Healthcare Reform
Healthcare reform has been debated throughout history, and continues to be a debate today. An initial healthcare plan was supported by Theodore Roosevelt in 1910. He campaigned on the promise of national healthcare, but he was defeated. Harry Truman proposed it thirty years later but the plan was vigorously opposed by American Medical Association (AMA) as socialized medicine (Palmer, 2010). As a Family Nurse Practitioner (FNP) who has been practicing for more than a year, an advanced nurse with a Master of Science in Administration for ten years, a military nurse leader for twenty years, and a home health and ICU nurse for more than twenty – five years, I agree that we need to rethink the direction of healthcare. Without
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According to American Academy of Nurse Practitioners (AANP), NPs rank as one of the fastest growing health-care professions with more than 135,000 NPs presently practicing in the United States, as opposed to increased from 125,000 NPs in 2008 (Martin, 2011). The Doctoral of Nursing Practice (DNP) programs positions NPs as leaders and advocates in policy development (National Organization of Nurse Practitioner Faculties (NONPF), 2005). The NONPF emphasizes entry-level competencies for DNP graduates are influencing health care policy and evaluating health care policy globally. In fact, exploring other nations’ health system problems and solutions may provide alternatives in managing local, state, and national healthcare needs. Many health system solutions start by getting involved with our local and state legislators. This area is one, which is an area I am exploring as I transition from FNP to a potential DNP student.
NPs play a critical part and fulfill an essential role in health care. According to AANP data, 9 percent of NPs specialize in pediatrics, while another 9 percent focus in women health. However, only 5 percent of NPs practice acute care while 10 percent of NPs provide care for the elderly, infants and psychiatric patients. Historically, Nurse Practitioners have provided primary care in rural areas when no other providers were available. In the 1960s, Loretta Ford,
Loretta Ford, is commonly known as the pioneer of the nurse practitioner role. The NP role was shaped by Ford, in collaboration with pediatrician Henry K. Silver in 1965, in response to the need for providers for well-child care, in community based settings (Zaccagnini & Waud White, 2017). Though many texts, Zaccagnini included, cite a physician shortage as the impetus for the creation of the role, Ford herself disputes the emphasis on this shortage, as one of several “myths” many of which continue to influence the NP movement (Towers, 2011). This creates a view of NPs as “physician extenders” or substitutes for physicians, and diminishes the role of the NP (Sullivan-Marx et al., 2007). The creation of the NP was in conjunction with nursing leadership, who were focused on creating graduate nurses for clinical specialization (Towers, 2011). The lack of providers simply created an opportunistic environment for nurses to reclaim the role that public health nurses had historically held, focusing on wellness, health promotion and disease prevention (Zaccagnini & Waud White, 2017). The first NPs were certified in the area of pediatrics, but soon began to develop focus on other populations, such as whole families, gerontology, women’s health, or psychiatry.
The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing
Over the last five years, the United States has implemented a new policy in which Americans will receive their health care benefits. This policy is known as the Patient Protection and Affordable Health Care Act which was implemented in 2010 through United States federal statue and signed into law by President Barack Obama. The intentions of the reform is to insure that all Americans have affordable access to health care benefits without struggling to afford the cost associated. The reform is broken down into nine title sections that affect all aspects of health care and changes that will be associated. In this paper, I will be discussing each of the title sections and how the changes will affect the field of nursing.
Nurse Practitioners (NPs) play a key role in long term health care by ensuring provision of holistic healthcare services particularly in remote areas and in those areas that have few physicians. Currently, there is a concern where there is a shortage of physicians in nursing homes and in other critical health care services questioning the care being provided (Colwill, Cultice, & Kruse, 2008). Due to population growth,
If there is one thing that most Americans are in agreement with, it is the vile shape of our U.S. health care system. There is no argument that the U.S. health care system is in need of an overhaul, however, there is much debate over just how to effectively go about the process. The public have voiced greatest concern in the health care areas of costs, quality and access. Many presidents have pondered the idea of health care reform; a few even made attempts to start the ball rolling. The first
Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.
According to the Garber & Skinner (2008), the United States spends more on health care than other nations but continues to score below other nations in numerous areas of measurement. These scores in, consideration with amount spent, suggest that healthcare is the United States is inefficient. Additionally, the United States has a significantly large portion of under
“The health reform law contains provisions that will produce more nurses to meet increasing demands for health care, prepare more highly-skilled nurses to better meet the needs of an aging population with more complex health problems, and create opportunities for nurses to participate in and lead efforts to redesign the nation’s ailing health care system,” said Susan Hassmiller, Ph.D., R.N., F.A.A.N., Robert Wood Johnson Foundation (RWJF) senior adviser
Many times, the people who are creating policies or legislation for health care reform are not the “first providers” of the health care system. As the journal article, “Influencing Health Care in the Legislative Arena” stated, “[nurses] are often the first providers to see clearly when and how the health care system is not effectively meeting patients needs;” hence, we need more nurses to take a stance in the legislative arena.
The author of this paper is a registered nurse, a graduate student of Maryville University who lives in San Mateo, California with zip code 94403. The author has conducted a search of her state and federal legislators. In this paper, committees of federal representatives and senators are discussed. Main focus is given to the legislators’ involvement in health care policy. The paper also discusses how California Action Coalition implements the recommendations of the Future of Nursing. Additionally, the relevance of selected websites (http://www.hhs.gov, http://www.house,gov, http://www.senate.gov, and http://www.thefutureofnursing.gov) to the author’s current practice and practice in the near future
Healthcare reform and politics are on the forefront of most citizens throughout the United States. Our access to healthcare has become a barrier for many citizens, and a hurdle for the advanced practiced registered nurses (APRN) throughout the years. Strict state laws have burdened APRNs and limited their practice throughout Ohio. It would be prudent to follow suit of other states, and retire the Collaborative Agreement; Richards and Polsky (2014) noted an immediate 20 to 30 percent increase in nurse practitioner providers in those particular states after it was retired. House Bill 216 (H.B. 216) helps modernize the Nurse Practice Act and the retire the mandatory collaborative agreement and extensive drug formulary. Within this paper, the contents and purpose will begin to unravel as I describe the meeting Naserin Salameh and I were able to connect with Representative Margaret Ann Ruhl of Ohio House District 68 on March 30, 2016, about H.B. 216.
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
Being a registered nurse affords one the option of working in many diverse healthcare settings. In any practice setting the climate of health care change is evident. There are diverse entities involved in the implementation and recommendation of these practice changes. These are led by the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM), nursing campaign for action initiatives, as well as individual state-based action coalitions. Nurses need to be prepared and cognizant of the transformations occurring in health care settings as well as the plans that put them at the forefront of the future.
For all of mankind, the cost of health care is a major daily stressor. This article stated an interesting fact that, “A concern of businesses and governments for at least 30 years, the cost of health care in the United States has approached 15 percent of the total gross national product (Barbara R. Heller, Marla T. Oros, and Jane Durney-Crowley, 2013, para. 19).” Even with that fact, there are over 40 million individuals living in the United States that do not have health care coverage. The total health care spending in America surpasses that of any other developed country. This is due to technological advances that are readily available and breakthroughs in medicine. Still, there are present concerns in nursing practices, such as: the affects on the nursing profession, treatment options for their patients, and the patients participation in their own care. This article stated, “Nursing professionals, who have historically taken the lead in health education and health promotion, are disappointed by the lack of financing and reimbursement available through managed care organizations for