19 Jul 1-This is a tough topic.  Here you are, a working family, you ar

1-This is a tough topic.  Here you are, a working family, you are going to school to better yourself even further and you millions of others are still faced with these decisions about health care.  When you say you pray I know you mean that literally because our daughter is in the same boat.  My husband keeps talking about wanting to retire early but he just does not understand the cost of having good health care.  I will probably be working until I am 90 because I will be afraid of Medicare and not being able to afford good care.  Wish we had better answers but we are not getting anywhere fast…that’s for sure.   2-The most important elements of the Affordable Care Act were to get more people insured, to keep costs down and to improve overall care and outcomes.  New laws were to make affordable health insurance available to more people.  The law would provide consumers with premium tax credits that will lower costs for households that qualify.  To qualify households must have incomes between 100% and 400% of the federal poverty level. Another component was to expand the Medicaid program.  This would now cover all adults with income below 138% of the federal poverty level.  In addition, the goal was to support medical care delivery methods designed to lower costs of health care overall.As nurses, we need to continue to be innovators and continue our work in research.  We need to focus on continuing to improve on patient safety and improving quality of care.  Nurses need to continue to be lifelong learners and meet demands of a changing society.  We must also continue to raise the bar for education with advanced degrees.  We must continue to push for more diversity in our profession to keep up with our diverse society to make patients more comfortable.  We also need to continue to bring our ideas to the table and be leaders within our organizations.  As we foster interprofessional collaboration the patients will benefit from teams working more closely together to improve patient care.   3-The key elements of the Affordable Care Act are the following: providing national access to healthcare coverage for the entire population from birth through retirement, this will provide coverage for about 94 percent of the American people, to improve quality, affordability and fairness of health insurance coverage, to enhance healthcare efficiency, quality, diversity and values, to reduce wasteful spending, and to improve public health by expanding clinical preventive care and community investments.The Act focuses on improving public health by investing in primary health care, especially in medically underserved communities. It also increased insurance coverage for clinical preventive services and procedures. For instance, physical examination, annual wellness visits, well child visits, immunizations, screening exams, like colonoscopy, mammograms and cervical cancer, are all covered by insurance with no cost sharing. In addition, the development of a national preventive plan and the establishment of a Prevention and Public Health Trust Fund, to fund investments in communities that will improve public health. Further investments are being made to in school-based health programs, preventive oral health care, tobacco cessation and adding prevention planning to Medicare.Nurses are play a vital role and a an extremely important driving force in the implementation of this law. By developing innovative care models like transition of care, home care, care management, and nurse managed clinics, nurses will improve quality of care and lower health care cost.  Also, participating in research to aid in scientific evidence-based practices which improves quality, safety and patient outcome. Advanced practices nurses help increase the availability of primary care providers and provide cost effective care. Lastly, nursing leadership will be needed to implement better workflows to reduce medication errors, improve quality and care coordination, and increasing access to medical care. For these reasons and many others, nurses are of upmost importance in the implementation process of this Act.