Global Health Comparison Matrix Essay
Global Health Comparison Matrix Essay
Paper details
- Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
- Explain the strengths and weaknesses of each policy.
- Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
- Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
- Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples. Global Health Comparison Matrix Essay.
- Explain how the health policy you selected might impact the role of the nurse in each country.
- Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.
National Health Insurance as a Measure of Social Justice in Health in the Global Health Agenda: Global Health Comparison Matrix (United States and the United Kingdom) and a Plan for Social Change
Healthcare financing in the United States is one of the most unaffordable in the world. Despite being a leading and wealthy developed country, the US does not have universal healthcare coverage like in other developed countries (The World Bank, 2018; WHO, 2019). This state has somewhat been mitigated by the Patient Protection and Affordable Care Act (ACA) of 2010 or “Obamacare” (Kominski et al., 2017). However, many Americans still cannot access affordable healthcare because of their low socioeconomic status.Global Health Comparison Matrix Essay. This paper compares the state of health insurance in the US and the UK as a social justice agenda in health, and also proposes a pan for social change spearheaded by the nurse as a change advocate.
- Global Healthcare Comparison Matrix
| The Global Healthcare Issue of Interest |
National Health Insurance |
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| Description of the Issue | Social Justice Agenda in Health
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| Country | United States of America (USA)
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The United Kingdom (UK) |
| A description of the healthcare policy in each of the two countries | The US is one of the few developed countries that do not have social justice in terms of healthcare financing and costing. This is despite the country having the Centers for Medicare and Medicaid Services (CMS) that is supposed to mitigate healthcare costs for the low income earners and the elderly (Holder et al., 2017).
Access to healthcare and socio-economic status are two of the most important social determinants of health or SDOH. The Affordable Care Act of 2010 or “Obamacare” was an attempt to redress the healthcare access inequality in the US by bringing into the coverage bracket the elderly and the poor with pre-existing conditions (Donkin et al., 2017; Holder et al., 2017). Despite this, however, more than twenty-six million Americans still do not have access to healthcare because of the prohibitive costs and insurance premiums. According to Holder et al. (2017), this means that access to healthcare as a SDOH is not yet fully addressed in the US and thus universal access to healthcare is still but a mirage. Global Health Comparison Matrix Essay. |
The National Health Service in the UK is the body that ensures all UK citizens are covered in terms of healthcare. Eight out of ten sterling pounds going into this healthcare insurance scheme comes from the taxes paid by the citizens. This means that the premiums are affordable as only the remaining 20% of the insurance cost is funded through premiums and employer contributions (Full Fact, 2019). This is in stark contrast to the situation in the US. The UK in comparison to the US can be rated highly in terms of universal health coverage (Holder et al., 2017). Social justice and equity in health as a global health agenda has therefore received much more attention in the UK than in the US.
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| The strengths of the healthcare policy | The healthcare policy of reference in the US is the ACA 2010. Its strength lies in the fact that it obliges payers to cover even the elderly and persons with pre-existing conditions at the same rates of premium.
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The equivalent of the ACA 2010 in the UK is the NHS. Its strength lies in the fact that it gives equal coverage to all UK citizens and does not penalize non-participation like the ACA. The 80% funding from taxes does not only fund the employed but also those without jobs. |
| The weaknesses of the chosen healthcare policy | The Affordable Care Act 2010 has a major weakness in that there are provisions that could be challenged in court by the different state governments. These state authorities therefore had the choice to implement them or not. This took away uniformity. | Being a model dependent on taxation of the employed by up to 80%, the NHS has as a weakness the fact that its funding goes down when unemployment rates go up. This is the situation at this moment that the novel coronavirus pandemic has resulted in major job losses in the UK. |
| How the social determinants of health or SDOH impact the global health issue.
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Two SDOH relevant to this global health issue of healthcare insurance coverage are socioeconomic status and access to healthcare. According to the United Nations World Health Organization (WHO), the third global health agenda is social justice in health. The two SDOH mentioned impact healthcare coverage in that low income Americans are unable to access quality healthcare services due to the cost (Donkin et al., 2017; Kickbusch, n.d.).
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In the case of the UK, the SDOH affecting healthcare coverage is still socioeconomic status. However, the effect in this case is positive in that since taxation from the employed is what funds healthcare coverage for all regardless of income level, poverty is not a factor in accessing healthcare in the UK.
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| How the US and UK governments have addressed the cost, quality, and access to healthcare insurance | As stated above, in the US access to healthcare is not yet universal despite the enactment of the ACA 2010. The cost is also still too high for most Americans since most insurance is in the hands of providers who decide the costs. However, quality is well addressed by the ACA since it requires services to move from volume-based to value-based care (Safran & Higgins, 2019). | The NHS only accredits well-regulated providers whose service quality is beyond reproach. As mentioned above, access to healthcare in the NHS is impressive. It follows then that cost is also not an issue as the scheme is 80% funded through taxation.
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| The way healthcare insurance policy has impacted the health of the global population | Disparate healthcare insurance policies around the world (lack of uniform universal access to healthcare) has impacted global health of the world population in that pandemics like the current covid-19 one can spread very fast due to inability to access healthcare in some poor parts of the world. | The same lack of uniformity in access to healthcare puts countries with good policies such as the UK at risk of pandemics such as the covid-19 because of global travel and commerce.
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| The potential impact of healthcare insurance policy on the role of nurse | The nurse is the primary patient advocate. Her role is affected by healthcare insurance policy in that nurses must lobby policy makers to amend policies that are detrimental to sections of the population. For instance, they must advocate for states to leave the provision for covering pre-existing conditions in the ACA. | Even though the NHS is much closer to universal healthcare coverage, the nurse in the NHS service must be prepared to have in mind alternative resource organizations that they can refer the occasional uncovered patient to (such as immigrants) in the UK.
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| The way global health issues impact local healthcare organizations and policies in the US and the UK | Global health issues impact local healthcare organizations in that they must have their local policies in sync with the rest of the world in pandemics such as the current one of covid-19. These efforts of uniformity are driven by the WHO. | Local UK healthcare organizations must operate within the context of global guidelines especially at times of global pandemics such as covid-19.
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| General Comments | Healthcare coverage in the US still has a long way to go to reach universal healthcare coverage status. | Even through the NHS is closer to the definition of universal healthcare coverage; a lot still needs to be done to reach this goal. |
- A Plan for Social Change
The nurse is the foremost healthcare worker tasked with the responsibility of advocacy for the patient. As such, the nurse is instrumental for there to be social change in terms of the social determinants of health of socio-economic status and access to healthcare.Global Health Comparison Matrix Essay. It is the nurse as the primary patient advocate who can advocate for social justice in healthcare access on behalf of the patient who cannot afford healthcare costs. But the nurse must first have a clear plan for social change. This plan would include three components or adopt a three-pronged approach as follows:
- Advocacy for change at the organizational level. This is where the nurse will lobby the organizational policy makers at her place of work to adopt patient-friendly policies with regard to those who may not be able to pay for some services. For instance, for those who may find admission or residence costs in the hospital unaffordable, the facility can offer them care through telemedicine as they remain at their homes.
- Collective advocacy at the professional level. This is where the nurse will partner with colleagues in their professional nursing organization such as the American Association of Nurse Practitioners (AANP) to offer a unified advocacy voice for policy change in favor of universal access to healthcare. This way, the association can petition the US Congress (Senate and House of Representatives).
- Lastly, the nurse who is a nurse leader can use her position to lobby individual legislators in her state by providing them with facts about the social justice agenda of healthcare insurance coverage in the state.
Conclusion
Social justice is among the highest priority agendas of the WHO. One of the issues of concern in these agendas is healthcare insurance coverage or access to healthcare. In comparing the US and the UK, it is clear that the US is still far from having a semblance of universal healthcare coverage (UHC). The UK on the other hand is closer to achieving this goal through its NHS. In all this, the nurse has an important role in ensuring social justice prevails in this global health issue of concern. Global Health Comparison Matrix Essay.
References
Donkin, A., Goldblatt, P., Allen, J., Nathanson, V. & Marmot, M. (2017). Global action on the social determinants of health. BMJ Global Health, 3(e000603). http://dx.doi.org/10.1136/bmjgh-2017-000603
Full Fact (2019). How is the NHS funded? https://fullfact.org/health/how-nhs-funded/
Holder, J., Torprey, P. & Cage, F. (July 25, 2017). How does the US healthcare system compare with other countries? Global Health Comparison Matrix Essay.https://www.theguardian.com/us-news/ng-interactive/2017/jul/25/us-healthcare-system-vs-other-countries
Kickbusch, I. (n.d.). Advancing the global health agenda. UN Chronicle. https://www.un.org/en/chronicle/article/advancing-global-health-agenda
Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. http://dx.doi.org/10.1146/annurev-publhealth-031816-044555
Safran, D.G. & Higgins, A. (2019). Getting to the next generation of performance measures for value-based payment. Health Affairs. https://doi.org/10.1377/hblog20190128.477681
The World Bank (2018). Universal Health Coverage. https://www.worldbank.org/en/topic/universalhealthcoverage
World Health Organisation [WHO] (2019). Universal Health Coverage. https://www.who.int/healthsystems/universal_health_coverage/en/. Global Health Comparison Matrix Essay.
