There are insurance companies that dictate what cares they cover, which providers and which medications

Elizabeth Homrighausen 1 postsRe: Topic 4 DQ 2

Health care systems in the United States are quite complex. There are insurance companies that dictate what cares they cover, which providers and which medications. When thinking about the multiple players that contribute to the delivery of health care services, we must analyze if the it is adequate for the patients needs. “The USA is currently the only high-income country without nearly universal health-care coverage. Attempts to achieve universal health coverage have been made since the 1940s but – apart from the development of Medicare and Medicaid (which provides coverage for the poor, near-poor residents, including children, pregnant women, parents, seniors and individuals with disabilities) in 1965 – little progress had been made before the implementation of the ACA (Affordable Care Act)”(Rice , et al., 2014). According to Rice, Medicare and Medicaid cover approximately 30% of the population, and in 2012 about 18% were uninsured.

“The ACA is much more than just a health insurance law. It touches on almost every aspect of the delivery of the health service and was designed to encourage more primary care, to promote a greater focus on quality and prevention, and to encourage doctors, hospitals and other providers to coordinate care through new entities called accountable care organizations” (Rice , et al., 2014). I believe that the ACA will not completely fix our health care problems, but it is certainly a start. One of down falls to the ACA is higher premium costs for patients with private insurance causing financial burden for the middle-class families. The great thing about the ACA is that it promotes health by having insurance companies cover the costs of preventive care. The role of nurses is to advocate for our patients well being and educate on the importance of health promotion and the continuation of health care needs. We must also help inform them what their health insurance covers as far as care, many patients don’t entirely know what all their insurance will and will not cover.

 

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