Policy Issues in US Healthcare

Policy Issues in US Healthcare Jessie E Salters   POLICY/ADVOCACY PROJECT The Georgia Public Policy Foundation is a 501(c) (3) non-profit, nonpartisan research institute. The Foundations mission is to improve the lives of Georgians through public policies that enhance economic opportunity and freedom. The Foundation is state orientated, independent, and without particular interest towards any political group. Georgias Public Policy Foundation conducts scholarly research and analysis of state public policy issues and work to educate citizens, policy makers and the media. Several events throughout the state are hosted each year to discuss issues relating to public policy issues that affect Georgians. The present policy issue of significance that this agency is actively seeking to address is health care spending. According to the Georgia Public Policy Foundation, (georgiapolicy.org/2016/08/guide-issues-health-care) the government office of accountability non health care spending accounts for the consistent overall percentage of our Gross Domestic Product (GDP) over time, however health spending increases at an overwhelming rate. Funds that are spent on Social Security, defense, domestic programs, etc., excluding interest expense left unattended causes unsustainable federal deficit spending. This type of spending overshadows other budget interests pertaining to education and transportation thus causing health care spending to strain Georgias families budgets. Health care is very complex and has many challenges to try and address as a whole. The Georgia Public Policy Foundations plan to address the issue is by focusing their attention on what they consider to be policy issues that are misrepresentative of our health care system. The Foundation is addressing the federal tax policy, the Emergency Medical Treatment and Active Labor Act (EMTALA) and coverage for pre-existing conditions.   The Foundation proposed to tighten gaps within the federal tax policy by redefining refundable tax credits to allow unused credits to reimburse safety net providers. This is assumed to be the most impartial way to improve access to health care and provide individuals with alternative ways to purchase health care insurance. The uncompensated care issues caused by the Emergency Medical Treatment and Active Labor Act would be alleviated by use of the tax credits. The tax credits would assist in the transparency between employers provided insurance vs. commercially purchased insurance. To prevent take-over by employer insurance the tax credits would only be offered to employees that dont have employer insurance. Pre-existing conditions would be address by replacing costly regulations with high-risk pools. This is beneficial to individuals who are considered to be medically uninsurable based on certain health conditions or reasons.   The Georgia Public Policy Foundations expected response as a result of their advocacy efforts would be a sound health policy with the characteristics being Patient Centered, Security for the Sickest, Equitable Tax Treatment, Personal Responsibility, Access for All, and Transparency. In reverence to the above current policy issue the article by Alan R. Weil, Coverage Expansion, Accountable Care, and More. Health Affairs 36, no.1 (2017):7 doi: 10.1377/hlthaff.2016.1607 expressed concerns that are associated with the above policy issues. This article identified health care as a primary talking point during the election year. The Affordable Care Act was considered to make Health Care accessible and affordable for all. However, health care coverage expansion, accountable care, and disparities are issues associated with the Georgia Public Policy Foundation. Health care premiums continued to sky rocket in 2016. The health care market is difficult to measure since insurance premiums continued to change from year to year and underwriting has a significant effect on prices. Premium increases are based on the prices of product offered and not products people actually buy. Health Affairs, (2016.1607) reported disparities in California that showed individuals switched their insurance plans to the plan of lowest cost. This in turn caused a rise in the amount of money paid by enrollees, more than individuals that were only searching for insurance. Reports indicated a third of individuals did not received insurance discounts due to the lack of knowledge or because of obtaining the insurance out of the Affordable Care Act Marketplace. Medicare Shared Savings Programs used data that was from two years of services provided by accountable care organizations (ACOs) that indicated racial and ethnic disparities.   New payment procedures are needed to ensure a positive quality of healthcare is provided and accessible. Cost and health care quality in the Alternative Quality Contract (AQC) was compared among enrollees in regions of Massachusetts with lower and higher socioeconomic status which found disparities in process measures but not in outcome measures. Medicare subsidies are not equal to the quality and improvements as in the Alternative Quality Contract. The information contain in this article illustrate and support the need for advocacy in implementing consumer driven health care reforms. This article describes how difficult it is to achieve health care at the local, state and federal levels due to systematic and controversial differences that are prevalent and are affecting our health care system. The need for continued advocacy at all levels is vital to succeeding at revitalizing our health care system. REFERENCES Alan R. Weil, Coverage Expansion, Accountable Care, And More: Health Affairs 36, no. 1 (2017): 7 doi: 10. 1377/hlthaff.2016.1607 Guide to the Issues: Health Care: Retrieved From; http://www.georgiapolicy.org/2016/08/guide-issues-health-care/

Need and Everyday Life Essay

Doing skills in everyday life allows us to meet our individual needs We can maintain support for our clients in their life by discussing their needs with them and how they wont to tackle them. I work in a unit for severe learning disabilities and we discuss with parents and the client what they would like to achieve Through the days we work with the clients for them to be able to fulfil their needs and activities. Working alongside them allows them to be able to complete their tasks themselves; this takes a more person centred approach. The clients also feel a sense of pride in what they have achieved and satisfaction. We could do the tasks for the clients and take away their choice it could lead to the clients having behaviour problems, also in the long term they will lose skills they have will not be able to learn or regain skills. 1. 2 Analyse reasons why individuals may need support to maintain, regain or develop skills for everyday life You may find that in different stages of life people will have different problems that affect skills for everyday life One of the clients I work with has autism and shows different variants during different times of the year At Christmas time his behaviour turned quite aggressive and everyday tasks took a lot long and needed a lot more support. He also needed the support to understand how the behaviour is not socially accepted. He attends college on a regular basis but as his social skills is quite limited because of his condition and during these times he requires more support from carers to be able to cope in the situation and carry on with the course he enjoys. As he is doing this on a regular basis and getting to know the people support is beginning to get less We also have to remind him about hygiene on a regular basis and are encouraging him to wash his own clothes and prepare his own food giving him the opportunity to live partially independently. At Christmas this skills were lost through his behaviour and he needed continual support to relearn them We also have clients that have physical disabilities as well as learning disabilities; to be able to develop skills for everyday life they require support. A lot go swimming and have learnt to swim but to be able to do this activity they need the support of carers to take them there and change them. 1. 3 Explain how maintaining, regaining or developing skills can benefit individuals In doing this it will help with the wellbeing of the individual. Physical wellbeing will mean the client is feed, are clean and tidy and this will lower the risk of infection making them healthy and happy. They will gain Psychological wellbeing which will give them increased confidence and will think better of themselves They gain emotional wellbeing; they will be happy and not have periods of depression Social wellbeing is something else that will be found they will be able to feel part of a community and belong By assisting in everyday tasks we are able to create a environment were the client has is happy and therefore promote wellbeing. 2. 3 Analyse possible sources of conflict that may arise When planning and ways to resolve them In our setting we share decision making with the individual and try to get them and their family included in the care and care planning. We do get problems sometimes however in the clients wishes and preferences. We have had an occurrence were an individual wanted to take apart appliances and put them back together again, this was dangerous to him and others around him, we did have to remove the appliances for his own safety. How ever since we have built up better relationships with him and learnt to understand his needs. He now goes to college on a course that allows him to do this. You may get individuals that want an activity that is not on their care plan or you might try to carry out something that the client does not want, these could result to a risk to the individual and others as the above example did. The best way to resolve this is by developing trusting relationships, mutual respect and negotiating other ways of doing things as we did with the college course. 3. 3 Describe actions to take if an individual becomes Distressed or unable to continue We do find that some of our clients become distressed during activities due to the nature of their problems. We can take a number of actions if this does occur We can offer reassurance to the person, communicating is important explaining that you understand and that they are safe. Praise their achievements in the task they are completing. We also have people on hand that can advise or assist in these situations. They one thing we always do is make sure the client is safe. We can also suggest to stop the activity with the client and take them away from the situation

Windshield Survey Essay

This windshield survey is a simple observation of a community. It involves collection of data to help define the community, the trend within the community, stability of the community and changes that may define the health of the community. Many dimensions of the community can be observed from a car drive observing the community life, and environment. Common characteristics to be noted are the people walking the street, gathering places in the community, quality of houses, community life rhythm, and geographic boundaries (Stanhope & Lancaster, 2012, p. 409-410). Community is defined widely by (Stanhope & Lancaster, 2012). According to the World Health Organization (WHO) community is a group of people, living in a specific geographical area. They may share a common culture, norms and values. Members of the community gain their social and personal identity by sharing their common beliefs, norms and values which has been developed by the community (Stanhope & Lancaster, 2012, p. 397). Co mmunity health is the meeting of the community collective needs by identification of the community problems, managing the behaviors in the community and between the larger society and community (Stanhope & Lancaster, 2012, p. 401). The community partnerships helps to bring about the changes necessary to fulfill the vision of Healthy People 2020. A foundation is provided by Healthy People 2020 for national health promotion and disease prevention. It is necessary to have community partnerships in order for the lay community members to have vested interest in the community success to improve the community health Stanhope & Lancaster, 2012, p 402). Community as client is the community as the nurse client. The community is only the client when the focus of the nurse is on the common or collective good of the community instead of the health of one individual (Stanhope & Lancaster, 2012, p. 398). The community chosen for this windshield survey is the city I currently reside in, Virginia Beach. It is located in the state of Virginia and a part of the Hampton roads. Hampton Roads consist of seven cities which are Virginia Beach, Norfolk, Chesapeake, Hampton, Newport News, Suffolk and Portsmouth. In my city of Virginia B each I live in the Ocean Front Community. We have a large military community related to the Naval Base Oceana Naval Air Weapon station. Virginia Beach is 249.02 square miles and the persons per square miles are 1,758.9. The population estimate in 2013 is  48,479. Persons under 5 years of age is 6.7%. The percentage of Persons under 18 years of age is 23.1%. Persons 65 years of age or older is 11.8%. Female percentage is 50.9%. The percentage of Whites alone is 68.9%, Blacks are 20.0%, Alaska native and American Indian 0.5%, Asians 6.6%, Native Hawaiian and other pacific Islander is 0.2%, persons with two or more races is 3.9% and Hispanics are 7.5%. Persons residing in the same home greater than a year is 82.2% of the population. High school graduates or person with a higher education makes up 93.6%. The veteran population for 2009-2013 is 61,100. The median value of homes are $267,600 with 2.62 persons per household. The median household income is $65,219. Persons living below the poverty level is 7.9% (United States Cens us Bureau. n.d.). Virginia Beach is located alongside the Atlantic Ocean on the east and the Chesapeake Bay to the north. The average elevation of the city is 12 feet ( VB GeoFacts and Information, n.d.). VB GeoFacts and Information. (n.d.). The homes in the community are mostly two story homes colonial style, or brick and aluminum side homes and one story homes. Homes in the community are well kept with manicured lawns. There are some condominiums and apartments in the area. There is no signs of abandoned buildings in the areas observed for the windshield survey. Virginia Beach is known for its tourism especially in the summer months. Not many pedestrians were noted walking along the street in the community during the current winter month. Joggers were noted early morning and evenings in the ocean front area of the community. Public transportation available in the city of Virginia Beach are buses and taxi cabs. There is no light rail system or train system that provides transportation. There are numerous attractions such as the aquarium, the botanical garden, the boardwalk, ocean breeze Water Park. The re are many open body of water around in the community for fishing besides the Atlantic Ocean. There are two malls located in the community Pembroke mall and Lynnhaven Mall. Many restaurants are available with a healthy choices. Only five fast food restaurants were noted on an 8 mile drive. There was 3 ABC stores noted selling liquor, and 2 Totally Wine stores noted. There are two super Walmart stores, one regular Walmart, and a Walmart Neighborhood. Food Lion and Farm Fresh are the other main grocery stores. Farm fresh provides a fresh salad bar daily. There are many Consumer Value Stores (CVS) with 24 hours pharmacy available. Patient First is chain of urgent care facilities  available within the community. They are open 7 days a week until 10pm. Sentara is the name of the group of hospitals in the community. There is Sentara Princess Anne Hospital and Sentara Virginia Beach General. There are many doctor offices, dentist office and other medical specialties available in the community. The schools average rating is 6 out of 10. Virginia Beach schools have many academic programs such as the Global studies & World language, health sciences Academy, Legal Studies, Technology, Visual & Performing Arts, International Baccalaureate program and mathematics & Science for high school students. Middle school children has advance academic programs available such as the middle years International Baccalaureate program (About Us, n.d). The community provides parks and recreation centers. There are numerous trails for outdoor hiking, sporting leagues for children and adults and fitness and wellness. There are a number of religions noted in the community catholic, united Methodist, southern Baptist and Jewish. Healthy People 2020 Health Indicators The Healthy people 2020 health indicator chosen for this community is the transmission of sexually transmitted diseases. Per Healthy People 2020 there is an estimated 19 million new sexually transmitted disease cases each year in the United States (Healthypeople.gov, n.d). Hampton roads area has a higher average of sexually transmitted disease, this eastern region had the highest rates in the state for gonorrhea, syphilis and chlamydia. State statistics showed in the region there were 2,620 girls’ ages 3 to 19 diagnosed with chlamydia comparing to 528 boys in the same age range. A study completed showed the rate of STD was much higher among blacks girls compared with 20 among the white race and Hispanic girls. The CDC has a difficult time comparing the statistics to Virginia reported figures because the health care providers are not required to report Herpes, Human Papillomavirus (HPV) and trichomoniasis to the local health department. This causes the state numbers to be less than reality. Another barrier that prevents the actual numbers is many people infected with STDs may not exhibit symptoms. Meaning STD is transmitted from one person to the other without realizing transmission of the disease. There is an estimate of 70 to 80 percent of girls with chlamydia with no symptoms. Untreated these STDs causes infertility. HPV is another infection that often does not manifest  symptoms. Virginia has a new law in place requiring sixth grade girls to receive HPV vaccines unless they opt out (Simpson, 2008). Virginia Beach Department of Public of Health clinic provides free, confidential education, counseling and testing for HIV. They provide Nurses and health counselors at their Virginia Beach clinic for clients found to be HIV positive. The clinic operates on a walk in basis for testing. They offer services for the patients to contact other sexual partners that may need testing and treatment (Clinic, n.d.). Virginia Beach does not have a large immigration population with many ethnicities. There are however many resources available to address different cultures within our community. Yearly the city has a Latin festival and reggae festival. I do not encounter many people of differe nt cultures from Latin countries or Caribbean countries in the community. It is mostly whites or blacks, there is very minimal encounters with other races. It can present a problem in the community if there should be a rise in a specific ethnicities from a different parts of the world such as Africa, or Asia. Nurses and other health care providers would definitely need conferences on cultural diversity. The most I have been exposed to diversity is while working as charge nurse for a correctional facility for the Common Wealth of Virginia. Immigration and Customs Enforcement held many immigrants there for a period of time at correctional facility. Aspects of the community that can affect residents’ health were not visible to myself from a windshield point of view. Virginia Beach government website gave more insight on the aspects that affect residents in the community. Three aspects listed are teenage pregnancies, low birth weight babies and child abuse. In conclusion Virginia Beach is a wonderful community. It is not congested, we have large areas that still trees, wild animals and fishing areas. It is a family oriented community in my opinion with many resources within the community to meet the needs of individuals. Crime is at minimal, the people in the community are genuinely polite, and there are many programs in the community provided by the city or YMCA promoting health and wellness. Reference About Us. (n.d.). Retrieved February 8, 2015, from http://www.vbschools.com/root/aboutus.asp CIty of Virginia Beach Community Indicators. (2011, September 1). Retrieved February 8, 2015, from

Law And Morality Essay - 2110 Words

Law and Morality It is not an everyday occurrence that someone must decide the fate of anothers life. The dilemma of making a decision that someone must die in order for the others to survive, can obviously be troubling. The process in which the termination of ones life may be easy to make, but to justify that decision is the most difficult one. This paper is given a situation in which a decision of taking ones life is essential. The situation is that a nuclear war has occurred, which has destroyed most of the centres of civilization. There are five people that are that have escaped death by finding their way to a nuclear bunker. These five people consist of a pregnant woman; an old man, who is a retired judge; two teenagers - a†¦show more content†¦Law and morality play a large role here, mainly because there is a legal issue and a moral issue associated with the predicament. The reason law has a part in the situation is that after the decision is made, it will be examined legally and must be accountable for its consequences. Morality has its place too, because many will find it morally wrong to take ones life despite any justification. nbsp;nbsp;nbsp;nbsp;nbsp;....there is some connection between law and morality, but the two are clearly not identical. First, morality is only concerned with right or wrong, with the good and evil; law is concerned with lots of things on which there is no right and wrong - procedures for land registration, incorporation and so on. Second, morality is to some extent uncertain and a matter for each individual, law tries to be objective, written down in black and white and there for all to see. Third, morality often leaves things vague and subject to general principle, law goes into specifics.1 nbsp;nbsp;nbsp;nbsp;nbsp;From that description of law and morality, it is obvious how they relate to the issue here. 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