explain how politics and economics may influence health and the health care system from your own perspective

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Classmate Post #1

Joanna H.

Main Question Post:

According to Stanhope and Lancaster (2016), politics plays a large role in policies made regarding healthcare. The role politics plays defines what organization or citizen is able to receive aide and subsequently what type of aide they are qualified to receive. Ms. Holtz, PhD, RN (Laureate Education, 2010d), agrees that politics plays a very large role in healthcare and states that it controls access to care, supplies and providers. Ms. Fitzpatrick, EdD, RN, FAAN (Laureate Education, 2010d), adds that the view of healthcare by the government, right vs privilege, is directly correlated to the policies made within that country in regards to healthcare.

In the case study described by Levine (2007), called Progresa, the government wanted to provide aide to the very poor living in rural areas, with little to no access to clean water, healthcare or nutritional food. To do this, they offered cash incentives to qualified mothers. This required a partnership between the mother and the government. The mother had to ensure her children went to school, were fed nutritious meals and taken in for their well child checks. In return, they received their monthly cash incentive. The program was found to improve outcomes for both the children and adult participants. The benefits noted were a decrease number of childhood illnesses, improvement in mobility and performance of daily activities for adults, higher incidence of school enrollment and increase in the growth rate of young children. Areas within this program of concern would be deciding who is poor enough to receive this benefit. When looking at those living in poor rural areas with no access to clean water, healthcare or nutritious food, how can only certain families be helped, leaving others to live under such horrible conditions? Is it ethical as a society to help those deemed very poor vs helping all citizens in need? Another concern would be loss of funding for this program and others like it. One way to continue providing for those in need if government funding is redacted, is via the community. There are many citizens who would like to help but don’t know where to begin. As nurses, we can help guide these citizens and work with our community leaders to help those in need by collecting food, clothing and household goods to distribute.

I do believe that there should be a partnership between those receiving aide and those distributing aide. If the government is providing funds to those in need, I believe they do have a right to require that the funds be used appropriately. There does need to be some accountability to those receiving aide, ensuring they are caring for their children, have access to proper healthcare for preventative visits as well as sick and access to healthy foods. Every community has citizens who are economically disadvantaged. I live in an affluent area of Dallas/Fort Worth yet can drive within my community or into Dallas, TX and see those who are homeless and in need of aide. Our community does offer help to those in need in various ways. We have a local resale store where all items, food and household, are donated, and sold at a low cost to families in need. Communities joining together can offer support to those in need. As healthcare providers, we too could and should offer free or low cost services to those in need.

References

Laureate Education. (Producer). (2010d). Public and global health: Political, ethical, and economical influences on health [Video file]. Baltimore, MD: Author.

Levine, R. (2007). Case studies in global health: Millions saved. Sudbury, MA: Jones & Bartlett

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.

Classmate Post #2

Crystal J.

Politics and economics have influenced health and the health care system for years as social inequalities continue to significantly increase (Gibson, 2017). Debates that have taken place in the United States (U.S.) political arenas have resulted in a massive political divide (Komlos, 2017). To date, the business of healthcare insurance has been hindered by the problem of adverse selection (Komlos, 2017). For example, individuals with the most healthcare needs have an increased probability of insuring themselves, as opposed to individuals who are healthy, which then increases the cost for everyone (Komlos, 2017). The Affordable Care Act attempted to bring this issue under discussion, with mixed results (Komlos, 2017). Health and health problems are the outcomes of a complex interplay of various factors (Senterfitt, Long, Shih, & Teutsch, 2013). Senterfitt et al. noted that social determinants play a significant part in the health of each individual in the community as well as collectively. Inequities in the composition of societal resources differ and can mean the difference between life or death, or one filled with good health or poor health (Senterfitt et al., 2013). Components of social and economic determinants of health include education, employment status, income, family and social support, as well as community safety (Senterfitt et al., 2013). Of significance is that researchers found that 40% of a populations health is formed by social and economic factors which also strongly influences health behaviors, the second largest contributor to health and longevity (Senterfitt et al., 2013). As an active participant in an employer-sponsored health insurance policy, the decisions for specific treatments or tests are still influenced politically and economically within such a lucrative business.

The United States relies mainly on private insurances in which fees for services, also known as the health insurance market, dictates that providers are paid for services they provide, as well as any additional services that they deem are necessary (Hariharan & Haney, 2017). This political and economic process has played a significant role in me and my family member’s access to health care when we experienced firsthand two visits to the emergency department for chest pain. Visits were then followed by an appointment with a primary physician then he ordered what he felt was another necessary and “correct” test, ultimately leading to a diagnosis of pericarditis followed by three-days of hospital admission/stay. Variables which contributed to a cost of thousands of dollars included the emergency room visits and tests, as well as primary care visits and tests, and subsequent hospital stay. Based on presenting symptoms of shortness of breath and chest pain, why would the physicians not order the test that diagnosed pericarditis, a very common CT scan? The role of the government could influence policy changes to maximize healthcare and minimize costs such as the fees for service and decrease the misuse of additional services provided and push for treating the patient and promote better patient outcomes.

The Affordable Care Act serves as an example of how federal legislation/intervention can speak to the inadequacies of health care efforts by further encouraging disease prevention and health promotion as cornerstones of overall health care reform, thus enhancing health outcomes and minimizing healthcare costs (Straube, 2013). For example, on June 16, 2011, the National Prevention Health Promotion and Public Health Council issued a 125-page report called the National Prevention Strategy (Straube, 2013). Prime strategies included four distinct areas; for example, building healthy and safe community environments, growing quality preventative services in clinical and community settings, empowering people to make healthy choices, and doing away with health disparities (Straube, 2013). Targeted priorities encompassed tobacco-free living, prevention of drug/alcohol abuse, healthy eating, active living, injury/violence-free living, reproductive/sexual health, and mental/emotional well-being (Straube, 2013). Optimal results would include a collaborative effort with community organizations, healthcare systems, businesses, and educational organizations among others, which all work in concert to promote the use of best practices that enable healthy living (Straube, 2013). Preventative measures promoted by the federal government can play a major role in achieving better quality, value, and success in healthcare (Straube, 2013).

References

Gibson, K. (2017). How politics is affecting healthcare in America. Retrieved from http://www.mikelweisser.org/politics-affecting-hea…

Hariharan, G. & Haney, T.M. (2017). Global perspectives on economics and healthcare. In C. Holtz (Ed.), Global health care: Issues and policies (pp.111-142). Burlington, MA: Jones & Barlett.

Senterfitt J.W., A. Long, M. Shih, & S. M. Teutsch. (2013). Social determinants of health: How social and economic factors affect health. Retrieved from http://publichealth.lacounty.gov/epi/docs/SocialD_…

Straube, B. M. (2013). A role for government. American Journal of Preventive Medicine, 44(1), S39-S42. doi.org/10.1016/j.amepre.2012.09.009