Ethics And Legal Aspects In Nursing Week 13 Please Answer

Ethics Legal Aspects In Nursing Wk 13please Answer The Following Dis

Ethics & Legal Aspects in Nursing WK 13 Please answer the following Discussion Question. Please be certain to answer the four questions on this week DQ and to provide a well-developed and complete answer to receive credit. Also, please ensure to have read the assigned chapters for the current week. Case Study, Chapter 21, Health Care Reform: The Dismantling of the Affordable Care Act As we entered 2018, millions of Americans still relied on Affordable Care Act (ACA) subsidies, health premiums were soaring, and provider choice was more limited than ever. There was, however, momentum for reform.

Health care was identified as the country’s leading priority for Democrats (54%) and the second highest priority for Republicans (42%) at the close of 2017. A group of registered nurses debate the issue of health care reform.

  1. The nurses debate whether the country feels that health care reform is really necessary. Discuss reasons why reform is needed and what that reform should address.
  2. What were the 10 essential benefits guaranteed by insurance plans in the ACA Health Care Marketplace?
  3. What are the successes of the ACA?
  4. What are the failures of the ACA?

INSTRUCTIONS: APA FORMAT IN TEXT CITATIONS WITH MINIMUM 3 PEER REFERENCES NO LESS THAN 5 YRS

Paper For Above instruction

Healthcare reform has been an ongoing priority in the United States, driven by the need to improve the accessibility, affordability, and quality of care for all citizens. The Affordable Care Act (ACA), enacted in 2010, represented a significant attempt to address longstanding issues within the healthcare system. Despite its initial success in expanding insurance coverage, the ACA has faced criticism and challenges, highlighting the necessity for ongoing reform efforts. This paper discusses the reasons why healthcare reform, particularly in the context of the ACA, is vital, examines the essential benefits guaranteed by ACA plans, and evaluates both the successes and failures of the legislation.

Reasons why healthcare reform is necessary

Healthcare reform is essential because the U.S. healthcare system has historically been fragmented, costly, and inefficient, resulting in disparities in access and outcomes. One primary reason for reform is the persistent high cost of healthcare services, which renders insurance premiums and out-of-pocket expenses unaffordable for many Americans. According to Woolhandler and Himmelstein (2019), administrative costs and high drug prices substantially contribute to the overall expenditure, burdening both consumers and taxpayers. Additionally, millions of Americans remain uninsured or underinsured, lacking adequate access to necessary health services. The ACA aimed to mitigate this issue by expanding Medicaid and establishing health insurance exchanges, but gaps still exist, especially among marginalized populations (Jost, 2020). Furthermore, the healthcare system's focus on treatment rather than prevention has led to suboptimal health outcomes, especially for chronic diseases. This misalignment prompts the need for reforms that emphasize primary care, health promotion, and equitable coverage.

The reform should address

Reforms should focus on reducing healthcare costs through administrative simplification, encouraging competition among providers, and negotiating drug prices to lower expenses. Enhancing coverage standards to ensure all individuals have access to essential health services is crucial. The expansion of Medicaid and the introduction of subsidies for middle-income families aim to mitigate insurance gaps; however, political opposition has limited these efforts. Policies that promote preventive care, chronic disease management, and social determinants of health can improve overall health outcomes and reduce long-term costs (Bachrach et al., 2020). Additionally, reforms should aim to improve healthcare quality by implementing evidence-based practices and reducing disparities in care delivery across different populations. The overarching goal is to create a sustainable and equitable healthcare system that prioritizes patient-centered care and lowers financial barriers.

The 10 essential benefits guaranteed by ACA Marketplace plans

The ACA mandates that all insurance plans offered through the Health Insurance Marketplace include ten essential health benefits to ensure comprehensive coverage. These include:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Pregnancy, maternity, and newborn care
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care

These benefits aim to provide a baseline of coverage to protect consumers from catastrophic health expenses and ensure access to essential health services (Kaiser Family Foundation, 2021).

Successes of the ACA

The ACA has achieved notable successes in expanding healthcare coverage. It is estimated that approximately 20 million Americans gained health insurance coverage through Medicaid expansion and the Marketplace exchanges (Sinaiko & Hirth, 2022). The law also mandated preventive services to be covered without copayments, increasing access to screenings and vaccinations. Additionally, the ACA introduced protections for individuals with preexisting conditions, preventing insurers from denying coverage or charging higher premiums based on health status. Furthermore, the ACA spurred innovations in healthcare delivery, such as Accountable Care Organizations, aimed at improving care coordination and reducing costs (Long & Marquis, 2020). These measures collectively contributed to improved health outcomes and financial protection for millions of Americans.

Failures of the ACA

Despite its successes, the ACA has encountered significant challenges. One critical failure is the persistent coverage gaps, especially among states that chose not to expand Medicaid, leaving millions uninsured. Moreover, premium costs and out-of-pocket expenses have continued to rise for many middle-income Americans, making coverage unaffordable despite subsidies. The law's implementation faced bureaucratic hurdles, and political opposition resulted in legislative and judicial challenges that slowed progress and created instability in the health insurance markets (Schoen et al., 2019). Additionally, the ACA did not fully address the high costs of prescription drugs or the administrative complexities that continue to burden healthcare providers and consumers. These shortcomings highlight the need for ongoing reforms to achieve the law's original goals of universal coverage, affordability, and quality (Blavin & Rice, 2021).

Conclusion

Healthcare reform remains an urgent priority to address the systemic issues within the U.S. healthcare system. While the ACA marked a significant step towards expanding access and protecting consumers, it also exposed areas needing further improvement. Future policies should focus on reducing costs, expanding coverage, improving quality, and promoting health equity. Continued legislative and reform efforts are essential to creating a sustainable healthcare system that serves the needs of all Americans.

References

  • Blavin, F. E., & Rice, T. (2021). The Affordable Care Act and health equity: Progress and challenges. Health Affairs, 40(2), 199-205.
  • Bachrach, D., et al. (2020). Preventive care under the Affordable Care Act: Impact and opportunities. American Journal of Preventive Medicine, 58(4), 543-552.
  • Jost, T. S. (2020). Expansion of Medicaid under the Affordable Care Act: Achievements and limitations. Journal of Health Politics, Policy and Law, 45(3), 389-406.
  • Kaiser Family Foundation. (2021). The ACA’s essential health benefits. Retrieved from https://www.kff.org/health-reform/fact-sheet/essential-health-benefits/
  • Long, S. H., & Marquis, M. S. (2020). Quality improvement and innovation in healthcare since the ACA. Medical Care Research and Review, 77(4), 367-373.
  • Sinaiko, A. D., & Hirth, R. A. (2022). The impact of ACA on health insurance coverage and healthcare utilization. Health Economics, 31(2), 211-226.
  • Schoen, C., et al. (2019). Assessing the ACA’s impact on affordability and coverage. Milbank Quarterly, 97(3), 695-734.
  • Woolhandler, S., & Himmelstein, D. U. (2019). Administrative costs of U.S. health care: Are they justified? American Journal of Public Health, 109(5), 686-687.

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