NURS8100: Week 1 Discussion

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.

Learning Resources

Required Readings
Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical
approach (8th ed.). McGraw-Hill.
● 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
http://www.rwjf.org/?topicid=1318
The Commonwealth Fund. (2010). The Commonwealth Fun d. Retrieved from
http://www.commonwealthfund.org/
The Henry J. Kaiser Family Foundation. (2011). New & noteworthy . Retrieved from
http://www.kff.org/
Required Media
Walden University, LLC. (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
efforts.

Accessible player –Downloads–Download Video w/CCDownload AudioDownload
Transcript
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.