Access to Health Care

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The Issue Access to Health Care

The Issue: Access to Health Care

Based on a study conducted in 2013, adults in the United States are more likely to forego health care services because of cost or difficulties associated with paying for such services despite having an insurance (Schoen, Osborn, Squires & Doty, 2013). Similarly, dealing with time-related issues is a concern in accessing health care services. When reviewing the extension of health care services in the developed world, it emerges that the U.S health care system is way off the mark in terms of comparativeness as its costs, affordability, and accessibility are prohibitive (Wong, Andersen, Sherbourne, Hays & Shapiro, 2012). Since the nursing profession is focused on the extension of health services, probing the topic is of utmost significance.

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Specific Problem

According to Schoen, Osborn, Squires, and Doty (2013), approximately 37% of the US adult population did not receive appropriate healthcare in 2013 because of its high cost. The scholars further indicated that forty percent of the population spent about one thousand dollars on medical care from their pockets irrespective of whether they were insured or not. Hence, even the insured people struggled to access healthcare in the US. The researchers further pointed out that up to 23% of the population faced serious problems offsetting their medical bills. Similarly, up to 32% of the population struggled with insurance paperwork or related disputes. Another significant finding was that 75% of the population believed that the health system needed a major overhaul in order to make it responsive to their needs. It was, however, stunning to discover that the US spent over eight thousand dollars on each person’s health care. Based on the above statistics, healthcare access is an issue of concern that warrants immediate attention.

Since coming into power, the Universal Healthcare Act, mostly known as Obamacare, was intended to address the issues of health care provision (Davis, Schoen & Kristof, 2010). Although the Act was seen as an important step, additional measures are required to redress recurrent problems as highlighted above. In particular, the issue of high costs needs to be addressed. In this regard, changing the existing law to make it more responsive to peoples’ needs is deemed significant.

Thoughts Regarding Chosen Policy

In the past, the United States began implementing insurance programs and market reforms (Kelley, McGarry, Fahle, Marshall, Du & Skinner, 2012). However, those who are uninsured remain vulnerable. Expanding insurance coverage is another aspect that should be considered. It must be noted though, that such a move may not be sufficient on its own. For that reason, improving the effectiveness of insurance would require redesigning the system, balancing cost-sharing roles with the ability to pay and ensuring that coverage is effective. The country may consider adopting a strategy involving the extension of after-hours care in addition to simplifying administrative complexity associated with the healthcare system. Seeking proposals from all stakeholders would also help in improving the healthcare system. The primary goal of any healthcare system is to enhance access with a view to attaining universal access. In order to achieve this objective, the above measures need to be considered.

Finding Current Status of the Issue

The issue of healthcare is highly debated owing to its significance within society. Finding information on the state of healthcare is relatively easy because there are a wide variety of sources on the topic. The number of such sources ranges from newspaper articles to journal articles. In addition, government websites such as or provide useful information relating to healthcare issues. Similarly, state bodies such as the federal and local governments provide information about healthcare and its access.

Level of Government

In the United States, district organizations are in charge of the provision of healthcare services. A big percentage of healthcare providers are under control of the private sector while only 20% are under the leadership of the government (National Institutes of Health Committee on Population, 2013). It is approximated that between sixty and sixty-five percent of healthcare provision is catered for by TRICARE, Medicare, Medicaid, the Veterans Health Administration, and the Children’s Health Insurance Program. Employers ensure a large percentage of people, while a small percentage is uninsured and depends on pocket money for healthcare services.

Provision of healthcare services remains largely in the purview of the federal government since it develops legislation on the issue. For instance, in 2010, it oversaw enactment of the Patient Protection and Affordable Care Act which brought wide changes to health insurance (Murray et al., 2013). It is noted that even at the local and state level, health provision needs to be carried out in tandem with the federal guidelines. Hence, the three levels are involved, although, the federal level seems to have more power.

Policy Responses in Past

Successful governments have attempted to resolve health access problem, attaining varied outcomes in the process. Under the Obama administration, legislative measures have been fronted. For instance, in 2010, the Patient Protection and Affordable Care and the Health Care and Education Reconciliation bills were signed into laws in the process of reforming healthcare access (Kelley et al., 2012). The laws were meant to increase the eligibility of citizens into Medicaid besides introducing a raft of measures aimed at resolving the health access concern. One of the notable effects of the laws was to bar insurance firms from setting caps on Medicare taxes and regulating fees charged by medical devices and pharmaceutical organizations (Schoen et al., 2013). Passing of legislation in Vermont making healthcare a human right is indicative of the reforms carried out under the Obama administration. It is noted that, although the United States health system still endures many concerns, the measures taken have set the stage for the enhancement of access to healthcare in the country. As a profession, nursing pertains to service delivery to people. Since the above measures have been geared towards increasing access to healthcare, then it is held that the measures are critical to nursing as they touch on the primary role of the discipline.

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Massachusetts Health Care

In 2006, Massachusetts introduced health care reforms so as to ensure universal health insurance access (Wong et al., 2012). Under the reforms, each resident was to attain insurance coverage at no cost. The policy was to cover people earning less than 150 percent of the federal level of poverty. The law has been amended to show consistency with the Affordable Care Act. Under the new provisions, the Commonwealth Health Insurance Connector Authority was set up to oversee the extension of insurance plans to the citizens. The 2006 health reforms in the state saw over 66% of the residents previously uninsured get insurance covers via Medicaid expansion. The insurance was under the administration of MassHealth. In the case of Massachusetts, the Commonwealth Health Insurance Connector Authority represents the federal government. MassHealth is a state agency which tackles the same issue. At the moment I do not have the contacts of these organizations or their representatives. In a bid to get the attention of the authorities, I intend to contact a member of our city council to table my proposal about the issue. In case he fails to act in time, I intend to contact the Commonwealth Health Insurance Connector Authority is the body to work with since, in my assessment, the body has wide powers to effect changes regarding healthcare access.

Plan for Legislative Visit

I plan to call the member of our city council during his office time to present proposals on improving the healthcare system.

Message to City Council Member

As already mentioned above, seeking the attention of policy-makers to push for a rethink on the policy on the issue is critical. Given that the local council members are in a position to influence the policy, I hold the view that contacting this holder of an office would aid my mission. As a nursing student, I understand many of the problems that affect our health care system. Health care concerns such as accessibility affect the extent to which a society contributes to the overall development process. Despite the important role health plays in the lives of people, the issue persists. Whereas the state has made considerable efforts to improve the situation, there still remain other possibilities for improvement. In seeking measures to improve healthcare accessibility, I suggest that insurance coverage be expanded. Although, such a move is commendable, improving the effectiveness of insurance should also be explored through the redesigning of the system and balancing cost-sharing roles with the ability to pay.

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Conveying the Message

City council members have busy itineraries. Hence, no effort will be spared in booking an appointment at an appropriate time. In order to achieve the anticipated goals, I intend to visit the council member’s office to prepare for a presentation. I will specify the time for presentation and the duration it is likely to last. I will also request the council member’s office to reveal the next member who can receive the information in case an unforeseen issue emerges.


When presenting a policy brief, it is demanded that a presenter sets it in an appealing manner. Ideally, a PowerPoint presentation would be important in highlighting the main points of the policy. However, doing the presentation over the phone complicates the use of PowerPoint. Nevertheless, I intend to prepare PowerPoint slides which I will send ahead of the presentation. Using the phone, I will be able to take the council member through the points and illustrate each step.

Expected Feedback

In practice, the academic fraternity is charged with the responsibility of highlighting or shedding light on issues facing society. After pointing out such issues, the academic fraternity may go further to suggest the strategies or approaches it deems appropriate in addressing emerging concerns. In light of such understanding, the expectation, in this case, does not differ significantly. As a nursing student, I am highlighting issues bordering on health care access in the US. In the same spirit, I am giving proposals that could be useful in redressing the problem. After my presentation, I expect the council member to state the issue in council meetings or lobby for an examination of the issue. My intention is to see the issue get into the agenda. From there, I expect policy responses modeled along with the suggestions made or any other appropriate ones being adopted. However, irrespective of the action taken, it is my conviction that I would have played my role as a nurse to point out some of the issues that affect the society’s healthcare problems.

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