Part 1
Notably, the cost of receiving healthcare in the United States has been on the rise in the recent years. It is, therefore, imperative that for the nation to address the problems associated with lack of sufficient healthcare there is the need to have caps on the skyrocketing nature of the healthcare costs (AHIP, 2016). The most notable areas where the rising costs have been detected include soaring costs of medical services, costly pharmaceuticals, unhealthy lifestyles, expensive medical technologies and the fee-for-service payment system whose only focus is on volumes instead of the expected value. It is worth noting that close to one-sixth of the country’s economy is channeled towards solving healthcare problems and it has been seen as rising every single day faster than inflation (Patton, 2015). However, the services are not commensurate with what is being paid for. Most of the monies collected from this system usually go to waste or used in inefficient manners. From the foregoing, therefore, these costs have got a profound effect on families that are dependent on these services.
Increasing healthcare costs translates to persons having less disposable income with them thereby struggle to balance between satisfying their daily needs for instance; food, rent, and monies fro daily upkeep. This factor also has implications for employers since it becomes challenging for them to recruit more employees and maintain their medical converges. To the local, state and federal governments, there are pressures in trying to balance between healthcare provision and other programs like education, infrastructure, and public safety. In this direction, therefore, nurses are supposed to be at the forefront in lobbying for policies that can be used to address these rising costs (Crowley & Golden, 2014). This is in line with ensuring that patients emerge with desirable outcomes from the inexpensive care they will have received from the nurses.
Part 2
In the state of Washington DC, the issue of rising healthcare costs has been addressed through cheaper healthcare services of which The Medicaid health care system forms the bulk. Medicaid is referred to as Washington Apple Health in this state. The healthcare services needs that are covered by Washington Apple Health include; maternity care, medical emergency care, dental and vision care fro children and adults, treatment for alcohol and substance dependence, covering the costs of medication, and the transportation of patients in situations that may be deemed necessary (Washington State Health Care Authority, 2016). This healthcare program has made it easy for additional persons to be included in the healthcare coverage with statistics pointing that close to half a million residents of Washington have since been included in the scheme. The levels of eligibility with this healthcare coverage are dependent on the income levels of the aspiring members and their poverty level in relation to the Federal Poverty Level. A person whose annual income is 16,000 dollars and is at 157% Federal Poverty level is eligible to qualify for this healthcare plan (Sommers, et al., 2014). Additionally, this healthcare system provides supplementary coverage for the elderly individuals that are already under the Medicare coverage system and whose income levels are at 70% in relation to the FPL or less. From the foregoing, therefore, many of the inhabitants of this state are able to have their healthcare costs covered with the objectives of having a cap on the increasing costs of healthcare in the country.
There is, however, concerns in regards to the Apple Health Medicaid system since determining how poor a person is for them to be included in the plan has proved to be a challenge to the authorities in charge of this arrangement. For instance, there are some residents who are too poor (in terms of their income levels and their federal poverty level) to meet the eligibility of this insurance coverage system. Additionally, there is also the ongoing debate amongst the middle-income group whose salaries are deducted to fund this healthcare system yet they are not part of it. Most of the middle-income group would rather enroll for private insurance covers which are better in terms of the services being offered as compared to the Apple Health coverage.
My proposals on how to solve theses two contentious issues will primarily focus on addressing the eligibility requirements for one to be included in the healthcare coverage and also address the issue that is of the middle-income group. The fact that the Medicaid system covers individual whose annual incomes are 16,000 dollars each year makes it a challenge to include others the extremely poor in the society (Berwick & Hackbarth, 2012). Therefore, there is the need for this legislation to be reviewed for more these people to be included in the system. On the issue of the middle-income group, it will be important that their contributions to the system in terms of the deductions from their salaries be reviewed to enable them to purchase their own private insurance plans.
Potential complications likely to face this arrangement will be reduced levels of funding based on the fact that more people will be included in the scheme though less funding opportunities will be available to oversee the rolling out of this plan. Since there will be fewer contributions to the plan by the middle-income group, the available funding will also reduce. Additionally, ensuring efficiency in this system will also be a challenge because of a large number of individuals and the bureaucracies that will follow.
The nurses play a significant role in educating the populations about the Apple Healthcare plan. In this direction, education on how to apply for the cover, the benefits associated with being included in the policy, the eligibility of individuals in this scheme, will be the sole role of nurses in this system. Additionally, nurses play the role of agents for change by advocating for reforms on the cover on areas where the state should expand to cover more individuals.
Conclusively, rising health care costs have proven to be a big a problem to many individuals in the country mainly because a lot of people in the country have got limited financial capabilities. The solution proposed for this problem, therefore, has been the creation of the Washington Apple Health which has ensured that more people are provided with insurance covers in the country.
References
AHIP. (2016). America's Health Insurance Plans - Rising Health Care Costs. Retrieved from https://www.ahip.org/Issues/Rising-Health-Care-Costs.aspx
Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. Jama, 307(14), 1513-1516.
Crowley, R. A., & Golden, W. (2014). Health policy basics: Medicaid expansion.Annals of internal medicine, 160(6), 423-425.
Patton, M. (2015). U.S. Health Care Costs Rise Faster Than Inflation. Retrieved from http://www.forbes.com/sites/mikepatton/2015/06/29/u-s-health-care-costs-rise-faster-than-inflation/#d99afe06ad25
Sommers, B. D., Graves, J. A., Swartz, K., & Rosenbaum, S. (2014). Medicaid and marketplace eligibility changes will occur often in all states; policy options can ease impact. Health Affairs, 10-1377.
Washington State Health Care Authority. (2016). What Low-Income Medical Coverage is available? Retrieved from http://www.hca.wa.gov/medicaid/pages/summaryofservices.aspx
