Select a current or proposed health care policy that is designed to improve a specific population’s access to quality, cost-effective health care. In a paper of 1,000-1,250 words, include the following:

Explain the policy and how it is designed to improve cost-effectiveness and health care equity for the population. Is the policy financially sound? Why or why not? How does the policy account for any relevant ethical, legal, and political factors and the nursing perceptive one must consider when implementing it?
To what state, federal, global health policies or goals is this particular policy related? How well do you think the policy is designed to achieve those goals?
Finally, discuss the advocacy strategies you would employ on behalf of your population to ensure they have access to the benefits of the policy. Explain, from a Christian perspective, the professional and moral obligation of advanced registered nurse to advocate for and promote health and prevent disease among diverse populations.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.  The Patient protection and affordable Care Act Essay Paper

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MS Nursing: Public Health

MS Nursing: Education

MS Nursing: Acute Care Nurse Practitioner

MS Nursing: Family Nurse Practitioner

MS Nursing: Health Care Quality and Patient Safety

2.1: Examine financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors.

2.2: Determine advocacy strategies for improving access, quality, and cost-effective health care for diverse populations.

4.2: Integrate appropriate state, federal, and global health policies and goals into the design of equitable health care for populations.

4.3: Examine the professional and moral obligation of master’s-prepared nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective.

Population Health Policy Analysis: The Patient protection and affordable Care Act (ACA 2010) Legislative Policy for Minority Marginalized Communities

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The current healthcare policy that has been chosen for this paper is the Patient Protection and Affordable Care Act of 2010. It is usually shortened to the Affordable Care Act or ACA 2010 or fondly referred to as Obamacare. The population for which it is designed to improve access to quality healthcare and cost-effectiveness of the care is that of marginalized minority communities. In the US context, these marginalized minority communities include African Americans and Hispanics as the majority. The ACA 2010 is a revolutionary healthcare policy that was formulated and signed into law by the Obama administration. Its aim was to incorporate the poor Americans who could hitherto not afford healthcare into the healthcare coverage bracket. Its implementation was to be done in phases over several years and some responsibilities for this were to fall on the individual state governments. According to Sultz and Kroth (2018), the main aim was to ensure there was some semblance of equity and justice in the access to healthcare by US citizens. When the Trump administration came, it took upon itself to destroy the gains that had been made by the ACA 2010 in terms of redressing the healthcare inequity that defined the American healthcare system. This was the infamous ‘repeal and replace’ undertaking by the Republicans under Trump (AAFP, 2020). But this is now being reversed back to the way it is by the new Biden administration that has already declared the restoration of the ACA 2010 to its original form. The purpose of this paper is to discuss the ACA 2010 and how it has brought about equity, justice, and cost-effectiveness in the US healthcare system.    The Patient protection and affordable Care Act Essay Paper

Explanation of the Policy and How It Is Designed to Improve Cost-Effectiveness and Healthcare Equity

The policy was signed into law in the year 2010. It sought to use economies of scale to afford healthcare coverage to a wider population of Americans at an affordable cost. The target in this was the poor Americans especially from the marginalized communities who could not afford healthcare. This alone managed to bring into healthcare coverage an additional 22 million low-income Americans (Kominski et al., 2017). To make everybody take healthcare coverage, the ACA 2010 policy imposes the individual mandate. This is the provision that requires everybody to take up healthcare coverage under the ACA 2010 if they are not already taking a private cover. If one does not do this, the policy imposes a penalty that the person not having the cover will pay. The purpose of this was to oblige everyone to take the affordable healthcare coverage under ACA 2010 so that the economies of scale would be realized.

The ACA 2010 policy also brought about equity and justice in healthcare by having provisions to give monetary incentives to payers so that they may cover older persons with pre-existing conditions. These are conditions such as type II diabetes, obesity, hypertension, and heart disease. Historically, it is the marginalized minority communities such as African Americans and Hispanics that are disproportionately affected by these pre-existing conditions. Lastly but not least, the ACA 2010 shifted focus from high-volume healthcare to high-value healthcare. Under it, providers would only be reimbursed for the quality of services delivered and not the quantity (volume). It is a paradigm shift from volume-based care to quality-based care. This is the whole essence of the pay-for-performance philosophy (Holmström, 2017). In all, the ACA 2010 is set to change the dubious distinction of the United States healthcare system as the most expensive in the world.

Fiscal Soundness of the Policy

The ACA 2010 is indeed financially sound. This is because the Obama administration realized the enormity of implementing it in terms of resources and therefore staggered its adoption and implementation. At the signing of the healthcare policy, it was estimated that its implementation over a period of 10 years would cost the taxpayer an estimated $940 billion (Amadeo, 2019). By staggering the implementation over ten years, it would not be necessary to have this entire amount at once. Rather, chunks of it would be required one step at a time as the policy is implemented.  The Patient protection and affordable Care Act Essay Paper

Policy Addresses Ethical, Legal, and Political Factors

The ACA policy addresses all the four major bioethical principles set forth by Beauchamp and Childress. These are beneficence, nonmaleficence, autonomy, and justice (Haswell, 2019). It seeks to bring the greatest benefit for the greatest number of US citizens (beneficence). It also seeks to remove the barriers that deny those poor US citizens coverage just because they have pre-existing conditions. This is respect for nonmaleficence. And because it empowers the low-income citizen to obtain healthcare coverage for quality healthcare, it gives them a voice in how they receive the care and the direction that it takes. This is respect for the bioethical principle of autonomy. Lastly, this policy expressly brings about justice to the millions of Americans who could not afford quality healthcare because of the astronomical cost.

Legally, the ACA 2010 considers the access to healthcare as a basic human right that all human beings are entitled to as an inalienable right. This is despite the fact that the US constitution does not expressly talk about healthcare in those terms. However, the constitution gives the Congress the authority to come up with favorable laws such as the ACA 2010. Politically, the ACA 2010 is identified with President Obama and that is why it is nicknamed the Obamacare. On a larger scale, it is viewed as a Democrat policy that is loathed by Republicans. This is the reason why Republicans under former President Trump attempted to mutilate it. All these three aspects must be kept in mind by the nurse as they carry out their duties influenced by this policy.  The Patient protection and affordable Care Act Essay Paper

Relationship to Global Health Policies and Advocacy Strategies

The most obvious global health policy that this ACA 2010 policy is related to is Universal Healthcare Coverage or UHC (WHO, 2019). This is where there us a single-payer system that guarantees all citizens equal access to healthcare whether rich or poor. In the US, ‘Medicare for All’ would have been the equivalent to the UK NHS where access to healthcare is universal for all regardless of socio-economic status (Cai et al., 2020). The ACA is well-designed to achieve this goal of UHC in the long run. This is because it has taken very bold steps in the direction of equity and justice. The most significant of these is the fact that it facilitates the coverage of individuals with pre-existing conditions. These are citizens that have always been denied healthcare coverage because of their conditions.

As a nurse who is a patient advocate, the advocacy strategies that would adopt to ensure that minority communities benefit from this policy are mainly two. The first one is to carry out community sensitization in the form of health education and promotion. This will involve teaching about the benefits of ACA 2010 and also about the individual mandate. The second one is to lobby the local representatives to speed up the actualization of the remaining provisions of the ACA 2010 so that the minority communities can benefit fully from it.

The Moral obligation of the APRN from a Christian Perspective

The moral obligation of the APRN to advocate for and promote health while preventing disease lies in the duty of care. As a nurse, the very decision to become a professional nurse makes you morally responsible for the care of communities and also for sensitizing them about the correct healthcare choices. The Christian narrative and worldview challenges us to be our brother’s keeper and to love our neighbor’s as we love ourselves. These are the guiding principles of the nurse.

References

Amadeo, K. (2019). How much did Obamacare cost? The Balance. https://www.thebalance.com/cost-of-obamacare-3306050

American Academy of Family Physicians [AAFP] (2020). ACA repeal and replace. https://www.aafp.org/media-center/kits/aca-repeal-replace.html

Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J.S., & Kahn, J.G. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLOS Medicine, 17(1), 1-18. https://doi.og/10.1371/journal.pmed.1003013

Haswell, N. (2019). The four ethical principles and their application in aesthetic practice. Journal of Aesthetic Nursing, 8(4), 177-179. https://doi.org/10.12968/joan.2019.8.4.177

Holmström, B. (2017). Pay for performance and beyond. American Economic Review, 107(7), 1753–1777. http://dx.doi.org/10.1257/aer.107.7.1753

Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. http://dx.doi.org/10.1146/annurev-publhealth-031816-044555

Sultz, H.A., & Kroth, P.J. (2018). Sultz and Young’s health care USA: Understanding its organization and delivery, 9^th ed. Jones & Bartlett Learning.

World Health Organisation [WHO] (2019). Universal Health Coverage. https://www.who.int/healthsystems/universal_health_coverage/en/

The Patient protection and affordable Care Act Essay Paper