Caring for Individuals, Families and Groups - Research Paper Example

? Caring for Individuals, Families and Groups Caring for Individuals, Families and Groups Introduction It has been found through different studies that the difference of 33 years exists between the shortest and longest living groups in the U.S. Moreover, the combined costs of premature death and the cost of health inequalities between the year 2003 and 2006 were to the tune of $1.24 trillion. Such disparities have arisen due to social and biological factors that affect the people in their lifespan. It has also been noted that this difference exists due to factors such as poverty, no access to healthcare and this mainly affects the racial and ethnic groups leading to poor health outcomes. (A Nation Free...p.2) The factors such as geographic location, mental health, age, gender, socioeconomic status, religion are found to be main determinants in health care discrimination. Lack of insurance is the biggest barrier, more than any other economic or demographic barrier that affects the quality of health care received by these groups. They constitute about one-third of the U.S. population, but make up more than half of the 50 million people who are uninsured. Of the total 50 million people who are uninsured, almost half belongs to the racial and ethnic group; while they constitute only one-third of the U.S. population. Reforms under the Affordable Care Act have to be seen in above light and it is likely to be a boon for many and may be a bane for someone. Some of the significant milestones of the act can be described as per the following. Benefits to Children and Senior Citizens The reforms have brought new rights and benefits for children and to those under the age of 26 to stay on their parent's health insurance. It has also ended annual limits on care. The new act provides 50% discounts on brand-name drugs to seniors in Medicare and it also provides tax credit to small businesses for extending insurance to employees. Providing Access to Insurance for Uninsured Americans with Pre-Existing Conditions Uninsured Americans with Pre-Existing Conditions A Pre-Existing Condition Insurance Plan (PCIP) is made for individuals who are uninsured for at least six months for that reason. States are also free to run the new programs. The Department of Health and Human Services will run the plan, if the state does not have a plan. This program will serve as a bridge until 2014, when any discrimination against pre-existing conditions will not be allowed. The act will have influences on health and caring across wide section of ethnic minorities in varied ways. Though, the Affordable Care Act is formulated to provide the health for all but it essentially addresses the needs of those who had no access to adequate coverage due to their underprivileged status. Well-Being, Health, and Safety of the American People The broad range of health indicators pertaining to racial and ethnic minorities is far worse than their non-Hispanic White counterparts hence well-being of these people needs special attention. Hence need is to create an environment that can control chronic diseases and associated risk factors. The effective community-based programs and policies can reduce and tackle the disparities in health standards. (A Nation free…p4) Racial and Ethnic Minority It is true that all American citizens do not have equal access to health care. Various racial and ethnic minorities, low-income groups and most of the underprivileged populations have higher rates of illness and less treatment options. Mostly, they do not have any insurance coverage for treatment. They’re less likely to get chance of preventive care and will have no access to the treatment and screenings to stay healthy. Preventing diabetes and heart disease is a tough task for them. Perhaps, this is the group who is going to get the biggest benefits from this new healthcare program. Economical Ways The Affordable Care Act is geared to reduce these disparities regarding health care by improving access to health care for all citizens. This is aimed at bringing down the treatment cost and likely to facilitate more controls to individuals and their families on their health. The Health and Human Services (HHS) Disparities Action Plan builds upon the Affordable Care Act that will bring insurance coverage to more than 30 million people. (A Nation Free…p7) The purpose is to transform current healthcare system by insuring the uninsured and making the coverage more secure for all those who have it. The 2010 Affordable Care Act is directed to meet these goals. 1. To provide protection in Medicare, Medicaid, CHIP, and other forms of health insurance. It allows coverage to all with preexisting conditions; no limit on care until lifetime as recommended by the U.S. Preventive Services Task Force (USPTF) in Medicare and Medicaid. 2. Expanding Medicaid coverage to individuals below age 65 and with 133 percent of the incomes of the federal poverty level by 2014. Implications on Nurses NHSC health providers practice in rural and urban federally designated health professional shortage areas. They serve in communities in every state including U.S Virgin Islands. Primary Care Nurse Practitioners and certified Nurse-Midwives are eligible under NHSC loan repayment. Under the emerging healthcare program HRSA will expand National Health Service Corporations and place more primary health care providers in those communities where there are shortages of nurses, physicians and dentists. The providers’ will get payments to clear their educational loan by serving at underserved areas. Under the Health Profession Opportunity Grant Programs, which aims at improving the work readiness and employment outcomes through their training programs such as registered nurses, certified nursing assistants, vocational nurses, home care aides. Graduates of the training program will receive industry-recognized certificates. Thus, the Obama reform holds great promise to nurses for varied and improved employment opportunities depending upon their training and skills. (A Nation free…p16) Evidence Based Clinical Guidelines The quality of care received by racial and ethnic minorities is not up to the mark. The following action will ensure the quality of care by removing barriers and through equitable use of evidence based clinical guidelines. Health plans through Health Insurance Exchanges, and new competitive health insurance markets for small employers and individuals will be established by 2014. That will include health education, wellness promotion and evidenced based approaches and manage quality care. Strokes and heart attacks are the major causes of early death for racial and ethnic minorities. HHS will take major initiative in providing quality care and reimbursement incentives for policy changes. (A Nation free…p17) Through Medicaid and CHIP, access to dental care will be provided. Since high percentage of racial and ethnic minority children are covered with public insurance, this will eliminate the disparities in oral health care services. This initiative will be working with states, other governmental agencies to develop oral health care plans. (A Nation free…p18) Nation’s health and human services infrastructure feels scarcity of primary care physicians, nurses, behavioral health providers, long-term care workers, and community health workers in the U.S. To reduce the shortages and gaps in workforce diversity, services of healthcare interpreters will be taken. Thus, the quality of patient-provider interactions will improve. Also, the strategies to improve cultural competence education and training for health care professionals and increasing ethnic diversity in the healthcare professionals will be undertaken. (A Nation free…p19) Evidence-based Community Preventive Health Activities Through the Affordable Care Act, evidence-based community preventive health activities will be implemented under the auspices of CDC Community Transformation Grants Program. Funding will be across multiple sectors to reduce cancer, heart attacks, and strokes by addressing a broad range of risk factors and conditions such as tobacco use, poor nutrition and physical inactivity and others. The program is designed to reach the wide spectrum of population giving special emphasis on reducing health disparities. A high profile campaign will be directed toward ethnic minority populations on importance of accessing preventive services related to tobacco use, proper nutrition and physical activity. Programs and interventions, culturally relevant and evidence based will be launched to reduce smoking prevalence among the affected groups. Efforts will include counseling, tobacco-free policies and cessation services at community health centers, mental health facilities and at substance abuse facilities. (A Nation free…p25) Environmental Health Risks and Safety Risks Factors for Children Immediate push is given by the tasks force under the auspices of HHS and EPA, to asthma disparities, chemical exposures to eliminate environmental health risks and safety risks to children. It aims at providing healthy settings on the aspects of living, learning and playing for children. (A Nation free…p27) Major Implications The new health care act never envisaged employers undercutting plans that provided coverage to employees for generations. Employer health benefits have been a major benefit to the middle class employees since World War II. Approximately 150 million workers are covered under employer group insurance schemes. Paul Keckley, executive director of the Deloitte Center for Health Solutions say that many companies are ready to drop benefits, though nobody would say openly about it. “We don’t want to be the first one to drop benefits, but we would be the fast second.’ We are hearing that a lot.” as stated by Paul Keckley. (Pat Dollard) “The economics of dropping existing coverage is about to become very attractive to many employers, both public and private,” said Gov. Phil Bredesen, D-Tenn. (Pat Dollard) Twenty one governors have strongly opposed some of the provisions of Obama’s healthcare law. In their communication to Health and Human Services Secretary Kathleen Sebelius, they have written that they do not endorse the policy of the federal government in its present form. (Wolf, Richard 2011). In fact, they asked for the following changes in the act. 1. Let states design the benefit plans eliminating all mandates. 2. Federal government should pay the full cost of subsidies as given to people inside exchanges. 3. Discriminatory provisions should be waived against consumer-driven health plans and against health savings account. 4. The states should be allowed to move non-disabled Medicaid beneficiaries into the exchanges. 5. Flexibility in operating health insurance exchanges should rest with states. They have categorically conveyed that law in present form will destroy their budgets. Based on recent ruling in Florida about invalidating the law, Florida authority is not at all pushing to implement the law. (Wolf, Richard 2011) Cost-effectiveness of Care Senator Rand Paul is of the opinion that Obama plan is going to cause disaster for the industry, for the patients and taxpayers. There are several new regulations and taxes on business that is going to cost billions of dollars per year. He further points out that premiums for health insurance have gone up, employers are dropping health coverage for their employees and layoffs have increased due to mandates and regulations. (Sen. Rand Paul) Implication in Form of Job Reduction and Wages Brian Blase reports in the Heritage Foundation that Obama’ Affordable Care Act is going to increase the cost of care rather than decreasing it. The new law gives a mandate that employers will be subject to tax penalty if they fail to provide adequate coverage to their employees provided they have more than 50 employees on their payroll. Brian calls it government intrusion on voluntary agreement between employer and employee. This mandate will change the basic nature of employer and employee relationship. The economic impact will be lower profits for many businesses and lower wages for many workers. This may also result into increased unemployment. The Congressional Budget Office (CBO) estimates that mandate will reduce employment by half percent and about 700,000 workers will get unemployed. (Blase, Brian 2011) Conclusion Obama healthcare plan has a lot to offer for deprived class, to retirees and to children but on practical implementation, to the authorities, it is likely to pose new threats and challenges. Only time will tell how effective the healthcare act will be in the long run in meeting its objectives to provide health care for all. Also, how some of the provisions of the act will be accepted by the states in a nation where free market concept is deeply rooted. References 1. A Nation Free of Disparities in Health and Health Care [Online] available at http://minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf [Accessed 19 April 2011] 2. Pat Dollard [Online] available at http://patdollard.com/2010/10/major-companies-to-dump-employee-health-care-due-to-obamas-communist-health-care-law/ [Accessed 19 April 2011] 3. Wolf, Richard 2011 [Online] available at http://content.usatoday.com/communities/theoval/post/2011/02/republican-governors-seek-changes-to-obamas-health-care-law/1 [Accessed 19 April 2011] 4. Sen. Rand Paul: Obamacare only exacerbates the problem [Online] available at http://cubachi.com/2011/03/28/sen-rand-paul-obamacare-only-exacerbates-the-problem/ [Accessed 19 April 2011] 5. Blase, Brian (2011) Obamacare and the Employer Mandate: Cutting Jobs and Wages [Online] available at http://www.heritage.org/Research/Reports/2011/01/Obamacare-and-the-Employer-Mandate-Cutting-Jobs-and-Wages [Accessed 19 April 2011] Read More