Discussion: Health Care Reform NURS 8100

March 6, 2022

Discussion: Health Care Reform NURS 8100

Discussion: Health Care Reform NURS 8100

Discussion: Health Care Reform NURS 8100


Feature of the Health Care System

One feature of the US health care system is that it is the most expensive healthcare in the world with results that would not agree with the cost. It is interesting to see that the US healthcare system has tried to evolve over the years and in that evolving has actually increased the cost of healthcare (Bodenheimer & Grumbach, 2020). Competition has fueled the improvement of healthcare, but at the cost of raising healthcare costs for the individual. There are other countries that have better health care systems in place, for a fraction of the cost. It would be interesting to investigate the actual cost of care and how much insurance companies gain compared to their actual payout. There is much that could be improved in the US health care system. It could be possible that the monetary issues prevent there from being major reform to the system because companies make such a large sum of money that they do not want things to change. As the US health care system has tried to change and become seemingly more affordable through the use of policy changes there has been an increase in the amount of money that they government pays, which is actually paid by US citizens through taxes (Bodenheimer & Grumbach, 2020). It seems that whenever the US health care system is taking one step forward it is also taking two steps back.


The Affordable Care Act (ACA) did provide more individuals with health care coverage. This has improved the health of many individuals. One condition of the ACA is that it protects individuals with preexisting conditions from insurance companies denying care based on their condition (Healthcare.gov, n.d.). This is a great benefit for many individuals, but it comes at a cost for the insurance companies. This mandatory coverage causes insurance companies to then have to try to balance out coverage for those individuals that are ill versus those individuals who are healthy which can end up costing those individuals that are healthy to pay for others in their groups (Bodenheimer & Grumbach, 2020). This causes insurances to have to base their premiums on an experience rating versus a community rating which potentially provides unfair coverage to individuals (Bodenhemier & Grumbach, 2020). This seemingly minor change from the ACA has a ripple effect in the way that insurance companies need to charge for care and how they will determine premiums for individuals. The ACA in general is an example of how the policy making process is in the United States. Making or changing policy in the United States is a very slow, very incremental process which makes it hard to change or add policies (Walden University, LLC, 2011). The ACA was a worked on for a long time and because of the changes that were made many companies had to adjust accordingly. Health reform in the United States is difficult because there are so many entities that want to make sure that they are not being left out or hurt in decisions or policies that are being made and so they will stall or stonewall different policies if they feel that it does not benefit them. When there are policy changes then there are adjustments that need to be made and sometimes that effects so many different things that the changes end up being a negative instead of a positive, such as individuals who have to pay too much for the ACA healthcare and therefore opt out and are fined for that decision (Bodenheim & Grumbach, 2020).


Bodenheimer, T., & Grumbach, K. (2020).  Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.

HealthCare.gov. (n.d.) Understanding the Affordable Care Act. Retrieved from https://www.hhs.gov/healthcare/about-the-aca/index.html

Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: The policy process. Baltimore: Author.

Discussion: Health Care Reform

After much public and political debate, in March 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. The PPACA is one of many health care reform efforts that have sought to correct key features of the U.S. health care system such as financing, service delivery, and care coordination. This week, you will examine the passage of PPACA as a milestone along the historical continuum of health care reform in the United States.

To prepare:

  • Review this week’s Learning Resources and media presentation, reflecting on the evolution of health care in the United States and the public’s response to health care reform efforts historically and currently.
  • Consider: What principal features of the U.S. health care system helped or hindered the enactment of federal health reform in March 2010? What challenges were encountered?
  • How do these conditions and/or challenges reflect characteristics of the policy process and the political environment?

By Day 3

Post a cohesive response that addresses the following:

  • Analyze at least one important feature of the U.S. health care system that is of particular interest to you. Explain why you think this feature is significant in terms of health policy and reform.
  • Describe one or more conditions or challenges specifically related to the passing of the PPACA. Explain how this exemplifies the nature of the policy-making process, and evaluate how it could relate to the question of why health reform in the United States has been so difficult.

Read a selection of your colleagues’ postings.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.


Learning Resources

Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical
approach (7th ed.). New York, NY: McGraw-Hill Medical.
 Chapter 1, “Introduction: The Paradox of Excess and Deprivation”
This chapter introduces the concept of “excess and deprivation”—p eople receiving either too
little or too much health care, which contributes to the weakness of the health care system.
 Chapter 2, “Paying for Health Care”
This chapter discusses the evolution of health care financing, including out-of–pocket payments,
individual private insurance, employment-based insurance, and government-financed insurance.

 Chapter 3, “Access to Health Care”
This chapter focuses on financial and nonfinancial barriers to health care and concludes with
influences to one’s health status unrelated to health care.
 Chapter 4,“Paying Health Care Providers”
This chapter provides information on how physicians and hospitals are paid.
HealthCare.gov. (n.d.). Understanding the Affordable Care Act. Retrieved
from http://www.hhs.gov/healthcare/rights/index.html

Posted by U.S. Department of Health & Human Services, this article provides an
introduction to the Patient Protection and Affordable Care Act of 2010 (PPACA).
HealthCare.gov. (n.d.). Understanding the Affordable Care Act: About the
law. Retrieved from http://www.hhs.gov/healthcare/rights/law/index.html

Also posted by U.S. Department of Health & Human Services, this article focuses on
specific provisions of the law and outlines how it will increase access to affordable
health coverage.
In Week 1 of this course, you are required to subscribe to one of the health information
services listed below. In preparation, review these different sites:
Agency for Healthcare Research and Quality. (2010). AHRQ PSNet Patient Safety
Network. Retrieved from http://psnet.ahrq.gov/
ModernHealthcare.com. (n.d.). Registration is free: The news is invaluable. Retrieved
from https://home.modernhealthcare.com/clickshare/addAccountFree.do
Robert Wood Johnson Foundation. (2011). Publications and research. Retrieved from
The Commonwealth Fund. (2010). The Commonwealth Fund. Retrieved from
The Henry J. Kaiser Family Foundation. (2011). New & noteworthy. Retrieved from

Home Page

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy:
The policy process. Baltimore: Author.

Note: The approximate length of this media piece is 11 minutes.

In this media presentation, Dr. Kominski and Dr. Zelman discuss the policy process and
provide an overview of the influence of policy on health care practices. Dr. Zelman also
discusses the challenges of passing new policy and relates this to health care reform

Accessible player
Optional Resources
Hammer, D., Phillips, B., & Schmidt, T. L. (2010). The intended and unintended
consequences of health care reform. Healthcare Financial Management, 64(10), 50–55.
Rettenmaier, A. J., & Saving, T. R. (2011, January 5). Reforming Medicare: The
Affordable Care Act versus the Rivlin/Ryan proposal. National Center for Policy
Analysis. Retrieved from http://www.ncpathinktank.org/pub/ba736
Stephens, J. H., & Ledlow, G. R. (2010). Real health care reform: focus on primary care
access. Hospital Topics, 88(4), 98–106.

Posted in nursing by Clarissa