By Day 3 of Week 1
Post your response to the discussion question: Consider a population health topic that rises to the presidential agenda level. How did two recent presidents handle the problem? What would you do differently?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
Discussion – Week 1
Original post:
The astronomical cost for prescription drugs continues to be a prioritized issue at the presidential level. It is an issue that plagues most Americans and has remained essentially unresolved throughout many presidential terms. Several issues surround the increased costs of prescription drugs. One main reason can be attributed to drug shortages. In October 2011, President Obama introduced an Executive Order directing the FDA and Department of Justice to help further reduce and prevent drug shortages, prevent price gouging, and guard consumers. During this time, a small number of drugs in the U.S. experienced a shortage in any given year, but the number of reported prescription drug shortages in the United States nearly tripled between 2005 and 2010, from 61 to 178 (The White House, 2011). Due to pharmaceutical manufacturing not being owned or operated by the U.S. government (Milstead, Short, 2019), the government cannot control the supply/demand chain or perceived shortages that lead to increased prices. With most Americans livelihood depending on necessary medications, there is little alternative but to bear the cost. President Obama’s Executive order included earlier and broader notification from drug manufacturers to the FDA of potential shortages, directed FDA to work with the Department of Justice to examine whether secondary drug wholesalers or other market participants were illegally hoarding medications or price gauging during a shortage, and increased staffing for drug shortage notifications (The White House, 2011).
Another issue regarding excessive prescription costs, also targeted during the Trump administration pertains to Medicare beneficiaries. “One of the largest drivers of increasing Medicare spending is the growing prices for physician-administered separately payable Medicare Part B drugs, which have risen an average of 11.5 percent annually since 2015, with total spending of approximately $30 billion in 2019” (Center for Medicare and Medicaid Services, 2020). The increasing high costs are attributed to the lack of competitive markets for Medicare part D drug costs and an incentive system that gives payments to hospitals, physicians and other practitioners on the volume of drugs they use and the price drug manufacturers set (Center for Medicare and Medicaid Services, 2020). President Trump’s administration introduced the Most Favored Nation (MFN) Model. This model aimed to lower prescription drug costs by paying no more for high-cost Medicare Part B drugs and the lowest price that drug manufacturers receive in other similar countries. Medicare beneficiaries would also pay lower coinsurance for these high-cost Part B drugs and not pay coinsurance on the add-on payment (Center for Medicare and Medicaid, 2020).
Both Presidents took aim at prevalent problems surrounding the issue of prescription drug costs. However, it continues to be a complex and difficult issue to address. Meanwhile, Americans continue to be left with minimal alternatives. In my view, until the influence of pharmaceutical lobbyists is addressed accordingly, pharmaceutical companies will continue to have the necessary leverage they need to control the price of prescription drugs and Congressional votes. This is where change should begin.
References
Centers for Medicare and Medicaid Services. (2020). FACT SHEET: Most Favored Nation Model for Medicare Part B Drugs and Biologicals Interim Final Rule with Comment Period. https://www.cms.gov/newsroom/fact-sheets/fact-sheet-most-favored-nation-model-medicare-part-b-drugs-and-biologicals-interim-final-rule
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
The White House. (2011). Fact Sheet: Obama Administration Takes Action to Reduce Prescription Drug Shortages in the U.S. https://obamawhitehouse.archives.gov/the-press-office/2011/10/31/fact-sheet-obama-administration-takes-action-reduce-prescription-drug-sh
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
Health care costs have been an issue for years, whether it be the cost of individual health insurance, the cost of medications and supplies, or the cost for procedures and doctor’s visits. While we cannot make/change health care laws ourselves, we can influence law makers. What is the best way nurses can make a large impact on lawmakers and influence them to create legislation that is beneficial for nurses and patients?
Dr. Mooring
1 year ago
Tamisha Bass
RE: Discussion – Week 1
Dr. Mooring:
Nurses have the opportunity to bring the issue of health care costs to the forefront of legislators for significant change. Developing relationships with legislators and other government contacts should be part of the process. “Nurses have learned that by using nursing knowledge and skill, they can gain confidence of government actors” (Milstead & Short, 2019). Through building these relationships, nurses can advocate for patients regarding the hardships of obtaining necessary medications or of the repercussions due the inability to obtain them. Most nurses have first- hand knowledge of the difficulties obtaining prior authorizations for patients, mainly due to costs. Also, of patient’s health decline due to the inability to afford medications or procedures. Nursing groups involved in the political process include the House Nursing Caucus and Senate Nursing Caucus (Milstead & Short, 2019). These groups hold meetings to discuss various important health issues. “The Congressional Nursing Caucuses have the responsibility of educating legislators on the issues important to the profession and the impact nurses have on America’s health care” (American Organization for Nursing Leadership, n.d.). These groups provide nurses the tools to advocate effectively for necessary policies. In all, nurses should feel empowered to be change agents for affordable health care.
American Organization for Nursing Leadership (n.d.). Congressional Nursing Caucus. Retrieved December 1, 2021, from https://www.aonl.org/advocacy/resources/congressional-nursing-caucus
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
1 year ago
charity hallahan
RE: Discussion – Week 1
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
One of the of the most recent and biggest topics for the 2020 election, (in my opinion), was the covid 19 virus. This virus put the entire worlds healthcare system on trial. It also, exposed the strengths and weaknesses of the healthcare system. Although the world was infected by the same virus, the thoughts and actions of how it should be fixed varied.
Most would agree that the Trump administration may have started late on protecting the country from the spread of covid. Although, I would admit that I didn’t truly believe that such a devastation to our country, economy, and health, would actually happen. He did expedite research, kick off the COVID 19 task force, helped to allocate funding for increased production, relief funds for individuals, business, and states (Jennifer et al., 2020). The Trump administration did seem to allow the states to reopen at their own pace while others remained closed.
The Biden administration took a stricter approach to masks and mandates. They wanted to enforce mask mandates for all states, regardless of their stance, and mandated vaccines for everyone. During the presidential debate, the certainty of keeping the country open seemed more like an uncertainty by his administration. The “New” covid plan in place by the Biden administration, address the need to keep schools open and get children vaccinated. It also has addressed the need for more resources in large hospitals and have allocated resources to those healthcare systems, (The White House, 2021).
I can’t really say which of these tactics are right or wrong. I think with every decision there is a consequence. By isolating people from one another you create a sense of protection, yet the isolation in itself, can often be more detrimental for some. Vaccinating everyone seems like the answer and the only true way to cut down on the spread but, firing workers who refuse only adds to an already failing system. Also, with the multiple variants, will the vaccine truly stop the spread? I think that we are all in this together and try to remember that we all have different views and needs. I think the first step to fixing these issues compromise. Make common sense decisions and work as team to create change.
Resources
The White House, (2021) Path Out of the Pandemic. https://www.whitehouse.gov/covidplan/
Kates, J., Michaud, J., Levitt, L., Pollitz, K., Neuman, T., Long, M., Rudwitz, R. Musumeci, M., Freed, M., Cubanski, J., (2021) Comparing Trump and Biden on Covid 19. https://www.kff.org/coronavirus-covid-19/issue-brief/comparing-trump-and-biden-on-covid-19/
1 year ago
Andrea Murphy
RE: Discussion – Week 1
Charity,
I agree with your point that firing nurses who refuse the COVID-19 vaccine is a huge point of concern for hospitals and for the nursing profession. With the nursing shortage in the US, our healthcare system cannot afford to lose more valuable nurses. The CDC reported as of November, 2021, about 30% of healthcare workers in the US are still unvaccinated (Ault, 2021). A hospital in my area recently laid off every unvaccinated employee. They couldn’t bring enough travelers in to staff the units in time and ended up bringing everyone back because they couldn’t keep the hospital open without such a large portion of the staff. The ANA recommends taking a non-judgmental approach when speaking with colleagues who are hesitant about vaccination, as coming across as confrontational can lead to even more vaccine hesitancy (American Nurses Association, 2021). As nurses, we should all be doing our part as professionals to promote vaccination and boosters amongst our coworkers, families, and communities.
References:
American Nurses Association. (2021). ANA calls for all nurses, healthcare workers to be vaccinated against COVID-19. HealthLeaders Media. https://www.healthleadersmedia.com/nursing/ana-calls-all-nurses-healthcare-workers-be-vaccinated-against-covid-19.
Ault, A. (2021, November 30). CDC: 30% of hospital workers in US still unvaccinated. Medscape. https://www.medscape.com/viewarticle/963287.
1 year ago
Janelle McEwen
RE: Discussion – Week 1
Charity, As nurses, we are trusted as having our patients’ best interests in mind, therefore, advocacy is part of our daily practice. One way that we can actively advocate for health policy formulations is by joining such professional organizations as the American Nurses Association (ANA), which amplifies nurses’ voices by lobbying Congress and executive agencies, and by offering information and tools that empower nurses to share their perspective and expertise directly with policymakers (ANA, 2020). Personally, I can write a letter to my local or national congressperson to sponsor or support a bill on the floor that will positively impact the healthcare choices and lives of my patients (AANP, 2020). My role will be to offer sufficient evidence from research and experience on the need of the bill and rally communities to pressure their legislatures to push for the bill.
References
AANP. (2020). Influence the law. https://www.aanp.org/advocacy/advocacy-resource/influence-the-law
ANA. (2020). Federal issues: Advocacy. https://www.nursingworld.org/practice-policy/advocacy/federal/
1 year ago
Claudia Paz
RE: Discussion – Week 1
1 year ago
Marissa Ludwig
RE: Discussion – Week 1
For this week’s discussion, one of the first population health topics that came to my mind was the opioid crisis. This issue is something that I personally am faced with quite frequently, as I’m sure many of you are as well. The opioid epidemic is one of the greatest and deadliest problems America has seen. The misuse, knowledge deficiency, dependence, and inappropriate prescription of opioids are the chief components to blame for this crisis (Vadivelu et al., 2018). Because this issue is so prevalent in America, a few presidents have dealt with the crisis on a federal level.
Most recently, in 2017, President Donald Trump declared a public health emergency and subsequently rolled out the Initiative to Stop Opioid Abuse as well as the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) Act in 2018 to combat the crisis. The president also implemented a Safer Prescribing Plan that assigned more significant restrictions and monitoring for physicians prescribing opioids. Additionally, the initiative allocated grants to increase education and prevention regarding Substance Use Disorders (SUDs), specifically for children and young adults. Grants were also allotted to reduce the SUD healthcare access disparities by increasing the availability of evidence-based treatment and follow-up care (Davis, 2019).
Not so recently, almost 20 years ago, President George W. Bush released a statement addressing the opioid crisis. In his statement, his primary focus was reducing drug demand by providing early education to children. The President discussed providing more funding towards the Safe and Drug-Free Schools and Communities Program as well as implementing an anti-drug campaign targeted toward children (Bush, 2002). Lastly, he briefly mentioned the allocation of money towards drug treatment and research.
Overall, I feel that while President Trump’s approach was more systematic compared to President Bush’s, both approaches had reasonable and logical solutions for addressing the opioid crisis. President Trump’s approach encompassed many aspects and resolutions to the problem, including increased prevention and decreased inappropriate usage, but I believe that it lacked complete enforcement. Overdoses and deaths resulting from opioids did initially decrease; however, the crisis is still at large and numbers have since risen since the pandemic began. President Bush’s approach primarily focused on youth prevention and lacked a more definite strategy. I think that moving forward, the crisis should be addressed on a continual basis and policies should be carried out further.
References
Bush, G. W. (2002, February 12). President Bush Announces Drug Control Strategy. U.S. Department of State. Retrieved November 28, 2021, from https://2001-2009.state.gov/p/inl/rls/rm/8451.htm.
Davis, C. S. (2019). The Support for Patients and Communities Act — What Will It Mean for the Opioid-Overdose Crisis? New England Journal of Medicine, 380(1), 3–5. https://doi.org/10.1056/nejmp1813961
Vadivelu, N., Kai, A. M., Kodumudi, V., Sramcik, J., & Kaye, A. D. (2018). The Opioid Crisis: A Comprehensive Overview. Current Pain and Headache Reports, 22(16). https://doi.org/10.1007/s11916-018-0670-z
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
One of the main arguments against government involvement in the opioid crisis is that people make a choice to use opioids and are suffering the consequences. However, as nurses, we cannot judge our patients for their choices. Rather, we must care for them with compassion and must always provide quality care. How can we encourage nurses to look past their personal bias related to opioid use and still provide excellent care? And how can we get lawmakers to devote time, energy and funds to combat the issue?
Dr. Mooring
1 year ago
Marissa Ludwig
RE: Discussion – Week 1
Dr. Mooring,
Addiction is often interpreted solely for lacking self-control, bad character, or just making bad decisions. In reality, it is a chronic disease that one will suffer from for a lifetime. Addiction has many influences and factors that come into play; however, neurochemical changes occur after the first choice to engage in substance use which may result in addiction (Bartlett et al., 2013). Addiction can be a hot topic for some nurses, and despite personal biases and opinions, nurses must remain nonjudgmental. There is a massive stigma around mental illness and addiction, and to remove this stigma, education of health care professionals is necessary. Reshaping nurses’ negative attitudes can be done by educating them to identify addiction as a disease rather than a choice. Nurses need to learn how to support these patients to provide compassionate care because a positive attitude will positively influence patient outcomes.
Nurses can be key stakeholders in healthcare policy change. To get involved in this issue and influence lawmakers to combat the crisis, nurses can join nursing organizations with the resources to help them get in touch with legislators (Oestberg, 2013). Nurses can volunteer for the policy organization at their place of work which also may help them get in touch with legislators. Nurses can also simply write emails or make calls to local and state representatives and voice their concerns and ideas.
References
Bartlett, R., Brown, L., Shattell, M., Wright, T., & Lewallen, L. (2013). Harm Reduction: Compassionate Care of Persons with Addictions. Medsurg Nurs., 22(6), 349–358.
Oestberg, F. (2013). Getting Involved in Policy and Politics. Nursing Critical Care, 8(3), 48. https://doi.org/10.1097/01.ccn.0000429392.92546.6f
1 year ago
charity hallahan
RE: Discussion – Week 1
Marissa,
I’m sure that we all know or have taken care of someone who was addicted to opioids. I think that decreasing amount of narcotics given to some patients was important but, also a disservice for others. There is such a sigma that comes with a prescription for narcotics, that it can be difficult for those who need them, to get their medications filled. A pharmacist can refuse to fill a prescription if they are concerned about the validity of the prescription. In December 24, 2015, the Board revised Rule 64B16-27.831 (Florida Board of Pharmacy, 2015) to clarify the pharmacists role of filling Opiates. “In filling these prescriptions, the Board does not expect pharmacists to take any specific action beyond exercising sound professional judgment” (Florida Board Of Pharmacy). It outlines the need to contact the prescribing physician and or speak with the patient about the need for the medication. They can also access the Prescription Drug Monitoring Database to inquire about previous prescriptions. While I agree that there should be a control on the Opioid crisis, I do feel we have made it more difficult for some to get the treatment that they need without offering a sound alternative to these medications.
References
Florida Board of Pharmacy. (2015, December 28). Validate Pain Medication Prescriptions. https://floridaspharmacy.gov/latest-news/validate-
pain-medication-prescriptions/
1 year ago
jamie Arrington
RE: Discussion – Week 1
President Biden is pro making definitive guidelines regarding the opioid crisis. He plans to undo Trump’s work by expanding the work of Obama Care. This provide access to prevention and treament, stop illegal drugs from entering the country, hold pharmaceutical companies responsible, limit prescriptions for opioids, etc..(Biden Harris, 2021).
References
Biden Harris. (2021). The Biden plan to end the opioid crisis. Retrieved on December 4, 2021, from https://joebiden.com/opioidcrisis/
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
Health care is a hot button issue for many people, and is certainly a primary platform for many current presidential hopefuls. As nurses we are affected both individually and professionally by health care legislation, thus it is our responsibility to understand what the law says about how we care for our patients. Below are two videos on the differences between ACA and AHCA. The first is a 17 minute video from the Institue of Health Improvement, in which Don Berwick gives a good explanation of the differences between the two acts of legislation. The second is a brief 7 minute animated video that gives a similar, less detailed overview of the changes.
This week, you are to compare health care policies of the last 3 administrations. Consider how those laws affect our patients, how they affect you, and how they affect what we do every day as nurses.
CLICK HERE to view the 17 minute video from the IHI and Don Berwick. If the link does not work, copy and paste the following url into your browser’s address bar – https://www.youtube.com/watch?v=KoTOzNRw8bg
CLICK HERE to view the 7 minute animated video AHA vs. AHCA. If the link does not work, copy and paste the following url into your browser’s address bar – https://www.youtube.com/watch?v=RmrAdp2_sk4
1 year ago
Janie Patterson
RE: Discussion – Week 1
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
Working as not only a RN but also as a RT I have seen many years of ups and downs in the health care field with employment and job availability. When I graduated radiology school in 1996 there were not many jobs out there to choose from so I had to just basically take what I could get. When I graduated nursing school in 2006 there were a few more jobs out there to choose from and I feel like that was mostly because of the more demand for nurses than x-ray techs at that time. Now we have a huge problem with shortages in almost all areas of the health care field from nursing, x-ray, physical therapy, administration and even physicians.
For many years now, the health care industry has changed in so many ways from technology advances, new discoveries made, average age for deaths increasing, changes in insurance and government regulations. Along with these changes have came growth which means more demand for staffing. With that being said, there have always been shortages in staffing especially in the nursing field.
Today since COVID-19 pandemic started there are even more staffing shortages seem throughout America and this is the time when we need more and more staff to handle the higher volume of patients and higher acuity of care. The past two presidents have tried to make the health care crisis in America better in different ways. President Obama passed the national “Obama Care” plan that enabled all people to have insurance. When President Trump came into office, he stopped the Obama plan and made it the peoples choice to have insurance and not be fined for not having it.
Which plan is better? Either way, there are still shortages in the funding to help hire the staffing that facilities need. So what’s the answer to this major issue? I see this everyday where I work. Staffing shortages causes over worked employees, nurse to staff ratio increasing, patients holding in the emergency department because there’s not enough staff to be able to fill the beds and patient care and satisfaction decreases. It’s a vicious cycle.
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
The goal of the health care reform was to increase access to care for all people. Yet, that did not happen in many states. It can be difficult, at times, to determine if what we hear from politicians is actually what they are following through with behind closed doors. As nurses and based on our code of ethics, it is our mission to provide equitable care to all patients and to work towards ensuring all communities have access to good quality care. While politicians work from a top down approach, what can we do as nurses to work on a bottom up approach and improve care for our patients?
Dr. Mooring
1 year ago
jamie Arrington
RE: Discussion – Week 1
Hi Janie!
I have heard horror stories about nursing homes and long term care facilities. Biden has many plans to provide COVID-19 support and relief for residents, families and health care staff. He is concerned about staffing, PPE, training, accountability and finance (Biden Harris, 2021).
References
Biden Harris. (2021). Biden-Harris plan to make nursing homes and long-term care facilities safe. Retrieved on December 5, 2021, from https://joebiden.com/covid-nursing-homes/
1 year ago
Monique Daniels
RE: Discussion – Week 1
Week 1 Discussion
The opioid crisis has drawn much attention as it has been increasing at alarming rates. According to the Congressional Digest, “greater than 140 people died daily from overdosing on drugs (Congressional Digest, 2018)”. This crisis has been growing for an extended period. President Clinton took a stance and assisted in fighting the opioid crisis. He reported that he knew some people who were personally battling with it. According to the Clinton Foundation, he and the foundation have placed much funding into educating communities on the opioid epidemic and equipping more people to have accessibility to Naloxone ( States News Service, 2017). Even in 2019, “Former President Clinton and his foundation have continued to keep his word on spreading resources to communities to reduce the instance of more Opioid-Related Deaths ( States News Service, 2019)”
Former President Trump has planned and implemented practices to assist in reducing the Opioid Epidemic. According to the MENA report, he authorized funds to the High-Intensity Drug Trafficking Area Program (HIDTA). He approved First Responders’ training to treat those who need treatment from overdoses and other related emergencies (MENA Report 2018).
There has been a known issue with there being an opioid epidemic for a while now. “The Comprehensive Addiction and Recovery Act Bill was created to assist in addressing the problem of the epidemic on more of a comprehensive scale (Milstead, 2016).” At this time, I would continue to provide and bring awareness to this severe issue. One other concern that I would try to address is getting people to help who have been placed in jail for some of the problems now being treated with prescriptions. Naloxone is currently more accessible so that in case of an emergency, it can be administered. I would continue to campaign to bring awareness to the opioid crisis. I would work with Providers to come up with alternatives and adjunct treatment plans. I have personally encountered patients who have increased pain, taken more than prescribed to help treat the pain, and have to “wait” until there is a next available appointment with the provider so that their pain can be reassessed and a new prescription can be generated. Nurses do have a frontline stance on assisting patients in helping with pain management.
References:
In the New Episode of the Clinton Foundation Podcast, President Bill Clinton Addresses the Ongoing Opioid Crisis with Former U.S. Surgeon General Dr. Vivek Murthy and Members of the Clinton Foundation Community. (2019, August 29). States News Service
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
United States: President Trump Signs Cantwell Provisions to Combat Opioid Epidemic Into Law. (2018, October 27). Mena Report.
WATCH LIVE TODAY AS PRESIDENT BILL CLINTON HOSTS OPIOID SUMMIT AT JOHNS HOPKINS UNIVERSITY. (2017, October 30). States News Service.
https://link.gale.com/apps/doc/A512277775/EAIM?u=minn4020&sid=ebsco&xid=0b781752
1 year ago
Monique Daniels
RE: Discussion – Week 1
Week 1 Discussion
The opioid crisis has drawn much attention as it has been increasing at alarming rates. According to the Congressional Digest, “greater than 140 people died daily from overdosing on drugs (Congressional Digest, 2018)”. This crisis has been growing for an extended period. President Clinton took a stance and assisted in fighting the opioid crisis. He reported that he knew some people who were personally battling with it. According to the Clinton Foundation, he and the foundation have placed much funding into educating communities on the opioid epidemic and equipping more people to have accessibility to Naloxone ( States News Service, 2017). Even in 2019, “Former President Clinton and his foundation have continued to keep his word on spreading resources to communities to reduce the instance of more Opioid-Related Deaths ( States News Service, 2019)”
Former President Trump has planned and implemented practices to assist in reducing the Opioid Epidemic. According to the MENA report, he authorized funds to the High-Intensity Drug Trafficking Area Program (HIDTA). He approved First Responders’ training to treat those who need treatment from overdoses and other related emergencies (MENA Report 2018).
There has been a known issue with there being an opioid epidemic for a while now. “The Comprehensive Addiction and Recovery Act Bill was created to assist in addressing the problem of the epidemic on more of a comprehensive scale (Milstead, 2016).” At this time, I would continue to provide and bring awareness to this severe issue. One other concern that I would try to address is getting people to help who have been placed in jail for some of the problems now being treated with prescriptions. Naloxone is currently more accessible so that in case of an emergency, it can be administered. I would continue to campaign to bring awareness to the opioid crisis. I would work with Providers to come up with alternatives and adjunct treatment plans. I have personally encountered patients who have increased pain, taken more than prescribed to help treat the pain, and have to “wait” until there is a next available appointment with the provider so that their pain can be reassessed and a new prescription can be generated. Nurses do have a frontline stance on assisting patients in helping with pain management.
References:
In the New Episode of the Clinton Foundation Podcast, President Bill Clinton Addresses the Ongoing Opioid Crisis with Former U.S. Surgeon General Dr. Vivek Murthy and Members of the Clinton Foundation Community. (2019, August 29). States News Service
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
United States: President Trump Signs Cantwell Provisions to Combat Opioid Epidemic Into Law. (2018, October 27). Mena Report.
WATCH LIVE TODAY AS PRESIDENT BILL CLINTON HOSTS OPIOID SUMMIT AT JOHNS HOPKINS UNIVERSITY. (2017, October 30). States News Service.
https://link.gale.com/apps/doc/A512277775/EAIM?u=minn4020&sid=ebsco&xid=0b781752
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
One of the main arguments against government involvement in the opioid crisis is that people make a choice to use opioids and are suffering the consequences. However, as nurses, we cannot judge our patients for their choices. Rather, we must care for them with compassion and must always provide quality care. How can we encourage nurses to look past their personal bias related to opioid use and still provide excellent care? And how can we get lawmakers to devote time, energy and funds to combat the issue?
Dr. Mooring
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
One of the main arguments against government involvement in the opioid crisis is that people make a choice to use opioids and are suffering the consequences. However, as nurses, we cannot judge our patients for their choices. Rather, we must care for them with compassion and must always provide quality care. How can we encourage nurses to look past their personal bias related to opioid use and still provide excellent care? And how can we get lawmakers to devote time, energy and funds to combat the issue?
Dr. Mooring
1 year ago
Monique Daniels
RE: Discussion – Week 1
WE can encourage staff to provide care for the patients as if we want someone to provide care for them. A suggestion to get lawmakers to devote time, energy and funds includes possibly having them shadow and walk a day in the caregiver’s shoes so that they can get our angle. This may assist in them seeing firsthand our challenges.
1 year ago
Claudia Rivera
RE: Discussion – Week 1
Introduction
Certain health topics and situations preceded each other depending on how they affect the country as a whole. One that stands up to me is the opioid crisis. This has become a plague that unfortunately has extended and affected not only the United States but is a world wide dilemma. The thing with this situation is that it doesn’t only affect in the aspect of simply causing the person to become an addict and fall into dependency. We also should take into consideration that is has trickling effects. Such usage causes constant readmission to hospitals, exposes the person to increase organ dysfunction, exposure to other diseases, and the list goes on. This thus becoming a vicious cycle which turns into dependence in the need for healthcare monitoring due to all these trickling secondary effects of the dependence. “Drug overdose in the United States rose 29.4% in 2020 to an estimated 93,331, including 69,710 involving opioids, according to the CDC. This a 5% increase from 2019.” (National Institute on Drug Abuse, N. I. H) (tjordan_drupal. (n.d.). This is in essence a disappointment because personally I feel like the war against it would be nearly impossible to defeat but keeping it at bay is by all means a start.
Statistics
To compare I chose the Trump administration and the current Biden administration. I feel like keeping the fight against it relevant gives a better comparison. Considering the alarming statistics regarding overdose about 70,000 Americans died related to said overdose. Since the year 2000 there has been 700k death and the federal budget for drug control in 2020 alone was 35 billion. As per the projected numbers the starting age for drug us is usually at 12 years old. The highest use is in males at 22 percent as opposed to the 17 percent in females. The age range of highest use is between the ages of 18-25% at 39% compared to the ages of 26-29 which are at a 34%. 9.7 million or 96.6 % of opioid misusers use prescription pain relievers. (Bustamante, J. (2021, September 25). Hydrocodone is the most popular prescription opioid with 5.1 million misusers. Hydrocodone gets prescribed at a rate that would medicate every American around the clock. Sitting back and digesting all these statistics simply makes the situation place itself in the limelight and really shows how big of a monster we have.
Trump
During the term of president Trump he secured a 6 billion in funds to combat the opioid epidemic, signed the SUPPORT for patients and communities act which was considered the larges legislative effort to address a drug crisis. The Department of Health and Human services was awarded during his term 9 billions in grants in order to increase prevention, treatment and recovery in the communities. Passed the CRIB Act in order to allow Medicaid to aid mother whose newborns were delivered with Opioid dependence. Decreased the amount of opioid prescription allowing for drug overdose to fall nationwide in 2018 for the first time in three decades. Aside from addressing the situation in the State itself, he addressed it from outside sources and received commitment from President Xi to schedule fentanyl and its analogues to keep the lethal substance away and brought a 27 percent decrease in heroin production in Mexico.(WHITEHOUSE. (n.d.).
Biden
For the Biden administration his approach to combat the crisis is to hold pharmaceutical companies, executives, and others responsible in their role. Plans to invest 125 billion in federal investment in order to create a more effective form of prevention, treatment, and recovery. His main focus also lies to stop overprescribing. Like Trump he also plans to continue to stem the flow of fentanyl and heroin from China and Mexico. This by allowing the “DEA to act expeditiously when a pharmaceutical distributor fails to adequately monitor shipments that could pose as a danger to the vulnerable communities and increase penalties to said companies that fail to stop such shipments.”( Democratic National Committee. (2020, August 3). Another point in order to stop this issue is to ban drug manufacturers from providing payments or incentives to physicians. They also have a plan proposed in order to terminate the pharmaceutical corporation tax break related to advertisement spending. MAT or Medication Assisted Treatment is also part of the plan and he projects it for it to be fully universal no later than 2025.The point of that program is to have all over the country in every substance abuse facility the availability for FDA approved medications. These were key aspects that stood up for me regarding both of these presidential terms.
Personal View
This isn’t a matter of political parties or our views on it, the situation in simply based on what has been done to oppress such issue. I personally think that both parties have had great ideas and approach to it. In my view and terms I personally think that the biggest contributor for the opioid crisis is within our own country. I understand there’s plenty of other parties like China and Mexico that contribute to the dilemma, however I think that controlling that aspect will take a lot of work. Yet, when it comes to big pharm the situation is different. The biggest instigator in my opinion of our current opioid crisis is big pharm. The lobbying that they do to prescribers by providing incentives in order to provide the medication that they choose is an easy stream and pipeline to have a patient become addicted to such medication. I think there is too little lack of regulation on big pharm as well as prescribing authority by physicians when it comes to prescribing medications. I would address that internal situation first and cut the cord between how much influence big pharm places on a physician. If more control would be place on big pharm, I personally feel there would be a decrease on the dependence for medications that unfortunately are creating more harm than good.
Reference
Bustamante, J. (2021, September 25). Substance abuse and addiction statistics [2021]. NCDAS. Retrieved December 1, 2021, from https://drugabusestatistics.org/.
Democratic National Committee. (2020, August 3). The Biden plan to end the opioid crisis. Joe Biden for President: Official Campaign Website. Retrieved December 1, 2021, from https://joebiden.com/opioidcrisis/.
National Institute on Drug Abuse, N. I. H. (2021, February 25). Overdose death rates. National Institute on Drug Abuse. Retrieved December 1, 2021, from https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates.
tjordan_drupal. (n.d.). CDC: Drug overdose deaths up 29.4% in 2020: AHA News. American Hospital Association | AHA News. Retrieved December 1, 2021, from https://www.aha.org/news/headline/2021-07-14-cdc-drug-overdose-deaths-294-2020.
WHITEHOUSE. (n.d.). Administration Achievements . National Archives and Records Administration. Retrieved December 1, 2021, from https://trumpwhitehouse.archives.gov/issues/healthcare/.
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
One of the main arguments against government involvement in the opioid crisis is that people make a choice to use opioids and are suffering the consequences. However, as nurses, we cannot judge our patients for their choices. Rather, we must care for them with compassion and must always provide quality care. How can we encourage nurses to look past their personal bias related to opioid use and still provide excellent care? And how can we get lawmakers to devote time, energy and funds to combat the issue?
Dr. Mooring
1 year ago
Claudia Rivera
RE: Discussion – Week 1
Hello Dr Mooring,
Unfortunately the concept of a bias applies heavily when providing care.In nursing leaving ones personal bias is taught but often times not applied.I see why many would use the argument that those that use opioid are suffering the consequences,but many fail to look what led to that.A child doesn’t wake up one day and chooses to sniff cocaine.We often fail to see what was the cause that led to the condition.Everything in life is a cause and effect.As nurses I say we need to apply the notion that unless you walk a mile in someones shoes you shouldn’t judge.A person that is dependent on opioid doesn’t necessarily has to be the stigmatized homeless person on the street.No it can be a lawyer,a politician,a celebrity,and even a nurse.
Getting to reach lawmakers is a heavy task,often times they applied said bias as previously stated and apply it.However,we cant be a healthy nation if we don’t fix our own internal issues.ANA does a great job in advocating for said issue.I think the unification of nurses to speak out is needed.Not to mention using proper networking and the boom of social media allows for a platform to be created and the issue to be brought into the limelight.
1 year ago
Johannys Bergolla
RE: Discussion – Week 1
Hello Claudia:
Kudos! Your post compares and contrasts in an excellent manner how the Trump and the Biden administration tries to deal with the opioid crisis. Illicit drug use such as heroin, the increase of illegal use of fentanyl, oxycodone, morphine contributes to a shorter life expectancy of men and women in the United States. To better formulate policies that will target the opioid crisis needs at its core, policymakers are focusing on the factors that contribute to addiction. Prescription of pain management regimen is a subject that has captured the attention of medical and government personnel. Ways to decrease the explicit use of narcotics and instead the prescription of substitutes can help alleviate the amount of narcotic a patient takes. Also, prescribing narcotics for a shorter period of time with doses that are not so close in time can also help decrease the dependence on such medications. Lack of education is also of great detriment to patient, since many people have heard of the perils of drugs but true information about its many consequences can remain obscure for many. Also, education for prescribers is also important since ways to prevent the overuse of prescription medication is a crucial part of prevention (Singh et al., 2019).
Singh, G. K., Kim, I. E., Girmay, M., Perry, C., Daus, G. P., Vedamuthu, I. P., De Los Reyes, A. A., Ramey, C. T., Martin, E. K., & Allender, M. (2019). Opioid Epidemic in the United States: Empirical Trends, and A Literature Review of Social Determinants and Epidemiological, Pain Management, and Treatment Patterns. International journal of MCH and AIDS, 8(2), 89–100. https://doi.org/10.21106/ijma.284
1 year ago
Blessing Nnakwu
RE: Discussion – Week 1
In case of of emergency, to reduce things like suicide and gun violence, previous president, Donald Trump believed that those with mental illness should be ‘involuntarily confined’. This coupled with the onset of COVID- which has been drastically affecting our economy and the mental health of many- made the issue of mental health much more shocking and important to address. Mr. Trump, on behalf of the topic had the following to say: “My administration is committed to preventing the tragedy of suicide, ending the opioid crisis, and improving mental and behavioral health. The pandemic has also exacerbated mental and behavioral-health conditions as a result of stress from prolonged lockdown orders, lost employment, and social isolation” (Le, 2020). President Trump also “released an executive order setting pandemic-related mental health needs as a priority, with the goal of preventing suicide, drug-related deaths, and poor behavioral health outcomes” (Nuzum & Abrams, 2020). Similarly, current President Biden has pledged to redouble efforts to existing mental health services including increasing funds, expanding facilities and investing in basic training to lead towards hiring more mental health clinicians, counselors, and educators (Nuzum & Abrams, 2020). The Biden administration, according to Simmons-Duffin and Chatterjee (2021) has also pledged “$85 million dollars in funding for mental health awareness, training, and treatment.” While the things the Biden administration has been doing for this issue have been relatively positive, I believe that the problem lies in the exorbitant prices of the resources available to people. Some people suffering from mental illnesses are unable to pay off the debts that come from clinics, therapy, and medication necessary to help treat them. There are even stories of people having to choose between being able to afford food for the month or going to a single 30-60 minute therapy session, which is absolutely ridiculous. To try and combat this, I would lower the prices or offer discounted or state/federal government funded options for these people, and propose a bill that would make it easier for patients to get necessary (and oftentimes life-dependent) medications with medicaid/medicare or another affordable health insurance and I would as well create a mental health awareness program for both young and old to benefit from as part of their human rights.
Work Cited
Le, D (2020). American Counseling Association: Your passion, Your profession, Our purpose. Retrieved from https://www.counseling.org/news/updates/2020/10/06/president-trump-issues-executive-order-on-behavioral-health#
Nuzum, R & Abrams, M (2020). The Commonwealth Fund: Improving Health Care Quality. Retrieved from https://www.commonwealthfund.org/blog/2020/health-care-2020-presidential-election-mental-health-and-substance-use-disorders
Simmons-Duffin, S & Chatterjee R (2021). Children’s mental health gets millions in funding from the Biden administration. Npr.org. Retrieved from https://www.npr.org/sections/back-to-school-live-updates/2021/08/27/1031493941/childrens-mental-health-gets-millions-in-funding-from-the-biden-administration
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
Access to mental health services has diminished drastically over the years, yet it seems that funding continues to decrease. We need more inpatient facilities, as well as more outpatient providers to ensure patients have the care they need. What can we as nurses do to ensure our patients have the mental health care they need? How can we advocate for them and get policy makers to increase funds for their care?
Dr. Mooring
1 year ago
Blessing Nnakwu
RE: Discussion – Week 1
Dr. Mooring,
Thank you for your response and I appreciate your great question! To ensure patients are receiving the care they need, I believe that nurses are supposed to provide holistic care, and educate patients on the importance of medication compliance and practicing coping skills, encourage them to participate in groups and therapy. We can also ensure they receive the care they need by establishing good communication skills, providing them with patient-centered care, and creating a relationship with them.
By starting petitions, attending town meetings and emailing policy makers, nurses can make aware the needs of patients regarding mental health. While creating a good nurse-patient relationship and helping them express themselves and their concerns, nurses can propose and advocate for a change in better treatment plans, payment solutions, and options that fit the patient’s needs.
1 year ago
shelley shipley
RE: Discussion – Week 1
Initial Post:
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
The past several decades health care has been at the forefront of most presidential agenda’s. Every election for almost as long as I can remember there has been some focus on health care, mostly concerned with the cost of health care and the access to health care. President Obama presented and passed the Affordable Care Act in 2010 allowing coverage for all Americans. There were several parts of the act that presented to be problematic. President Trump attempted to dismantle the Affordable Care Act on his first day in office by executive order and present other options for Americans in regards to health care coverage. President Biden is attempting to develop a plan to increase available coverage for Americans by decreasing the age from 65 to 60 years old, thereby covering more elderly Americans.
As I read all of these articles I am perplexed by its complexity. I am certain that the majority of the American population struggle with obtaining quality health care coverage and certainly are not aware of how to navigate the many pathways to our system. There are so many avenues in our current system that even the educated find it difficult to navigate. Compounding the ambiguity of current health care system, most individuals find that acquiring or accessing our systems to be cumbersome and inefficient. As I have worked in public health and the emergency department, it is a revolving door to the same pitfalls time and time again. Countless people are not educated and/or know how to proceed in getting adequate coverage or do not have the resources to access the system. Although there are defined efforts and strategies to bring this health care to every individual the system has failed to incorporate large portions of our populations. Our inner city populations, our homeless, and our mental health populations are star examples of not insured or under insured populations. Our current Fee for Service model is obviously proving to be ineffective and costly, but could be potentially diverted by implementing a system that is a universal approach or and universal payor source. There are of course more options that can be available but the core of the program is one overseeing entity.
There are so many theories of how to fix our health care system that even I find all of it overwhelming almost the feeling of defeat before the battle. I believe that as Nurse Practitioners it is our duty to continue to rise in the forefront of the policies that affect our patients and “us” as providers. I would continue to push forward with initiatives to provide better access for our communities by increasing the full scope of practice for NP’s, increase access by modern technology via telehealth or virtual providers. Provide incentives and increased education to providers to serve in our over burden communities (Milstead, Short, 2019). In my readings I have ever so slightly just grazed over the dilemma’s facing our current delivery method of our heath care system as well as the lack of providers to embrace our communities, but I do believe that “nursing health research can lead to development of knowledge that improves the access, health and patient safety” and prove to provide and deliver improved nursing care and better patient outcomes ( Jones & Mark, 2005). ACA seeks to reduce the overall health care costs by encouraging and prompting providers to provide wellness programs, healthy active living models and other various programs to promote maintenance so as not to incur use of specialist, testing services, increased Er visits and longer hospital stays (Milstead, Short,2019). I believe that with the collaboration of our health care professionals, our politicians and our government to oversee that there is a solution to our chaotic and overburdened system.
References:
Jones, C. B., & Mark, B. A. (2005). The intersection of nursing and health services research: Overview of an agenda setting conference. Nursing Outlook, 53, 270‒273.
Short, J.A.M.N. M. (2017). Health Policy and Politics (6th Edition). Jones & Bartlett Learning. https://mbsdirect.vitalsource.com/books/9781284155235
1 year ago
Quanza Mooring WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 1
The goal of the health care reform was to increase access to care for all people. Yet, that did not happen in many states. It can be difficult, at times, to determine if what we hear from politicians is actually what they are following through with behind closed doors. As nurses and based on our code of ethics, it is our mission to provide equitable care to all patients and to work towards ensuring all communities have access to good quality care. While politicians work from a top down approach, what can we do as nurses to work on a bottom up approach and improve care for our patients?
Dr. Mooring
1 year ago
shelley shipley
RE: Discussion – Week 1
First Response:
Dr. Mooring, I believe that we need to start with the basics of ” proper education and training” for nurses. Educate the nurses to the current barriers in place that are inhibiting the ability to provide or administer appropriate quality care to our patients and educate the nurses on how to achieve the “Triple Aim of Healthcare: 1) better care; 2) better health; and 3) lower healthcare cost ( Hain, 2014). First and foremost we need to address the barriers to nurses within the scope of their practice, encourage professional organizations, networking, policy, education, and the upward shift to wellness programs, health maintenance and health promotion.
We need to increase our education to our nurses about what services are available to our patients and encourage our patients to own their healthcare. Encourage involvement in programs, “American Nurses Association (ANA) and its state constituent associations, as well as specialty nursing groups, can provide their members with the tools they need to be successful. The success of these organizations’ efforts in the legislative arena depends in large part on their members’ involvement with and understanding of the importance of an effective legislative presence on behalf of the profession” (Milsteadt, Short, 2019).
Reference:
Hain, D., Fleck, L., (may 31,2014)” Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign” OJIN: The Online Journal of Issues In Nursing Vol.19, No. 2, Manuscript 2.
Short, J.A.M.N. M. (2017). Health Policy and Politics (6th Edition). Jones & Bartlett Learning. https://mbsdirect.vitalsource.com/books/9781284155235
1 year ago
Yvonne Addo
RE: Discussion – Week 1
Main Question Post
Opioid addiction has always been and is still a major problem in the US. It is a national health concern and in due of that, providers sometimes cannot even comfortably prescribe pain meds to patients who really need them. As a home care nurse, I have come across patients who need narcotics for their pain, but are sometimes told to take Tylenol, all because of the fear of prescribing those meds. It is true, Opioid addiction is very prevalent and is killing a lot of people and care must be taken in the way and manner that opioids are prescribed to patients. Infact, according to an online article, “In 2016, we lost more than 115 Americans to opioid overdose deaths each day…Preliminary numbers in 2017 show that this number continues to increase with more than 131 opioid overdose deaths each day”(“Facing addiction in America,” 2018). Looking at these numbers, opioid addiction is detrimental to the US society as a whole and care must be taken. This brings me to how some past US presidents have handled this issue in the past.
First, looking at President Trump, he saw opioid overdose as a serious problem in the country, whereby announcing opioid related public health emergency in 2017. President Trump acted on the issue by establishing what was called “Support Act” and what this did was to monitor the way and manner providers write narcotic prescriptions. With this act, Providers are now electronically tracked while prescribing opioids, so clients are not going around different states getting opioid from providers. While preventing the misuse and overuse of opioids, another part of the Support Act is to see to it that with the proper education and training in school, providers are able to prescribe opioids to those patients who really need them. The Support Act is not the only measure president Trump’s administration put in place. As the saying goes, “prevention is better than cure”, with the help of department of Health and Human Services,(HHS) President Trump’s adminstration put in place preventative measures such as educating the general population, especially the youth on risk of opioid misuse. Funds were also set aside to help those who were already affected. Trump was also able to get other countries on board to stop the trade of illegal drugs into countries.
Now, with President Obama, he was more concerned about Americans attaining health insurances that will help them receive care whenever needed, and that is why his focus was on the Affordable Care Act, popularly known as the Obama Care. Even though President Obama also set up a plan to create awareness of Opioid overdose, by declaring the week of September 18 through September 24, 2016 as prescription opioid and heroin epidemic awareness week, where he encouraged the general population to bring to the public attention the outbreak of opioid and heroin, his main focuse was putting more money into the care of those already affected and also providing affordable insurance for Americans.
In conclusion, both of these two Presidents tackled the opioid crisis, and they were both for the better good of the general population; however, like I have stated earlier, I think implementing preventative measures is always the better way to go. Much more funds or money is spent in curing for a problem than it is needed in creating awareness. Yes, President Obama was first, and his approach was more towards cure, then President Trump came and his focus was more towards preventative measures. If I were to be in this position, I would have taken the direction of putting preventative measures in place while also caring for those already affected, to see hoe best they could be saved. I would do more than setting up a week as an awareness week, but rather would do more like President Trump did. His approach yielded good results and I think the nation should continue to use it.
References
Facing addiction in American. (2018). The surgeon general’s spotlight on opioids. Substance abuse and mental health s ervices administration (US); office of the surgeon general (US). Washington (DC): US department of health and human services; 2018 Sep. https://www.ncbi.nlm.nih.gov/books/NBK538436/
President Donald J. Trump is fighting to end the opioid crisis that has devastated too many American communities. U.S. mission to international organizations in Vienna. President Donald J. Trump is fighting to end the opioid crisis. https://vienna.usmission.gov/president-donald-j-trump-is-fighting-to-end-the-opioid-crisis/
Presidential proclamation –Prescriptio n opioid and heroin epidemic awareness week, 2016. (2016). The White House. Office of the press secretary. https://obamawhitehouse.archives.gov/the-press-office/2016/09/16/presidential-proclamation-prescription-opioid-and-heroin-epidemic
Shapiro, A., Villarroel, R. L., & George, P. (2019). A call to maximize impact of the SUPPORT for patients and communities act through standard inclusion of opioid use disorder treatment curricula in medical schools. Advances in medical education and practice. 2019; 10: 581-583. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683946/