Population Health Policy Analysis
Question 1
The Indian Health Service Act was enacted in 1976 after the amendment of the Social Security Act, to legitimize the Indian Health Service to permit the reimbursement by Medicaid and Medicare for healthcare services provided to members of the American Indian and other Alaskan Natives within the service, provided in the tribal healthcare organizations (CRS Report, 2016). This health policy therefore focuses on providing insurance cover to the Native Indians in the United States, who are approximately 2 million members (Sequist et al., 2016). The IHS provides services such as ambulatory care, emergency care, inpatient services, public health nursing, dental services, and preventive healthcare. Some of the health issues that affect this population, warranting preventing healthcare include diabetes and cancer.Population Health Policy Analysis
The IHSA improves health equity by enabling the more than 2 million Native Indians to access healthcare. It reduces disparities by helping them manage and prevent health conditions such as alcoholism considering the study by Ehler & Gizer (2013) which revealed a heritability factor of alcoholism among the Native Indian population. Walker, (2019) asserts that people from the native tribes tend to experience economic marginalization compared to the white people, hence, making it challenging for them to access quality care since they lack cover and money to pay for the out of pocket medical expenses. Therefore, by providing medical cover for this population, the IHSA is a policy which promotes healthcare equity by eliminating the disparities brought about by genetic and economic factors that affect the tribes.
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This policy is financially sound because most of the funding comes from the Congress, and the tribe members appropriate the funding. With an annual budget of $5.9 billion, the tribe committees appropriate the funding for those in need. The policy is financially sound because most of it is used to eliminate the disparities that led to the marginalization and higher mortality rates of members from the native tribes.
One of the ways that this policy accounts for the nursing perspective during implementation is through the provision of community-focused funding for specific illness treatment such as diabetes. This fact creates a nursing perspective that requires the nurse to be more aware of the population and cultural differences when interacting with other community members, and develop cultural knowledge and awareness to provide them with quality and culture-specific nursing care.
Question 2
The IHSA, through the ISH, is committed to eliminating cancer as a disease that affects the native tribes and contributes to their high mortality rate. Cancer is a global health concern, and is the second leading cause of death. In 2018 alone, cancer claimed more than 9.6 million lives. Globally, 1 in every 6 deaths is from cancer, which affects mostly the low and middle-income populations. The Native American tribes have a high cancer mortality, given that the Native Indian is 2.3 more times to have cancer, and likely 2 times likely to die from it compared to other ethnicities such as the African Americans, Hispanics, and white people (HHS, 2018). Cancer is a global pandemic and through the IHSA, the policy addresses this issue by providing funding to individuals from the Indian populations.Population Health Policy Analysis
The IHSA, through the Indian Health Service, is designed to achieve the goal of eliminating cancer as a disease and reducing the mortality rate by the healthcare programs it funds. Another way is by providing preventive services such as cancer screening to encourage early detection of this disease. Early cancer detection is paramount to achieving positive outcomes with reduced chances of mortality. When cancer is detected early, the physical damage to the body is reduced, hence, there are lowered chances of mortality since it has not metastasized throughout the body. Therefore, the program provides funding for preventive services and reduces the mortality rate. The funding that the IHS provides for these communities is instrumental in encouraging them to undergo cancer surgeries considering a significant number of Native Americans are less likely to undergo cancer surgeries, which are life-saving (Guadagnolo et al., 2016). By doing so, the IHS helps in achieving the global goal of eliminating cancer as the cause of mortality among populations across the globe.
Question 3
To ensure that my organization has access to the benefits of the IHSA, I would encourage the nurses and other practitioners to hold community health forums with the Native Indians in the community, to first establish our presence as healthcare organization. This step is important because it would expose the healthcare organization to the Native Indians, and the Native Indians to the organization. It is imperative that the organization appears friendly and welcoming to this community to eliminate chances of the members feeling unwelcome. The members also need to understand that the healthcare organization is committed to inclusive healthcare, by enrolling into HIS, and being listed as one of the healthcare providers that uses the IHS to provide medical services to members from this population. This is an important step, and would require the healthcare officials within the hospital management team to approach the tribal leaders with a proposal to consider seeking medical services from the facility. The tribal leaders are the most crucial aspect players in convincing the tribe members to seek healthcare services in the organization. Additionally, the tribal leaders would also appropriate the funding to ensure that my healthcare organization is part of the HIS and abides by the provisions of the IHSA.
From a Christian perspective, an advanced registered nurse should advocate and promote health from diverse populations because the Bible says in Philippians 2:4 that people should not only look to their interests, but also the interests of others. It is important to remember that the United States the majority of the population white, automatically classifying the rest as the minority. Since the majority are privileged, the Christian thing to do is to advocate and promote the health for diverse populations. The Bible also quotes in the book of Galatians 6:2, that Christians should bear one another’s burdens because it fulfils the law of Christ. Nurses who practice Christianity should strive to fulfill this law. Therefore, nurses should follow this Scripture to ensure that they are in tandem with the Christian way of life.Population Health Policy Analysis
References
CRS Report. (, 2016). The Indian Health Service (IHS): An Overview. Everycrsreport.com. Retrieved 17 November 2020, from https://www.everycrsreport.com/reports/R43330.html#_Toc440461389.
Guadagnolo, B. A., Petereit, D. G., & Coleman, C. N. (2017). Cancer Care Access and Outcomes for American Indian Populations in the United States: Challenges and Models for Progress. Seminars in radiation oncology, 27(2), 143–149. https://doi.org/10.1016/j.semradonc.2016.11.006
HHS. (2018). Cancer and American Indians/Alaska Natives – The Office of Minority Health. Minorityhealth.hhs.gov. Retrieved 17 November 2020, from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=31.
Mauk, K., & Hobus, M. (2019). Nursing as ministry. Jones & Bartlett Learning.
Sequist, T., Cullen, T., & Acton, K. (2016). Indian Health Service Innovations Have Helped Reduce Health Disparities Affecting American Indian And Alaska Native People. Health Affairs, 30(10), 1965-1973. https://doi.org/10.1377/hlthaff.2016.0630
Walker, M. (2019). Fed Up With Deaths, Native Americans Want to Run Their Own Health Care (Published 2019). Nytimes.com. Retrieved 17 November 2020, from https://www.nytimes.com/2019/10/15/us/politics/native-americans-health-care.html. Population Health Policy Analysis