DNP advocacy to improve health outcomes
The health care system has faced several changes that have brought about a tremendous shift from fee-for-service delivery to a managed care system. Many people are unable to care for themselves due to low literacy levels, poverty, old age, ethnicity and racism, and rural location (Larrabee, 2015). The aforementioned aspects have affected decision making on matters that concern their health outcomes. Due to this, there has been need to implement some changes that would ensure that the residents are able to seek health care and are well informed on the ways to care for themselves. The government has a great role in ensuring that the residents are healthy by improving the quality of lives thus leading to high productivity in the economy.
Studies have shown that in America, 2014 had the most changes in health care but were surpassed by those made in 2105. The president of California proposed a bill that would see a paradigm shift from fee-on-delivery to a managed system (Hassmiller, 2013). Through this system, there was going to be a drop in the number of underinsured as well as the uninsured residents in the state. This implies that those that had not been insured would start to enjoy these services. Consequently, those that had been insured would be assured of continued support even after loss of job, if they fell sick or got disabled, or further if they lived with people who underwent these occurrences.
In the past, the underinsured and insured were quite many with the best services being accorded to those that paid their insurance cover fees. This made many underinsured people fail to seek the highly important service. The failure to have equity among all the citizens led to high mortalities among the poor. The proposed bill was geared towards enrolling more residents to the Affordable Care Act (ACA) (Grossman & Valiga, 2016). Further the Medicaid would be expanded so that it could cover more people. This was seen as a means to ensure that that the number of the underinsured and uninsured continued to drop considerably.
Another aspect that has brought this change is the increment of prices for drugs. These costs are made to be met by the Medicaid. The limited funding that is expected to cater for this skyrocketing costs has led to poor services to the patients. There has been increased mortality rates for the middle aged whites. Research has shown that these deaths were due to suicide brought about by low wages and stagnating socioeconomic status brought about by challenges that middle class residents face in America (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011). The increased costs had not been catered for in the past thus people would pay their bills once they visited health care facilities.
The bill proposed by the Florida senate president was in a bid to ensure equity in service delivery to all residents irrespective of their socioeconomic status. There were various discussions between senators and governors who felt that the federal government could not afford all the funds that were required to improve the health care system (VanBeuge & Walker, 2014)). In addition, the increase of prices for drugs as well as the high population would ensure that a great percentage of the government revenue would be used in the health sector. However, after several discussions, there was need to expand Medicaid so as to promote among the Americans.
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation., & Institute of Medicine (U.S.). (2011). The future of nursing: Leading change, advancing health. Washington, D.C: National Academies Press.
Grossman, S., & Valiga, T. (2016). The new leadership challenge: Creating the future of nursing. Philadelphia: F.A. Davis Company
Hassmiller, S.B. (2013). The future of nursing: Lessons in crafting successful policies. Policy, Politics, & Nursing Practice, 14(2), 55-56. Policy Politics Nursing Practice-2013- Hassmiller-55-6.pdf
Larrabee, B. (2015). How health care blew up the 2015 session. The News Service of Florida. http://www.sayfiereview.com
VanBeuge, S.S., & Walker, T. (2014). Full practice authority—Effecting change and improving access. to care: The Nevada journey. Journal of the American Association of Nurse Practitioners 26, 309–313 Nevada Full Practice Strategy VanBeuge_et_al-2014- JAANP.pdf