Improve the Publics Health in USA Discussion

Nurses have worked to improve the public’s health in the U.S. for over 130 years (Stanhope & Lancaster, 2020). From the establishment of professional nursing to advocacy to policy development, nurses have made contributions to improve healthcare. Nurses have the responsibility to advocate for equal rights in healthcare to reduce morbidity and mortality. However, the government ultimately has the power the approve changes to the healthcare system. In 1988 the Institute of Medicine (IOM) reported a reduction in political support and financing therefore limiting public health services (Stanhope & Lancaster, 2020). The U.S. has struggled with providing affordable and accessible healthcare for decades and lacks in social justice.

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When I think of the words “social justice,” the words that come to mind are rights, equality, and safety. Distributive or social justice is an ethical principle requiring a fair distribution of benefits and burdens based on society’s needs (Stanhope & Lancaster, 2020). In healthcare, this would be equal to socialized medical care in which everyone has access to healthcare regardless of race, ethnicity, and socioeconomic status. Socioeconomic status plays a significant role in the accessibility to healthcare and the outcomes of public health (Laureate Education, 2009c). Especially among the homeless population. There are over three million homeless in the U.S., and most do not receive healthcare (Laureate Education, 2009c). Nurses have advocated for improved healthcare through organizations and policy-making, but the U.S. continues to have a flawed healthcare system.

The U.S. has the most expensive healthcare system globally but ranks last in providing affordable, accessible, and equitable healthcare (The Commonwealth Fund, 2014). We need to look at other countries such as the United Kingdom, Canada, and Sweden, as their healthcare systems offer equal access to their citizens. The United Kingdom’s government funds healthcare, offering equal access to healthcare and currently has the best healthcare system in the world(Holtz, 2017). When President Obama implemented the Patient Protection of an Affordable Care Act, I feel this was a step in the right direction. This healthcare reform aimed to provide universal coverage to reduce health insurance disparities (Courtemanche, Marton, Ukert, Yelowitz, Zapata, & Fazlul, 2019). However, there were flaws in this Act and left many being fined for not obtaining coverage. If I could wave a magic wand, I would implement universal healthcare such as that of the United Kingdom and Sweden. With equitability, I would expect to see a reduction of chronic diseases, improved mental health, reduced morbidity and mortality, and overall improved public health.

References:

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., Zapata, D., & Fazlul, I. (2019). The

three-year impact of the Affordable Care Act on disparities in insurance coverage. Health

Services Research, 54 Suppl 1, 307-316. doi:10.111/1475-6773.13077

Holtz, C. (2017). Global health care: Issues and policies (3rd ed.). Burlington, MA: Jones &

Bartlett.

Laureate Education (Producer). (2009c). Family, community and population-based care:

Vulnerable populations [Video file]. Baltimore, MD: Author

Stanhope, M., & Lancaster, J. (2020). Public health nursing: Population-centered health care in

the community (10th ed.). St. Louis, MO: Elsevier

The Commonwealth Fund. (2014). Mirror, mirror on the wall, 2014 update: How the U. S.

health care system compares internationally. Retrieved from

http://wwwlcommonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

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Social justice means that everyone in society deserves the right to fair and equal treatment. Regardless of age, race, sex, gender, region, creed, disability, political affiliation, nationality, who their parents were, or what part of town they live in, social justice is fairness across the board. Social justice is “the moral imperative to avoid and remediate unfair distributions of societal disadvantage” (Dukhanin et al., 2018, p. 27). Social justice is not the same as socialized medicine or communism. Socialized medicine offers medical services to anyone, regardless of their ability to pay, and is run by the government. The government has the final say in all decisions regarding medical services and how they are rendered, not the people. Communism is the opposite of democracy and capitalism. Communism advocates for “a system in which goods are owned in common and are available to all as needed”, you are not allowed to own property or your own business and “make something of yourself”, you are forced to stay on the same level as everyone around you (Merriam-Webster, n.d., para. 1). I agree with the idea of social justice; everyone deserves fair treatment.

The Constitution does state that everyone has the right to the pursuit of happiness, but I do not see what that has to do with whether the health care system is fair or not. I do not think the current health care system is fair. The insurance companies have been allowed to run medical costs up so much that many people cannot get the health care they need. The only people benefiting from this current system are the insurance companies.

If I could wave a wand and try to fix the health care system, I would remove the concept of insurance and implement a cash payment system. When the population pays cash for medical services, the cost of the services would be much more affordable. Consequently, there is an incentive for hospitals and medical clinics to provide the best care to patients to gain their business. As it stands, hospitals are forced to charge ridiculous amounts for services to pay the insurance companies, which in turn pass on the increased monetary burden to businesses that employ the same people that are using the hospitals/clinic services. Decreased wages, lay-offs, and increased insurance premiums are the result for the businesses to be able to stay in operation. For example, a CBC lab costs about $3 cash price; insurance companies charge $50 for the same test. Where do you think that money is coming from? That money does not come from the insurance companies; it comes from the taxpayers. If cash pricing were implemented, people everywhere would have the fairness of reasonable pricing for medical services and no price gouging by the insurance companies. It would be just like having to pay for groceries or getting your car fixed.

References

Dukhanin, V., Searle, A., Zwerling, A., Dowdy, D. W., Taylor, H. A., & Merritt, M. W. (2018). Integrating social justice concerns into economic evaluation for healthcare and public health: A systematic review. Social Science & Medicine, 198, 27–35. https://doi.org/10.1016/j.socscimed.2017.12.012

Merriam-Webster. (n.d.). [communism]. Retrieved October 5, 2020, from https://www.merriam-webster.com/dictionary/communism