Comment 1

My evaluation of the United States health care system leaves me concerned for our future generations. According to healthypeople.org there are three components to gaining access to health care in the U.S. These include having health insurance, access to health services and timely care. It is estimated that 44 million Americans are uninsured and another 38 million Americans do not have adequate health insurance. Not having health insurance can affect gaining access into the healthcare system and cause financial burden to those in need of service. Often times these people go without seeking care for conditions that could have been avoided. This can pose a greater risk for those who have to support a family. Even for those who have adequate insurance may experience a hard time to get an appointment or procedure done in a timely manner. There can also be gaps in their insurance that make it hard to gain access. Patients may be referred out of state to address a medical need that is not offered in their current location. This again can be financially difficult for the patient in need (Office of Disease Prevention and Health Promotion [ODPHP], 2018). In 2012, the U.S spend 2.8 trillion dollars on the healthcare system and yet there was still a poor outcome (World Health Organization [WHO], 2014). Healthcare reform was implemented in 2010 in order to help patient gain access to affordable healthcare. It has helped more than 20 million people get insurance. This was a necessary step in order for the United States to gain control of the issues listed above (American Public Health Association [APHA], 2018).

Comment 2

October 01, 2013 was the very first day that Americans were able to sign up for private health insurance through the Health Insurance Marketplace. The Affordable Care Act (ACA) act was to provide tax credits to cover portions of the cost of coverage. Under the ACA nobody was to be denied coverage based on pre-existing conditions. Medicaid and  was available to low income families and families with children could apply for the children’s Health Insurance Program (CHIP). Under the ACA the doctors where held accountable to quality not quantity of patient care.

The ACA created the National Prevention Strategy, a guide for the country to achieve, in the most effective way, improved health and well-being (Healthy Americans, 2013). The new ACA law included the availability of prevention or health center funding.  But with this new law arose many challenges for the community nurse and the public health. Many of  those new insured had inadequate health care and they require additional education and care from the nurses. There was also a call for screening/preventive services to be shifted to the community health care centers instead of the clinics or Hospitals. This is putting a strain on the community Health care workforce requiring Communities to hire additional nurses, but this is a hard task to do, because of the current national Nurses shortage. There are incentives in place to encourage current nurses to advance their education to Nurse Practitioners to help with the increased need for additional Health care providers in our communities.