Understanding Nursing Concepts

Affordable Care Act

Affordable Care Act is a federal statute that Obama signed into law in 2010 during his administration. It is also referred to as the United States reform law meant to make the lives of the patient better through an easy access to healthcare services and at the same time reducing the money they spend on treatment via regulation as well as taxes. The principle focus of the Affordable Care Act is to provide affordable health insurance to all the Americans lowering the healthcare spending across America, monitoring the health insurance industry and making healthcare and health insurance better (Act, 2010). This discussion will try to explore more on the Affordable Care unit as it related to the health insurance.

How Affordable Care Unit Functions

Health Insurance Marketplace plans are demonstrated into four metal categories. The four metals are Bronze, Silver, Gold, and Platinum each with different and unique specification. The most important thing to note about these metals is that they do not present the quality of medical care, but rather, they demonstrate how a person and his or her plan split the total cost of their health care cost.

A person is therefore eligible to decide and choose the most affordable metal category that describes his or her insurance plan split cost. The metal categories are as follows;

These metals are arranged according to their values. As their values increase, their health insurance coverage also increases as compared to what they are required to pay in deductibles and copays. In addition, the plans vary with the highest one with higher metal tier attracting a higher monthly premium than the one with low metal tier, but they pay less in case of medical care than those with low metal tier.

For Bronze, the health plan (insurance company) pays 60% of the total medical expense of people while they are expected to pay 40%. For silver, the health plan pay 70% and the person pays 30% of the entire medical expense. For Gold, while the insurance company pays up to 80%, a person only pays 20% of the total medical bill, and similarly, Platinum accommodates 90% to be paid by the insurance company while a person pays 10%. After buying the health insurance, one is expected to pay a monthly coverage fee known as premium which is paid whether or not a person goes to the hospital, buys medication or consults the doctor. Even though medical care services are addressed in unison, the service of payment is the one that differs along the metal tiers. This is because, the consumer-cost varies along the metal tiers with platinum attracting a higher premium than the rest. Similarly, the services for platinum are accommodating and more satisfying than the rest, because a person pays only 10% of the medical bill while the insurance company pays the rest.  

The Affordable Care Act (ACA) was implemented in the United States with an aim of improving American live. However, it is not worth assuming that there is an equivalent number of five populations that dwell in America. The implication of ACA was to increase the access to health insurance coverage to the millions of naturally American citizens and the non-citizens who have been in the US for five years and above. This, in one way or the other will reduce uninsurance among the immigrants who live in the US lawfully, as well as the naturalized citizens. ACA will also help to reduce the medical bills of the Americans living under the poverty line.

In addition, ACA will raise the insurance coverage especially among the immigrant children. However, the participation in ACA varies between citizen and non-citizen children that have non-citizen parents than citizen children that have citizen parents (Kenney et al, 2011). In addition, Americans with language as the first language are more likely to benefit from the ACA that those citizen with English as their second language. The most important thing is that ACA is meant to improve the living standards of all the Americans. As they pay their monthly premium according to their favorite metal tier, they are eligible to paying less in case of medical services. Lawful Americans are required to benefit from this medical insurance policy so as to help them keep fit even when they do not have enough money to cater for the medical bill. However, unauthorized immigrants are not eligible to the ACA and are not whatsoever allowed purchasing any coverage.

After implementing the Affordable Care Act, the number of uninsured people in America gradually reduced meaning that most of them are insured. However, as indicated above, coverage differs at some point depending on whether an American citizen, non-citizen as well as age, as elaborated below displaying an estimate of the uninsured individuals;

Graph retrieved from Urban Institute Analysis of 2009 American Community surveyNotes

African American culture

Culture is a way that a distinct group of people define and interact their world. Besides, culture can be defined by the way people in a certain group think critically to analyze the situations that surround them and interact well to the environment. In one way or the other, culture impact to the health either negatively or negatively, meaning that what people do I accountable to their health. According to the question posted after chapter five’s readings, I decided to choose African-American culture in which I performed their cultural assessments.    

Historically, there was a disparity in the healthcare sector regarding how patients are treated and the allotment of healthcare jobs. African American patients were disregarded and were not treated as they should just because of their culture. On the same note, medical doctors were assigned duties based on their cultures. Therefore, African Americans could hardly trust their physicians and hospitals because they were aware of what was happening even if they went to the hospitals. This means that it was easier for an African American to seek traditional medicine or simply die than seeking medical care. However with time, nurses with color as well as white nurses have imbued in the nursing culture, with an objective of practicing equality in the health sector and have equal treatment regardless of the color (Brach & Fraserirector, 2000).

Most of the African Americans are centered on a culture that looks into church and family. Their bonds are extended to their grandparents, aunts, cousins, uncles and other individual either biologically related or not but having a unique family role to play or that attachment. When it comes to health related issues, family members always consult the elder person to decide on their behalf. The older member can decide on the best way forward after examining the sick person. One of the most common means of treatment is the use of traditional herbs that have been deduced to have medicinal values. In addition, most of them believe in Christian teachings and believe in the church. Therefore, some of them get support from their churches because they strongly believe that God is the best healer.

Today, most of the African Americans have changed their perception on health sector. Given that there are more African American culture nurses than they were many years ago, African Americans are becoming conscious about their health, they are comfortable to seek treatment and health screening. Even though most of them are suspicious about their past experience, they can now trust healthcare providers and trust their physician that they will give nothing but the best. Most of them have heard about Tuskegee that was experimented on African Americans, meaning that they still have distrust on physicians until a time they will be assured that the health sector is friendly to all Americans. In addition, most of them are reluctant to share their family or personal issues, therefore having family relation as their only way to express their healthy issues. On the same note, the elder member is the only one expected to go out and buy the medicine or look for a physician whom they can trust as they try to maintain their culture.

Chapter six case study

Question one

• Language barrier
• Racial disparities
• Financial difficulties
• The distance between the hospital and the place of work
• Lack of medical insurance
• Lack of freedom
• Lack of light in the County Medical Assistance (CMA)

Question two

This population has been handed legal visas to work in the US. Therefore, they should be granted with health care. To finance this group, I would give them an insurance equivalent to the time they are required to work in America. To do this, I would consider the four metal tiers in the marketplace and choose the one eligible to them, based on the kind of work, duration as well as the expected salary. The focus here is on market-based financing. By paying for their coverage, I would talk to their employers and come in term with them, where they should compensate for this coverage. I would make a choice of Bronze, meaning that as I Pay 60%, the group will be supposed to pay 40% every month.  On another instance, these groups can be financed by the government. On this note, I would ensure that each person fills the CMA before commencing to work. CMA is crucial because one is eligible to medical assistance, which is required even by such groups working in the US (Clark, 2015).   

Question three

Fee-for-Service (FFS) System will be more appropriate for providing care to the migrant population than managed care. This is because, with FFS, they can see any physician whenever they want to. Given that this population has come to work in America for a prescribed time, they require medical consultation at one time or the other. In addition, changing environment can pose threats to this population meaning that they need medical advice. In line to this, people can only work successfully if they are healthy, and therefore, FFS will ensure that this population has all it takes to work diligently and visit any physician in any case they have doubts concerning their health (Clark, 2015).    

References

Act, A. C. (2010). Preventive services covered under the Affordable Care Act. Retrieved November, 12, 2010.

Brach, C., & Fraserirector, I. (2000). Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review, 57(4 suppl), 181-217.

Clark, M. J. (2015). Population and community health nursing (6th). Boston, MO: Pearson.

Kenney, G. M., Lynch, V., Coyer, C., Resnick, D., Haley, J., & Huntress, M. (2011). Coverage Gains for Children: Increased Participation in Medicaid and CHIP in 2009.