Environmental Health

Environmental Health

Health Insurance

            The health of individuals and groups is influenced by many factors including health insurance, healthcare cost, healthcare statutes and the programs and activities by healthcare organizations such as CMS and PICORI. Americans can access health insurance coverage through the federal government or private third parties. The signing of the Affordable Care Act (ACA) in 2010 introduced health insurance requirements that made it mandatory for most Americans to have insurance cover. According to KFF (2017), any person who does not meet the exemption criteria for health insurance is subject to pay a penalty. The penalty for an adult is about $695 while that for a child is about $347.5. Some of the exempted persons include undocumented immigrants, members of an Indian tribe, incarcerated persons, persons eligible for the hardship exemption and persons with income below the minimum requirement for filing tax returns. I feel that increased government involvement in the healthcare for individuals and families through statutes such as the ACA is crucial to supporting the local, state and national health promotion and disease prevention efforts.

            Currently, the elderly and low-income persons in the U.S can access essential preventive and restorative healthcare services at subsidized costs. Medicaid and Medicare are funded through taxes and beneficiary premiums. This approach allows the distribution of the healthcare burden and reduction of healthcare disparities across different socioeconomic status. Expanding the eligibility criteria for federally funded health insurance programs such as Medicaid is crucial to enhancing the affordability of healthcare because the government, unlike private insurance providers, is not focused on profit maximization. Allowing individuals the freedom to choose whether to be insured or not leads to declined public health status and increased strain on emergency healthcare services because the uninsured persons cannot afford the cost of seeing a medical doctor. The population’s risk for both communicable and non-communicable diseases will increase due to the high cost of healthcare services, which are normally subsidized through the federal insurance programs. 

PCORI AND CMMI 

            PICORI’s mission is to help people make informed healthcare decisions and support the improvement of healthcare delivery and outcomes by enabling evidence-based healthcare through information derived from patients, caregivers and the healthcare community (PCORI, n.d.). The organization’s health promotion priorities include the evaluation and comparison of health prevention, diagnosis and treatment options to determine the option that will work the best for individuals and groups with particular healthcare needs. The other priority by PICORI is to fund research, conduct research and disseminate research information to support effective healthcare decisions by providers and patients. Some of the important research-related initiatives by PICORI include building data infrastructure, advancing research analysis methods and training patients, providers, researchers and other stakeholders to participate in health research. The organization’s work has a significant impact on healthcare policies, laws and regulations.

            CMMI’s mission is to support health transformation by identifying, developing and testing new ways for paying for and delivering care at reduced costs while ensuring enhanced quality of care for individuals and families based on the six aims of quality healthcare (CMS, 2016). The organization spreads awareness about the new care delivery and payment models to ensure the widespread adoption of the models at all levels of healthcare. CMMI’s initiatives are helping healthcare providers to attain enhanced patient outcomes through the effective identification and response to the underlying causes of poor health. The availability of models that enable quality care at lower costs is crucial to the success of public health initiatives.   

Medical Malpractice and Healthcare Rights

            I would eliminate Joint and Several Liability for defendants who are responsible for less than 30 percent of the harm suffered by the plaintiff. The practice of nursing faces a multitude of inherent risks that predispose individuals to negligence and malpractice claims (Sohn, 2013). Therefore, it is important that the extent of liability be accessed in consideration of the degree of each individual’s contribution to the resulting injury. It would be unfair to impose 100 percent liability for each defendant regardless of his or her role in the plaintiff’s harm. I feel that patients should claims damages from a medical procedure or treatment if they suffer reasonably significant physical, psychosocial or emotional harm. This criterion will discourage claims based on minor errors that could be addressed through alternative dispute resolution approaches. I believe that there should be a cap on the payments for non-economic damages. The cap should be set at 150 percent of the economic damages. Medical malpractice claims are also affected by costs such as attorney fees, administrative costs, and claimant and defense costs.

            Prisoners have a right to preventive and curative healthcare services just like the rest of the population. However, creating a healthy prison is nearly impossible considering the prison environment, which is characterized by high levels of deprivation, volatility and violence. Overcrowding, poor hygiene and inefficient ventilation constitute the major factors that predispose prisoners to the risks of various communicable diseases (Ross, 2013). Therefore, prisoners should be screened regularly and vaccinated for diseases such as TB and Hepatitis. Furthermore, the regular disinfection of prison facilities is crucial to prevent diarrheal diseases. Psychosocial support services such as counseling are crucial for the prisoners with psychological, emotional or spiritual distress.