Political issues in nursing
Introduction
Healthcare reform is built on the existing health insurance system and aims at providing more people with the coverage of health insurance. It also seeks to establish protection of customers legally and educate them how to buy insurances. The legislation proposed on health reform is intended to change how health care gets delivered, organized and financed. However focus has been put on the responsibility of federal government; impact of loweringMedicare spending growth rate; provision to pay physicians plus other practitioners who are qualified and collection of information about procedures for end of life care. The policy shows facts on the impact of the reform legislation.
The role of the federal government
The government is tasked with financing overseeing, delivering healthcare and organizing healthcare. The states are also given the responsibility of controlling the health insurance companies. The federal government regulates the insurance companies so that they do not fix prices. The federal government protects consumers from violation of privacy and marketing that gets mislead. The federal and state government gives tax subsidiaries to healthcare. Under the reform, there would be changes made to the legislation that would create a government run insurance health plan that would fund itself using premiums other than being funded by taxpayers. The debate is quite extensive regarding such reforms.
The relationship between nursing and politics has never been mutually exclusive. Nurses form the largest group of employees in the healthcare department. Their large numbers ensure that lawmakers engage them at a national or local level. The various healthcare reform issues that have politicized include; social security, Medicare, national insurance, healthcare care cost and healthcare for families who earn a low income. Also, smoking bans issued have been politicized, issues related to end of life care, insurance reimbursement, staffing, education and children.Pollution and allocation of healthcare resources are also politicized issues in nursing. With the help of technology, nurses have been able to giveout their opinions on pressing nursing issues and care for patients better. The political processes that address nursing matters are often challenged to get facts right, and application of less power.
Social security
Social security benefits individuals who have labored entirely in their lives. Healthcare reforms social security has run a political versus domestic tug- of –war. Social security has pressure when it comes to cost in healthcare,because themajority of seniors checks fromsocial security gets reduced by the rise in health expenses. Healthcare reforms provide that costs in the healthcare system needs to get brought down because the purpose of social security will need to get changed drastically. However, this can only get prevented by expanding social security and making it more generous. Nursing has been affected by social security issues because they have to limit care to the elderly.The promiseto give benefits to the right beneficiaries should get strengthened and not get cut. Millionsof beneficiaries have opposed the political move tocut benefits of social security, and have opposed the move by the government to increase the age of retirement. Also, Americans have greatly opposed the effort in privatization of social security.
The nurse’s associations have urged the public to strengthen and protect social security. Even so, some politicians have also voiced anincrement in social benefits. However, this is a long stretch. Cutting social benefits would greatly affect the seniors who are vulnerable and require social security benefits.Nurses have argued that indeed reforms in social security are vital butshould be about providing better social security benefits and services. The social security tax should get reduced or abolished and should at least help individuals invest their long term savings.
Healthcare cost
The rise in health care cost means that people have less money to spend on other things. Politicians have argued that child welfare and transport improvements receive lesser budget allocations due demands from the health sector. Some politicians have said that health care cost have led to economic inequality.Decline in healthcare reimbursement has seen a larger number of patients become unable to pay for healthcare;this leads nurses to work more with less money. Nurses are required to get innovative and involve all staff to reduce healthcare cost. Healthcare reforms have proposed that healthcare cost can get reduced byinvesting in health infrastructure. Healthcare reform has recognized that nurses play an important role in reducing healthcare cost through emphasis on prevention, providing primary care and services related to care coordination. The rise in healthcare cost is a complex political issue that will continue being debated on until a solid solution gets sought.
The need to reform the national health care system has causedstrain on the need to reduce the spending curve. The government has focusedon reducing spending on hospitals. The government’s spending has forced publiccalls to reduce the same because the country has run into debts. One of the ways that control in health care spending can get achieved through changing the way by which the health providers get paid. The government hopes that there will be greater promotion in efficiency without causing harm to the quality of care provided. The government hopes to not reduce the access of health services sincenurses form the bulk of healthcare providers and form the biggest labor costs in hospitals. The current healthcare system has major dissatisfactions that create challenges to nurses. The health care system has to undergo a lot of reforms because politics has made the reforms difficult since they want to run their private agendas onthe health system.
Healthcare for families with low income/ Medicaid
Medicaid Is a program for medical services forindividuals few resources and, with low income. Medicaid provides inpatient and outpatient services, prenatal care, vaccines and even family planning services among other services. It is a cost sharing system that does not cover poor individuals.All the states have the provision of low-cost healthcare topeople with low income, families and children. HealthCare reforms have proposals that intend to expand the coverage of Medicaid. They plan to provide new options to families whose children get entitled for Children’sHealth Insurance Program. The reforms would also change how sharing of costs by state and federal governments. Families that earn low income, and not able to have government health insurance, they would qualify for subsidies to assist in purchase coverage.
Below a certain income Medicaidcovers adults and their families. The healthcaresystem has many challenges and even families who have health insurance encounter problems getting care and paying for the care. Low- income families face barriers suchas lack of coverage by insurance and even poor access to health services as well as not being able to afford the cost of healthcare. Studies conducted showed that families that have health insurance facetrouble gaining access to health services. Especially families with a public health insurance complained of not feeling welcome in the health services and having to travel distances that were long. Low- income families with no insurance struggled toafford health insurance. The barriers that low- income families face are too great to get overcome easily. Public health insurance has with time expanded its coverage to those who are poor, and we have seen family physicians able to provide essential services to populations that are vulnerable. With such efforts being made many of the low- income families and many elderly people still do not have proper access to medical services.Nurses, on the other hand, have a duty to care for the patients and hence have a hard time providing medical services. Nurses feel that the government needs to do more to ensure that patients get the right care when they need it and at the right time.
Medicare
Medicare paysfor disabled and elderly persons. The funds used to pay for Medicare are half contributed by the employer while the other half gets contributed by the employee. This money gets set aside and gets to hospitalsand privateinsurance companies. HealthCare reforms seek to lower the spending on Medicare. Projected savings from Medicare is suggested to come to insurance payments from the government when offering private Medicare. Medicare savings would be made from reducing the payment increased for services than increasing the physician’s fees and reducing readmissions to hospitals.This can be prevented by directing the payments to specific medical procedures or conditions as an alternative to paying each provider independently. Even so, hospital stay is expensive when compared to receiving treatment in a nursing home and at home. Currently, there are investigations getting carried out on fraud surrounding Medicare andMedicaid research grants. However, nurses have reported that some seniors were unhappy because they did get qualification for being in a nursing home since they were under observation and not admission.
End of life care
End of life issues getsrelated to palliative and end of life care. Healthcare reforms have the advance care planning that allows patients to discuss with their physicians voluntarily about end of life care. The voluntary consultation becomes a benefit covered by Medicare. The consultation should include a discussion about key considerations and questions, their explanations and advance directives that include a durable power of attorneys and living wills. The healthcare provider is supposed to explain the end of life services and available support for the same. The discussion should also include hospice and palliative care with its benefits. It does not in any suggest that patients much choose the services. If Medicare beneficiaries decide and agree on the end of life benefits then, they are required to either choose full treatment or other treatments. The table parliamentary bills are designed to improve the patients quality of life delivered to patients during their final moments. Healthcare reforms also require group health insurance to have to prove the end of life care information. Individuals would also benefit voluntarily if got disabled through legal support by advance care planning. Politics has influenced the decision for people to plan their end of life. Medicare has deprivedof doctors the opportunity to discuss with patient's such an important conversation. End of life has been described as assisted suicide and majority of states have legalized it. In the recent years, voters have kept thegovernment out of personal decisions such as end of life decisions. Even the religious citizens are slowly accepting end of life planning. Nurses face an ethical dilemma when end of life care is concerned (Health Affairs, 2014).
Staffing
Healthcare reform needs to get addressed from staffing issue. Registered nurses in majority of health organizations are taking care of too many patients all at once. Patients suffer because ofavoidable complicationsarise and the number of re- admissions keeps rising. The shortage of nurses has become an agenda in politics because nurses have continued to migrate in search for greener pastures. Retaining nurses has become a major problem as wellas has been recruiting new ones. Nurses need to get valued and recognized for their good work. Low staffing compromises the healthcare and safety of patients.Also, the length of stay in the hospital is increased. Bills have been set up to call for staff limits that are adjusted on the needs of patients. Healthcare reforms needs to address overtime because it has become soexpensive,and thusit is not cost effective to a medical centre. Hospitals areaccountable for making plans on nurse planning and ensure safety for patients. Nurses being overworked have made them demotivated, and some staffing shortage has led to a go slow. Such shortage has sometimes seen nurses in lawsuitsdue to neglect and hence healthreforms should mitigate such risks against nurses(Fereell, 2014).Even though present staffing ratios have been suggested to better healthcare provision the ratios do not help the nurses to get flexibleenough to fit in their staffing plans, to suit the needs of patients and medical institutions. Adequate staffing helps to save operational costs in the medical centers. The healthcare reforms seek into delaying retirement for experienced registered nurses to curb theshortage and have also provided some of the best technological machines to assist nurses work safer(Fereell, 2014).
Allocation of healthcare resources
Healthcare resources are very scarce, and hence some of the ethical issues raised by the public and politicians are not new.Healthcare resources have always been scarce, not unless the government comes up with a strategy to make them sufficient for all patients. Technology has become the main determinantof the resources. Some of the healthcare reforms ethical issues addressed are benefits to the community and rights to individuals. The decisions on scarce medical resources are allocated using appropriate criteria that are ethically related to the medical needs of the patients. The criteria could include thesum of resources needed, urgency of need, chance of benefit, the extent of benefit and also achange in quality of life.Quality life judgments are made when patients get prioritized to avoid death or poor outcomes that could run to extremes.The nonmedical method of selection includes social worth, age and the ability to pay. The contribution of the patient to the illness also is a criterion as well as the lack of considerationto past use of health resources(Fereell, 2014). The reforms suggest that the decision to allocate resources should get done by respecting thepatient’s individuality. Patients who get denied allocation of medical resources needs to get informed of reasons behind the decision.
Conclusion
Politics can affect nursing either positively or negatively. However, politics tends to drag issues that nursing needs to get addressed in a short period.Healthcare reforms have been debated for quite some time now. Bills get tabled every day to address such reforms with little progress. Nursing is greatly affected by political issues that dictate the kind of treatment patients should get offered. Healthcare reforms should get addressed,and investments should get done to ensure that the cost of accessing medical services is reduced especially for low- income earners and the elderly in the society. Nurses play a significant role of ensuring that patients recover from their illnesses and educate the society more about health issues. The elderly and low- income earners are mostly affected by the political issues that affect the performance of nurses. Nurses form the largest number of health employees and hence when they speak they get listened to. Health care reforms should vigorously involve nurses to have the changes that people want in the medical sector.
References
Fereell, N. (2014). The Nursing Shortage: Exploring the Situation and Solutions. Retrieved from
<http://www.minoritynurse.com/article/nursing-shortage-exploring-situation-and-
solutions>
Health Affairs (2014). Key Issues in Health Reform. Retrieved from
<http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=10.>
Nursing informatics .com (2014). Nurses and Political Action. Retrieved from
<http://www.nursing-informatics.com/N4111/LA8.pdf>
