Access And Coverage For Health Care In Americans Essay

Nursing 510
Week 1

Discussion Prompt 1
Discuss your position regarding access to and coverage for health care. Are we obligated to provide access to and coverage for health care for all Americans as an entitlement (a right), or should health care be considered a commodity that is subject to the influences of economic, social, and market demand (supply and demand)? Be sure to include the rationale for your position in your discussion.Access And Coverage For Health Care In Americans Essay
Discussion Prompt 2
What are the barriers to nurses’ participation in the development of health care policy at the state or national level or in an organization in the United States? Why do you think these are barriers? Support your opinion with a rationale or example.

ORDER  HERE A PLAGIARISM-FREE PAPER HERE

APA and References.

Week 1 Public Policy Meeting Approval
Click here to submit your public policy meeting approval.
Create a thread seeking approval for your public policy meeting. Choose a meeting to view or attend. It must be a public policy body at work and related to health care. If it is a recorded meeting, please make sure it has been posted within the last year. Access And Coverage For Health Care In Americans Essay
Click on this forum, then click ‘Create New Thread’. Title the thread with your name and the name of the policy meeting. For example: Janice Smith: Affordable Health Care Policy Meeting
In the body of the thread, include
• the title or topic focus of the policy meeting
• the date and time of the meeting
• the location of the meeting (if online, include the website). Some websites are:
o https://www.c-span.org/ (search the video library or the live sessions)
o http://www.youtube.com (perform a search for your topic)
o Your local government or healthcare organization websites

We need to find a public meeting topic, some of the them that I now have been approved, it is just to give you an idea. Once the topic is approval we will need to right and essay for the next assignment, now is just the topic with the date and time that take place.

Senate Hearing on Corporate Liability during the corona virus pandemic.
Proposal to achieve universal health care coverage
White house coronavirus task force testifies on coronavirus response and responding phase
Senate health committee hearing on health care cost act Access And Coverage For Health Care In Americans Essay

Over the last ten years there have been dramatic changes in the health insurance environment in the United States, spurred on by broad reforms in the public health insurance sector. In 2006 the Medicare Prescription Drug, Improvement and Modernization Act went into effect, providing broad access to prescription drug insurance for millions of elderly Americans. In 2014 the main provisions of the Patient Protection and Affordable Care Act began to be felt, dramatically changing health insurance markets, particularly for those seeking non-group coverage. These legislative changes both raise questions regarding how well the policy changes meet their goals, as well as offering new variation with the potential to answer questions of fundamental economic significance.Access And Coverage For Health Care In Americans Essay

This dissertation addresses such important questions surrounding the effectiveness of public health insurance in meeting policymakers’ goals, and the implications of public health insurance for private markets. In the three chapters of this dissertation I utilize the policy changes of Medicare Part D and the Affordable Care Act to provide quasi-experimental estimates of retirement lock, of the correlation of risk aversion and crowd-out of private insurance, and of the effectiveness of the individual health insurance mandate in expanding coverage.Access And Coverage For Health Care In Americans Essay

The first part studies the implications of public drug insurance for labor markets. This part examines whether the lack of an individual market for prescription drug insurance causes individuals to delay retirement. I exploit the quasi-experiment of the introduction of Medicare Part D, which provided subsidized prescription drug insurance to all Americans over age 65 beginning in 2006. Using a differences-in-differences design, I compare the labor outcomes of individuals turning 65 just after 2006 to those turning 65 just before 2006 in order to estimate the causal effect of eligibility for Part D on labor supply. I find that individuals at age 65 who would have otherwise lost their employer-sponsored drug insurance upon retirement decreased their rate of full-time work by 8.4 percentage points due to Part D, in contrast to individuals with retiree drug insurance even after age 65 for whom no significant change was observed. This reduction was composed of an increase of 5.9 percentage points in part-time work and 2.5 percentage points in complete retirement. I use these estimates to quantify the extent of the distortion due to drug insurance being tied to employment, and the welfare gains from the subsidy correcting that distortion. The results suggest that individuals value 1ofdruginsurancesubsidyasmuchas3 of Social Security wealth.Access And Coverage For Health Care In Americans Essay

The second part of this dissertation considers the effect of public drug insurance on private drug coverage, with a focus on the correlation of crowd-out and risk aversion. I utilize Health and Retirement Survey data around the time of introduction of the Medicare Part D prescription drug insurance for the elderly in order to estimate crowd-out of private prescription drug insurance. I use individuals between the ages of 55 and 64, who are not eligible for the program, as a control group relative to individuals aged 65 to 75, who are eligible. I take a differences-in-differences approach to estimation by comparing outcomes before and after 2006, when Medicare Part D went into effect. I construct measures of risk aversion by exploiting unique questions eliciting risk preferences in the Health and Retirement Survey, as well as information on whether individuals have other kinds of insurance, or engage in risky behaviors. I find substantial differential crowd-out by risk aversion: every standard deviation increase in risk aversion was associated with about 5 percentage points less crowd-out, over a base crowd-out rate of 50%-60%. More risk averse individuals also saw greater reductions in out-of-pocket spending on prescription drugs due to Part D, particularly at high levels of spending: at the 85th percentile of spending an individual one standard deviation more risk averse than the average experienced a decline of 110/yearduetoPartDeligibility,aboveandbeyondthegainsforanaveragelyriskaverseindividualof382/year.Access And Coverage For Health Care In Americans Essay

The third part of the dissertation estimates the effectiveness of the individual mandate in the Patient Protection and Affordable Care Act in expanding health insurance coverage. This paper studies the impact of the individual health insurance mandate in the Patient Protection and Affordable Care Act (PPACA) on health insurance coverage. This mandate went into effect in 2014, alongside various other elements of the PPACA. I focus on individuals ages 26-64 who are ineligible for the subsidies or Medicaid expansions included in the PPACA to isolate the effect of the mandate from these other components. To account for changes unrelated to the PPACA that occur over time and affect insurance coverage I utilize a control group of residents of Massachusetts who were already subject to mandated insurance following the 2006 health care reform in their state. Employing a differences-in-differences design applied to data from the American Community Survey, I find that the mandate caused an increase of 0.85 percentage points in health insurance coverage, or a 17% decline in the uninsurance rate. This increase was concentrated in coverage purchased directly by individuals, rather than acquired through an employer, and predominantly affected younger individuals. Both these observations are consistent with the mandate ameliorating adverse selection in the individual health insurance market.Access And Coverage For Health Care In Americans Essay

The importance of access to health care services in society determines the standards and state of health within a population. Health disparities is a big issue in the United States and is defined as inequality of the care that a person or community get due to certain factors. Some believe that these factors are just racial related but there are many more factors that are considered. Disparities in health do not refer only to ethnic and racial disparities, but rather the general health situation in the community. Access to health care services determines the disparities that exist in society, and this affects all ethnic and racial groups in the country.Access And Coverage For Health Care In Americans Essay

The Importance of Health Care
Courtesy iStock
Jump ahead to…
A Disparity
Barriers for Children
Children’s Health Insurance Program
Bibliography
A Disparity
The disparity is determined by the extent of health outcomes within a population, meaning that all factors around an individual including their environment, age and even socioeconomic status will play a key role in determining their health (HealthyPeople2020, 2014). According to Obama Facts, in the course of 5 years, more than one hundred thousand Americans died in the United States because of lack of access to health care services (Facts on Deaths Due to Lack of Health Insurance in US). Unfortunately, this number also includes infants and children that are affected as well by the lack of healthcare due to disparities. In the following essay, it will be further discussed why some children face barriers to accessing health care services because of different factors and the policy that has been established to help with this issue.Access And Coverage For Health Care In Americans Essay

Barriers for Children
There are many factors that can influence whether a child receives healthcare or not. One of the first mentioned factors is the geographic location. If the parent or guardians of that child have no means to get to a medical facility, then how are they supposed to get the needed care? A second factor that is taken into consideration is the financial aspect especially those that are considered poor. “The opportunity cost of seeking health care is likewise relatively higher for poorer than wealthier households. This is because the poor often earn income directly from their labor. Caring for sick children may divert the labor and time of poor parents away from income-generating activities, thereby reducing household income” (BARRIERS TO ACCESS TO CHILD HEALTH CARE). Culture plays a big role as well when it comes to somebody receiving healthcare. If that child’s religion or culture have traditions that prevent them from receiving healthcare, then this is something the child has no control over. A big challenge that healthcare professionals face is the patient’s lack of knowledge and importance of bringing one’s child for checkups and/or when to bring them in to get seen for an acute visit. Approximately 70 percent of child deaths is down to delays in delivering health care services, and this means that caregivers have to be familiar with specific health institutions where they know they will get good service (BARRIERS TO ACCESS TO CHILD HEALTH CARE).Access And Coverage For Health Care In Americans Essay

ORDER   HERE NOW

When they are brought in but don’t have the finances to pay for the services, the quality of care lowers. Inequality of care in not something that is rare in the healthcare system. A child with an expensive healthcare insurance will receive high quality care compared to the child that came through the emergency room and has no type of coverage. Healthy People 2020 have chosen Health Disparities as one of their overarching goals and are working to end this in the world. The objective of ‘Healthy People 2000’ was to reduce health disparities among Americans. The focus of this group was not just the reduction of health disparities that exist in the community, but achieving health equity for all the relevant groups in society to guarantee equal access to health services (HealthyPeople2020, 2014).Access And Coverage For Health Care In Americans Essay

Children’s Health Insurance Program
There are families that are financially unable to pay for healthcare insurance and are covered under Medicaid benefits. Although this is fortunate, there are the middle-class families that just make a little more about the cut off to be considered under Medicaid. In 1997, Children’s Health Insurance program was developed and establish to help these families with children so they could be covered and receive care. The two programs have helped reduce the uninsured rate among children and, from 1997 after the enactment of CHIP, to 2012, the uninsured rate among children dropped from 14 percent to 7 percent. Several millions of children accessed health insurance covers, and this new low in the number of uninsured children was a positive breakthrough in getting more children access to health services. The group of children specifically targeted were those below the federal poverty level, and the general uninsured rate during this period would drop from 25 percent to15 percent. (Paradise, 2014). This program has greatly reduced the percentage of children that go without receiving care because poor children continue to suffer as cost-effective child health interventions fail to reach them.Access And Coverage For Health Care In Americans Essay

The U.S. health care system faces significant challenges that clearly indicate the urgent need for reform. Attention has rightly focused on the approximately 46 million Americans who are uninsured, and on the many insured Americans who face rapid increases in premiums and out-of-pocket costs. As Congress and the Obama administration consider ways to invest new funds to reduce the number of Americans without insurance coverage, we must simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps — even for those with access to insurance coverage.

There is broad evidence that Americans often do not get the care they need even though the United States spends more money per person on health care than any other nation in the world. Preventive care is underutilized, resulting in higher spending on complex, advanced diseases. Patients with chronic diseases such as hypertension, heart disease, and diabetes all too often do not receive proven and effective treatments such as drug therapies or selfmanagement services to help them more effectively manage their conditions. This is true for insured, uninsured, and under-insured Americans. These problems are exacerbated by a lack of coordination of care for patients with chronic diseases. The underlying fragmentation of the health care system is not surprising given that health care providers do not have the payment support or other tools they need to communicate and work together effectively to improve patient care.Access And Coverage For Health Care In Americans Essay

While many patients often do not receive medically necessary care, others receive care that may be unnecessary, or even harmful. Research has documented tremendous variation in hospital inpatient lengths of stay, visits to specialists, procedures and testing, and costs — not only by different geographic areas of the United States, but also from hospital to hospital in the same town. This variation has no apparent impact on the health of the populations being treated. Limited evidence on which treatments and procedures are most effective, limited evidence on how to inform providers about the effectiveness of different treatments, and failures to detect and reduce errors further contribute to gaps in the quality and efficiency of care. These issues are particularly relevant to lower-income Americans and to members of diverse ethnic and demographic groups who often face great disparities in health and health care.Access And Coverage For Health Care In Americans Essay

Reforming our health care delivery system to improve the quality and value of care is essential to address escalating costs, poor quality, and increasing numbers of Americans without health insurance coverage. Reforms should improve access to the right care at the right time in the right setting. They should keep people healthy and prevent common, avoidable complications of illnesses to the greatest extent possible. Thoughtfully constructed reforms would support greater access to health-improving care — in contrast to the current system, which encourages more tests, procedures, and treatments that are at best unnecessary and at worst harmful.

This report reviews the evidence on a range of payment and delivery system reforms designed to improve quality and value. It reaches several conclusions:

1. While there is ongoing debate about the ability of various delivery system reforms to increase value, there are clear attributes of different approaches to reform that are more likely than others to improve health and slow cost growth.

Chronic Disease Management, Primary Care Coordination, and Health Information Technology (HIT) — There is strong evidence that particular approaches or programs in these areas can improve quality and health outcomes. Some interventions also show evidence of lowering total cost growth. At the same time, these reforms, as implemented, have been very heterogeneous, and improvements in value and especially reductions in cost have not been automatic. While we find promising evidence that delivery system interventions can help slow the growth of health care costs, we argue that it should be possible to achieve larger and more certain savings by having meaningful risk-adjusted accountability incentives and requirements in place. These incentives and requirements should also be tied to particular quality improvement steps.Access And Coverage For Health Care In Americans Essay