Effects On Public Health Of Health Care Reform Essay

Length: 15 pages Sources: 8 Subject: Healthcare Type: Essay Paper: #40260343 Related Topics: Medicare Reform, Public Health, Healthcare Policy, Smoking In Public
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Health Care Reform Effecting Public Health United States

Healthcare reform is an integral part of the United States healthcare system. Below is an evaluation of the effects healthcare reform has had on healthcare in the U.S. Internet sources as well as peer-reviewed journals will be looked at so as to see the effects.

The cost of healthcare has been on the rise. Issues of healthcare quality ought to be paid attention to and healthcare access equity improved upon (Health Care Transformation). Given these causes, while some differences exist on what reforms to carry out, a majority of Americans hold the belief that the U.S. Healthcare delivery systems need some improving. For a long time ANA has been advocating for reforms in healthcare and several of the Affordable Care Act (ACA) provisions are in line with the Health System Reform Agenda of the ANA. The ANA gave a chart that gives information concerning the recently proposed changes to healthcare and the implications they will have on nurses (Health Care Transformation). As of now, a majority of the proposed changes are a reflection of the Patient Protection and Affordable Care Act (Public Law 111-148) (ACA) provisions. ANA has invited Americans to follow updates they will make on the chart that show the progress in nursing influences on regulations as well as other activities so as to ensure the implementation of health reform as well as certain provisions in the ACA as the Supreme Court makes a decision that upholds most of the law's provisions. The chart also highlights the opportunities Registered nurses and APRNs can exploit to use new programs and healthcare innovation pilots, and grant funding for their education and the funding for development of the nursing workforce (Healthcare Transformation).

Provisions of the Affordable Care Act

The law subsidizes 100% of the states expense to take care of the added population, slowly lowering it to 90% by the 2020 financial year. As the court decided, states can opt-out of the Medicaid expansion as well as the added funding without putting their prevailing levels of funding in danger (Healthcare Transformation). Registered nurses form the bulk of the professionals in clinical care and they practice and are educated within the healthcare system. Registered nurses take their education within a holistic environment that establishes the family, individual as well as the community as one in a system that is interconnected so as to be able keep citizens well and heal them (Healthcare Transformation). Registered Nurses are important to the push for changes required in healthcare, with the aim of transformation of the "sick care" in its current state to a future real "health care." The ANA is currently engaging with makers of policy at the federal level and other regulators so as to advocate for a transformation system that encompasses the contributions nurses and nursing make and continue to make.

On June 28, 2012, nearly all the ACA provisions were upheld by the Supreme Court, including the provisions on "shared responsibility" in the purchasing of health insurance (the so-called "individual mandate"). Through upholding this fact, several provisions survived challenges, including the advances made for and by nurses and nursing (Healthcare Transformation). The Court did away with an aspect of the ACA which would have called for states to expand the eligibility for Medicaid by the year 2014 to every person whose income is below 133% of the federal poverty level, or forgo all Medicaid matching funds from the federal government. Federal health reform makes use of a systematic approach which begins the current health insurance system in the country (What Is Health Care Reform). Health reform seeks to improve on the current system of health insurance so as to give health insurance access to a lot more individuals, build consumer protection legal structures and put up measures that will ensure consumers are shopping knowledgeably about health insurance (What Is Healthcare Reform).

Aspects of Health Care Reform

Health care reform encompasses the following steps:

Expansion of Medicaid so as to afford more individuals with small incomes access to coverage

Encouraging the employers to give coverage to their employees

Provision of credits for the purchase of health insurance by Americans who get moderate incomes so that they can qualify for Medicaid

Streamlining the buying of health insurance by establishing Health Insurance Exchange

Strengthening protection of consumers and make transparency a requirement

Encouraging preventive and primary care

Requiring a majority of Americans to buy health insurance

As was the case in the past, the debate on health insurance right now puts the emphasis on treating individuals when they become sick. This focus on treatment does not appreciate the importance of maintenance of health in the


The advantages of a population that is healthy far outweigh the costs that will be incurred (Kemp, 2012). While illness treatment is a key component of health care, strengthening and reforming the healthcare system is equally crucial to bettering the health of the nation's population and to the effective management of the resources we have (Kemp, 2012).

Significance of Health Care Reforms to Public Health

Actually, the Partnership for Prevention outlines the three major aims of public health as promoting better health for every citizen, preventing the consequences due to a person suffering from various illnesses and protecting the safety and health of the population (Kemp 2012). While some overlap might exist, public health as a discipline varies greatly from healthcare practice, which encompasses health assessment, symptoms diagnosis, treatment of illnesses and the management of impairments due to chronic conditions. The primary obligation of public health is protecting and promoting the health of the population by prevention, public policies and regulations as well as protection of the environment (Kemp 2012). The same view was expressed by Kenneth Arrow in an essay he penned in 1963 when he gave a description of medical care as nothing but taking care of shelter, sanitation, clothing and nutrition. These aspects are key to medical care especially when an individual does not have them. Debates about medical care right now are overshadowed by competitive politics and discussions about technologies and medical interventions (Kemp 2012). As this happens, the cost of healthcare in the country is out of reach to many people and is continuously being inflated, even growing from 5.2% of GDP in the year 1960 to 17.6% in the year 2009, a growth trajectory which is expected to continue.

A report released in 2009 on local health departments (LHDs) roles indicates that reform in health care is important to public health. It gives an illustration of the contradiction that exists between the expansion of healthcare coverage while lowering resources being channeled to LHDs. It gives data that shows that health care can claim only 10% of health outcomes, the rest is determined by a range of health factors that include socioeconomics, physical environments and behavior (Kemp 2012). Even though medical care can extend survival and lead to an improvement on prognosis following serious illnesses, more crucial to the population's health is the economic and social conditions which cause illnesses and make people require medical care. Bad economic and social circumstances have effects on health for a person's entire life. People who are low on the scale have two times the risk of contracting illnesses and suffering premature deaths as the members of the population who are higher up on the scale (Kemp, 2012). The report indicates that an agreement can be reached on what to target in the basic economic and social issues and asserts that raising LHD funding could probably save $20 in healthcare costs for every dollar spent on prevention. This can be attained by having a focus on the fundamental causes of poor health such as abuse of substances, smoking, poverty, pollution, homelessness, violence and abuse of substances (Kemp, 2012).

Gotison and Jacobson are also calling for secure and adequate long-term funding for public health. They opine that the public health system is in shambles and should be rebuilt from the ground up. They assert the significance of promotion of health and the prevention of diseases. As opposed to conventional wisdom, lack of healthcare isn't the main cause of illnesses and death (Kemp 2012). They are in agreement that causes of illnesses involve the environment, socioeconomics and behaviors. Furthermore, they agree that the main aim of any health system ought to be improvement of the health of the population, which might not result from interventions in Medicare (Kemp 2012). They indicate that there is a lot of evidence demonstrating the cost effectiveness of public health interventions, while this is not the case for the current costly health care system.

The Effect of Health Care Reforms on Public Expenditure

The U.S. expenditure on healthcare is approximately two trillion dollars. This figure is more than those of any other industrialized nation in the world (Johnson, 2012). As per the data given by the Organization for Economic Cooperation and Development (OECD) the United States expenditure is two…

Sources Used in Documents:



Kemp, C. (2012, October 11). Public Health in the Age of Health Care Reform. Retrieved January 21, 2015, from http://www.cdc.gov/pcd/issues/2012/12_0151.htm


How National Health Care Reform Will Affect a Variety of States. (2011, April 5). Retrieved January 21, 2015, from http://www.rand.org/news/press/2011/04/05.html
What is Health Care Reform? (2012, April 1). Retrieved January 12, 2015, from http://www.healthcarereform.ny.gov/summary/
Anderson, A. (2014, March 18). The Impact of the Affordable Care Act on the Health Care Workforce. Retrieved January 21, 2015, from http://www.heritage.org/research/reports/2014/03/the-impact-of-the-affordable-care-act-on-the-health-care-workforce
Update on health care reform. (2013, March ). Retrieved January 21, 2015, from http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm
Goroll, A., & Hunt, D. (2015). Bridging the Hospitalist -- Primary Care Divide through Collaborative Care. The New England Journal Of Medicine, 372, 308-309. Retrieved January 22, 2015, from http://www.nejm.org/doi/ref/10.1056/NEJMp1411416#t=article
Johnson, T. (2012, March 26). Healthcare Costs and U.S. Competitiveness. Retrieved January 22, 2015, from http://www.cfr.org/competitiveness/healthcare-costs-us-competitiveness/p13325
Health Care Transformation: The Affordable Care Act and More. (2014, June 18). Retrieved January 22, 2015, from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/HealthSystemReform/AffordableCareAct.pdf

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