Introduction
Healthcare policy has a significant impact on access to high-quality care among diverse populations. Policymakers can develop bills and legislation that improves or hinder access to care by affecting out-of-pocket costs, insurance prices, and care providers’ work. One example of a recent healthcare policy impacting access to high-quality, cost-effective care is American Patients First. This policy was developed by the Trump administration in an effort to reduce drug prices and out-of-pocket healthcare costs.
While the policy could benefit multiple populations, its potential impact is likely to be most evident among people with low-income levels. The present paper will seek to review the policy, examine how it relates to public health goals nationally, and explain the advocacy strategies that can help to ensure that people from my population can access its benefits.
Overview
American Patients First is a government policy aimed at improving the functioning of the entire healthcare sector to enhance control over drug prices, lower healthcare costs, and increase transparency. The four main areas of the policy are competition, negotiation, incentives, and out-of-pocket cost reduction (U.S. Department of Health & Human Services, 2018). With respect to competition, the policy is expected to increase competition by promoting innovation and competition in the medical sector and improving manufacturers’ compliance with regulatory processes (US DHHS, 2018). In terms of negotiation, the policy enhances the focus on value-based purchasing in federal programs and implements changes to Medicare Parts B and D, designed to improve the government’s control over prices (US DHHS, 2018).
Incentives for lower list prices will also be provided to manufacturers, wherein drug producers will be required to include list prices in advertising, and Medicare’s drug-pricing dashboard will become more transparent (US DHHS, 2018). Finally, the policy also attempts to lower out-of-pocket costs by providing more cost-related information to Medicare Part D beneficiaries (US DHHS, 2018). On the whole, these measures could help address current problems in the U.S. healthcare sector.
The policy addresses various ethical, legal, and political factors impacting healthcare. First of all, it focuses on the ethical principles of autonomy, justice, and beneficence by enhancing cost transparency and allowing patients to make more informed decisions regarding their healthcare use while also improving the quality of care through competition and regulation (The White House, 2019).
Secondly, the policy seeks to amend Medicare Part D by allowing for price negotiation, which was prohibited under the previous policy (Dabbous, François, Chachoua, & Toumi, 2019). These measures could provide legal support for the increase of sponsors’ power in price negotiation, thus lowering care prices. Political factors are also addressed as part of the policy since it proposes reforms to the government’s role in health care regulation and delivery (Dabbous et al., 2019).
From the nursing perspective, the implementation of this policy could affect the ability of providers to deliver high-quality services due to the shift to a value-based care model. Value-based care provides many benefits to providers and patients alike, but it can also restrict care providers’ autonomy and be difficult to implement due to the complexity of the costing mechanism (Meola, 2019). Thus, monitoring, assessing, and mediating the effect of this policy on nurses and other care providers is essential to ensure smooth implementation and great outcomes..
Financial Foundations
In order to have the desired effect on healthcare costs, the policy has to be financially sound. In a recent review, Block (2018) discusses the economic foundations of American Patients First, including the sources of cost reduction. Based on the review, the policy appears to be financially sound because it targets real sources of increased healthcare costs and offers ways of encouraging manufacturers to reduce prices. For instance, by improving the transparency of cost-related information delivered to patients, the program would help to reduce out-of-pocket costs paid by customers by enhancing their knowledge of cost structure and alternatives (Block, 2018).
Secondly, by regulating rebates, the government would also be able to reduce drug costs paid by patients (Block, 2018). Finally, improving the availability of generic drugs would also help to ensure that lower-priced treatment alternatives are available to patients (Block, 2018). While the effects of these changes are likely to be noticeable for individuals, the financial impact on the industry would be rather small, as Block (2018) estimates. Thus, the policy is financially beneficial because it brings benefits to patients with minimal investment and without hurting the profitability of the industry significantly.
Compliance with Public Health Goals
Healthy People 2020 is a set of national public health goals that are often used to guide policymaking and healthcare initiatives. Based on the description and analysis of the policy, it aligns with the topic of access to health services and the goal to “improve access to comprehensive, quality health care services” (Office of Disease Prevention and Health Promotion, 2020, para. 1). One of the main objectives of this goal is to reduce the share of people who cannot access health care services, dental services, or prescription drugs due to various factors (ODPHP, 2020).
One of the core reasons as to why people experience delays in access to healthcare is the high cost of treatments and care. By reducing out of pocket costs and prescription drug prices, American Patients First could assist in achieving the national goal of enhancing access to care. Thus, the policy is well suited to help realize this goal and targets an important issue reflected in other healthcare policies and plans.
Advocacy Strategies
My patient population is diverse and includes many African American and Hispanic patients who often suffer from poor access to care. Some patients lack insurance; others cannot afford to pay high out-of-pocket costs. In order to ensure that my patients have access to the benefits of the policy, I would encourage my colleagues and the organization to raise awareness about the policy among patients and care providers. I would also contact local officials to propose ways of improving knowledge about the policy among local residents, particularly those who do not visit their care providers often due to inadequate access. These strategies would help to inform people about the new options available to them under American Patients First.
Professional Moral Obligations
Advanced registered nurses have moral and professional obligations to advocate for patients, promote health, and prevent disease among populations because these activities reflect the Christian values of service, justice, and compassion. Various professional associations have emphasized the importance of these values to Nursing. For instance, the American Nurses Association’s (2015) Code of Ethics for Nurses posits that nurses must advocate for their patients, practice with compassion, and act consistently with their obligation to promote health and provide high-quality care.
Conclusion
Overall, American Patients First is a useful policy that could improve access to care among diverse populations in America. As part of my nursing practice, I intend to support this policy by enhancing people’s awareness about it and helping them to access the benefits it provides. Staying informed about health policies and communicating information to my community will assist me in fulfilling my duty as an APN.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.
Block, A. E. (2018). An economic evaluation of “American Patients First”—The Trump administration’s strategy to lower drug prices. Health Policy, 41(7), 1-2.
Dabbous, M., François, C., Chachoua, L., & Toumi, M. (2019). President Trump’s prescription to reduce drug prices: From the campaign trail to American Patients First. Journal of Market Access & Health Policy, 7(1), 1579597.
Meola, A. (2019). How and why the value based payment model is trending in the healthcare industry. Business Insider.
Office of Disease Prevention and Health Promotion. (2020). Access to health services.
U.S. Department of Health & Human Services. (2018). American Patients First: The Trump administration blueprint to lower drug prices and reduce out-of-pocket costs.
The White House. (2019). President Donald J. Trump is putting American patients first by making healthcare more transparent. Web.