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NURS 6050 Policy and Advocacy for Improving Population Health

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NURS 6050 Policy and Advocacy for Improving Population Health

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

Lower Health Care Costs Act of 2019

Introduction

One of the major concerns of every American is healthcare. Healthcare is a complex, multifaceted issue, and voter concerns include the cost, quality, and availability of care as well as the availability of insurance and coverage of pre-existing conditions. Out of the many healthcare bills in the Congress, few will receive the bipartisan support necessary to move them through Congress, and it’s likely that fewer will be signed into law by the president. Currently, one of the healthcare issues pending in Congress is S 1895, the Lower Health Care Costs Act of 2019. This bill was introduced by Senators Lamar Alexander, R-Tennessee, and Patty Murray, D-Washington (U.S. Congress, n.d.). If the bill is eventually passed into law, it will help in lowering some healthcare costs.

This legislation will reduce what Americans pay out of their pockets for health care in three major ways:

Eliminate Surprise Medical Bills

  • First, the legislation will end “surprise” medical bills. A surprise medical bill is a bill from an out-of-network provider that was not expected by the patient or that came from an out-of-network provider not chosen by the patient. This, in turn, leads to extraordinarily high healthcare costs. Chartock et al. (2019) found that 11% of mothers experienced a surprise out-of-network bill with their first delivery, and this was associated with an increase of 13% in the odds of switching hospitals for the second delivery, compared to mothers who did not experience a surprise bill. The bill will also require health insurers to make certain information, including estimated out-of-pocket costs, accessible to enrollees through specified technology such as mobile applications (U.S. Congress, n.d.).

Transparency in Services Offered

  • Second, it creates more transparency. You can’t lower your health care costs until you know what your health care actually costs. The bill applies to in-network cost-sharing requirements to certain emergency and related non-emergency services that are provided out-of-network and requires health care facilities and practitioners to give patients a list of provided services upon discharge and to bill for such services within 45 days (U.S. Congress, n.d.).

Address Drug Price Increase

  • This bill will attempt to address rapid and significant drug price increases that have occurred in the last few years, with drug companies often raising prices significantly, especially when the drug is unavailable from other drug companies. According to Deb & Curfman (2020), the 2018 price increase alone was estimated to have added $1 billion to US health care costs. The authors cite the price of the world’s best-selling drug, adalimumab (Humira), which was increased by 7.4% for 2020. Also of concern is drug companies’ practice of paying generic drug makers to keep generic versions off the market so prices can remain high (Evans & Fleming, 2019). The bill will revise certain requirements to expedite generics and biosimilars’ approval, including requirements relating to citizen petitions, application effective dates, and labeling (U.S. Congress, n.d.).

This bill means a lot to healthcare consumers. The bill’s passage will reduce or eliminate “surprise” medical bills, create transparency in the healthcare industry, and finally alleviate financial burdens on the patients.

References

Chartock, B., Garmon, C., & Schutz, S. (2019). Consumers’ Responses To Surprise Medical Bills In Elective Situations. Health Affairs38(3), 425–430. https://doi-org.ezp.waldenulibrary.org/10.1377/hlthaff.2018.05399

Deb, C., & Curfman, G. (2020). Relentless Prescription Drug Price Increases. JAMA: Journal of the American Medical Association323(9), 826–828.https://doi-org.ezp.waldenulibrary.org/10.1001/jama.2020.0359

Evans E. & Fleming K. ( 2019). 5 Key Healthcare Issues Pending In Congress: ‘New Rules’ That Could Change How You Get Healthcare. Retrieved January 10, 2021 from https://www.forbes.com/sites/allbusiness/2019/07/07/5-key-healthcare-issues-pending-in-congress-new-rules-that-could-change-how-you-get-healthcare/?sh=679db6451ed9

U.S. Congress. (n.d.). S.1895 – Lower Health Care Costs Act. Retrieved January 10, 2021 from https://www.congress.gov/bill/116th-congress/senate-bill/1895

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

RE: Discussion – Week 7Collapse

Main Post

Nursing is a profession where the care that is provided should be evidence base, and as we can attest to the fact that we have seen some practices that have no evidence behind it, yet nurses continued to practice that way because it became the culture of care. As our profession is and should be practiced based from evidence we must venture away from those practices and adhere with the evidence base practices. The health policy that I selected is Bill H.R.4647, Protecting Medicare Beneficiaries with Pre-Existing Conditions Act. This bill sponsors are Rep. Schneider, Bradley Scott [D-IL-10], was introducedNrse 6050 policy and advocacy for improving population health

NRSE 6050 Policy and Advocacy for Improving Population Health

on 10/15/2019. The background for this proposed bill/problem goes way back before the Affordable Care Act (ACA), whereas people that had pre-existing health conditions were denied health insurance or their prices were way higher to the point where they could not affordable to pay and went uninsured for decades (Giled & Jackson, 2017). President Franklin D Roosevelt introduced the Social Security Act, President Lyndon Johnson made an amendment to the Social Security Act with the passage of Title1X where the Medicare Act was introduced under Title V111. Prior to the ACA, health insurance was obtained medically, meaning insurance companies were privy to an individual health record and other risks factors which they use to determined eligibility and applicants had to fill out a lengthy form with their medical history (Claxton et al., 2016).  Medicare Act was introduced at the federal state level to provide coverage to the poorest citizens (Auerbach, 2019). The Patient Protection Affordable Care Act (PPACA) was passed in to law 2010 which protects people with pre-existing health condition against insurance companies that would deny them health insurance coverage (Auerbach, 2019).

There is enough evidence to support the fact that people with pre-existing conditions were denied health insurance because before the passage of the PPACA insurance companies were not held accountable.  According to Claxton et al. (2016) more than 18% of applicants were denied health insurance before the ACA act and many more people that had pre-existing condition did not apply because they were already informed that they would be denied. PPACA has extended coverage and hold insurance accountable, no preexisting inclusion and now more than 32 million more people have gain access to insurance coverage including people with pre-existing conditions such as patients with cancer (Plaxe & Nagle, 2014).

References

Auerbach, M. P. (2019). Patient Protection and Affordable Care Act: Overview. Salem Press

Encyclopedia.

Claxton, G., Cox, C., Damico, A., Levitt, L., Pollitz, K & Kaiser Family Foundation. (2016).

Pre-existing conditions and medical underwriting in the individual insurance market

prior to the ACA. Montana, 25, 152-000.

Glied, S., & Jackson, A. (2017). Access to Coverage and Care for People with Preexisting

Conditions: How Has it Changed Under the ACA? Issue Brief (Commonwealth Fund)18,

1–12.

Plaxe, S., & Nagle, V. L. J. (2014). Patient Protection and Affordable Care Act (“Obama

Care”). Journal of Gynecologic Oncology Nursing24(1), 25–26.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.

Review the health policy you identified and reflect on the background and development of this health policy. NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.RE: Discussion – Week 7Collapse

The recent law to ban abortion in Texas sent shock waves across the state and outside, bringing fear of the repo effect as policymakers interfered with a human right. The right to women’s health services. The law put forth restrictions on abortion as early as six weeks and even gave the power for ordinary citizens to sue health care providers found to break this law in the state (Najmabadi, 2021).

To prevent the passing of the outrageous law in California, Rep. Chu, Judy (D-CA-27) introduced the bill H.R.3755- Women’s Health Protection Act of 2021. The bill persuaded Congress to protect the right of individuals, in this case, women, when it is time to make an informed decision to terminate the unwanted pregnancy and the protection of providers involved in performing abortion procedures under standardized protocols (Congress.gov, 2021). The Women’s Health Protection Act bill is currently under the Senate review, and it has been used to bring public awareness and to the legislatures on the impact of anti-abortion rules, which through informed evidence, its consequences have been found to perpetuate decreased access to safe abortions, as evidenced by a review of the literature completed by Espinoza et al. (2020), which showed an increased rate of infection and mortality amongst 22 million adolescent girls globally.

Also, increased service cost has hindered women from participating in economic and social developments, leaving women vulnerable to socio-economic exploitations from the opposite sex. Last, the sharp increase in mental health disorders and health disparities in minority ethnics have been associated with limited access to women health services and has continued to affect other preventative vital health services that include screenings, contraceptive services, sexually transmitted disease services, prenatal care, and adaptation services (Congress.gov).

The fourteenth amendment of the U.S. Constitution gives rights to all American citizens, thus protecting a woman’s right to make adequately informed and educated health decisions and abortion being part of them.

References

Congress.gov. (2021). H.R.3755 – Women’s Health Protection Act of 2021 . Retrieved from CONGRESS.GOV: https://www.congress.gov/bill/117th-congress/house-bill/3755/text

Espinoza, C., Samandari, G., & Andersen, K. (2020, April). Abortion knowledge, attitudes and experiences among adolescent girls: a review of the literature. Sexual and Reproductive Health Matters, 28(1); PMC7888105. doi: 10.1080/26410397.2020.1744225.

Najmabadi, S. (2021). Gov. Greg Abbott signs into law one of nation’s strictest abortion measures, banning procedure as early as six weeks into a pregnancy. THE TEXAS TRIBUNE.

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

*Note: Throughout this program, your fellow students are referred to as colleagues.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 7 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 7

To participate in this Discussion:

Week 7 Discussion

RE: Main Question Post

Hello, Sierra Savage (colleague).

I noted that your health policy you have chosen was The Families First Coronavirus Response Act 2020. I found your chosen health policy interesting in reading seeing the public is in a current pandemic related to this novel virus as in the coronavirus. It was interesting to see what The Families First Coronavirus Response Act 2020 was focusing on. You stated in your paper that The Families First Coronavirus Response Act 2020 is a response strategy to the coronavirus outbreak, and its focus was on the provision of free coronavirus testing, paid sick leave, food assistance, and unemployment. I found it partially as in The Families First Coronavirus Response Act 2020 to be a bit biased.

There is so much about this virus that is unfolding before our eyes. We are learning more and each day something new about this virus (Coronavirus).

According to the Washington Post in the United States, the Coronavirus appears to be infecting and killing African Americans at a disproportionately high rate (Thebault, Ba William, 2020).). This emerging stark racial disparity led the Surgeon General to acknowledge in personal terms the increased risk for African Americans amid growing demands that the public-health officials release more data on the race of those who are sick, hospitalized and dying of a contagion that has killed more than 12,000 people in the United States (Thebault et al., 2020).

It was stated in the Washing Post that the reason for African Americans being affected at a disproportionate rate had to with African Americans having higher rates of diabetes, heart disease, and lung disease are well documented, and noted by  Louisiana Governor John Bel Edwards that health problems make people more vulnerable to the new respiratory disease, but there has never has been a pandemic that brought the disparities so vividly into focus (Thebault et al., 2020).

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Nurs 6050 policy and advocacy for improving population health
NURS 6050 Policy and Advocacy for Improving Population Health

Because of this crisis, the Lawyers’ Committee for Civil Rights Under Law and hundreds of doctors joined a group of Democratic lawmakers, including Senators Elizabeth Warren (Mass.), Cory Booker (N.J), and Kamal D. Harris (Calif), in demanding the federal government to release daily race and ethnicity data on coronavirus testing, patients and their health outcomes, seeing that the data for the Centers for Disease Control and Prevention has only released figures by age and gender (Thebault et al., 2020).

The data being reported by the Centers for Disease Control and Prevention is only including age and gender and leaving out racial or ethnic data. I find this data to be disturbing and biased. Civil rights law prohibit federally funded health care providers from administering services in a discriminatory manner, said Kristen Clarke, president and executive director of the Lawyers’ Committee of Civil Rights Under Law, which joined with medical professionals to call for the immediate release of racial and ethnic data on coronavirus infections, testing, and deaths (Wambsgans, 2020)

According to the Washington Post article, 2020, even though some activists argued African Americans have been more exposed because many held low-wage or essential jobs, such as food service, public transit, and health care, that required African Americans to interact with the public, I find this to be a poor argument in that is still does not address data on race and ethnicity not being reported, as being left out of data for the Center for Disease Control and Prevention.

According to the Center for Disease and Prevention Control (CDC), guidelines in every state is legally required to track data on testing and treatment by race, as it has done during other outbreaks. Fewer than a dozen have released that data so far (Evelyn, 2020). According to what is being found, African Americans are particularly more vulnerable. According to Kristen Clarke president and executive director of the Lawyers’ Committee of Civil Rights, this is a social, economic and racial justice issue (Evelyn, 2020).

I feel that the Families First Coronavirus Response Act 2020, needs to be re-assessed, in that health care officials need to consider different factors that should be included for this health care policy to be justifiable (unbiased).

REFERENCES

Reise Thebault, Andrew Ba Tran, & Vanessa Williams (2020). Washington Post. The coronavirus is infecting and killing black Americans at an alarmingly high rate. Retrieved April 09, 2020, from

Https://www.washingtonpost.com/archive

Jason E. Wambsgans (2020). National Broadcasting Company news. African Americans may be dying from COVID 19 at a higher rate. Better data is essential, experts say. Retrieved April 10, 2020, from

Https://nbcnews.com

Kenya Evelyn (2020). The Guardian. It’s a racial justice issue: Black Americans are dying in greater numbers from COVID-19. Retrieved April 10, 2020, from

Https://www.theguardian.com


ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

  • Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
  • Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
  • One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
  • I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

  • Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
  • In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
  • Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
  • Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

  • Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
  • Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
  • I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

  • I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
  • As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
  • It is best to paraphrase content and cite your source.

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Nurs 6050 policy and advocacy for improving population health
NURS 6050 Policy and Advocacy for Improving Population Health

LopesWrite Policy

  • For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
  • Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
  • Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
  • Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

  • The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
  • Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
  • If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
  • I do not accept assignments that are two or more weeks late unless we have worked out an extension.
  • As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

  • Communication is so very important. There are multiple ways to communicate with me: 
    • Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
    • Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours

Name: NURS_6050_Module04_Week07_Discussion_Rubric

ExcellentGoodFairPoor
Main PostingPoints Range: 45 (45%) – 50 (50%)Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.Supported by at least three current, credible sources.Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.Points Range: 40 (40%) – 44 (44%)Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.At least 75% of post has exceptional depth and breadth.Supported by at least three credible sources.Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.Points Range: 35 (35%) – 39 (39%)Responds to some of the discussion question(s).One or two criteria are not addressed or are superficially addressed.Is somewhat lacking reflection and critical analysis and synthesis.Somewhat represents knowledge gained from the course readings for the module.Post is cited with two credible sources.Written somewhat concisely; may contain more than two spelling or grammatical errors.Contains some APA formatting errors.Points Range: 0 (0%) – 34 (34%)Does not respond to the discussion question(s) adequately.Lacks depth or superficially addresses criteria.Lacks reflection and critical analysis and synthesis.Does not represent knowledge gained from the course readings for the module.Contains only one or no credible sources.Not written clearly or concisely.Contains more than two spelling or grammatical errors.Does not adhere to current APA manual writing rules and style.
Main Post: TimelinessPoints Range: 10 (10%) – 10 (10%)Posts main post by day 3.Points Range: 0 (0%) – 0 (0%)Points Range: 0 (0%) – 0 (0%)Points Range: 0 (0%) – 0 (0%)Does not post by day 3.
First ResponsePoints Range: 17 (17%) – 18 (18%)Response exhibits synthesis, critical thinking, and application to practice settings.Communication is professional and respectful to colleagues.Responses to faculty questions are fully answered, if posed.Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.Demonstrates synthesis and understanding of learning objectives.Response is effectively written in standard, edited English.Points Range: 15 (15%) – 16 (16%)Response exhibits critical thinking and application to practice settings.Communication is professional and respectful to colleagues.Responses to faculty questions are answered, if posed.Provides clear, concise opinions and ideas that are supported by two or more credible sources.Response is effectively written in standard, edited English.Points Range: 13 (13%) – 14 (14%)Response is on topic and may have some depth.Responses posted in the discussion may lack effective professional communication.Responses to faculty questions are somewhat answered, if posed.Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.Points Range: 0 (0%) – 12 (12%)Response may not be on topic and lacks depth.Responses posted in the discussion lack effective professional communication.Responses to faculty questions are missing.No credible sources are cited.
Second ResponsePoints Range: 16 (16%) – 17 (17%)Response exhibits synthesis, critical thinking, and application to practice settings.Communication is professional and respectful to colleagues.Responses to faculty questions are fully answered, if posed.Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.Demonstrates synthesis and understanding of learning objectives.Response is effectively written in standard, edited English.Points Range: 14 (14%) – 15 (15%)Response exhibits critical thinking and application to practice settings.Communication is professional and respectful to colleagues.Responses to faculty questions are answered, if posed.Provides clear, concise opinions and ideas that are supported by two or more credible sources.Response is effectively written in standard, edited English.Points Range: 12 (12%) – 13 (13%)Response is on topic and may have some depth.Responses posted in the discussion may lack effective professional communication.Responses to faculty questions are somewhat answered, if posed.Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.Points Range: 0 (0%) – 11 (11%)Response may not be on topic and lacks depth.Responses posted in the discussion lack effective professional communication.Responses to faculty questions are missing.No credible sources are cited.
ParticipationPoints Range: 5 (5%) – 5 (5%)Meets requirements for participation by posting on three different days.Points Range: 0 (0%) – 0 (0%)Points Range: 0 (0%) – 0 (0%)Points Range: 0 (0%) – 0 (0%)Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

Name: NURS_6050_Module04_Week07_Discussion_Rubric

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