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Universal Healthcare

Mrs. Elena Vale-Saquieres, BSN, RN

Keiser University Graduate School of Nursing

NUR520G1: Health Systems, Policy, and Resource Management

Instructor: Dr. Barbara Cole

Universal Healthcare

Abstract

Universal and unified healthcare is commonplace worldwide; however, in the United States the topic has become a life-changing policy awaiting for approval. Although our healthcare system is continuously being enhanced and modified to create more opportunities, the ever rising costs are greatly impacting the services being provided. The question then arises who deserves universal healthcare? Systems throughout the nation all market-based; lead to a lack of unified care and discrimination of at risk immigrant populations; yet the issue stands, what is the debt owed to immigrant’s vs the duty owed to our citizens? Because of our cultural and social agendas there is a major gap between healthcare being seen as a personal choice rather than a human right. In the proceeding paragraphs, both the pros and cons of Universal immigrant care will be further explored providing insights into the commodity of healthcare.

Current Situation Necessitating the Change

Universal and unified healthcare is commonplace worldwide; however, in the United States, the topic has become a life-changing policy waiting for approval. Although our healthcare system is continuously being enhanced and modified to create more opportunities, the ever rising costs are substantially impacting the services being provided (Glen, 2013). The question then arises who deserves universal healthcare? Systems throughout the nation all market-based; lead to a lack of unified care and discrimination of at-risk immigrant populations; yet the issue stands, what is the debt owed to immigrants vs. the duty owed to our citizens? Because of our cultural and social agendas, there is a significant gap between healthcare being seen as a personal choice rather than a human right (McGuinness, 2014)

The United States spends 2.4 trillion dollars a year in healthcare. More than a third of these funds only for the funding of illegal immigrant care. Health care reform in the United States under the Affordable Care Act barred uninsured illegal immigrants from receiving subsidies or tax credit to participate in the Heath Insurance marketplace. The restrictions under the Affordable Care Act which consist of 11.2 million individuals who will be left without coverage even though its aim is to reduce health care cost and provide equal opportunity care. Despite the limitations, additional funding through expanding Medicaid program that relies on public and not for profit hospital funding create a safety net of providers and increasing federally qualified health centers and migrant health centers to provide the very much needed comprehensive care for illegal immigrants all funded by the Federal Health Resources and Service Administration (Hall, 2011).  The extension of the coverage for illegal immigrants will increase quality of care which can decrease cost on emergency expenditure and can extend to act as a preventative measure rather than allowing for the progression of illness that can increase health care cost in the future.

Health policy maker and stakeholder should advocate actively in drawing a line between access to healthcare and allocate these resources that should not rely on patch work system but design a program that is eligible to fit the major categories who are exempted from federal insurance mandate and adopt fee scales that will require patient to make contributions (Hall, 2011).

Agenda Setting

When considering the proposed agenda, it is imperative to focus on certain aspects of concern. These areas include many portions of our society which will gear the agenda to focus on the need for universal healthcare. Take into consideration the unauthorized workers which are a critical component of our micro and macro economies. As approximately 78 million boomers prepare to retire in the upcoming years, unauthorized workers will take their place leading to a demand on healthcare initiatives (Johnstone, 2015). Illegal immigrants will inevitably form part of the majority of the population in the near future therefore it is key for stakeholders to reduce the risk of healthcare standard decline. It is the goal of the agenda to provide access to care from a universal perspective in order to ensure that everyone in our society may lead healthy and productive lives. Stakeholders will benefit from the provision of universal immigrant healthcare because of the plethora of cases of infectious diseases. These cases go unidentified by practitioners due to the fear of immigrants in seeking care consequently creating possible epidemics in our already unstable societies (Okoronkwo, Onwujekwe, & Ani, 2014). In retrospect, seeing that there is a clear plan and goal, the stakeholders must focus on how to reduce the risk of a decline in the standards of care and the provision of efficient care to all.

Model to Bring About Change

Literally millions of individuals immigrate to the United States each year; some of the most recent data suggests that in the second quarter of 2015 the immigrant (foreign – born) population residing in this country exceeded 42 million (Zeigler & Camarota, 2015).  These numbers include both legal and illegal (undocumented) immigrants.  The data reported suggests that the majority of these immigrants are from Mexico and Latin America.  The Department of Homeland Security and other researchers suggest that eight of every ten of illegal immigrants are from Mexico or Latin America (Zeigler & Camarota, 2015).  Another source reports that illegal immigrants total in excess of 11 million in 2014 and that almost half of these illegals are Mexican (Krogstad & Passel, 2015).  These are some of the best and most current figures available; however, they are by nature estimates based on available data; given the fact that many illegals are fearful of the Immigration and Naturalization Service (INS) these figures maybe underreported.

Edward Jenner has long be credited with the birth of vaccination and modern immunization programs; history suggests that immunizations existed prior to Jenner’s success in 1796 (The College of Physicians of Philidelphia, 2016).  In this 200 year plus history of medicine and immunizations several diseases have been virtually eradicated within the US.  In the US over a dozen childhood diseases have all but been eliminated with the use of vaccinations; diphtheria, small pox, rubella, measles, polio, and H. influenza each numbered in the thousands of cases each year.  Since the introduction of immunizations these same diseases now total less than 500 cases annually (Culp-Ressler, 2013). The fact that the US has virtually eliminated several childhood diseases does not mean that these same diseases do not exist and even thrive in other parts of the world.

Design Strategy

Given the fact that millions immigrate to the US each year and many come from countries with less developed healthcare delivery systems; this poses a direct threat to the health and well-being of the general population of this country.  Swine flu, dengue fever, tuberculosis, and even possible Ebola are diseases that may be brought to the US by illegal immigrants (Illegal Alien Minors Spreading TB, Dengue, Swine Flu, 2014).  Many of these illegal immigrants are minors and are being cared for at least temporarily by US Border Patrol Agents; putting them and their families at risk; many have reportedly contracted diseases from these illegals (Illegal Alien Minors Spreading TB, Dengue, Swine Flu, 2014).  Many diseases that are routinely found in other geographic locations are not the same as are found in the US; this fact and the huge numbers of minors attempting to enter the US illegal has led to the increased need for health and well – being checks of those attempting entry.  Since screenings are initiated after attempted entry is made the potential for spreading undetected diseases is increased; many of these individuals are held in health camps that are attempting to screen and prevent the spread.  These camps have seen increases in several communicable disease in these unvaccinated minors; this poses a significant risk to the health and well – being of the general public of the US (Siegel, 2014).  The health risks associated with illegal immigrants are real and the potential for the spread of disease to the general public is a true health risk.

Implementation Strategies

To ensure continuation of care for the masses vs. the individual the agenda proposes to provide a safe haven of care while being fiscally conscientious of government funds- this in turn will provide an unalienable human right to safe and effective cost efficient healthcare to all humans despite race, location, nationality, and legal status. Legal immigrants start businesses which also create jobs for American workers. Immigrants who are legalized develop new technologies and fill gaps in the work field which will aide in the creating of a universal system (Barr, 2013). Furthermore, immigrant children are our future majorities becoming the future leaders in engineering, science, and medicine which in our best interest warrants universal care to protect our future leaders. At the end of the day then, immigration support will reduce the costs of healthcare by allowing immigrants to have jobs and gain access to insurance. Immigrants who are legalized will be able to supplement our economy and healthcare system through their financial input and healthcare systems will be better suited from the boost in funding from illegal immigrants vs. lack of funding from illegals who are not able to pay for services (Johnstone, 2015). All in all, the benefits of the implementation of universal healthcare do outweigh the overall risks.

Evaluation Strategies

Lastly, when evaluating the agenda, it is imperative to recall that any change takes time and commitment from both our society as well as our stakeholders and governing bodies. After the 30-day mark, the overall implementation of groups and action plans should ensue. Governing bodies will be expected to keep logs which document overall costs and trends as well as noted changes in major cities or counties. Furthermore, weekly or biweekly meetings should take place with at risk populations who would greatly benefit from universal healthcare to ensure that contact groups are implemented and that social centers are implemented to create access points for illegal immigrants who desperately need assistance. In order to achieve progression from a universal standpoint while also providing encouragement and focus for the stakeholders, clients should also adhere to the proposed actions plans so as to limit issues and errors which would cause delays. Lastly, these programs should focus on rechecks every 3 months in order to maintain stability and ensure client adherence which will continuously promote a greater progression towards a universal healthcare system.

Conclusion

Conclusively, the implementation of universal healthcare for all immigrants as well as citizens is indeed a great priority for our nation. A great deal of care must be taken into the assessment of this potential policy as it will assist and create a greater sense of pride and inclusion amongst all in our healthcare system as well as all of the at risk populations. As an advanced practice nurse, the goal is to find ways for clients to adhere to health plans by focusing on the resources available to the client vs. only focusing on the costs to our government. Through holistic care and the incorporation of universal health care initiatives the healthcare system can potentially decrease the modifiable risks of developing further health disparities in our nation. We must always strive to provide support, understanding, and mentoring so as to ensure that all active and non-active members of our society are at peak health.

References

Barr, P. (2013). Health on hold. But Obama legislation would let them live in U.S. legally. Modern Healthcare, 43(5), 6.

Gilcrist, A. R. (2013). Undocumented Immigrants: Lack of Equal Protection and Its Impact on Public Health. Journal Of Legal Medicine, 34(4), 403-412 10p. doi:10.1080/01947648.2013.859958

Glen, P. (2013). Health Care and the Illegal Immigrant. Health Matrix: Journal Of Law-Medicine, 23197.

Johnstone, M. (2015). Rationing universal healthcare. Australian Nursing & Midwifery Journal, 23(1), 25-25 1p.

McGuinness, K. M. (2014). Institutional decision making: Empowering of health system and economic transformation. American Psychologist, 69(8), 817-827. doi:10.1037/a0037620

Hall, M.A. (2011). Rethinking Safety-Net Access for the Uninsured. The New England Journal of Medicine 364;1: 7–9.

Khan, T. (2014). Treating the Undocumented and Uninsured Immigrant. Podiatry Management, 33(7), 159-160 2p.

Okoronkwo, I. L., Onwujekwe, O. E., & Ani, F. O. (2014). The long walk to universal health coverage: patterns of inequities in the use of primary healthcare services in Enugu, Southeast Nigeria. BMC Health Services Research, 14132. doi:10.1186/1472-6963-14-132

Appendix

Universal Healthcare Elevator Speech

The United States spends 2.4 trillion a year in healthcare. More than a third of these funds are put forth toward funding for illegal immigrant healthcare. It is imperative to form a health care reform in the United States under the Affordable Care Act which allows for uninsured illegal immigrants to receive and participate in the Heath Insurance marketplace.

Universal healthcare is commonplace worldwide; however, in the United States the topic has become a life-changing policy awaiting for approval. Although our healthcare system is continuously being enhanced and modified to create more opportunities, the ever rising costs are greatly impacting the services being provided. The question then arises who deserves universal healthcare? Systems throughout the nation all market-based; lead to a lack of unified care and discrimination of at risk immigrant populations; yet the issue stands, what is the debt owed to immigrant’s vs the duty owed to our citizens? Because of our cultural and social agendas there is a major gap between healthcare being seen as a personal choice rather than a human right. Equipoise is necessary to create a lasting policy which supports universal healthcare for all.

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