Introduction
The issue of access to care has been high on the agenda for healthcare organizations. Without access to comprehensive and quality health care, it would be impossible to promote and maintain the population’s health, prevent diseases, unexpected deaths, and comorbidities from occurring or reduce unnecessary disabilities (Healthy People, 2017). This paper will focus on identifying the most appropriate legislation to address the problem of access to care, describing the impact of the issue on nursing practice, and analyzing the benefits of the policy change targeted at improving access to care.
Issue Description, Background, and the Impact on Nursing Practice
In the United States, health disparities are highly likely to affect the representatives of ethnic minorities such as Latinos, Native Americans, African Americans, and Asian Americans. The level of income of a certain community group also plays a significant role in determining whether fair and equal access to care will be enforced. Collectively, illnesses and deaths that result from unequal access to healthcare lead not only to psychological trauma but also significant economic costs (Ramirez, Baker, & Metzler, 2008). For example, between 2003 and 2006, the cost of such disparities exceeded a trillion U.S. dollars (Powell, 2012).
This stark figure shows that there is an issue of healthcare disparities that affect a large portion of American minority communities. It is important to mention that discrepancies in health care are not new, nor did they appear within the past decade. As mentioned by Evelynn Hammonds, a Harvard College Dean, the issue existed more than a hundred years ago, when poverty, racism, economics, taxation, and public policies prevented minority groups from attaining the same quality of care as the majority (as cited in Powell, 2012).
The issue of unequal access to health care among minority communities goes against one of the key principles of nursing practice to provide care in a way that is respectful to all patients equally. Overall, the healthcare system is highly fragmented, which means that it is difficult for nurses to navigate, especially in those cases when patients and nurses “are asked to seek care across multiple providers and settings for which there is little to no coordination” (Salmond & Echevarria, 2017, p. 13). From the lack of unity, arises the issue of unequal access to care, which disproportionately affects ethnic and racial minorities as well as patients with lower socioeconomic status.
Legislation to Improve Access to Care
Because issues of minorities cannot be addressed on the federal level, it is recommended first to introduce a state-specific legislation that will cover minority populations in that region. Such an approach can also be explained by the fact that the population distribution by race or ethnicity can vary from one state to another, which means that the issue of minorities not having equal access to healthcare differs within state legislations.
According to the statistics provided by Kaiser Family Foundation (2017), there are less than 1% of Native Americans in the state of Florida while there are 8% of Native Americans in Oklahoma. Therefore, it is recommended to introduce the policy change in states separately to cater to the minorities that need the most support.
As to the scope of practice associated with the policy, nurses will play a significant role of advocates to improve access to primary care for vulnerable populations (ethnic minorities and low-income communities) (Xue, Ye, Brewer, & Spetz, 2016). Through collaborations with community leaders and stakeholders, nurses can raise awareness of the issue of unequal access to healthcare and facilitate the private and governmental funding of the policy.
As mentioned by Tao, Agerholm, and Burstrom (2016), there is a lack of evidence to support the positive influence of reimbursements on the racial and socioeconomic inequity in access, quality, and utilization of health care. Therefore, financial programs that will fund minorities’ healthcare needs will include either loan payments or complete financial coverage depending on the type of healthcare services needed (Sherman, Trisi, & Parrott, 2013). Key stakeholders of the policy will include state legislators, healthcare providers, and community members interested in reducing the gap in the access to care.
Benefits of the Policy and the Impact on the Nursing Practice
It is expected that improving access to health care of minority populations through financial aid will be beneficial for all stakeholders involved as well as be a positive aspect of the nursing practice and the healthcare industry as a whole.
Minority groups will get financial support for their healthcare needs, and policymakers will get praise from the community and get experience in developing legislations to cater to specific population groups, while nurses and other healthcare providers will get more leverage when treating patients of minorities. Support for the change would be found within communities that lack resources to fund their healthcare needs as well as among public figures and social justice advocates that promote equity in health care.
When it comes to the impact on the nursing practice and healthcare in general, a policy to support the healthcare access of minority communities will be highly beneficial from all perspectives. Equal access to health care implies that nurses will not encounter barriers associated with fragmentation. This means that nurses will receive better navigation throughout their service, they will no longer have to seek the assistance of multiple specialists and make negotiations to provide patients from underserved communities with the level of care that they deserve.
Policy Aspects and Overall Analysis
The policy targeted at the improvement of access to health care for minority groups (ethnic minorities and low-income patients) will be associated with the following aspects (recommendations):
- Changing the scope of practice. Not only primary care physicians but also RNs, NPs, and PAs should assist in offering care to underserved communities to expand opportunities for patients (Sederstrom, 2014).
- Innovative solutions for care optimization. In cases when financial support cannot be provided to underserved patients, innovative solutions such as shared appointments should be introduced. This practice will allow healthcare providers care for several patients simultaneously while offering better access for minority patients.
- Investing in workforce. Apart from providing patients with financial aid for funding their health care needs, the policy will take into account healthcare providers’ wages. Because primary care is less preferred compared to specialized care due to compensation disparities, it is essential for legislators to consider improving the financial aspect of hiring a skilled workforce.
- Reducing the administrative burden. Access to care for patients is also associated with the amount of time that healthcare providers can offer. Because of the administrative burden to complete non-clinical paperwork, they fail to give attention to the underserved community members. It is crucial to take into consideration even such minor aspects as paperwork because they can contribute to the exasperation of the disparities in healthcare access.
- Financial support. Ranging from charitable donations from the public, non-profit organizations, and local governments, the key aspect of the policy change is the significant financial support of minority patients that lack resources to address their healthcare needs.
From a personal perspective of a healthcare provider, a policy that will take into account the needs of underserved communities such as ethnic minorities and low-income households will only bring a benefit. If to remember the first principle of nursing practice: “nurses and nursing staff treat everyone in their care with dignity and humanity – they understand their individual needs, show compassion and sensitivity, and provide care in a way that respects all people equally,” the policy to improve access to care will ensure the aspect of equality and allow nurses to provide the same level of care to their patients (Royal College of Nursing, 2017, para. 2). Also, given the aspects of the policy specified above, it will also take into consideration the needs of healthcare providers regarding the optimization of their practice.
Concluding Remarks
Any policy changes come with benefits and risks. Key benefits of the policy to improve access to care of minority and low-income patients include financial support, improved health outcomes, enforcement of equal treatment, and the optimization of practitioners’ performance. On the other hand, the policy presents financial risks such as the lack of funding. Overall, the promotion of equal access to healthcare is an issue of social justice that should be resolved through the collaboration of community stakeholders and state legislators.
References
Healthy People. (2017). Access to healthcare services.
Kaiser Family Foundation. (2017). Population distribution by race/ethnicity. Web.
Powell, A. (2012). Closing the care gap.
Ramirez, B., Baker, E., & Metzler, M. (2008). Promoting health equity: A resource to help communities address social determinants of health. Atlanta, GA: Centers for Disease Control and Prevention.
Royal College of Nursing. (2017). Principles of nursing practice.
Salmond, S., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12-25.
Sederstrom, J. (2014). 7 ways to improve access. Web.
Sherman, A., Trisi, D., & Parrott, S. (2013). Various supports for low-income families reduce poverty and have long-term positive effects on families and children.
Tao, W., Agerholm, J., & Burstrom, B. (2016). The impact of reimbursement systems on equity in access and quality of primary care: A systematic literature review. BMC Health Services Research, 16, 542-552.
Xue, Y., Ye, Z., Brewer, C., & Spetz, J. (2016). Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review. Nursing Outlook, 64, 71-85.