Public Health Policy Paper

The United States has a very unique healthcare system. Does this mean that we are simply leagues ahead of the rest of the world in healthcare? Unfortunately, not at all. The ideal of American exceptionalism is apt to describe our healthcare system. That is, our current system is exceptionally bad. Per capita, the United States spends “twice the average of other developed countries” on healthcare ("United States Per Capita Healthcare Spending Is More Than Twice The Average Of Other Developed Countries"). Yet, in the World Health Organization’s ranking of healthcare systems by nation, the U.S. comes in at a dismal 37th place, despite spending the most per person of any country on Earth on healthcare ("World Health Organization’s Ranking of the World’s Health Systems").

The United States health care system ranks 37th in the world. Statistically, it’s bizarre how United States is amongst one of the most advanced nations in the world and the fact that it spends more on its healthcare

The Affordable Care Act was passed to provide American’s better access to health insurance coverage. In addition to better access the ACA improved health care quality and lowered health care cost. The ACA reformed health insurance by expanding coverage, holding insurance companies accountable, lowering health care costs, guaranteeing more choices, and enhancing the quality of care. Although some states have not implemented all the benefits of the ACA, most citizens do have access to health insurance. This paper will address some of the general highlights of the ACA, how it impacted healthcare and the nursing practice.

The Affordable Care Act, also known as Obamacare or ACA, was signed into law in March 2010 with the goal to expand insurance coverage to millions of Americans over a period of several years. Since its enactment six years ago, there have been millions of Americans that have gained access to coverage. The most notable of this population would be the disabled, mentally ill, and impoverished. In order to continue to provide quality outcomes for patients, especially patients of vulnerable populations, extra focus must be given to ensure access to healthcare, decreasing disparities, and harvesting improvement in areas such as preventative care, education, and maximizing quality of life. With this influx of people entering the healthcare field, the role of nurses and nurse leaders is also expected to change. Nursing scope of practice and education will be expanded to create an elite healthcare provider. This will include maximizing knowledge in areas of holistic care, education, and preventative care. The incorporation of the ACA into healthcare for vulnerable populations will have several implications for nurses including expanding leadership roles, changing the healthcare delivery model, and providing a broad range of care.

According to Schroeder “ the United States spends more on health care than any other nation in the world, but ranks poorly on every measure of health status” ( Schroeder,1). Schroeder discussed the two main reasons why the United States ranks so poorly on every measure of the health system. One of the reasons for the low ranking in the American health system is “the pathways to better health do not generally depend on better health care” (Schroeder, 1); the fact that we have access to advance tools and technologies in our health care system does not necessary mean that we are healthier than other countries. Determinants such as behaviors patterns, environmental exposures and social circumstances also greatly influence our health.

The Affordable Care Act of 2010 was a transformative piece of legislature aimed at putting health insurance back in the hands of the public. This comprehensive healthcare plan outlines several key provisions that apply to nursing. "The Affordable Care Act is working to make health care more affordable, accessible and of a higher quality, for families, seniors, businesses, and taxpayers alike. The Patient Protection and Affordable Care Act clearly represents a movement toward much-needed, comprehensive and meaningful reform for our nation’s healthcare system (About, 2014).

Contrary to what many people believe, America’s health status is not quite “up-to-par,” to say the least. Over forty-seven million people in the United States lack health insurance; that is more than 15% of our nation’s population! At first this disturbing truth seems impossible to believe, being as America is one of the most technologically advanced and economically developed countries in the world. “We spend trillions of dollars per year on medical care. That’s nearly half of all the health dollars spent in the world. But we’ve seen our statistics. We live shorter, often sicker lives than almost every other industrialized nation. “We rank 30th in [global] life expectancy” (Adelman 2008). Knowing this brings rise to the question: why are

Every individual in the world deserves to enjoy health and wellness. Maintaining or achieving proper health needs enables individuals to be productive at work and leisure. Traditionally, many people have had barriers obtaining adequate healthcare due to economic constraints or personal inconveniences. Despite impressive technological advances in medicine, the challenge of delivering quality healthcare to the Americans continues to be debated amongst the nation’s political and healthcare leaders. The aging baby-boomers and the increased number of uninsured people add to the equation of population growth which results in limited access to primary healthcare for the entire public. On the

Our healthcare system needs major restructuring. Major improvements needs to begin with "all health care organizations, professional groups, and private and public purchasers should adopt as their explicit purpose to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States", (Crossing the ……, 2001).

In 2010, the Affordable Care Act invoked a $75 millon dollar demonstration project known as the Medicad Emergency Psychiatric Demonstration that was amended in section 2707 of the Affordable Care Act (ACA). The change seemed to be just what the nation needed, however, there was fine print added to the amendment that changed the interpretation. The fine print stated, patients who are on Medicaid from the ages of 21-65 seeking inpatient mental health care can receive treatment under the law. However, the inpatient facility will receive no

The U. S healthcare system undergone major changes in the past 100 years. Scientific advancement coupled with increased sophistication of the health care workforce including physicians and nurses have given an international reputation to U.S health system. Even though weakness can be found like lack of primary health access, high infant mortality rate and increased numbers of uninsured people in U.S. A growing demand of patients with chronic illness over the age of sixty-five, is challenging to the health system.

The article, “When Cutting Access to Health Care, There Is a Price to pay” in the New York Times and written by Eduardo Porter highlights the health crisis that is being experienced in the United States. This has contributed to the low economies due to low productivity since the sick people cannot work. The article states that in a research conducted by experts, the United States is ranked as having the highest mortality rate (Porter, 2017). Conditions such as heart diseases, diabetes, and infectious diseases also top in the list. Early deaths have become the norm in teenagers and young adults, due to health conditions related to obesity, chronic diseases, sexually transmitted diseases, and hypertension among others.

Healthcare Reform has been and still is a highly debated controversial political issue in this country. It has been a hot topic of past presidential campaigns, with many proposed solutions, none of which were enacted upon by Congress. The Affordable Care Act (ACA) was passed in 2010. This law or Obamacare, as it is commonly called, was designed to cover the 48 million Americans, including about 1 million in New Jersey who did not have health insurance. It is envisioned to provide seamless, affordable, quality care that is accessible to all. Great emphasis will be placed on transforming our current “sick care” hospital system into a community “health care” system of prevention and health promotion. This paper discusses the evolving and future roles of nurses under the new system. It also examines the proposals of a joint committee made up of members of the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF), as an initiative to help nurses in their new leadership roles to a healthier nation.

There are over three million nursing professional in United States and they make the largest segment of nation’s health care workforce. Nurses can play a vital role in helping to realize the objectives set forth in the 2010 affordable act, legislation that represents the broadest health care overhaul since the 1965 creation of Medicare and Medicaid program (IOM 2010). Due to the restricting barriers nurses were not able to respond effectively to the changing health care systems. In 2008, The

The U.S. Department of Health and Human Services (HHS) stated that "The health of the individual is almost inseparable from the health of the larger community and that the health of every community in every state and territory determines the overall health status of the nation." It has now become clear that our economy in terms of healthcare insurance is not healthy; the healthcare system in the United States spends 1 cent of every healthcare dollar in the prevention of diseases and 99 cents on the cure. Our healthcare system is the most expensive and yet arguably among the least cost effective in the developed world. Despite the highest per person health care spending among the Organization for Economic Cooperation