1.The Affordable Care Act (ACA) was a movement put into effect in 2010, and has also been referred to as Obama Care, after President Barack Obama; The goal of the Affordable Care Act was to make insurance more accessible to those who were previously unable to obtain or maintain insurance coverage. (Affordable Care Act, 2020). The main points of the ACA were to change the previously strict and inflexible rules of healthcare coverage, in turn making it more accessible. The ACA prevented insurance companies from denying coverage to those with pre-existing conditions, a common practice previously; changed the age a child can remain on their parents insurance plan to 26; allowed consumers to appeal denials of coverage by an insurance provider; canceled out benefit limits on insurance, and made preventative care a no cost service to the consumer, to be covered 100% by insurance companies. (Sanger-Katz, 2017).
The most important role this plays in public health is moving towards coverage for all citizens. This allows populations that were previously unable to obtain care, to now do so and not have as high out-of-pocket costs, It also pushes the nation towards primary prevention through preventative care. This will allow major and costly complications to be delayed and decrease the cost of healthcare per person. The system also rewards people for having health coverage, not just patients, but also physicians. Patients are rewarded through tax breaks for providing proof of coverage each year, and physicians are rewarded for meeting goals in patient care. This method does play to our desires to achieve goals that have been set for us, but also can pose the downfall of false medical claims and over prescribing to meet those goals. My opinion is that the ACA pushed for the trend of primary prevention, but can easily cause over extension and ordering or prescribing of un-necessary procedures and medications in attempt to meet goals, creating a sort of catch 22 situation. It is important in modern times to have access to healthcare to secure financial stability, but how many of the procedures and tests that are draining finances are really necessary?
As a nurse it is our responsibility to make sure patients are properly educated on the services important to their care. We must take a role of advocate for the patient to give them the knowledge to properly respond to the options available to them. When we give the the tools to take an active role in their own care we are helping to prevent overprescribing and unnecessary hospitaliztions. We can promote primary prevention, through education.
References
Affordable Care Act [webpage]. (2020). Healthcare.gov. Retrieved October 13, 2020, from https://www.healthcare.gov/glossary/affordable-care-act/
Sanger-Katz, M. (2017). Biggest Changes Obabcare made, and those that may disappear. The New York Times. Retrieved October 13, 2020, from https://doi.org/https://www.nytimes.com/2017/01/13/upshot/the-biggest-changes-obamacare-made-and-those-that-may-disappear.html
- The Affordable Care Act that was enacted in March of 2010, has helped 20 million people get health insurance. (Health, n.d.) There are numerous elements of the Affordable Care Act that are in relation to community and public health. The ACA makes a move in making sure health care coverage is affordable as well as accessible to all Americans. There is funding that is directed for public health to help pay for different prevention programs including the Infant and Early Childhood visiting program. This is a program that I was able to do some clinical work with and this program is amazing. Nurses would go to the home of new moms and talk to them, assess their needs as well as the babies needs. The nurse would be able to lay eyes on the home situation. This public health nurse completes weight checks which can make a huge difference in their well being if a concern is caught early and addressed. These nurses follow mom and baby until the child is the age of 3, being a support to mom and child in a health home situation as well as monitoring the child’s mental and physical development. Nurse-Family Partnership is a huge asset to have helping create a better future for the mom and child. (Nurse-Family Partnership, 2019) Some other programs that are funded by the ACA regarding public health include programs that support research and tracking on different health measures, CHIP which is an immunization program for children, as well as many more. The use of these programs works to reduce the disparities in the community, improve access to insurance and preventative health care as well as improve health outcomes. (Health, n.d.)
It is the community health nurses role to assess the families they work with and get them into the program to support their well being and needs. The community health nurse will work to build a trusting, supportive relationship with his/her patient’s and support them to a healthier state of being both physically and mentally. The nurse refers them as necessary and works as a contact for them to reach out to with continued needs. This nurse may help the to apply for programs, follow up with healthcare needs, and be their support system throughout the time they work together. The Affordable Care Act really does numerous things for our country that is necessary to continue to lower health care costs and support a healthier country.
References
Health, T. N. (n.d.). Health Reform. Retrieved from American Public Health Association: https://www.apha.org/health-reform#:~:text=By%20making%20health%20coverage%20more,disparities%2C%20improve%20access%20to%20preventive
Nurse-Family Partnership. (2019). Retrieved from Becker County, MN: https://www.co.becker.mn.us/dept/public_health/nfp.aspx
3.There are many elements of the Affordable Care Act (ACA) with almost 1,000 pages of information. Upon examination of the document, I believe that the most important aspects of the ACA to community and public health are as follows; no lifetime or annual limits, coverage for preventable health services, coverage for pre-existing conditions, nursing student loan program, nursing student loan repayment program, nurse-managed health clinics, and advanced nursing education grants (HHS, n.d.). With the advent of the changes that were brought about with the ACA, it allowed for more Americans to access healthcare coverage through a national exchange network, allowing for more individuals to access to healthcare coverage (Ziran, & O’Pry, 2020). As noted, the addition of these exchanges was not listed in what I believe are the most important elements of the ACA. As Ziran and O’Pry stated within their research, many did obtain health insurance, but many were left without access to private providers and treatments that do not accept the government options plans (Ziran, & O’Pry, 2020).
The role of the nurse in implementing the new laws are intertwined within the community. With more individuals that have health coverage means that more patients will be seeking healthcare services. Nurses are the most trusted members of the healthcare profession, so nurses have the responsibility to assist our patients to answer the questions regarding the new system and laws (Salmond, & Echevarria, 2017). Not only are community nurses educating our patients about the new laws, but nurses are also the backbone of providing safe, quality, and patient-centered care. The ACA has been moving healthcare from fee for service care to more value-centered payment this leaves nurses at the forefront of being responsible for care coordination, data analysis, and quality improvement (Salmond, & Echevarria, 2017). Allowing for nurses to take advantage of the education programs offered in the ACA. Community nurses are change agents and work to develop partnerships with patients, practitioners, and families to direct education for positive goal attainment (Salmond, & Echevarria, 2017).
Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopedic nursing, 36(1), 12–25. https://doi.org/10.1097/NOR.0000000000000308
U.S. Department of Health & Human Services (n.d.). About the Affordable Care Act [website]. http://www.hhs.gov/healthcare/facts/timeline/index.html
Ziran, B. & O’Pry, K. (2020). Proposal of a new shared payment model for healthcare financing in the United States: a hypothesis. Patient Safety in Surgery, 14(1), 1–8. https://doi-org.lopes.idm.oclc.org/10.1186/s13037-020-00242-w