Healthcare Reform and 4 Positions of the ANA(Health Care
Order instructions:
Required to navigate the ANA website, and write a paper on Healthcare Reform and 4 Positions of the ANA(Health Care Reform must be included). This paper will discuss the position of ANA. Paper should include past experiences from you or a colleague. Must follow APA and should b 5-7 pages. Cover page & reference not in 5-7 pages.
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 1 of 15
19
3
2
1
1
1
23
14
5
1
DOCUMENT
823168526_Healthcare_Reforms_Revised
SCORE
84
ISSUES FOUND IN THIS TEXT
70
PLAGIARISM
Checking disabled
Contextual Spelling 19
Confused Words
Grammar 7
Faulty Subject-Verb Agreement
Wrong or Missing Prepositions
Determiner Use (a/an/the/this, etc.)
Incorrect Verb Forms
Punctuation
Sentence Structure 1
Faulty Parallelism
Style 43
Passive Voice Misuse
Wordy Sentences
Unclear Reference
Improper Formatting
Vocabulary enhancement
of 100
No errors
No errors
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 2 of 15
823168526_Healthcare_Reforms_Revised
HEALTHCARE REFORMS 2
Running Head: HEALTHCARE REFORMS 1
Healthcare Reforms and ANA’s Position
Student’s Name
University Affiliation
Date
Abstract
One of the principal roles of every government is to
provide quality healthcare to its citizens. In doing this, the
US government has often adopted healthcare reforms. The
last major healthcare reform was the Affordable Care Act
(ACA). However, with the entry of a new administration,
the Trump government is seeking to repeal Obamacare and
replace it with another healthcare system. While the
1
1
Possibly confused word: healthcare
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 3 of 15
administration cites the high cost of Obamacare and other
flaws as the main reasons for the proposed reforms, other
stakeholders such as American Nurses Association (ANA)
are concerned that the reforms may not achieve positive
outcomes. The government, on the other hand, insists that
it will be a better alternative to the ACA. As such, ANA
has opposed the current efforts to replace Obamacare until
the proposed reforms meet four key principles. These
include promotion of cost-effective healthcare, workforce
improvement, innovation in service delivery, and availing
of health insurance to all. This paper discusses the four
principles that represent ANA’s position regarding
healthcare reforms. ANA has also made its position clear
on several key areas in nursing. These include workplace
bullying, use of prescription medicine, care in education
and medication in older adults. This study looks at these
positions too.
Healthcare Reforms and ANA’s Position
Healthcare is a matter of national interest and has recently
proved to be emotive as well. When immediate former
president assumed office, one of his main priorities was
reforming the healthcare system. According to Obama,
America lacked a universal healthcare system; hence,
managing the broken healthcare system was too costly for
the government as well as for individual citizens.
Moreover, a significant portion of the American population
was not covered by healthcare insurance (BBC, 2010).
Overall, healthcare reforms are major healthcare policy
changes or developments introduced by the government
2
3
4
5
6
7
8
9
10
2
Repetitive word: administration
3
Repetitive word: reforms
4
Overused word: key
5
Possibly confused word: healthcare
6
Possibly confused preposition
7
Unusual word pair
8
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 4 of 15
and which are intended to improve the quality, efficiency,
and coverage of healthcare. A good example is the
Affordable Care Act (ACA), popularly referred to as
Obamacare. Obamacare was adopted to improve
healthcare coverage, improve quality, as well as
reducing healthcare costs (Obama, 2016). Before the
adoption of Obamacare, there was serious debate
regarding its merits and demerits. Even with the new
Trump government, the healthcare reform is still
controversial even as the government wants to repeal it.
However, it is not the government and politicians alone
that are involved in the debate on healthcare reforms. One
of the main stakeholders is the American Nurses
Association (ANA), which has always taken an active role
in healthcare reforms in the US. This paper reviews the
position of ANA with regard to proposed healthcare
reforms, specifically the proposal to repeal Obamacare.
Proposed Healthcare Reforms
Part of President Donald Trump’s campaign promises was
the repeal and replacement of Obamacare, which he called
a disaster. According to him and the Republicans, it is
absolutely necessary to replace the Obamacare with a
new healthcare system that will be less costly and will
improve coverage while ensuring a higher quality of
healthcare.
As part of the proposed reforms, the Trump administration
proposes to reduce the role of the federal government in
the healthcare system by giving more resources and
flexibility to states . Additionally, the proposed reforms
will allow insurers sell their policies in all US states.
Although the proposed replacement of Obamacare will
retain the tax credit system, it will be based on age as
well as income as opposed to Obamacare where it was
based on income alone. Finally, with regard to patients
with pre-existing conditions, the proposed policy still
protects this group. However, it does leave room for
11
12
13
14 15
16
17
18
19
20 21
Overused word: main
9
Passive voice
10
Overused word: major
11
Possibly confused word: healthcare
12
[reducing ? to reduce]
13
Overused word: main
14
[ ]
15
Possibly confused word: healthcare
with regard to ? about
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 5 of 15
insurers to charge such patients more (Kliff, 2017).
ANA’s Position on Proposed Reforms
As one of the most vocal and influential bodies of
healthcare professionals with a membership of over 3.6
million nurses, ANA has been vocal in this controversial
debate regarding the repeal and replacement of
Obamacare. ANA has been clear that it opposes the
proposal on the basis that it has not gone through the due
process that should be inclusive, transparent, thoughtful,
and deliberate. It also raises concerns regarding the
proposed reforms, some of which are likely to undermine
the gains made through Obamacare such as greater
coverage and the income-based credit system (Bristow,
2017). In an official document released by ANA regarding
their position on health care reform, the body made it clear
that it opposes any efforts to annul Obamacare without
proposing a replacement plan that is based on four
fundamental principles (American Nurses
Association,2017). These principles represent the
positions of the ANA on the proposed healthcare reforms.
Promoting and Supporting Cost-Effective Preventive
Healthcare
According to ANA, any healthcare reform should
address the issue of preventive healthcare appropriately.
Specifically, healthcare reforms should support and
promote preventive healthcare that is cost-effective. To
achieve this, the ANA advocates for a partnership based
on engagement between the different stakeholders,
specifically the healthcare providers and the patients
(American Nurses Association, 2017). This means that
the proposed healthcare reforms should be patient-based
such that the patient is not seen or treated as a passive
participant. Additionally, the ANA calls for the removal of
all restrictions and barriers to the full contribution of
registered nurses (RNs) and advanced nursing practitioners
(APRNs) to patient care (American Nurses Association,
22
23
24
25
26
27
16
[absolutely necessary ? necessary]
17
Repetitive word: proposes
18
[states ? States]
19
Passive voice
20
Passive voice
21
[ ]
22
Repetitive word: vocal
with regard to ? about
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 6 of 15
2017). This implies that any healthcare reform that
makes it difficult or impossible for professional nurses to
perform their roles in providing healthcare should not be
accepted. Healthcare professionals such as nurses are
tasked with the responsibility of providing the necessary
healthcare services, including preventive healthcare.
However, if there are restrictions imposed on them by the
existing healthcare system, it becomes difficult for them to
perform this role effectively. Therefore, the position of the
ANA is that any healthcare reform should be enabling
rather than restricting for them to serve the patients well.
ANA’s position also focuses on the cost and outcomes of
healthcare reforms. Apparently, the body supports
reforms that will enhance care coordination to reduce the
costs of healthcare while enhancing patient outcomes
(American Nurses Association, 2017).This position is in
line with the common drivers of healthcare reforms. For
example, when the Obamacare was adopted, it was
motivated by concerns about the unsustainable costs of
healthcare as well as the poor patient outcomes (Obama,
2016). With regard to the proposed healthcare reforms to
replace Obamacare, critics have raised concerns regarding
the costs (Custer, 2016). If the cost of healthcare goes up,
many Americans, especially the poor, will not be able to
afford it. The ANA is concerned that such reforms could
leave out a significant number of people.
Building a Suitable Workforce
The ANA also calls for the establishment of a nursing
workforce that will be able to meet the challenging and
growing demand for healthcare (American Nurses
Association, 2017). Currently, America faces a serious
challenge in workforce capacity in the healthcare system.
As demand for healthcare services grows because of
the growing population, aging, and emergence of new
healthcare challenges, the number of professional nurses
entering the system is still far lower leading to a
28 29
30
31
32
33
34
35
36
37
39 38
23
Passive voice
24
Repetitive word: principles
25
Possibly confused word: healthcare
26
Possibly confused word: healthcare
27
Unclear antecedent
28
Unclear antecedent
29
Possibly confused word: healthcare
30
Passive voice
31
Repetitive word: healthcare
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 7 of 15
significant shortage. According to recent estimates from
the Bureau of Labor Statistics, between 2014 and 2022,
nursing shortage will hit 1.2 million (Grant, 2016). In view
of this shocking reality, the ANA is concerned that any
healthcare reforms that do not address this problem will
only be a waste of resources.
According to the ANA, healthcare reforms should address
the challenge of workforce shortage by promoting the
training and development of more nurses (American
Nurses Association, 2017). Right from school, the body
calls for the government to provide incentives to
encourage more people to pursue nursing and ultimately
join the profession. For example, by providing grants and
loan reliefs, the government will encourage more people to
choose nursing . In the workforce, ANA also calls for the
provision of adequate support by the nursing faculty to
ensure a robust workforce (American Nurses Association,
2017). Overall, it is the position of the ANA that, for a
healthcare reform to be acceptable, it must address the
fundamental issue of workforce shortage and the
challenges experienced by nurses in their work.
Protecting Universal Health Coverage
With regard to access to healthcare services, the ANA’s
position is that any acceptable healthcare reforms should
protect Americans from being denied access to insurance
coverage. Specifically, the body calls for the protection of
patients with pre-existent conditions. It fears that they may
be denied health cover due to their conditions (American
Nurses Association, 2017). In the current healthcare
system, Obamacare, the patients with pre-existing
conditions are covered . However, the proposed
replacement of Obamacare, while protecting this
provision, does not seal all loopholes that health insurance
providers may use to charge a premium on such patients.
This, according to ANA, would be an unacceptable
reform, hence the opposition to the proposed reforms .
40
41
42
43
44
45
32
Possibly confused word: healthcare
33
Repetitive word: reforms
34
Repetitive word: enhancing
35
Overused word: common
36
Possibly confused word: healthcare
37
[ ]
38
Repetitive word: demand
39
Repetitive word: healthcare
With regard to ? About
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 8 of 15
Additionally, the ANA’s position is that any healthcare
reforms should cover every American by ensuring that
they are covered under an affordable health insurance
plan, which provides minimum benefits including
preventive services, inpatient/outpatient services, mental
health, chronic disease management, maternity services,
rehabilitative services, prescription drugs, and screenings
(American Nurses Association, 2017). In line with the
constitutional provision for access to quality healthcare for
every citizen, the ANA is keen to ensure that any
healthcare reforms do not leave out a section of the
public because of some unreasonable factors such as cost,
lack of stable income, and poverty. Healthcare reforms
should focus on ensuring universal coverage as healthcare
is a basic need.
Obamacare had a significant impact on America’s quest to
achieve universal healthcare coverage. Through this
healthcare reform, over 17 million Americans obtained
health insurance coverage, which has resulted in a
significant drop of uninsured Americans from 49 million to
29 million between 2010 and 2015 (Obama, 2016).
However, there are still many Americans who are not
covered . This means that the country is yet to reach
the universal healthcare coverage.The ANA supports the
concept of universal health coverage. It is this position that
informs its support for healthcare reforms that will bring
the country closer to universal healthcare coverage.
Reforms that do not improve coverage towards universal
healthcare coverage, according to ANA, are not good and
should not be adopted.
Innovation in Healthcare Delivery
With regard to the delivery of healthcare, the ANA
holds that any healthcare reforms should be innovative in
how they deliver healthcare to the patients. In this regard,
ANA anticipates healthcare reforms that do away with
some of the problems and challenges in the existing
47
46
48
49
50
51
52 53
54
55
56
57
40
[ ]
41
Possibly confused word: healthcare
42
[nursing ? to nurse]
43
[ ]
In view of ? Given
With regard to ? About
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 9 of 15
healthcare delivery models. For example, the professional
nurses’ body expects healthcare reforms to do away with
the free-for-service reimbursement model and instead
embrace models that will encourage effective utilization
of the available resources and reward quality. Other issues
that ANA expects any healthcare reforms to do away with
include annual coverage limits, lifetime caps, copayments,
and deductibles (American Nurses Association,
2017).
As part of the innovation in healthcare delivery, the ANA
expects that healthcare reforms will support Medicaid
expansion to more people, including those that are
currently not covered, empower patients to become more
actively involved in making informed choices and
incentivise more people to take health insurance coverage
(American Nurses Association, 2017).All these proposals
are geared towards ensuring overall improvement in the
delivery of healthcare. The ANA understands the
healthcare system well because its members are directly
involved in the system. They know the real problems and
weak areas that need to be addressed . With regard to
the delivery models, the ANA members know that there
are some fundamental problems and challenges that can
be addressed through appropriate healthcare reforms.
However, not all reforms will address these issues .
Hence, the ANA is keen to ensure that any proposed
healthcare reforms are going to address these issues .
As we move towards a patient-based healthcare system, it
is important that healthcare reforms enhance the role and
active participation of patients in the healthcare system.
This calls for the adoption of healthcare policies and
measures that will ensure patients and empowered through
being informed of the options that they have with regard
to access to healthcare. For example, patients need to
know the available insurance coverage options that they
can use to access healthcare to select the most cost-
58
59
60
61 62
63
64
65 66
67 68
69 71 70
72
73
44
Passive voice
45
Repetitive word: reforms
46 Wordiness
47
Passive voice
48
Possibly confused word: healthcare
49
Possibly confused word: Healthcare
50
Possibly confused word: healthcare
51
Possibly confused word: healthcare
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 10 of 15
effective and appropriate ones. This is what the ANA
wants in any healthcare reforms. Healthcare reforms that
treat patients as passive recipients of healthcare are
unacceptable because they can be used to exploit the
patients.
ANA’s Four Positions
ANA’s Position on Bullying and Violence
ANA does not condone or promote incivility and violence
at work. It requires nurses to create a civil environment
and show kindness to everyone. All nurses are required to
treat their colleagues and visitors with dignity (American
Nurses Association, 2017). The body also expects that its
professionals will be treated with the same respect that
they treat others. Hence, ANA does not tolerate violence,
either from its nurses or towards them. It calls upon all
nursing stakeholders to come together to create a working
environment without incivility or workplace violence. All
stakeholders are expected to adopt the best strategies to
combat workplace bullying. ANA observes that although
its position on workplace bullying was meant for nurses,
it can also be adopted by other professionals who
collaborate with nurses in health care provision. From my
past experience , incivility at work can lead to low
productivity. An uncivil nurse not only lowers the
reputation of the health facility but also reduces the morale
of his colleagues.
ANA’s Position on Care in Educational Settings
ANA holds the position that the health of students should
be addressed in school as a way of optimizing learning.
It suggests that this be achieved through collaboration
where public health and educational needs of the children
are given priority (American Nurses Association, 2017).
However, the success of this approach will depend on
collaboration between health and education stakeholders.
Here, the nurse is expected to coordinate care, disseminate
information and make use of the school’s unique position
74
75
77 76
78
79
81 80
82
83
85 84
86
52
Passive voice
53
Unclear antecedent
54
Possibly confused word: healthcare
55
Repetitive word: reforms
56
[ ]
57
Possibly confused word: healthcare
58
Overused word: effective
59
Possibly confused word: healthcare
With regard to ? About
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 11 of 15
to address students’ health needs. One is expected to
provide both direct care as well as delegated care. ANA
recommends that the ratio of nurses to students be 1:750.
Each school should have its own nurse. Where schools
share a nurse, their total student population should not
exceed 750. From my school days, I remember health had
a great impact on performance. Whenever I was sick for
a long period of time , my school performance would
be greatly affected.
ANA’s Position on Medication in Older Adults
The nurses’ body promotes safe use of medication
among older adults. In relation to this, the association
supports continuous evaluation and monitoring of the
medication profiles of older adults (American Nurses
Association, 2017). It also advocates that medication
information be communicated clearly to older adults as
well as everyone involved in caring for them. When
older patients move from one level of care to another,
their medication should be reconciled . ANA is of the
position that more research relating to older people and
pharmaceutical drugs should be conducted . ANA
suggests that a further research be carried to get a
better understanding of how clinical interventions affect
the provision of care to old people. From my experience
dealing with older patients, there is a need to promote safe
use of medication them. Continuous monitoring and
evaluation will go a long way in improving service
provision to older adults.
ANA’s Position on Abusing Prescription Drugs
ANA is opposed to both fraudulent prescriptions as well as
misuse of prescribed drugs by its members. Nurses
working in all sectors are encouraged to undergo thorough
pharmacology education to ensure that drugs are
prescribed appropriately (American Nurses Association,
2017). This education has to touch on the possibility of
prescription drugs to be addictive, patients at risk of being
87
88
89
91 90
92
93
94
95
96 97
98 99
100 101
102
103
104 105
60
Passive voice
61
Passive voice
62
[ ]
63
Repetitive word: know
64 Wordiness
65
Passive voice
66
Possibly confused word: healthcare
67
Repetitive word: reforms
68
Repetitive word: address
69
Possibly confused word: healthcare
70
Repetitive word: address
71
Repetitive word: issues
72
Unclear antecedent
73
[ ]
74
Unclear antecedent
With regard to ? About
with regard to ? about
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 12 of 15
dependent on drugs, and the legal accountability of nurses
as far as drugs are concerned. ANA is of the opinion that
nurses have to be educated on prescription practice. It
also suggests that nurses be well educated on how to
handle metabolism-altering drugs such as steroids. From
my experience, not enough attention is given to the
addictive ability of prescription drugs. Both patients and
nurses should be made more aware of the risks involved.
Conclusion
Healthcare reforms provide a great opportunity for
addressing existing weaknesses and challenges in the
healthcare system. The ACA helped in enhancing health
insurance coverage in America. However, not all health
reforms are appropriate. That is why bodies such as ANA
are involved in analyzing and debating proposed
healthcare reforms, such as the one by the Trump
administration that seeks to repeal and replace ACA. The
professional nursing body has opposed the proposed health
care reforms based on four principles. The ANA has also
made clear its position on various important issues in the
profession. The positions it has taken on these issues is
geared towards ensuring that nurses relate
professionally with one another as well as ensuring that
the patient receives the highest possible quality of care.
References
American Nurses Association. (2017). ANA principles on
health care system reform. Retrieved from
http://www.rnaction.org/site/DocServer/HC_Talking_Point
s.pdf?docID=2841.pdf
BBC. (2010). Q&A: US healthcare reform. Retrieved from
106
108 107
109
110
111
112
113
75
Unusual word pair
76
Passive voice
77
Repetitive word: treated
78
Repetitive word: stakeholders
79
Passive voice
80
Passive voice
81
Repetitive word: adopted
82
[past experience ? experience]
83
Passive voice
84
Passive voice
85
[be ? is]
86
Passive voice
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 13 of 15
http://news.bbc.co.uk/2/hi/8160058.stm
Bristow, G. (2017). Just in: American Nurses denounce
Trump’s new healthcare plan. Retrieved from
http://bipartisanreport.com/2017/03/08/just-in-americannurses-denounce-trumps-new-healthcare-plan-details/
Custer, B. (2016). If Donald Trump repeals Obamacare, it
could cost the US government $41 billion. Retrieved from
https://qz.com/834667/donald-trump-has-promised-torepeal-obamacare-but-it-wont-be-easy-or-cheap/
Grant, R. (2016). The U.S. is running out of nurses.
Retrieved from
https://www.theatlantic.com/health/archive/2016/02/nursin
g-shortage/459741/
Kliff, S. (2017).Trump proposed 5 specific policies to
replace Obamacare. Here’s how they work. Retrieved from
http://www.vox.com/policy-andpolitics/2017/2/28/14771954/trump-congress-obamacareplan
Obama, B. (2016). The United States health care reform
progress to date and next steps. Journal of the American
Medical Association, 316(5), 525–532.
87
Repetitive word: expected
88
[own]
89
Overused word: great
90
Overused word: long
91
[period of time ? period]
92
Overused word: greatly
93
Repetitive word: medication
94
[ ]
95
Repetitive word: medication
96
[be ? is]
97
Repetitive word: older
98
Repetitive word: older
99
Repetitive word: care
100
Passive voice
101
[is of]
102
Repetitive word: older
103
Passive voice
104
[ a further]
105
[be ? is]
In relation to ? About
Grammarly GRerapomrtmgeanrelryated on Friday, Mar 31, 2017, 11:12AM Page 14 of 15
106
Passive voice
107
Passive voice
108
Repetitive word: educated
109
Passive voice
110
Overused word: great
111
Repetitive word: healthcare
112
Repetitive word: issues
113
G
