Policy and Advocacy for Improving Population Health

NURS 6050: Policy and Advocacy for Improving Population Health

Walden University

NURS 6050: Policy and Advocacy for Improving Population Health

Week 1 Main Post

Health care as a privilege

I have worked and provided my medical coverage since I was 16 years old. At the time, I felt I was healthy and hated to pay money for health insurance when I never went to the doctor. At one point, I dropped my health insurance for a year just to save the money for school. In that year, I had an emergency appendectomy and had to stay four nights; the hospitalization was not covered by insurance at all. I got bills in from radiology, anesthesia, lab, and then the main hospital bill; I felt overwhelmed with all the bills. Luckily, the hospital provided a program that would lower my bill by 80% if I worked full-time or was in school. I also negotiated with the other departments to pay half of all my bills, if I came in and paid cash. I was fortunate enough to have worked and saved enough money to pay all my bills off. I immediately signed back up for health insurance having realized that quality health care was a privilege. I knew I had to work hard and pay for insurance so that I could continue to get good care and be financially covered.

As a working nurse who still pays for health coverage, I believe quality and affordable healthcare is a right for everyone; however, I do not think we, as taxpayers, should cover the cost. In my opinion, everyone should receive quality care, but to receive the best care, one does need health coverage. I do believe health coverage is a privilege that one must work for and provide for themselves. When I was uninsured, I received great care while in the clinic and hospital; I was just not financially covered.  Food and water are also right to us but a privilege. I feel the same way about health coverage as I do food and water- it is necessary but must be self-provided. The government helps people who are not able to work or afford health insurance with programs such as Medicaid and Medicare.  

Government’s role in healthcare

The healthcare delivery system is a vast and complex system, and I believe we need the support and guidance of our federal, state and local government. I think the government plays a big part in our healthcare system by providing and funding some of the most significant programs in health care, Medicaid and Medicare. Without these programs, the majority of the low-income and the elderly would be without coverage. However, I feel like the government should be more stringent with who qualifies for Medicaid which may help with the cost. The government is also responsible for the passing of The Patient Protection and Affordable Care Act. I do think everyone deserves affordable health insurance but not at the expense of taxpayers.

More specific roles of the government are broken down in chapter two, figure 2.2 of Health Care Delivery in the United States. Figure 2.2 separates the federal, state and local governments roles in our health system. It shows the federal government is responsible for developing national health policies, providing health insurance to the poor, disabled and elderly, veteran health care, tax policies for employers, and funding training for physicians. (Dangremond, 2015, figure 2.2) The government at the state level plays a significant role in the Medicaid program; the local government plays a major role in managing the local hospitals.

In a Health Affairs article, it states “A federal leadership role is also warranted because the government is the single largest payer for health care and the single largest provider of care.” (Schoenbaum, Audet, & Davis, 2003, p. 184) The healthcare system would not be what it is today without all aspects of the government.

Technological issue impacting health care delivery

The technical matter I chose that has a substantial impact on the delivery of health care is telemedicine. With telemedicine, physicians and practitioners can use telecommunication technology to evaluate, diagnose, and deliver health care as well as share clinical information on patients. Telemedicine would benefit our health care delivery system by increasing medical access to the patient, decreasing the cost of health care due to better management of people’s health, and by allowing specialty physicians to expand their practice to other areas of the world.

In the article,” Empirical analysis of the long-term effects of telecare use in Nishi-aizu Town, Fukushima Prefecture, Japan”, the long term effect of telemedicine was studied. This study focused on the treatment and management of chronic diseases such as hypertension, diabetes, stroke, and heart disease. Akematsu, Nitta, Morita, & Tsuji, found that the use of telecare decreased the treatment days by 4.2 days and the cost by $64,944 per user per year. (Akematsu, Nitta, Morita, & Tsuji, 2013)

I think telehealth will soon expand to be an important part of the health care delivery system and when it does I feel like private entities should address it. I feel like physicians and nurses should run telehealth. I do think that the government needs to have some part in the system, but not mandating how it is operated or used. I believe that the government should mandate the use of telecare, especially in rural areas and provide funding for the technology.

References

Akematsu, Y., Nitta, S., Morita, K., & Tsuji, M. (2013, September 13). Empirical analysis of the long-term effects of telecare use in Nishi-aizu Town, Fukushima Prefecture, Japan. Technology And Health Care: Official Journal Of The European Society For Engineering And Medicine, 21(2), 173-182. http://dx.doi.org/10.3233/THC-130728

Dangremond, C. K. (2015). A visual overview of health care delivery in the United States. In J. R. Knickman & A. R. Kovner (Eds.), Health care delivery in the United States (11th ed. (pp. 13-27). New York, NY: Springer Publishing

Schoenbaum, S. C., Audet, A. J., & Davis, K. (2003). Obtaining greater value from health care: The roles of the U.S. Government. Health Affairs, 22(6), 183-190. http://dx.doi.org/doi: 10.1377/hlthaff.22.6.183