What is the role of health care reform in shifting the focus
Week 1 DQ 2:
What is the role of health care reform in shifting the focus from a disease-oriented health care system toward one of wellness and prevention, and how does nursing fit into this shift?
The United States spends more on health care than any other country yet is lower in health rates such as life expectancy, infant mortality and other indicators of health. Shifting health care to focus more on preventative measures, health education, and screenings can reduce acute health care costs and improve health indicators such as life expectancy and cancers (Benjamin, 2011). Health care reform has started to shift to put more focus on prevention in addition to the ongoing health care needs of the currently chronically ill. In 2010, President Obama signed into law The Affordable Care Act which required health insurance to cover preventative services with no copay or deductible necessary. So not only did this act expand health coverage to millions that previously had none but it took away the cost for those not able to afford preventative care (“The Affordable Care Act”, 2010).
Nurses are at the forefront of health care and have roles that are very versatile. The shifting from disease treatment to prevention will require some shifting across the continuum of care. There will still always be a need for acute care and hospitals but hopefully that is much less in the future. A shift to patient centered care and community care will require nurses to shift roles to education of the patient, family, and community on a preventative level. Promoting the right diet, exercise, avoidance of carcinogens, culturally specific factors, and recommended preventative screenings. Nurses will be coordinating, educating, and leading the people of this country to optimal health. Tracking outcomes as measures of effectiveness and participating in continuous quality improvement and collaboration between the differing areas of health care. Working in communities to reduce and ultimately get rid of health disparities and factors that hinder people from optimal health (Salmond, & Echevarria, 2017).
Knowledge Probe
Please consider reflecting on what you know about preventative health as a practice focus, or conversely, your experience with patients who lacked preventative or wellness care and therefore needed intense acute care. How does this knowledge or experience impact your current feelings and beliefs around topic?
I believe there will always be a need for acute care, there will always be struggles, especially with those whom are hard to reach in rural areas. We are products of our environment and how we are raised. It is very hard to reach out in small areas, people can be resistant to care due to lack of knowledge of it. My mother was raised on a small dairy farm and where as she is fairly healthy at this time, she was raised in an environment where you only go to the doctor when you absolutely have too. Dentists were unheard of, she still asks me why I am brining my kids to the dentist all the time. I bring them twice per year, the recommended amount for x-rays and a cleaning, she still can’t fathom why I need to bring them if they are fine. My mother had dentures my age 30. There are also a lot of people that believe that their body is theirs to do what they please with it in terms of toxic substances and what they put into their body. I do however think that many good things can happen if more money and effort was put into the community and public health sectors for preventative education.
References
Benjamin R. M. (2011). The national prevention strategy: shifting the nation’s health-care system. Public health reports (Washington, D.C. : 1974), 126(6), 774–776. doi:10.1177/003335491112600602
Centers for Medicare and Medicaid Services. (2010). The Affordable Care Act’s New Rules on Preventive Care. Retrieved from https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/preventive-care-background.html
Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopedic nursing, 36(1), 12–25. doi:10.1097/NOR.0000000000000308
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