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Affordable Care Act & Nursing
There are a number of different provisions of the Affordable Care Act that were designed to improve the health care system -- well, all of the provisions were designed to do that. The most immediate improvements will be the provisions that low the cost of drugs (such as the Medicaid rebate for brand name drugs) and the generics approval change. The biggest change that affects the quality of care is probably the provision regarding readmissions. The core of this provision is the idea that high rates of readmissions indicates a relatively poor standard of care is being given; so penalties for high readmission rates will encourage hospitals to have a higher standard of care in the first place, doing more for underlying conditions instead of just treating symptoms. Another beneficial provision is that plans now need to cover several types of preventative screening.
There are a number of provisions that address the issue of disparity of access to health care. The provisions surrounding insurance are all included, for example the fact...
The insurance exchanges are another means by which the disparity of access is reduced because people will have set plan types that they can purchase, but then these can easily be compared. That everybody has to buy into one of these plans is technically going to increase access.
There are some provisions that will be quite challenging. The biggest challenges comes from the net effect of bringing more people into the insurance system. While it is relatively easy to have people sign up on an insurance exchange, what is more difficult is that this increase in demand will be tough to manage. Providers may have to reconsider how they do business, and certainly this will affect supply and demand for medical professionals. There may be shortages of physicians, which would put more pressure on RNs, but many nursing specialties are also facing chronic shortages as well. Until the supply of professionals can be increased -- a process that can take years -- there may be significant system-wide personnel shortages that could compromise care quality.
All of the various tax code changes may be tough to implement, such as forcing people to pay a penalty if they do not buy insurance -- enforcement of measures like…
References
Djukic, M. & Kovner, C. (2010). Overlap of registered nurse and physical practice: implications for U.S. health care reform. Policy, Politics & Nursing Practice. Vol. 11 (1) 13-22.
Sommer, A. (2001). How public health policy is created: Scientific process and political reality. American Journal of Epidemiology. Vol. 154 (12) S4-S6
Winkelstein, W. (2009). The development of American public health, a commentary: Three documents that made an impact. Journal of Public Health Policy. Vol. 30 (1) 40-48.
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