Health Care Coverage to Uninsured Maryland Citizens

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Statement of the policy problem

In its current state, the Task Force to Study the Provision of Health Care Coverage to Uninsured Marylanders is vulnerable. Although the policy seems to enhance hope among the poor and unfortunate Marylanders, the process of its implementation may prove to be a challenge. The policy has stipulated the factors that are to be considered for its full implementation. However, financing the proposal seems like it will be a challenge. The government has not allocated funds for the full implementation of this bill.

Although the bill has come at the right time when Maryland’s residents are grappling with the high costs of healthcare, the financing aspect in the implementation process is inadequate. As a result, the bill will allow hospitals in Maryland as well as Federal Qualified Health Centers to use the allocated federal funds. To mitigate the problem of financing the implementation process, healthcare facilities will have to supplement their low reimbursement rates to cater for the cost of healthcare services at a lower rate. The problem in this arrangement is that the government allocations are normally limited and they may not match the specific needs of Maryland’s residents.

In this bill, the problem that has been left unresolved is the issue of federal funding. In many instances, the political elite has been raising issues of national importance hence creating a mood of hope among the citizens. However, such promises and initiatives require an action plan to back them and bring them to full actualization. In the current form of the bill, the backing of a state-approved financial plan is notably missing and this may be a major challenge when it comes to the implementation process.

Description of the policy background (social, economic, ethical, political/legal)

Social issues

With the high economic strains, the poor and vulnerable citizens are at risk of health complications. To mitigate this problem, the government seeks to rescue the people through a legally backed act that will allow easy access to healthcare services. To pursue this goal, a task force was created first to investigate the number of people without a health insurance cover. This includes the study of the provision of healthcare coverage to uninsured Marylanders (Lee, et al., 2014). This is very important especially for the implementation process. The implementation of the policy will require the task force to establish the extent of insurance covers in the population.

This will help them in deciding how to approach the entire process. Therefore, the main purpose of the task forces it to establish and study the extent and availability of healthcare coverage to the residents in Maryland (Lee, et al., 2014). To understand the extent of healthcare coverage in the state, the policy explores to establish the category of people excluded from the Federal Patient Protection and Affordable Care Act (Lee, et al., 2014). It also establishes the effects of the exclusion from the coverage on the residence to determine its implications.

Economic Issues

The policy also seeks to establish whether there are local policies that have been created to address the issue of exclusion (Giardina & Newman, 2011). Also, the policy is based on economic considerations where the residence that is unable to access healthcare services due to financial inabilities will be cushioned against the harsh and steep cost. If the policy is implemented as planned, it will greatly influence several issues in society. One of the greatest implications of this policy is the fact that it reduces the discriminatory effect among the citizens. In nutshell, the current situation creates a level of discrimination that is unnecessary.

The policy seeks to solve the social-economic imbalance between the privileged and the less privileged individuals in society. Currently, wealthy individuals make up the highest percentage of the insured population. It is ironic to have financially able individuals covered for health services considering the frequency of illnesses in this category is minimal compared to the frequency among the poor. Rich people can afford the high prices of access to health services but the poor may not be in a position.

Ethical issues

Euthanasia is an ethical dilemma in the field of nursing and the big challenge is to determine whose decision it should be to allow for voluntary death. Patients suffering from acute pain may prefer death than the agony they go through. In Dax Cowart’s case, he was going through an unbearable pain after he was severely burned in an incident that led to the death of his father (Franklin Springs Family Media, 2009). While on his sickbed, he kept pleading that he be left to die. The dilemma comes in when the health practitioner is the one to facilitative the death plea.

One of the most fundamental components of Euthanasia is that it must be a deliberate intervention to terminate life with the intent of relieving a patient’s intractable suffering (Franklin Springs Family Media, 2009). The only type of euthanasia that is acceptable in most countries is voluntary euthanasia. On the other hand, Non-voluntary and involuntary euthanasia is considered to be murder. Whichever way we look at it, this medical process has dreadful implications on our social values, morals, and norms. Death is one of the most feared events in human existence. Causing death is therefore not the only forbidden activity as far as loss of life is concerned.

Encouraging or helping an individual to terminate his or her own life is an ethical issue that cannot be justified under any circumstances. It is against our norms and moral values to decide when to stop living. That decision is believed to be a reserve of the supreme God who is the giver of life (Burt, 1998). In nursing, the dilemma is whether to alleviate the patient’s pain by performing euthanasia or to allow the giver of life to decides the patient’s fate. This creates a very difficult dilemma for the nursing profession.

The rationale for being an agenda

For children and families to have a collaborative relationship with the systems that provide healthcare services, families must be involved. As the community systems strive to avail healthcare to children and families, in return families must also take the initiative to learn how the systems interact with each other. In pediatric healthcare, the most effective form of care is Family-Centered Care. Family’s involvement in healthcare enhances the possibility for successful outcomes.

Financial consideration

In every business engagement, the management of risks that can lead to losses/gains that can be incurred by a companion investment is very crucial (Acharya, Lochstoer & Ramadorai, 2013). Every person engaging in a business is looking forward to making profits and not losses. Therefore, a hedge is used to remove the probability of making losses for an organization or a single entity. In essence, hedging is a risk management strategy used in offsetting a looming loss because of several factors. One of the major factors that pose a loss risk in any investment is the fluctuation in the prices of supplies, currencies, or securities (Armantier & Treich, 2013).

For an organization or a company to protect itself from the above-mentioned risks, preventive measures are required. In effect, hedging comes in handy to perform this function. Hedging I considered to be a different way of ensuring a business without getting an insurance cover. An individual or an organization can protect its capital against the drastic effects of inflation through several measures. One of the most common strategies used in averting the implications of inflations on one’s capital includes investing in high-yield financial instruments (Arouri, Jouini & Nguyen, 2012). Such instruments include bonds, notes, and shares, real estates, or precious metals markets (Arouri, Jouini & Nguyen, 2012).

Policy goals/objectives

According to Donna E. Shalala, the majority of the American residents are insured. This article argues that nurses can provide the solution to America’s health challenges. According to this article, there is confusion about what nurses are capable of doing and what they cannot do. Over the years, nurses have been very helpful to the healthcare system. With the help of nurses, the quality of health services, especially in rural areas, has been improved (Carroll).

As it is suggested in a report by the institute of medicine, the future for nursing as a profession looks bright. The report recommends that the outdated restrictions in nursing should be reviewed. This will enhance their ability to perform more functions and increase service delivery. The report also recommends that nursing leadership in hospitals should be enhanced. In most hospitals and healthcare centers, nurses are not represented in boards of directors’ panels.

Identification of stakeholders

This is one of the reasons causing nurses’ interests to be left out in the decision-making processes in the health industry. Nurses’ representation should not only be effected in hospitals boards, but also all health sectors (Smith). In addition to the above recommendations, the report also suggests that nursing education should be supported and improved. Some nurses who have advanced degrees are not sufficient to serve the current population. Therefore, the demand for nursing is gradually outdoing its supply. This must be addressed to avoid a major catastrophe in the future. Nurses’ functions and roles in the health system are very limited.

The report recommends that nursing should be diversified to cover different areas to increase its range of services. Lastly, it is important to have effective data reporting and complaint delivery systems in place to avoid mishaps. Reporting systems will be very useful in monitoring and predicting the needs of the labor force, hence helping in improving the quality of service. Currently, some states have already acted in response to this report’s recommendations. They include New York City, Kentucky, and Minnesota.

Criteria to meet the objectives

Cities have tried to implement these recommendations but have failed. They include California, Florida, and Indiana. However, the efforts are expected to be resumed and there are high chances that they will succeed in removing these barriers. One of the major arguments for removing these obstructions is because nurses can offer high-quality care services and at an affordable cost compared to the regular physicians who offer similar services at a very high cost (Carroll). To improve the healthcare system in the United States of America, the best place to start the process is by dealing with the issues affecting nurses.

By removing the existing barriers in the health care system, the government can expand health services to reach out to almost 8 million new patients. This is a major accomplishment if it can be achieved. By defying these recommendations, the state will be hindering access to healthcare services. A sizable percentage of the population will be denied the chance to access medical services if the recommendations are not adhered to. Nurses should be allowed to utilize their acquired knowledge to the maximum if the quality of and access to health services are to be enhanced. The discrimination that nurses face as they perform their duties should be avoided at all costs. Just like other health practitioners, nurses have the expertise to deal with most of the basic health issues (Simpson, Slutskaya, and Hughes).

Evaluation of options based on criteria

The article gives a very broad perception of the nursing profession. I think allowing nurses to offer health services without restrictions is a good strategy to deal with health issues in the country. However, it is unlikely that the services offered by nurses will remain affordable after they are allowed to be fully in charge. Services offered by nurses may be only affordable due to the restrictions that are in place (O’Shaughnessy). Who knows what will happen if they are given the full authority to carry out other functions like treatment? I predict a situation whereby nurses will also increase the cost of their services to match the cost charged by other physicians.

I believe that a nurse-friendly care service delivery system can achieve better results than the current system. In the current system, a patient can be kept in the waiting area for hours, while the doctor is attending to a different patient. Health issues are sometimes spontaneous and quick action is required. The waiting time can sometimes result in fatalities. If nurses were allowed to treat and diagnose, such risks would be significantly reduced. In addition to this, it is also important to note that accessing the services of a physician is sometimes very costly and too expensive for most patients. However, this can be improved, since nurses can offer the same services at a cheaper price.

The difference between the cost of health services offered by doctors and nurses is not based on the quality, rather on the principle of demand and supply. Doctors and specialized physicians are very few in every health facility. Nurses make up a greater percentage of the total number of employed health practitioners (Wolf). The increase in the supply of health services due to the increased number of personnel will cause a reduction in the general cost of health services.

Therefore, the current health system should be reviewed and nurses should be given the mandate to progress with treatment as per their knowledge. Over time, nurses accumulate enough experience in their practice to warrant them the right to deal with very complex health situations. This should account for the decision of involving them in the practice.

Financial considerations

It is also impractical to assume that by allowing nurses to offer healthcare services the cost will automatically reduce. I support the recommendations fully, but I think the cost of health services may not be significantly altered to the advantage of the patients. The nursing training curriculum can be improved to increase nurses’ range of services. This can be beneficial to the country’s healthcare system. However, the cost of learning and the improved quality will be at a cost.

The perspective presented in this article suggests that nursing is the ultimate answer to the high cost of healthcare services. As Shalala has noted, the Affordable Care Act was meant to promote care and help the nurses to acquire skills to be in a position to educate the patients. This will ultimately improve the quality of care as well as improving its cost. The United States of America has taken the necessary steps according to Shalala to reduce the number of uninsured citizens in the country. However, Shalala asserts that systematic problems and partisan politics have affected the role played by nurses in the healthcare system.

Solutions with the problem statement

ACA has been affected by internal politics hence the difficulties in licensing. Another challenge facing the nursing fraternity and that is hindering their licensing is the problem of offering universal access to care (Truthaboutnursing.org). The supply of health care services is not matching the demand currently. This is a major challenge, which can only be addressed by licensing of nurses and the enhanced powers given to them to function easily.

Nurses can help in improving the healthcare system if they were allowed to assess, diagnose, treat, educate, and coordinate health services for patients. However, allowing nurses to perform these functions can have different implications for different interested groups. To the doctors, I believe the move will be contested bitterly. Doctors will not be pleased to see their juniors performing functions that are preserved for them, considering their level of training.

On the other hand, I think patients will have different angles of looking at it. A great number of patients might benefit greatly from this plan concerning access to services and cost reduction. Allowing nurses to treat patients will reduce the waiting time and increase the number of patients being treated per day. Doctors are very few in most hospitals therefore they can only serve a handful of patients per day. If nurses are allowed to diagnose and treat patients, the number of deaths in health care facilities is likely to reduce. This will enhance the provision of health services and reduce costs.

Conclusion

This paper has discussed several issues concerning nursing and healthcare services concerning the task force bill for Maryland’s residences. It has discussed the ethical dilemma involved in nursing, the rationale for making this policy an agenda among other aspects that are vital for this report. At the end of this paper, is a concise presentation of the solutions to mitigate the problem as stated at the beginning of the paper?

References

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Simpson, R., Slutskaya, N., & Hughes, J. (2012). Gendering and embodying dirty work: men managing taint in the context of nursing care. Dirty Work: Concepts and Identities, 1(1) 165.

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