NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

NRSE 6050 Policy and Advocacy for Improving Population Health

NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

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When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

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RE: Discussion – Week 7

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Main Post

Nursing is a profession where the care that is provided should be evidence base, and as we can attest to the fact that we have seen some practices that have no evidence behind it, yet nurses continued to practice that way because it became the culture of care. As our profession is and should be practiced based from evidence we must venture away from those practices and adhere with the evidence base practices. The health policy that I selected is Bill H.R.4647, Protecting Medicare Beneficiaries with Pre-Existing Conditions Act. This bill sponsors are Rep. Schneider, Bradley Scott [D-IL-10], was introduced on 10/15/2019. The background for this proposed bill/problem goes way back before the Affordable Care Act (ACA), whereas people that had pre-existing health conditions were denied health insurance or their prices were way higher to the point where they could not affordable to pay and went uninsured for decades (Giled & Jackson, 2017). President Franklin D Roosevelt introduced the Social Security Act, President Lyndon Johnson made an amendment to the Social Security Act with the passage of Title1X where the Medicare Act was introduced under Title V111. Prior to the ACA, health insurance was obtained medically, meaning insurance companies were privy to an individual health record and other risks factors which they use to determined eligibility and applicants had to fill out a lengthy form with their medical history (Claxton et al., 2016). Medicare Act was introduced at the federal state level to provide coverage to the poorest citizens (Auerbach, 2019). The Patient Protection Affordable Care Act (PPACA) was passed in to law 2010 which protects people with pre-existing health condition against insurance companies that would deny them health insurance coverage (Auerbach, 2019).

There is enough evidence to support the fact that people with pre-existing conditions were denied health insurance because before the passage of the PPACA insurance companies were not held accountable. According to Claxton et al. (2016) more than 18% of applicants were denied health insurance before the ACA act and many more people that had pre-existing condition did not apply because they were already informed that they would be denied. PPACA has extended coverage and hold insurance accountable, no preexisting inclusion and now more than 32 million more people have gain access to insurance coverage including people with pre-existing conditions such as patients with cancer (Plaxe & Nagle, 2014).

References

Auerbach, M. P. (2019). Patient Protection and Affordable Care Act: Overview. Salem Press

Encyclopedia.

Claxton, G., Cox, C., Damico, A., Levitt, L., Pollitz, K & Kaiser Family Foundation. (2016).

Pre-existing conditions and medical underwriting in the individual insurance market

prior to the ACA. Montana, 25, 152-000.

Glied, S., & Jackson, A. (2017). Access to Coverage and Care for People with Preexisting

Conditions: How Has it Changed Under the ACA? Issue Brief (Commonwealth Fund), 18,

1–12.

Plaxe, S., & Nagle, V. L. J. (2014). Patient Protection and Affordable Care Act (“Obama

Care”). Journal of Gynecologic Oncology Nursing, 24(1), 25–26.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.

Review the health policy you identified and reflect on the background and development of this health policy. NRSE 6050 Week 7 Discussion 1: Evidence Base in Design

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

*Note: Throughout this program, your fellow students are referred to as colleagues.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 7 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 7

To participate in this Discussion:

Week 7 Discussion

RE: Main Question Post

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Hello, Sierra Savage (colleague).

I noted that your health policy you have chosen was The Families First Coronavirus Response Act 2020. I found your chosen health policy interesting in reading seeing the public is in a current pandemic related to this novel virus as in the coronavirus. It was interesting to see what The Families First Coronavirus Response Act 2020 was focusing on. You stated in your paper that The Families First Coronavirus Response Act 2020 is a response strategy to the coronavirus outbreak, and its focus was on the provision of free coronavirus testing, paid sick leave, food assistance, and unemployment. I found it partially as in The Families First Coronavirus Response Act 2020 to be a bit biased.

There is so much about this virus that is unfolding before our eyes. We are learning more and each day something new about this virus (Coronavirus).

According to the Washington Post in the United States, the Coronavirus appears to be infecting and killing African Americans at a disproportionately high rate (Thebault, Ba William, 2020).). This emerging stark racial disparity led the Surgeon General to acknowledge in personal terms the increased risk for African Americans amid growing demands that the public-health officials release more data on the race of those who are sick, hospitalized and dying of a contagion that has killed more than 12,000 people in the United States (Thebault et al., 2020).

It was stated in the Washing Post that the reason for African Americans being affected at a disproportionate rate had to with African Americans having higher rates of diabetes, heart disease, and lung disease are well documented, and noted by Louisiana Governor John Bel Edwards that health problems make people more vulnerable to the new respiratory disease, but there has never has been a pandemic that brought the disparities so vividly into focus (Thebault et al., 2020).

Because of this crisis, the Lawyers’ Committee for Civil Rights Under Law and hundreds of doctors joined a group of Democratic lawmakers, including Senators Elizabeth Warren (Mass.), Cory Booker (N.J), and Kamal D. Harris (Calif), in demanding the federal government to release daily race and ethnicity data on coronavirus testing, patients and their health outcomes, seeing that the data for the Centers for Disease Control and Prevention has only released figures by age and gender (Thebault et al., 2020).

The data being reported by the Centers for Disease Control and Prevention is only including age and gender and leaving out racial or ethnic data. I find this data to be disturbing and biased. Civil rights law prohibit federally funded health care providers from administering services in a discriminatory manner, said Kristen Clarke, president and executive director of the Lawyers’ Committee of Civil Rights Under Law, which joined with medical professionals to call for the immediate release of racial and ethnic data on coronavirus infections, testing, and deaths (Wambsgans, 2020)

According to the Washington Post article, 2020, even though some activists argued African Americans have been more exposed because many held low-wage or essential jobs, such as food service, public transit, and health care, that required African Americans to interact with the public, I find this to be a poor argument in that is still does not address data on race and ethnicity not being reported, as being left out of data for the Center for Disease Control and Prevention.

According to the Center for Disease and Prevention Control (CDC), guidelines in every state is legally required to track data on testing and treatment by race, as it has done during other outbreaks. Fewer than a dozen have released that data so far (Evelyn, 2020). According to what is being found, African Americans are particularly more vulnerable. According to Kristen Clarke president and executive director of the Lawyers’ Committee of Civil Rights, this is a social, economic and racial justice issue (Evelyn, 2020).

I feel that the Families First Coronavirus Response Act 2020, needs to be re-assessed, in that health care officials need to consider different factors that should be included for this health care policy to be justifiable (unbiased).

REFERENCES

Reise Thebault, Andrew Ba Tran, & Vanessa Williams (2020). Washington Post. The coronavirus is infecting and killing black Americans at an alarmingly high rate. Retrieved April 09, 2020, from

Https://www.washingtonpost.com/archive

Jason E. Wambsgans (2020). National Broadcasting Company news. African Americans may be dying from COVID 19 at a higher rate. Better data is essential, experts say. Retrieved April 10, 2020, from

Https://nbcnews.com

Kenya Evelyn (2020). The Guardian. It’s a racial justice issue: Black Americans are dying in greater numbers from COVID-19. Retrieved April 10, 2020, from

Https://www.theguardian.com

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
- Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
- Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours