Nightingale’s Environmental Theory: The Exclusion of Illegitimate Immigrants from Medicaid/ Medicare Cover in the U.S.
Introduction
The natural environment, political, legal and social policies can have significant health impacts on an individual and the community at large. For instance, political and social policies may limit certain segments of society such as the illegal immigrants from accessing affordable health care services, thus leading to health care disparities. Nightingale claimed that political and social isolation is associated with poor environmental and social conditions, which include overcrowding, unemployment, inaccessibility to basic services and poor diet (Hegge, 2013).
Many Americans and the unauthorized immigrants in the U.S. have not attained their peak achievable health fitness, because of health cover seclusion policies and environmental conditions such as poor living conditions. The Affordable Care Act (ACA) of 2010 was and is still an attempt to improve and expand the accessibility of health care services that is supported by the health insurance policies. The act has been largely successful and has been applauded by various stakeholders and interested parties. However, the act excludes unauthorized immigrants from the federally funded health care policies, namely Medicaid and the Medicare health care programs, leaving them with no alternative but expensive out-of-pocket health care services (Medicaid, 2015).
Current political influence in the U.S. is still restrictive for illegal immigrants. They are not allowed to access both social and health care benefits that are enjoyed by the American citizens. Consequently, the ACA policy hinders illegal immigrants and some Americans with improper registration statuses, from accessing health cover and benefits provided under Medicaid or Medicare services. The immigrant population is generally unemployed or is of low-income backgrounds. Therefore, their disadvantaged backgrounds limit their access to the alternative out-of-pocket and expensive health care services, as a consequence of seclusion from health care insurance policies (Medicaid, 2015). Seclusion from health care insurance cover leads to undesirable economic and social outcome (Hegge, 2013).
Application of Nightingale’s Theory to the Problem
The exclusion policy to federally-funded health care insurance policies results into poor health among immigrants and the effects may radiate to the general populations. Immigrants maybe infected with communicable diseases, such as tuberculosis or cholera, which may spread to the general population thus contributing to significant poor health outcomes to the general population (Medicaid, 2015). There should be equity when it comes to health care for all, regardless of the citizenship statuses. Political and legal influences on health care need be equity driven rather an isolative in nature because political and legal powers have a significant influence on health with significant outcomes (Hegge, 2013).
Nightingale’s Environmental Theory supports the use of statistical and logical reasoning for the betterment of health for all individuals. Health care providers have a role to influence politicians and policy makers to make social reforms that reduce the plight of illegal immigrants. Quantitative and qualitative studies need be carried out to assess and compare health outcomes due to health insurance seclusion. Studies should also conduct to evaluate the socio-economic and health outcomes of admitting illegal immigrants to Medicaid or Medicare programs. Immigrants, irrespective of their legal status, should be treated as human beings. Policy makers should look for ways of solving the illegal migration issue their issues but not to isolate them from various social benefits, which worsen their condition (Hegge, 2013).
The gap between the rich and the poor continue to grow with time (Medicaid, 2015). According to Hegge (2013), the Nightingale’s Environmental Theory asserts that unemployment, poor social status, diet and living environmental conditions results into poor health outcomes. The theory is still relevant today as poor social statuses, overcrowding, squalid living conditions and poor diet predisposes one to both communicable and non-communicable diseases and poor health status. It is a true case of illegal immigrants in the U.S. despite the fact that majority of them are young and relatively healthy and cheap to insure than the ageing American population (Hegge, 2013).
Relevant Stakeholders
Identifiable stakeholders that may help to address the immigrant issue when it comes to health are the American citizens, the federal and the state governments, health insurance stakeholders, health care providers and the policy makers. If stakeholders reconsider their decisions and overrule the restrictive health care access policies, then it would not only benefit alone to illegal immigrants but all Americans in general (Medicaid, 2015; Hegge, 2013).
The Necessary Resources to Address the Issue
Policy and social change should favor employment equality, access to health care cover and improved accessibility to basic facilities such as sewage collections systems, clean water and living environments for all people living within the U.S. Immigrant, indigenous communities and the economically deprived populations should be availed with affordable health insurance cover. The federal and state governments should consider the plight of disadvantage population in their funding and policies that govern health care cover (Medicaid, 2015; Hegge, 2013).
The Measures of Success and Conclusion
Measures of success will include existence of non-discriminatory and non-inhibitive health care insurance services, equality and affordability of the health care services, improved public health outcomes based and extension of social and health benefits to all immigrants.
References
Hegge, M. (2013). Nightingale’s Environmental Theory. Nursing Science Quarterly, 26(3), 211-219.
Medicaid. (2015). Affordable Care Act. Retrieved on Feb. 28, 2016 from, http://www.medicaid.gov/affordablecareact/affordable-care-act.html
