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Week 1 discussion

The Role of Government in the U.S. Health Care System

As stated in the course text, Health Care Delivery in the United States, “the health care enterprise is one of the most important parts of the U.S. social system and of our economic system as well” (Kovner and Knickman, 2011, p. 4); however, with millions of citizens uninsured, rising costs, massive health disparities, and the need to improve quality and access, many view health care as a broken system. As such, it continues to be a significant political issue in the United States. Most agree that something needs to be done to fix the health care system, but the methods and solutions for addressing problems vary greatly, particularly with respect to the role government should play. Proponents of varying approaches often have strong, emotional opinions, making compromise difficult.

In this Discussion, you will consider the role of government in health care, and you will examine the impact of a social, economic, technological, ethical, or legal issue on health care delivery.

To prepare:

With this week’s Learning Resources in mind, consider this question: Is health care a right or a privilege?

Review the media presentation for this week, focusing on the role of the government in health care including Affordable Care Act.

Pinpoint a social, economic, technological, ethical, or legal issue that could, or has, affected health care delivery in the United States.

Locate a current article from the popular press (within the past 6 months) related to the health care issue you identified. How does this article inform your understanding of the influence of your selected issue in the health care debate?

By Day 3

Post your position on whether health care in the United States is a right or a privilege, and explain what you believe to be the proper role of government in health care. Justify your position. Explain how the social, economic, technological, ethical, or legal issue you selected is impacting health care delivery and whether this issue should be addressed by the government or by private entities. Identify the article you selected, and explain how this article informs your stance.

Read a selection of your colleagues’ responses. Focus particularly on those questions raised to which you can add comments based on shared experiences or situations. Consider how your colleagues’ postings reflect and/or differ from your own perceptions and opinions.

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Reference:

Kovner, A. R., & Knickman, J. R. (Eds.). (2011). Health care delivery in the United States (10th ed.). New York, NY: Springer Publishing.

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Week 2 discussion

Nurses as Leaders in Health Care Reform

As health care delivery in the United States continues to evolve, either through mandates, improved technologies and training, or other drivers, nurses remain at the forefront in facilitating the success of new initiatives. In 2010, the Institute of Medicine formed a committee of experts to address the following question: “What roles can nursing assume to address the increasing demand for safe, high-quality, and effective health care services?” In the final report of the committee, The Future of Nursing: Leading Change, Advancing Health, the authors stated:

This report offers recommendations that collectively serve as a blueprint to (1) ensure that nurses can practice to the full extent of their education and training, (2) improve nursing education, (3) provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement efforts, and (4) improve data collection for workforce planning and policy making. (p. 10)

For this Discussion, you will focus on the research recommendations presented by the committee concerning the role of nurses as leaders. The committee members believe that answers to these research questions are needed to advance the profession of nursing and to further expand their role in health care reform and improvement.

To prepare:

Review Chapter 7 in The Future of Nursing: Leading Change, Advancing Health report provided in the Learning Resources. Focus on the information in Box 7.3, “Research Priorities for Transforming Nursing Leadership.”

Select one of the research priorities listed in Box 7.3 that is of particular interest to you and applicable to your career interests. Consider the benefits and challenges of researching and addressing this priority in nursing.

Using the Walden library, identify two to three current articles that address your selected research priority. Consider the current state of research efforts on this priority.

Reflect on how the research findings for your area of priority impact nurses as leaders in organizations and health care reform. Why is research on this priority important?

By Day 3

Post a description of the priority you selected and the benefits and challenges of further researching this area. Provide an overview of the articles you found (using appropriate APA citations) relating to this priority, and highlight any key findings. Explain how continued research in this area could strengthen the ability of nurses to lead in both individual organizations and as advocates of health care reform.

Read a selection of your colleagues’ responses. Focus particularly on those questions raised to which you can add comments based on shared experiences or situations. Consider how your colleagues’ postings reflect and/or differ from your own perceptions and opinions. Review the Learning Resources for any clarification needed before responding.

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Reference:

National Academy of Sciences. (2011) The future of nursing: Leading change, advancing health.

Retrieved from https://download.nap.edu/catalog.php?record_id=12956

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Week 3 discussion

Financing of Health Care

With coinciding concerns about health care costs and the imperative to improve quality of care, health care providers and others face difficult decisions in the effort to achieve an appropriate balance. Such decisions often are addressed in the policy arena. How do policymakers evaluate which health care services should be financed through government programs? How do ethics-related questions and other considerations play into this evaluation process? Is it possible to contain costs and provide accessible, high-quality care to all, or is the tension between cost and care inherent in the U.S. health care delivery system? These questions are central to health care financing decisions in the United States.

For this Discussion, you will focus on the policy decision-making process that determines what types of care are covered by public and private insurers and the ethical aspects of such financial decisions.

To prepare:

Read the following case study, “Hard Economic and Finance Choices in US Healthcare” (Milstead):

Case Study 1: Hard Economic and Finance Choices in US Healthcare

Applied economics is all about managing scarce resources. Economics is an amoral field of study: it is neither moral nor immoral. Morality and values are determined by individuals at the personal level and by group consensus or majority opinion at the national level. State and federal governments determine the ‘will of the people’ about how to use scarce resources for the good of a nation.

The U.S. health care system is an exemplar of scarcity: primary care physicians, substance abuse treatment centers, trauma centers, registered nurses, and the money to pay for goods and services. Finance is all about how to pay for goods and services. The Medicare Payment Advisory Commission (MedPAC) is appointed by the Executive branch of the federal government to make decisions about what the Medicare program will and will not pay for. In this role, MedPAC makes decisions about medications, procedures and treatments. Examples of MedPAC decisions include coverage for left ventricular assistive devices as a destination therapy, coverage for bariatric surgery, and in 2010, coverage of the drug Provenge™. By law, MedPAC is not allowed to use price or cost of any treatment in its decision-making processes.

Review the information in the Washington Post article “Review of Prostate Cancer Drugs Provenge Renews Medical Cost-Benefit Debate” in the Learning Resources.

Consider how policy decisions currently are made about what will and will not be paid for and what changes, if any, could improve the process.

Reflect on how the Washington Post example illustrates the tension between cost and care.

By Day 3

Post your analysis and assessment of the ethical and economic challenges related to policy decisions such as those presented in the Washington Post article. How does this type of situation contribute to the tension between cost and care? Substantiate your response with at least two outside resources.

By Day 6