather Willison

RE: Discussion – Week 1

COLLAPSE

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MAIN DISCUSSION POST

NURS 6050N: Policy and Advocacy for Improving Population Health

Is Healthcare a Right or a Privilege? The Government’s Role.

As a healthcare professional, the question of healthcare in the United States being a right or a privilege is not easily answered. While I may believe that healthcare is a basic human right, I also believe that with that right comes individual responsibility. For the last several years the hot topic in healthcare has been the Affordable Care Act (ACA). While the ACA has allowed more Americans to gain access to healthcare through the marketplace and other government sponsored programs, it is my opinion that a more concerning issue continues to be overlooked. As a registered nurse employed in a busy specialty office, the biggest concern our patients have boils down to medication cost and in turn access. I believe that our federal government would serve its constituents better by taking measures to control the rising costs of pharmaceuticals. Assignment Nurs 6050 Week 1 Paper

How the Rising Cost of Prescription Drugs Impacts the Delivery of Healthcare

Increased prescription costs can have dire consequences for our population, particularly for those people with chronic illnesses. These rising costs can lead to increased premiums and copays, as well as patients being noncompliant with prescribed care as noted by Dr. Richard Fogel in a recent online article in the Huffington Post (Chau, 2016). Noncompliance can lead to more acute visits to providers, thus perpetuating the financial concerns. Pharmaceutical companies have the power to set prices for their drugs. According to a Reuters analysis (Humer, 2016), the retail cost of four of the nation’s top 10 medications actually increased by greater than 100% over the last five years. This price increase doesn’t only affect consumers but also employers and government sponsored health programs. Pharmaceutical companies do offer copay savings cards to those with private insurance coverage but, those receiving government assistance do not qualify (i.e. ACA, Medicare plans).

In Conclusion

To reiterate, I do believe that all people have the right to healthcare but, I also believe that the responsibility for such a privilege rests on the individual rather than our government. The government should instead focus itshealthcare reform efforts on reducing healthcare costs that are currently primarily controlled by the pharmaceutical industry.

References

Chau, L. (2016, May). Rising Prescription Pricing has Dire Consequences. Huffington Post. Retrieved from http://www.huffingtonpost.com/lisa-chau/rising-prescription-pricing-has-dire-consequences_b_10116378.html

Humer, C. (2016, April). Exclusive: Makers took big price increases on widely used U.S. drugs. Reuters. Retrieved from http://www.reuters.com/article/us-usa-healthcare-drugpricing-idUSKCN0X10TH

Jynnah Snow

RE: Discussion – Week 1

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Healthcare, Right or Privilege?(jyanah snow)

Healthcare in America, is it a right or a privilege? Depending on who you talk to, many believe it is both. For America to flourish, the need for people to be in good health is a must. “Good health is essential to participate in the political and social system, to work to support ourselves and our families, and to pursue happiness and a good life” (Koverner & Knickman, 2015, p.4). The Center of Disease Control (CDC), conducted a study in 2012 and found that over 117 million Americans, which is about half of the population, have at least one chronic disease. According to the CDC (2016), chronic diseases include heart disease, cancer, type 2 diabetes, obesity, stroke and arthritis, which are “all among the most common, costly and preventable of all health problems” (CDC, 2016). So over half of the population have some sort of chronic disease that can be preventable. Almost every person knows now that smoking is horrible for their health because it can cause lung disease, heart disease, strokes and cancer. All of which can be prevented if the person did not smoke. Yet, millions of Americans still smoke to this day. So is healthcare a right or a privilege? This is a great question. Should healthcare be given to all of those people who continue to eat high fat foods, smoke and drink alcohol and abuse their bodies causing chronic diseases like obesity, heart disease, and strokes? Growing up, my family was very low income, lived of food stamps and any help my mother could get from the government to help. My mother has been deemed disabled and cannot work and my father dropped out of school when he was in 8^th grade. They had four children that they could barely care for. Thankfully, the Medicaid gave my brothers and myself the medical care that we needed. Assignment Nurs 6050 Week 1 Paper. My youngest brother had horrible asthma and was hospitalized at least once a year for respiratory distress. If my mother couldn’t take my younger brother to the hospital, he would have never lived pass his toddler years. I think healthcare in America is a right. Of course, the system needs to be re-vamped. But if America is going to survive and flourish, we need people who are in good health. My brother is now part of the working class and contributes to society.

Currently, there is a great debate if healthcare should be a privilege or a right. There are two presidential candidates who have the complete opposite look when it comes to healthcare in America. Republican candidate, Donald Trump stated blasted Sanders plan “Medicare-for-all’ plan Thursday, saying access to healthcare is a privilege that should be earned, rather than a right…America didn’t become great through handouts,” (Hobbus, 2016). He continued to say that people should prove their worth, have degrees and those who make more than $100,000 and those who have no college degree and work minimum wage jobs shouldn’t have access to health insurance. Some of our greatest leaders didn’t come from the upper class. According to The Best of Art of Manliness, (2009), some of the greatest men from very little included Benjamin Franklin, Thomas Edison, Abraham Lincoln, Henry Ford and Walt Disney. I will have to say to Donald Trump, I disagree with you. Healthcare is not a privilege, it is a right.

The Role of Government in the U.S. Health Care System

The government should play a role in healthcare. Medicaid & Medicare are programs that were created to help those in dire need of healthcare. They are now the two largest health insurance companies. Medicaid alone has more than 65 million beneficiaries costing over $400 billion annually. Private insurance companies were getting more and more expensive every year and many people were not able to get insurance for several reasons. They worked at a place that didn’t offer employee insurance, or were denied due to pre-existing conditions. So many Americans went without insurance. But that does not mean they do not get sick. They still get healthcare that they will probably never be able to pay for. So hospitals lose money and in turn increase what they charge to make up for the losses. Obamacare or aka Affordable Care Act is a sore subject in many people eyes, but I think that the government had to do something about the epidemic of uninsured people in America. This new law “expands eligibility for public insurance, uses federal subsidies to make private coverage more affordable, and adds an overarching requirement that nearly all Americans have some form of health insurance” ((Koverner & Knickman, 2015, p. 29-30). This is the government stepping in to help the ever growing problem of healthcare in America. It may not be the final answer, but I think it is a step in the right direction.

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References

CDC. (2016). Chronic Disease Overview. Retrieved May 31, 2016, from http://www.cdc.gov/chronicdisease/overview/

Hobbus, R. (2016). Donald Trump: Healthcare is a Privilege, Not a Right. Retrieved May 31, 2016, from http://realnewsrightnow.com/2016/01/donald-trump-healthcare-is-a-privilege-not-a-right/

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

McKay, B. (2009). The Best of Art of Manliness | The Art Of Manliness. Retrieved May 31, 2016, from http://www.artofmanliness.com/2009/01/01/the-best-of-art-of-manliness-2008/

Judy Walton

RE: Discussion – Week 1

COLLAPSE

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Judy Walton

Walden University

NURS 6050N: Policy and Advocacy for Improving Population Health

Is Health Care a Right or a Privilege?

Health care is a privilege and a right that not all are able to maintain. According to media video there are still greater than 65 million people in the United States that do not have health care coverage. The government impacts health care in many ways. The video also reports, at one point in time Medicare would reimburse for the care that was given. Currently because the costliness of they have a set reimbursement price for specific illnesses these are DRG’s- diagnosis-related groups (Laureate Education, Inc., 2012d). The government encourages employers to provide coverage for their employees as well as distribute health insurance to the poor and disabled. When the Affordable Care Act of 2010 was enacted it widened the government’s role (Knickman & Kovner, 2015, p.40, para. 2). Private coverage was made more affordable and new rules were placed on insurers and employers to make insurance more accessible. Now, through the tax code, a penalty must be paid if any American does not have some form of coverage (Knickman & Kovner, 2015, p. 41, para 2, Assignment Nurs 6050 Week 1 Paper). The United States is one of the richest countries, but we have the highest mortality rate compared to other industrialized countries. The numbers are staggering when you compare the United States to Japan, they see a physician on average 14 times per year spending an estimated $3,000. The United States has an estimate of 5 visits per year and spends an average of $7,000 (Laureate Education, Inc., 2012d). Although we are a richer country, the math still does not add up to me when comparing mortality rates and quality of care.

I believe health care is both a right and privilege. All Americans have the right to health care to sustain the best quality of life. Not one life is more important than another. We are privileged to have assistance programs for coverage, such as Medicaid. Medicaid provided around 60 million Americans with coverage estimating $415 million dollars (Knickman & Kovner, 2015, p.33, para. 4).

The New York Times: Cost-of-Living Health Care

The area of health care is the care that should be available to people before they are critical in nature in the United States. This article provides an insight on a topic that usually is a topic for discussions for all, this is cutting the cost of health care without decreasing the quality of care. According to the article in the New York Times, “Intermountain has already saved money by renegotiating the cost of surgical staplers, pitting a cheaper manufacturer against another and saving $235,000 a year. It saved $639,000 a year by ensuring that heart attack patients get into the catheterization lab within 90 minutes of emergency room contact, thereby helping patients recover faster”(Abelson, 2016, Feb 18). This is a way to make health care available to most people all including those that may need a cut. The plan is to decrease costs this will allow more to get the appropriate care before it is a emergent situation.

References

Abelson, R. (2016, Feb 18). Cost-of-living health care. New York Times Retrieved

from http://ezp.waldenulibrary.org/login?

url=http://search.proquest.com/docview/1765751039?accountid=14872

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing

Laureate Education, Inc. (Executive Producer). (2012d). Introduction to healthcare delivery, part I. Baltimore, MD: Author

Funmilayo Olugbemi

NURS 6050N: Policy and Advocacy for Improving Population Health

Is health care a right or a privilege?

I would state that healthcare is both a right and a privilege. We have one of the biggest and the greatest health care in the world but not everyone has access to it due to breakdown in the system and disparities in the health care delivery system. This is a great challenge to receiving the best health care delivery that most belief is a right. It can also be said that health care is a privilege because if we want a vibrant, active and productive economic society, then the society and the government ought to get involved. The degree of the involvement is always a debatable issue. There is estimated 17% of the society that are insured and over 60% who get their health care insurance through the employers (Laureate Education, Inc., 2012d).

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The role of government in health care including Affordable Care Act

There were three basic problems that existed in the health care system prior to the law makers looking into health care reforms that precluded the accessibility of affordable health care insurance cost, they are as follows: small business owners and self-employed people are not able to provide health insurance to their employees, and people with catastrophic disease are mostly excluded from insurance market (Knickman & Kovner, 2015, p.38, para. 3). If there are no checks and balances in the system this great country would not have become what it is. Let me use myself as an example. Where I was born, there is no infrastructure or any subsidy for health care cost, hence no matter how much the cost of health care delivery is, you as the consumer has to pay for it. Therefore people stay home to use the indigenous barks, leaves and roots which in the end may or may not cure what hails them. Hence, people’s life are cut short. Here in the US, it is not so.

With government involvement, is the development of Medicare and Medicaid in the 1960s for older adults and the vulnerable poor people respectively. Hence government became largest payer of healthcare insurance thereby having a greater impact in dictating health care cost that even trickles down to other health care insurance. There was a big change in healthcare cost and payment in the 1980s, when the government changed from cost based payment system to a prospective payment system whereby the government pay a set amount for a given illness or disease. This has impacted the health care cost and payment system and led to what was called the DRGs (Diagnosis-Related-Groups) in the 80s. In the 90s, President Clinton made a tremendous effort by proposing for a healthcare reform because of the continuous rising cost of health care but it failed. Why? It was stated that probably people were not ready. The public is now much more interested and wants a reform in the health care system. We spent double the amount per capital in the US, yet we have higher mortality rate. For example, Japanese that has the oldest population in the world goes to see health care provider almost three times the US population and they spend less than 50% of what US spend per year. We spend more but achieve less health care outcome (Laureate Education, Inc., 2012d). With the enactment of Affordable Care Act (ACA) of 2010, there’s greater participation of the government in the delivery of health care and a projection that quality and cost of health care will develop into a more vital part of health care delivery discussion. If the enactment of ACA keeps moving forward, then the emphasis will be on coordination of care in becoming a huge part of the health care organization that will capture an emerging section of the market. However, consumers are still uncertain on the future steps of the ACA. Nonetheless the probability is that people will be more involved in their health care (Knickman & Kovner, 2015, p.26-27, para. 2).

Washington Post wrote an article titled “what New Delhi’s free clinics can teach America about fixing its broken health care system”. This article is about how a 20 week old pregnant woman who nearly collapsed and may have lost her pregnancy or died was triaged in a free clinic in only about 15 minutes. She was transferred to a nearby hospital and the entire process was automated from check-in to retrieving the medical records, testing, analysis and ambulance dispatch without any form of paper work and all the care was free. This was made possible through the development of an android tablet called Swasthya Slate. Again because of government involvement in health care delivery in India, the Delhi health minister came up with the idea for the clinics using this android tablet which inadvertently reduced suffering, and health care costs as people are getting timely care without the use of the emergency room. In conclusion, healthcare is both a right and a privilege.

References:

https://www.washingtonpost.com/news/innovations/wp/2016/03/11/what-new-delhis-free-clinics-can-teach-america-about-fixing-its-broken-health-care-system/

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing

Laureate Education, Inc. (Producer). (2012d). Introduction to healthcare delivery, part I. Baltimore, MD: Author

Assignment Nurs 6050 Week 1 Paper