Discussion: NURS 8100 Week 1 The Health Care System, Part 1
Discussion: NURS 8100 Week 1 The Health Care System, Part 1
The evolution of health care in the United States has been a roller-coaster story of good intentions that were often buffeted by economic and social change, compromised by special interests, and beset by passionate differences of opinion. The primary goals of health care reform have been fairly consistent: to increase access, lower costs, and improve quality. Many efforts to bring about change, however, have not resulted in policy. Why has this been such a challenge? What barriers have prevented reform efforts from being successful? Exactly how to fix the weaknesses of the current health care system continues to be an issue of public and political debate, and one which continues to be played out in the policy arena.
This week, you will examine the history and evolution of health care and consider how health care financing has been central in shaping the current system. You also will examine provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA)—a groundbreaking attempt at reforming the U.S. health care system by the enactment of new policy.
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| Looking Ahead
In Week 2, you will begin an assignment that requires you to interview a policy maker. Due to the time-sensitive nature of getting on the desired individual’s schedule, you may wish to review this assignment now to begin thinking about who you might like to contact. |
Objectives
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Students will:
- Analyze principal features of the U.S. health care system
- Evaluate the policy process in relation to challenges for health care reform
- Access online learning resources for professional growth and development
Learning Resources
Required Readings
Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.
- Chapter 1, “Introduction: The Paradox of Excess and Deprivation”This chapter introduces the concept of “excess and deprivation”—p eople receiving either too little or too much health care, which contributes to the weakness of the health care system.
- Chapter 2, “Paying for Health Care”This chapter discusses the evolution of health care financing, including out-of–pocket payments, individual private insurance, employment-based insurance, and government-financed insurance.
- Chapter 3, “Access to Health Care”This chapter focuses on financial and nonfinancial barriers to health care and concludes with influences to one’s health status unrelated to health care.
- Chapter 4,“Paying Health Care Providers”This chapter provides information on how physicians and hospitals are paid.
In Week 1 of this course, you are required to subscribe to one of the health information services listed below. In preparation, review these different sites:
The Henry J. Kaiser Family Foundation. (2011). New & noteworthy. Retrieved from http://www.kff.org/
Required Media
Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: The policy process. Baltimore: Author.
Note: The approximate length of this media piece is 11 minutes.
In this media presentation, Dr. Kominski and Dr. Zelman discuss the policy process and provide an overview of the influence of policy on health care practices. Dr. Zelman also discusses the challenges of passing new policy and relates this to health care reform efforts.
Optional Resources
Hammer, D., Phillips, B., & Schmidt, T. L. (2010). The intended and unintended consequences of health care reform. Healthcare Financial Management, 64(10), 50–55.
Stephens, J. H., & Ledlow, G. R. (2010). Real health care reform: focus on primary care access. Hospital Topics, 88(4), 98–106.
Discussion: Health Care Reform
After much public and political debate, in March 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. The PPACA is one of many health care reform efforts that have sought to correct key features of the U.S. health care system such as financing, service delivery, and care coordination. This week, you will examine the passage of PPACA as a milestone along the historical continuum of health care reform in the United States.
To prepare:
- Review this week’s Learning Resources and media presentation, reflecting on the evolution of health care in the United States and the public’s response to health care reform efforts historically and currently.
- Consider: What principal features of the U.S. health care system helped or hindered the enactment of federal health reform in March 2010? What challenges were encountered?
- How do these conditions and/or challenges reflect characteristics of the policy process and the political environment?
By Day 3
Post a cohesive response that addresses the following:
- Analyze at least one important feature of the U.S. health care system that is of particular interest to you. Explain why you think this feature is significant in terms of health policy and reform.
- Describe one or more conditions or challenges specifically related to the passing of the PPACA. Explain how this exemplifies the nature of the policy-making process, and evaluate how it could relate to the question of why health reform in the United States has been so difficult.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 1 Discussion
Assignment: Staying Current: Online Resources
Technology is providing increasingly rich and credible resources for staying abreast of the latest trends and issues in health care. Many recognized organizations provide regularly disseminated updates via their websites, and offer this information free to subscribers. As you proceed through the DNP program, you will find that receiving these updates will support your professional growth as a scholar practitioner.
To prepare:
Explore the following resources found inthis week’s Learning Resources:
- AHRQ Patient Safety Network
- Modern Healthcare Alerts
- RWJ Nursing News Digest
- The Commonwealth Fund
- The Henry J. Kaiser Family Foundation
To complete:
- Select one service and subscribe to receive e-mail alerts or updates.
- Copy and paste your successful subscription notification into a Word document.
By Day 7
Submit the Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
- Click the Week 1 Assignment link.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 1 Assignment
Week in Review
This week, you evaluated challenges in the policy process for health care reform and analyzed principal features of the U.S health care system. You also accessed online learning resources for professional growth and development.
Next week, you will have an opportunity for an authentic experience as you bring a health care issue of concern to the attention of your state or national politician and consider the unintended consequences that may arise as a result of reform policy, such as the individual mandate.
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Name: NURS_8100_Week1_Discussion_Rubric
| Excellent | Good | Fair | Poor | ||
| RESPONSIVENESS TO DISCUSSION QUESTION
Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. |
Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*. |
Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*. |
Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*. |
Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*. |
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| CONTENT KNOWLEDGE | Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course. |
Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course. |
Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course |
Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course. |
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| CONTRIBUTION TO THE DISCUSSION | Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature. |
Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature |
Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas. |
Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas |
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| QUALITY OF WRITING | Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints. |
Points Range: 5 (16.67%) – 5 (16.67%)
Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;. |
Points Range: 4 (13.33%) – 4 (13.33%)
Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints. |
Points Range: 0 (0%) – 3 (10%)
Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints. |
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| Total Points: 30 | |||||
Name: NURS_8100_Week1_Discussion_Rubric
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Discussion: NURS 8100 Week 1 The Health Care System, Part 1
The U.S. health care system is different from other developed countries in that it does not have a standardized health system or universal health care coverage. The U.S. has a hybrid healthcare system, while other developed nations have a single-payer national health insurance system, a national health service, or a multi-payer universal health insurance fund (Papanicolas et al., 2018). The uneven health insurance coverage in the U.S. health system is an important feature of interest to me. Many Americans do not have access to health care since it is restricted to: Persons with health insurance; Americans covered under government insurance programs; Persons who can afford to purchase private health insurance; Individuals who can get health services through safety net providers (Papanicolas et al., 2018).
The feature is significant in relation to health policy and reform since policies and reforms are needed to increase Americans’ access to healthcare. Examples of approaches to address the issue include formulating policies that provide health insurance coverage to Americans from low-income families (Papanicolas et al., 2018). Policies on health insurance also need to be modified to allow the disproportionately uninsured Americans to access quality healthcare.
The passing of the Patient Protection and Affordable Care Act (PPACA) came with conditions that triggered legal and political controversy. It had a mandate requiring Americans to obtain health insurance or get penalties, with some exceptions, especially for low-income Americans who cannot afford insurance (Talbert et al., 2018). The condition was viewed as necessary to cover healthcare costs in the U.S. The controversy brought by this condition led to delays in the policy-making process. Policymakers challenging the policy argued that the condition overstretched Congress’s commerce clause power (McIntyre & Song, 2019). This explains why health reforms in the U.S. have been complicated since some policymakers argue that proposed reforms are unconstitutional.
References
McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2), e1002752. https://doi.org/10.1371/journal.pmed.1002752
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039. https://doi.org/10.1001/jama.2018.1150
Talbert, P. Y., Martin, L. F., Frazier, M., & Byas, D. (2018). Benefits and Challenges of the Affordable Care Act: What should be the Future of the ACA in 2018? Acta Scientific Medical Sciences 2.5, 09-16.
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