NURS 6150 Week 7 Essay Discussion
Public Policy: Implementation of Affordable Care Act
The implementation of The Patient Protection and Affordable Care Act (PPACA) in 2010 gave approximately 30 million more Americans access to affordable, medical care. In 2013 alone, 13 million Americans signed up for healthcare due to the PPACA (Schmittdiel et. al., 2017). This policy affects my career as a nurse because of significant increase in the number of patients we treat daily. However, the PPACA does not positively affect the quality of care we provide to our patients, but it increases the quantity of patients we care daily.NURS 6150 Week 7 Essay Discussion
The healthcare driver that The PPACA was designed to address was a combination of cost and accessibility. As stated previously, the PPACA was developed to give healthcare access to millions of uninsured Americans at an affordable price. Yes, the PPACA is achieving its intended goals. The American Journal of Public Health reported that the rate of American’s who could not afford their prescriptions dropped from 8.3% to 5% in 2015 (Kennedy & Wood, 2016). The percentage of individuals who had a primary care provider increased from 59% to 73% and the percentage of patients who delayed seeking medical care due to the cost decreased from 37% to 25% (Schmittdiel et. al., 2017). To summarize, the implementation of the PPACA increased the probability of patients filling their prescriptions, provided access to quality, primary care providers, and increased the likelihood of patients seeking medical treatment in a timely manner by offering affordable medical plans. As a result, massive rise in hospital census has caused another issue of safe staffing, is the healthcare issue that I would like to address.
Healthcare Issue: Safe Staffing
Nurses are the largest group of healthcare workers employed that provide direct patient care, which is often used to analyze overall patient outcomes (Cho, Chin, Kim, & Hong, 2016).
Evidence proves that safe nurse-patient ratios decreased the likelihood of a patient adverse event such as a medication error, probability of obtaining a pressure ulcer, or risk for fall (pp.75). A safer work environment, including a lesser patient assignment, has proven to reduce adverse events by 45% in a recent study (pp. 80). A lesser patient assignment can increase patient and nurse satisfaction, decreasing the likelihood of nurses developing burnout and seeking other employment. I would like to see a policy mandating proper nurse-patient ratios that would provide high quality and safe care to patients and help employers retain their nurses.NURS 6150 Week 7 Essay Discussion
Kingdon’s Model
The first stream in Kingdon’s model is the problem stream (Milstead, 2016). The problem stream for my proposed healthcare issue is Press Ganey scores. The struggle to get high patient satisfaction is directly correlated with our inadequate staffing patterns. There are several shifts where we are understaffed, and nurses have twice the workload forcing them to provide less than high quality care to accommodate the needs of their patients. They are becoming fatigued which force them to look for shortcuts and not providing adequate care to their patients.
The second stream is the policy stream (Milstead, 2016). There should be a policy to mandate all hospitals to provide adequate nurse-patient ratios taking unit type, patient acuity, available resources, and staff educational needs into consideration (American Heart Association,2016). The nurses will send letters to Congress describing their current personal experiences including their near misses and adverse events that occurred due to unsafe staffing ratios and they will share their stories on social media to help rally the community to be on their side (pp.87). The response that the nurses will request is the development of a policy stating that nurse- patient ratio should depend on patient acuity, level of education of the nurse, and the availability of on unit resources.
The third stream of Kingdon’s Model is the political stream (Milstead, 2016). We can emphasize that the decline in Press Ganey scores are related to inadequate staffing and the patients would benefit from a better nurse- patient ratio. Patient satisfaction is crucial because insurance companies are now paying healthcare facilities by their satisfaction scores. We can assume that the community will be behind this policy, and help lobby for its development because it directly benefits patients in our community.
The letters from nurses explaining their negative experiences and how it affects the patient outcomes plus the increase of awareness of the community regarding the issue will help the legislature pass the bill to develop the safe-staffing policy (Milstead, 2016). This policy of two to three patients to one nurse will benefit patient outcomes, increase nurse and patient satisfaction, and decrease the rate of negative adverse events. This policy will also help my unit to retain nursing staff and increase unit morale and productivity.
The United States of America’s political system is described as democratic with Republican and Democratic parties forming the majority. Since time in sundry, exercising democracy during elections, especially on campaign platform, has reached maturity. In any presidential election, it is apparent that a Democratic Party nominee faces off with a Republican Party nominee.NURS 6150 Week 7 Essay Discussion
America’s presidential election results are often determined by policy inclination and practicality as perceived by the public and technocrats. Specifically, the politics of the Tea Party and the Affordable Care Act have closely interacted in the past in the opposition of the Obama Care.
Directly, the Affordable Care Act is one of the tests of popularity of the Tea Party outfit against its opponents. Thus, the influence of the Tea Party in the Affordable Care Act cannot be dismissed. This analytical treatise attempts to explicitly discuss the Affordable Care Act (Obama Care) and the Tea Party on the tenet of how these topics interact with each other.
The Affordable Care Act
Despite the controversy it courted, the Obama Care (Affordable Care Act) has presented a comprehensive health policy which mainly adopts the redistribution economics to ensure that every American is covered under the scheme (US Department of Health and Human Services par. 11). Despite initial rejection by a section of Americans, the policy carried the day as it promised to make health very affordable to the low income groups. At present, the only challenge is implementation since it will have to cover very many people.
Through partnership with insurance companies, this policy has been described as basically what the Americans need after the just ending financial crisis characterized by reduced disposable income. This policy has been successful in Norway and its only determinant of success in America will be its implementation module. As proposed in the policy, the aspect of individual mandate has been supported by both houses and even President Obama’s opponent from the Republican Party.
The aspects of fairness, objectivity, and transparency define a policy. Objectivity minimizes biasness and prejudice when drawing a policy. On the other hand, fairness involves collective consultation with stakeholders and adopting consultative decisions. Transparency involves the aspects of proactive reviews that are consistent with the performance evaluation and monitoring system. Reflectively, the Affordable Care Act proposed by President Obama contains all these aspects within its scope.
This policy on healthcare is objective and targets to make healthcare provision affordable to the upper and lower economic ends citizens of America. It has specific projections and intentions that are multifaceted and based on recommendations of the expert and other stakeholders. The transparency aspect of this act is that it has the target monitoring unit and active reporting channel during implementation (Wittes 17).
Though very complex, the Affordable Care Act is intrinsic of the demand and supply in the market, social, and public demands against a backdrop of manageable cost constraints of health provision in America. The main components of the policy can be quantifiable for viability, ease of implementation, and realization of the intended goals which are reducing the cost of health provision and providing health insurance to all the citizens of America.NURS 6150 Week 7 Essay Discussion
The Obama Care Act has special interest on the multiple disadvantaged Americans who could not afford the private healthcare systems of the day. Multiple disadvantaged groups in health status refer to groups within the population that are victims to worst health risks due to healthcare policy discrimination.
Due to their low socioeconomic status, they are not able to afford quality Medicare. Disadvantaged groups strain to get healthcare services due to low income bracket. Often these groups exist within the larger population as is the case in America where low income and middle income brackets are more than 80% of the population. Due to their low living standards, these groups are the major beneficiaries of affirmative healthcare actions provided by the Affordable Care Act (IIzetzki 2).
The Affordable Care Act has two parts. The first part deals with health insurance. The second part is the Medicare insurance coverage which helps pay for the doctor’s services, outpatient hospitals care, and some other medical services that are not provided by part A. There is no need to pay a monthly payment (premium) for part A since taxes paid prior to the retiring from employment are earmarked for this cover. Part B, on the contrary, assists in the defraying the cost for these medical services when needed (IIzetzki 3).
The Tea Party
The tea party is a populist American outfit associated with libertarian and conservative inclinations on political and economic policy implementation and functionality. As a movement, this association has direct influence on political future of America and policies debated and passed by the congress.
Specifically, resounding interest surround the influence of foreign currency on the dollar as a protectionist assembly of tools for mass influence. This outfit offers its members a platform for awareness creation on the economic, social, health and political factors that directly affect the Americans.NURS 6150 Week 7 Essay Discussion
Reflectively, several private individuals with republican, libertarian, democratic, and independent inclinations identify themselves with this outfit. This community perceive themselves as true Americans who would do anything to protect and reaffirm the constitutional founding upon which their nation was laid by statement. Tea party movement consists of members drawn from all professional fields. The members of this outfit are united by their perception on how the political leadership of the US is handling its duties and policies.
The Tea Party has remained in the front line in promoting democracy within the US through promotion of freedom of speech by sponsoring its members of parliament to pass critical bills and hold series of pro or anti government protests. Basically, sustainable democracy as enshrined in the beliefs of the Tea Party outfit offers a practical sketch map for intellectual development and political maturity.
Thus, this group endeavors to campaign for sustainable democracy which ensures reliable governance and democratic issue base confrontation of challenges affecting the citizens from insecurity, social justice, and respect of human rights. Reflectively, sustainable democracy as a concept of the Tea Party’s institutional approach is applicable in reforms and offers a solution based management of government institutions.
In the realms of social secularization, the transitional facilities of the Tea Party outfit assist the institutionalization of units of the American society to create an accepted mode of interaction. The operating mechanisms of these efforts are in the traditional and economic development of the US societal conditions promoting public interest. Interestingly, many of the Tea Party members oppose the Obama Care (“Defund ObamaCare now” par. 7).NURS 6150 Week 7 Essay Discussion
The Tea Party and the Affordable Care Act
Process evaluation examines actual implementation and development within a specific act such as the Affordable Care Act. Reflectively, the independent Tea Party has reviewed the quantifiable fulfillment of targets of the Affordable Care Act as unfair to the middle income household since they view the act as an opportunity for the government to collect more taxes.
On the other hand, impact evaluation examines long term changes that have surfaced as part of the success or failure of a project. It examines the long term effectiveness of policy based programs after implementation. The Tea Party members from the republican inclination are in the forefront of impeaching the Affordable Care Act because of the fear of letting the government to run their healthcare (“De fund Obama Care now” par. 7).
Since the Affordable Care Act is an intriguing idea, the Tea Party focuses on a mirrored reflection of what a society would like to visualize from a string of intertwining ideas. Instead of adopting the impersonal consciousness, step wise process, and absolute necessity assumptions aimed at creating a sustainable, friendly, and acceptable irksome feeling to the Obama Care, the Tea Party has adopted a partisan approach in their criticism. In fact, it is only the minority members who seem to oppose the act in totality.
At quantitative level, the Tea Party outfit does not adopt the expected continuous process of embracing both ecological dimension and internal operation engine as a measure of variance between the benefits and demerits of the Obama Care. Thus, it is apparent that the Tea Party is likely to lose its objectivity since their negative stand on the Obama Care is not supported by any public poll. Thus, they cannot claim to be representing the interests of the true Americans in opposing the Affordable Care Act.NURS 6150 Week 7 Essay Discussion
Personal reflection
Change advocacy is a necessity towards actualizing ideas acceptable to the society. Irrespective of the social and economic climate in which change agents operate, the questions to consider in change advocacy revolve around policy solutions, engagement, administration, and change argumentation. In the America society, citizens have adopted bureaucratic, ideological, legislative, and mass appeal to advocate for change.
The Tea Party outfit operates on the bureaucratic, mass appeal and ideological appeal when supporting or opposing government act. Under the bureaucratic arrangement, individual involved is often an expert with vast experience in the subject of change. For instance, in the new health plan proposed by the Obama administration, experts have presented a well researched optional approach into health provision to the government decision makers with an intention of convincing this group to accept their proposal.
In practicing ideological advocacy as a means of influencing change, individuals sharing the same ideology can mobilize together in protests and demonstrations to express their dissatisfaction’s to the decision making organs for appropriate actions as is the case with the Tea Party outfit.
Conclusion
The Obama Care has given special attention to the disadvantaged groups in health services provision. The Obama Care has made healthcare affordable and easily available to the poor Americans. However, the Tea Party is against this act since the bureaucrats have proposed better approach towards provision of affordable healthcare to the Americans.
Just like any other political or social outfit, the Tea Party has considerable influence on the successful implementation of the Affordable Care Act. From this discussion, it is apparent that individuals sharing the same ideology can mobilize together in protests and demonstrations to express their dissatisfaction’s on different government policies. NURS 6150 Week 7 Essay Discussion