NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

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Lower Health Care Costs Act of 2019

Introduction

Get Rid of Unexpected Medical Bills

To begin, the bill will prohibit “surprise” medical bills. A surprise medical bill is one that the patient did not request or expect to receive from an out-of-network physician. As a result, the cost of healthcare is exorbitant. According to Chartock et al(2019) .’s study, 13 percent more mothers who received a surprise out-of-network cost for their first delivery were more likely than mothers who did not to choose a different hospital for their second delivery. Furthermore, the law requires health insurers to make certain data available to members via specific technology, such as mobile applications, such as estimated out-of-pocket expenses (U.S. Congress, n.d.).

Acceptance of the Services Offered

Furthermore, it improves transparency. You cannot lower your medical bills until you understand the exact cost of your therapy. The law requires health care facilities and practitioners to give a list of supplied services to patients upon discharge and to bill for such services within 45 days. It also requires in-network cost sharing for some emergency and associated non-emergency services supplied outside of the network (U.S. Congress, n.d.).

One of the major concerns of every American is healthcare. Healthcare is a complex, multifaceted issue, and voter concerns include the cost, quality, and availability of care as well as the availability of insurance and coverage of pre-existing conditions. Out of the many healthcare bills in the Congress, few will receive the bipartisan support necessary to move them through Congress, and it’s likely that fewer will be signed into law by the president. Currently, one of the healthcare issues pending in Congress is S 1895, the Lower Health Care Costs Act of 2019. This bill was introduced by Senators Lamar Alexander, R-Tennessee, and Patty Murray, D-Washington (U.S. Congress, n.d.). If the bill is eventually passed into law, it will help in lowering some healthcare costs.

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This legislation will reduce what Americans pay out of their pockets for health care in three major ways:

Address Drug Price Increase

This bill will attempt to address the recent rapid and significant increases in drug prices, with drug companies frequently raising prices significantly, especially when the drug is unavailable from other drug companies. According to Deb and Curfman (2020), the 2018 price increase alone added $1 billion to US health-care costs. The authors cite the price of adalimumab (Humira), the world’s best-selling drug, which was raised by 7.4% for 2020. Concerning is the practice of pharmaceutical companies paying generic drug makers to keep generic versions off the market so that prices can remain high (Evans & Fleming, 2019). The bill will revise certain requirements to expedite the approval of generics and biosimilars, such as those relating to citizen petitions, application effective dates, and labeling (U.S. Congress, n.d.).

This bill is extremely important to healthcare consumers. The passage of the bill will reduce or eliminate “surprise” medical bills, increase transparency in the healthcare industry, and finally relieve financial burdens on patients.

References

Chartock, B., Garmon, C., & Schutz, S. (2019). Consumers’ Responses To Surprise Medical Bills In Elective Situations. Health Affairs38(3), 425–430. https://doi-org.ezp.waldenulibrary.org/10.1377/hlthaff.2018.05399

Deb, C., & Curfman, G. (2020). Relentless Prescription Drug Price Increases. JAMA: Journal of the American Medical Association323(9), 826–828.https://doi-org.ezp.waldenulibrary.org/10.1001/jama.2020.0359

Evans E. & Fleming K. ( 2019). 5 Key Healthcare Issues Pending In Congress: ‘New Rules’ That Could Change How You Get Healthcare. Retrieved January 10, 2021 from https://www.forbes.com/sites/allbusiness/2019/07/07/5-key-healthcare-issues-pending-in-congress-new-rules-that-could-change-how-you-get-healthcare/?sh=679db6451ed9

U.S. Congress. (n.d.). S.1895 – Lower Health Care Costs Act. Retrieved January 10, 2021 from https://www.congress.gov/bill/116th-congress/senate-bill/1895

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

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RE: Discussion – Week 7

Main Post

Nursing is a profession where the care that is provided should be evidence base, and as we can attest to the fact that we have seen some practices that have no evidence behind it, yet nurses continued to practice that way because it became the culture of care. As our profession is and should be practiced based from evidence we must venture away from those practices and adhere with the evidence base practices. The health policy that I selected is Bill H.R.4647, Protecting Medicare Beneficiaries with Pre-Existing Conditions Act. This bill sponsors are Rep. Schneider, Bradley Scott [D-IL-10], was introduced

NRSE 6050 Policy and Advocacy for Improving Population Health
NRSE 6050 Policy and Advocacy for Improving Population Health

on 10/15/2019. The background for this proposed bill/problem goes way back before the Affordable Care Act (ACA), whereas people that had pre-existing health conditions were denied health insurance or their prices were way higher to the point where they could not affordable to pay and went uninsured for decades (Giled & Jackson, 2017). President Franklin D Roosevelt introduced the Social Security Act, President Lyndon Johnson made an amendment to the Social Security Act with the passage of Title1X where the Medicare Act was introduced under Title V111. Prior to the ACA, health insurance was obtained medically, meaning insurance companies were privy to an individual health record and other risks factors which they use to determined eligibility and applicants had to fill out a lengthy form with their medical history (Claxton et al., 2016).  Medicare Act was introduced at the federal state level to provide coverage to the poorest citizens (Auerbach, 2019). The Patient Protection Affordable Care Act (PPACA) was passed in to law 2010 which protects people with pre-existing health condition against insurance companies that would deny them health insurance coverage (Auerbach, 2019).

There is sufficient evidence to support the claim that people with pre-existing conditions were denied health insurance because insurance companies were not held accountable prior to the passage of the PPACA. According to Claxton et al. (2016), prior to the ACA act, more than 18% of applicants were denied health insurance, and many more people with pre-existing conditions did not apply because they were already told they would be denied. PPACA expanded coverage and held insurance companies accountable, and now more than 32 million more people have access to insurance coverage, including people with pre-existing conditions such as cancer patients (Plaxe & Nagle, 2014).

References

Auerbach, M. P. (2019). Patient Protection and Affordable Care Act: Overview. Salem Press

Encyclopedia.

Claxton, G., Cox, C., Damico, A., Levitt, L., Pollitz, K & Kaiser Family Foundation. (2016).

Pre-existing conditions and medical underwriting in the individual insurance market

prior to the ACA. Montana, 25, 152-000.

Glied, S., & Jackson, A. (2017). Access to Coverage and Care for People with Preexisting

Conditions: How Has it Changed Under the ACA? Issue Brief (Commonwealth Fund)18,

1–12.

Plaxe, S., & Nagle, V. L. J. (2014). Patient Protection and Affordable Care Act (“Obama

Care”). Journal of Gynecologic Oncology Nursing24(1), 25–26.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.

Review the health policy you identified and reflect on the background and development of this health policy. NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

RE: Discussion – Week 7

There is a growing sense of unease about the repo effect after the passage of Texas’ new abortion ban, which has sent shockwaves throughout the state. A woman’s legal right to health care. Restrictions on early abortions were placed in place, with the authority to sue health care professionals found to have broken the law in the state given to residents (Najmabadi, 2021).

To prevent the California law from becoming law, Judy Chu (D-California 27) introduced the Women’s Health Protection Act of 2021 (H.R.3755). Two key points in the bill’s success in Congress were protecting women’s freedom to make an informed decision about terminating an unwanted pregnancy and ensuring the safety of providers involved in abortion procedures under established standards (Congress.gov, 2021). The Senate is currently reviewing the Women’s Health Protection Act bill, which was used to raise public awareness about anti-abortion laws and to educate legislators about the consequences of anti-abortion policies, as evidenced by Espinoza et al. (2020), who discovered an increased rate of infection and mortality among 22 million adolescent girls in a review of the literature.

Rising service costs have hampered women’s participation in economic and social growth, leaving them vulnerable to socioeconomic exploitation by people of the opposite gender. Last but not least, the dramatic rise in mental health issues and health disparities among people of color has been linked to a lack of access to women’s health services and has continued to affect other preventative vital health services, such as screenings, contraception, STD treatment, prenatal care, and new mother adaptation services. (Congress.gov).

The fourteenth amendment to the United States Constitution protects every American citizen’s right to make informed and educated health-care decisions, including abortion.

References

Congress.gov. (2021). H.R.3755 – Women’s Health Protection Act of 2021 . Retrieved from CONGRESS.GOV: https://www.congress.gov/bill/117th-congress/house-bill/3755/text

Espinoza, C., Samandari, G., & Andersen, K. (2020, April). Abortion knowledge, attitudes and experiences among adolescent girls: a review of the literature. Sexual and Reproductive Health Matters, 28(1); PMC7888105. doi: 10.1080/26410397.2020.1744225.

Najmabadi, S. (2021). Gov. Greg Abbott signs into law one of nation’s strictest abortion measures, banning procedure as early as six weeks into a pregnancy. THE TEXAS TRIBUNE.

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

*Note: Throughout this program, your fellow students are referred to as colleagues.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 7 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 7

To participate in this Discussion:

Week 7 Discussion

RE: Main Question Post

Hello, Sierra Savage (colleague).

I noted that your health policy you have chosen was The Families First Coronavirus Response Act 2020. I found your chosen health policy interesting in reading seeing the public is in a current pandemic related to this novel virus as in the coronavirus. It was interesting to see what The Families First Coronavirus Response Act 2020 was focusing on. You stated in your paper that The Families First Coronavirus Response Act 2020 is a response strategy to the coronavirus outbreak, and its focus was on the provision of free coronavirus testing, paid sick leave, food assistance, and unemployment. I found it partially as in The Families First Coronavirus Response Act 2020 to be a bit biased.

There is so much about this virus that is unfolding before our eyes. We are learning more and each day something new about this virus (Coronavirus).

According to the Washington Post in the United States, the Coronavirus appears to be infecting and killing African Americans at a disproportionately high rate (Thebault, Ba William, 2020).). This emerging stark racial disparity led the Surgeon General to acknowledge in personal terms the increased risk for African Americans amid growing demands that the public-health officials release more data on the race of those who are sick, hospitalized and dying of a contagion that has killed more than 12,000 people in the United States (Thebault et al., 2020).

It was stated in the Washing Post that the reason for African Americans being affected at a disproportionate rate had to with African Americans having higher rates of diabetes, heart disease, and lung disease are well documented, and noted by  Louisiana Governor John Bel Edwards that health problems make people more vulnerable to the new respiratory disease, but there has never has been a pandemic that brought the disparities so vividly into focus (Thebault et al., 2020).

Because of this crisis, the Lawyers’ Committee for Civil Rights Under Law and hundreds of doctors joined a group of Democratic lawmakers, including Senators Elizabeth Warren (Mass.), Cory Booker (N.J), and Kamal D. Harris (Calif), in demanding the federal government to release daily race and ethnicity data on coronavirus testing, patients and their health outcomes, seeing that the data for the Centers for Disease Control and Prevention has only released figures by age and gender (Thebault et al., 2020).

The data being reported by the Centers for Disease Control and Prevention is only including age and gender and leaving out racial or ethnic data. I find this data to be disturbing and biased. Civil rights law prohibit federally funded health care providers from administering services in a discriminatory manner, said Kristen Clarke, president and executive director of the Lawyers’ Committee of Civil Rights Under Law, which joined with medical professionals to call for the immediate release of racial and ethnic data on coronavirus infections, testing, and deaths (Wambsgans, 2020)

According to the Washington Post article, 2020, even though some activists argued African Americans have been more exposed because many held low-wage or essential jobs, such as food service, public transit, and health care, that required African Americans to interact with the public, I find this to be a poor argument in that is still does not address data on race and ethnicity not being reported, as being left out of data for the Center for Disease Control and Prevention.

According to the Center for Disease and Prevention Control (CDC), guidelines in every state is legally required to track data on testing and treatment by race, as it has done during other outbreaks. Fewer than a dozen have released that data so far (Evelyn, 2020). According to what is being found, African Americans are particularly more vulnerable. According to Kristen Clarke president and executive director of the Lawyers’ Committee of Civil Rights, this is a social, economic and racial justice issue (Evelyn, 2020).

I feel that the Families First Coronavirus Response Act 2020, needs to be re-assessed, in that health care officials need to consider different factors that should be included for this health care policy to be justifiable (unbiased).

REFERENCES

Reise Thebault, Andrew Ba Tran, & Vanessa Williams (2020). Washington Post. The coronavirus is infecting and killing black Americans at an alarmingly high rate. Retrieved April 09, 2020, from

Https://www.washingtonpost.com/archive

Jason E. Wambsgans (2020). National Broadcasting Company news. African Americans may be dying from COVID 19 at a higher rate. Better data is essential, experts say. Retrieved April 10, 2020, from

Https://nbcnews.com

Kenya Evelyn (2020). The Guardian. It’s a racial justice issue: Black Americans are dying in greater numbers from COVID-19. Retrieved April 10, 2020, from

Https://www.theguardian.com

Debbie, great selection. The Health policy selected Health Equity and Accountability Act of 2020 is a major piece of legislation that has address multiple issues that affects us.

The Health Equity and Accountability Act (HEAA), sweeping legislation that would address health disparities among racial and ethnic minorities as well as women, the LGBTQ+ community, rural populations, and socioeconomically disadvantaged communities across the United States. Oct 7, 2020
According to Walden University Supporters of the HEAA point to statistics that demonstrate the current lack of health equity. For example, mental health research has found that while mental illness is more or less equally prevalent in all groups, members of minority groups enter treatment later and have worse outcomes. Similarly, health issues like diabetes, cancer, chronic hepatitis B, and HIV are all more prevalent in one or more minority group than they are in the straight, white population.  These disparities are the result of multiple issues, including lack of healthcare access, a lack of cultural competency among providers, and a lack of research into and/or understanding of the medical conditions disproportionately affecting minority groups.

References

Walden University. (2021, November 4). The-facts-behind-the-health-equity-and-accountability-act-HEAA. Walden University. Retrieved January 9, 2022, from https://www.waldenu.edu/online-doctoral-programs/phd-in-public-health/resource/the-facts-behind-the-health-equity-and-accountability-act-heaa