Future of Nursing
What is the cost of health care in the U.S.? What is the comparative value of the U.S. Healthcare System?
The United States maintains the highest cost of healthcare in the world. Data released in 2019 showed that the United States spent approximately 3.6 billion dollars on healthcare which represented 11,072 dollars per individual (Cai, Runte, Ostrer, Berry, Ponce, Rodriguez, Bertozzi, White & Kahn, 2020). Consequently, the United States is followed by Switzerland at 7,732, Germany at 6,646 and Sweden at 5,782 dollars per person annually per person (Cai et al., 2020). The high healthcare in the United States is blamed on complexity of the healthcare system, multiple systems squandering resources, and rising drug costs.
Who pays for health care in the U.S.? Who should pay?
The health care is funded by the federal government, private health insurance, and individuals seeking services from healthcare providers. The government funds the healthcare system through its Medicaid and Medicare alongside other programs they run consisting of about 50 percent of the medical spending in the country (Richard, Walker & Alexandre, 2018). The private insurance programs through employers pay about 388 dollars per month translating to about 33 percent of all medical costs (Richard, Walker & Alexandre, 2018). The rest, about 17 percent is paid by individuals using their incomes (Richard, Walker & Alexandre, 2018). Since many people do not have health insurance and the health care is consistently soaring, I believe the government should pay for the health care costs through universal access coverage.
Is individual access to health care a right or a privilege?
Other countries around the world perceive individual access to healthcare as an absolute right but the United States treats it as a privilege. This means health care services are available to those who can afford it. As such, the number of people without health care insurance is high. Per Cai et al. (2020), the number of people without health insurance in the United States was 27.5 million in 2018 representing 8.5 percent of the general population. Those not enrolled in health care insurance plans are financially burdened and contend with poor health. The risk of financial ruin and contending with poor health disadvantages them and does not grant them equal opportunity in the American society.
What, in your opinion, are the current U.S. Health Care System design shortfalls, if any? How would you re-design it, if needed? Who should be responsible for the re-design?
The United States health care system has design shortfall in regard to addressing chronic diseases. The chronic diseases like heart diseases, stroke, cancer, diabetes are quite common and are expensive to treat, yet they are preventable health problems (Saver, Martin, Adler, Candib, Deligiannidis, Golding, Mullin, Roberts &Topolski, 2015). It is revealed that 50 percent of Americans do not receive the appropriate care for chronic diseases (Saver et al., 2015). As such, health care services are available to those who can afford it. I would use the chronic care model to design the system to produce desired results for patients, while also improving the quality of care and financial performance of the entire health care system. The design would engage health care teams, patients, and families to focus on heath care goals, needs, and ability of the system to yield preferred medical outcomes. The responsibilities of redesigning the health care system fall on senior leaders, clinicians, and administrators because they comprehend the tenets of quality improvements efforts.
What are the essential provisions of the 2010 Patient Protection and Affordable Care Act (PPACA)? What impact do you think the PPACA will have on the U.S. Healthcare System? The U.S. economy?
The Patient Protection and Affordable Care Act (PPACA) attempt to increase consumer insurance protection by prohibiting lifetime and annual monetary caps on insurance coverage. The legislation prohibits insurance plans from excluding children suffering from preexisting medical conditions (Rosenbaum, 2011). The PPACA would reduce the number of the uninsured Americans by 50 percent and increase the beneficiaries of Medicaid programs by 15 million (Rosenbaum, 2011). The PPACA will increase productivity and employment opportunities to people thereby impacting on the economy. The law assures access to healthcare services implying that people will be healthy and thus productive and employable.
Which problems would Accountable Care Organizations (ACO) solve? Do you think ACOs present an effective solution to these problems?
Accountable Care Organizations (ACO) promises to control wastage of resources in the Medicare system occasioned by inappropriate payments to healthcare providers. Additionally, the ACO seeks to enhance the provision of better healthcare services to Medicare patients (Nathan, Thumma, Ryan & Dimick, 2019). Provision of better health care services to patients promises to save money for both health care service providers and patients. The ACO does not present effective solutions because the baby boomer generation is attaining retirement age (Nathan et al., 2019). The aging of the population means that Medicate programs would further be taxed jeopardizing the desire to regulate wastes of resources and guarantee the provision of quality services.
What role do registered nurses currently play within the U.S. Healthcare System? What role, in your opinion, should the RNs play? How effective is the RN profession? Is there a common voice among the nurses in the U.S.?
Registered Nurses (RNs) are important in the healthcare system as they perform varied roles. The RNs coordinate care from broad spectrum of health care service providers, manage patients with intense needs, and help patients to transition to home setting after discharge (Goodman, 2015). Additionally, RNs provide primary care in the form assessments, diseases diagnosis, prevention, treatment, and drug prescriptions. In my opinion, RNs should focus on health promotion and education initiatives to prevent the onset of chronic diseases burdening the health care system, yet are preventable. Notably, RNs are effective in optimizing the best patient outcomes. The RNs closely analyze the effectiveness of care plans before implementing them on patients (Goodman, 2015). The RNs have a voice through the American Nurses Association (ANA). Through ANA, RNs are able to foster high standards of nursing practice, advance safe care, and foster an ethical operating environment.
What are the essential themes in the latest Institute of Medicine’s Report on the Future of Nursing?
The IOM report discusses key themes importance in advancing the nursing profession. The report claims nurses should be allowed to operate to the maximum limit of their scope of practice based on their level of education (Nickitas, 2010). I agree with this finding on the proposition that nurses can optimally contribute in the improvement of the healthcare services if they are not limited by their job descriptions. The other key message is the need to allow nurses to advance their knowledge through continuous education in a remodeled nursing education system (Nickitas, 2010). I agree a remodeled nursing education will allow nurses to acquire fundamental knowledge essential in improving the quality of services offered in the healthcare system.
Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J., & Kahn, J. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLoS Med 17(1), e1003013.
Goodman, T. (2015). RN-to-BSN programs key to reaching an important nursing goal. AORN, 102(1), 1-2.
Nathan, H., Thumma, J., Ryan, A., & Dimick, J. (2019). Early impact of Medicare Accountable Care Organizations on inpatient surgical spending. Annals of Surgery, 269(2), 191–196.
Nickitas, D. (2010). A vision for future health care: Where nurses lead the change. Nursing Economics, 28(6), 361-385.
Richard, P., Walker, R., & Alexandre, P. (2018). The burden of out of pocket costs and medical debt faced by households with chronic health conditions in the United States. PLoS ONE 13(6): e0199598.
Rosenbaum S. (2011). The Patient Protection and Affordable Care Act: implications for public health policy and practice. Public Health Reports, 126(1), 130–135.
Saver, B., Martin, S., Adler, R., Candib, L., Deligiannidis, K., Golding, J., Mullin, D., Roberts, M., & Topolski, S. (2015). Care that matters: Quality measurement and health care. PLoS Med 12(11), e1001902.