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Week 3 Discussion Prompt 1
Top of Form
Identify three components of the Patient Protection and Affordable Care Act that went into effect in 2014 and discuss their impact or potential impact on the practice of nursing and medicine. Be specific as to what the provision states, who it affects, and the impact that it may have.
Bottom of Form
There are several components to the Patient Protection and Affordable Care Act. One component is that the Affordable Care Act provides access to all. The ACA expands to Medicaid. All the states must be able to accommodate those with Medicaid and make the process to enroll, more simple. This affects the practice of nursing and medicine because Medicaid was once the insurance that could be turned away. Now, care is offered and available to all.
The second component is the Patient and how health care is delivered. With ACA, the model is set-up to fit the needs of the patient. This model knows that the care involves multiple disciplines and it is set-up to incorporate from pharmacy needs to home health care needs. This changes the way we provide care because we may not have to wait months for approvals. We know that everything is incorporated and we can provide services that we once may not have been able to.
The final component is the Cost of Care. Affordable Health care does not mean free health care. Affordable Health care provides price points for all. If you would like more coverage, you need to pay more. This creates and issue when providing care because we must be upfront with costs. Nurses and other health care providers may now seem like debt collectors. A role we are not used to having.
Many items are involved in the Patient Protection and Affordable Care Act. In March 23, 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law this is also known as Obama Care. In 2014 some significant changes that were made in the Obama Care was that it was prohibited to discriminate any patients from obtaining health care coverage based on pre-existing conditions also Medicaid was also obligated to provide health insurance to those individuals who did not qualify for Medicare (Anderson, 2020). One of its components is that all individuals should have access to health insurance. Employers are expected to provide health care coverage to their working employees. Benefits under Medicaid were also expanded to help all individuals have access to health insurance vs before it was selective. Secondly, the Patient Protection and Affordable Care Act control the cost of health care in this case the Medicare and Medicaid programs were changed. In this component there are different tiers of health coverage that an individual can purchase the more an individual pays the more health coverage they obtain. The third component of the Patient Protection and Affordable Care Act demands the improvement of the health care and its quality (Austin & Wetle, 2017, p. 11).
Week 3 Discussion Prompt 2
Top of Form
Describe a type of health care spending that you consider wasteful or services that you consider have little or no benefit. Explain why you find the spending wasteful, and if eliminated, what impact it may have on the American public.
Bottom of Form
A type of health care spending that I think is wasteful is overtreatment and/or performing unnecessary diagnostic procedures. Unnecessary treatment can negatively affect quality of life, increased financial costs to individuals and wasted resources and opportunity costs to the health system (Armstrong; 2018). Avoiding overtreatment and procedures that are not necessary can save time, money, protect patients from harm, avoid needless pain and suffering. Physicians may overtreat their patients because of the fear of malpractice, being sued and because patients may request or demand certain procedures to be performed such as blood drawn, screenings, imaging etc. However, if physicians and patients communicate with one another, focus on patient education and come to a decision together, then this results in more conservative care or management.
This reduces the likelihood of patients go under an invasive procedure, have unnecessary lab tests or take certain medications (ex. antibiotics, if it is not necessary for their condition). A 50% reduction in “unnecessary services” would result in $105 billion in savings each year, or about 4% of total national healthcare spending (Lyu; 2017). Eliminating unnecessary procedures can help the public save money and not be exposed to certain risk factors such as having a surgery and getting an infection, or any other harm whether it is psychological, behavior affects and physical harm.
Overuse of the care such as unnecessary treatments or diagnostics services is a type of health care spending that is wasteful at a times. Some patients are so dominating over health care professionals with the threat to sue them if they did not meet their expectation of care and manipulate them to writing the unnecessary orders of blood works even if they have been within the normal range for the past one to two years and there has been no change in their health or overusing the antibiotics (Nelson, 2015). Nelson did the three studies to learn about the health care’s main wasteful spending and not surprising to me unnecessary services/care was at the top in all of them.
I personally have experienced it too. We do get some patients every now and then, who practically dictates their plan of care to doctors and nurses regardless of their health status. I had one patient who was getting a comprehensive metabolic panel every other day for a month until he got discharge just because at one point, in the beginning, his sodium level was little out of the range (not critical), he obsessed with knowing his level every day. For me, it was a pure waste of money and waste of lab tech’s time.
By reducing or eliminating such overuse of treatment, hospitals can save the money as use the same resource for a client who really needs it. In a given personal example, frequent blood work increases the risk of infection at the Venipuncture site and also leads to overuse of veins. In 2014 Federal was providing the 100% funding for the health coverage to individuals below or at the 133% of Federal Poverty Line (FPL) but by 2017, the funding decreased to 90% (Mason, etl., p-188). Therefore as a consumer and healthcare professionals, it’s our responsibility to use these funding wisely, so that more and more people can ripe its benefits.