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public-health policy

Describe a public-health policy issue with which you have personal and/or professional
experience, and about which you are interested, familiar, and passionate. Why is this issue of
particular interest/importance to you and to the profession of nursing? Examples of policy issues
Access to health care will be the health care policy issue for this assignment

  1. What is the specific problem, including background, surrounding this issue? Is there a
    need for a new law or campaign related to this issue? Is there a need for change to an existing
    law? Is there need for a change in regulatory issues? What specific supportive evidence do you
    have for this issue, including evidence and references? You will need to include this in your
  2. Review thoughts regarding your chosen healthcare policy issue. It is important to
    analyze your issue thoroughly. Be sure you address the following with evidence and research:
    � Context
    � Goals/options
    � Evaluation of options
    � Recommended solutions
  3. How can you find out the current status of this issue? Is there a website (professional
    organization such as the American Nurses Association or local, state, or federal government) that
    provides status updates or alerts? Please describe.
  4. What level(s) of government does your issue involve (local, state, federal)? What level
    of government is your immediate target? Please describe.


The measure to which people have such resources as well as their ability to use them is what care
accessibility entails. When care is accessible, it means that there is an adequate supply of
services, an opportunity to use it, and that people could use it at the time they need it. The issue
of care accessibility is crucial for a nurse as well as the nursing profession. It is the focus of a
nurse and the nursing profession to ensure that patients get the services they require. This means
that nurses must have the resources necessary for practice for them to serve their patients. If such
resources are unavailable, inadequate, unaffordable, or limited to particular groups, then patients
would not access quality nursing services.

The Existing Problem in Access to Health Care

Access to health care in the US is an area of concern with studies revealing disparities to
the use of services along different markers. Mandal reported that a significant portion of the
American population cannot enjoy quality health services owing to factors such as lack of health
insurance, financial resources, and health care professionals. The observer also noted obstacles to
the access of health services such as structural, age, legal, and language barriers as well as
irregularities of care sources as determinants causing limited care accessibility in the country
(2014).So as to address these factors, there may be a need to campaign for the adoption of certain
changes in the current policies. The prioritized issues in such campaigns would purpose to
increase and measure care accessibility. Health care promotion agencies have recommended
approaches that would increase care accessibility and its measurement so that it is appropriate,
safe, effective, and inclusive of preventive strategies (, 2014). The
institutions have also advocated that such measures address the diverse requirements of
populations as well as the safety of palliative, emergency, and long-term forms of care
(, 2014).The Affordable Care Act of the US is worth mentioning on matters


concerning care accessibility. Researchers and statisticians noted that since the institution of the
ACA, there had been an increase in the number of insured persons and people’s visits to
healthcare professionals, though it did not necessarily impact on the degree to which the
population specialized at particular health care institutions (Martinez, Ward, & Adams,
2015).However, despite its huge achievements, ACA would require changes so that it addresses
other factors affecting care accessibility other than affordability. Critiques have noted that while
the act emphasizes on affordability, it does not necessarily promote accessibility in that it fails to
ensure that users enjoy quality care. Critiques have argued that the Act has been associated with
poorer services as patients flock in healthcare institutions. They point out that there has been
increased waiting times as the Act only increases the number of patients reaching hospitals with
minimal consideration for the available healthcare professionals as well as medical facilities
(Anderson, 2014).From such a perspective, it is evident that ACA needs significant
modifications so that its users can access high-quality medical services.
Critique of Empirical Evidence

Fiscella (2011) investigated America’s progress in the provision of health services and
noted that for the recent decades, the country has not fully addressed health care disparities that
limit people’s access to care (Pg. 78). However, the researcher noted that the ongoing reforms
may have significant impact on health services accessibility and equity of care. The researcher
noted that through extensive insurance covers, the reforms might cause remarkable
improvements on accessibility of care. Fiscella pointed out that people’s access to care varied
with their ethnicity, economic status, and social status (2011, Pg. 78).There are other research
works supporting observation that significant disparities exist and that they are accelerated by
social factors such as homelessness (Hwang, Ueng, Chiu, Kiss, Tolomiczenko, Cowan,


Redelmeier, 2010). Further research shows that such disparities root from county levels. In the
year 2006, for example, research indicated that Massachusetts outdid New England in the
reduction of health care access disparities (Zhu, Brawarsky, Lipsitz, Huskamp, & Haas, 2010,
Pg. 1356). According to Zhu et al., the provision of equitable care would require more specific
interventions than general reforms (2010, pg. 1356). In addition, measures of improving care
accessibility among the American population should address not only the availability of services,
but also its quality. It is also recommendable that the measures focus on vulnerable groups such
as the aged and homeless, as they would most likely have difficulties reaching quality services
(Hwang et al., 2010).

The Importance of Care Accessibility to Nursing
Nursing is a primary discipline in calling for healthcare reforms (Hassmiller,
2010).Nurses play important roles in serving patients and they would have knowledge
concerning factors that influence care accessibility among their clients as well as measures that
would help overcome them. The professionals also play directly in influencing the quality,
equitability, availability, and timeliness of care that patients get. From a different perspective,
nurses offer services such as prevention of diseases, managing patients with chronic ailments,
and offering humanitarian care such as that of compassion and comfort. This shows that the
professionals play a wide variety of roles in serving patients. As such, their involvement in
reforms that seek to improve care accessibility would be necessary.
Agencies that Give Updates on Care Accessibility
Centers for Disease Control and Prevention is an example of agencies that give updates
on care accessibility among different populations in the US (Martinez, Ward, & Adams, 2015).


The agency gives descriptions of measures such as people’s access to personal doctors, their
interaction with nurses, exploitation of medical, dental, and pharmacy services among other
determinants. Healthy People 2020 is also a proactive agency in monitoring accessibility of
health care among US populations. The initiative has described the expectations of health care
stakeholders concerning people’s ability to exploit and enjoy quality medical services
(, 2014). In most cases, the issue of care accessibility affects healthcare from
the national level. Policies that have most influence on care accessibility such as the ACA are
federal institutions. Overcoming the disparities seen in the health system would require the
modification of such federal institutions. However, evidence has indicated that there are
significant disparities among counties and states, and therefore, it is important to first address the
disparities at these lower levels before focusing on the larger national setup (Zhu et al., 2010). As
such, this assignment addresses care accessibility with emphasis on the local level.


There are significant hindrances to care accessibility in the United States. The disparities
are more evident along the lines of social status, ethnicity, financial abilities, as well as culture.
Though most of the influential policies of access to health care are designed at the federal level,
studies show that the implementation of such policies at the local and state levels accounts
significantly to the occurrence of the inaccessibility disparities. It would be important to modify
the existing policies so that they address factors such as the quality of care and ease to use it in
addition to focusing on its availability. The nursing profession should play centrally in such




Anderson, A. (2014). The impact of the affordable care act on health care workforce.The
Heritage Foundation.


Fiscella, K. (2011). Health Care Reform and Equity: Promise, Pitfalls, and Prescriptions. Annals
of Family Medicine, 9(1), 78–84.
Hassmiller, S. (2010).Nursing’s role in health care reforms.American Nurse Today, 5(9).
Healthy Access to health services.Us Department of Health and Human
Hwang, S. W., Ueng, J. J. M., Chiu, S., Kiss, A., Tolomiczenko, G., Cowan, L., …Redelmeier,
D. A. (2010). Universal health insurance and health care access for homeless persons.
American Journal of Public Health, 100(8), 1454–1461.

Kottke, T. E., &Isham, G. J. (2010).Measuring health care access and quality to improve health
in populations.Preventing Chronic Disease, 7(4), 73.
Mandal, A. (2014, August 6). Disparities in access to health care.
Martinez, M. E., Ward, B. W., &Adams, P. F. (2015).Health care access and utilization among
adults aged 18–64, by race and Hispanic origin: United States, 2013 and 2014.
Hyattsville, MD: National Center for Health Statistics.
Zhu, J., Brawarsky, P., Lipsitz, S., Huskamp, H., & Haas, J. S. (2010).Massachusetts health
reform and disparities in coverage, access and health status.Journal of General Internal
Medicine, 25(12), 1356–1362.

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