The Importance of the Healthcare Sector
The healthcare sector is a critical infrastructure in any society since it acts as a pillar that facilitates the attainment of people's and the nation's aspirations and desires. The role played by the sector cannot be overemphasized especially due to the growing demand for health services associated with social improvements contributing to long life expectancies associated with a higher prevalence for chronic conditions requiring progressive care. As a social service, the maximization of services received from numerous providers is crucial and should be structured in accordance with the principles of reaching Pareto optimal conditions. However, the United States is faced with growing healthcare challenges that affect public healthcare causing significant disparities and hindering access to affordable and quality care in both rural and urban areas. The growing advocacy at the state, federal, and international levels for better health services is yet to be fulfilled in the contemporary society due to the presence of both avoidable and non-avoidable circumstances. The government and other policymakers should strive to improve access to better health services across all regions in the United States through the adoption of efficient structures and models. An effective way to address the problem of challenges experienced in the healthcare sector affecting public health is to implement a single-payer universal coverage system, expand the nurses' scope of practice and autonomy, and promote a culture of integrative preventive care.
Universal Health Coverage
Universal health coverage characterized by a single payer system improves better public health access by eliminating financial challenges experienced through the commercialization of health services. According to Christopher and Caruso (2015), some of the shortcomings in the public health domain include limited accessibility owing to poor and inadequate coverage practices and the huge financial burden associated with access to affordable care. The study acknowledges the contributions made by the recent Obama changes through the implementation of the Affordable Care Act that sought to expand the insurance coverage as a positive gesture towards achieving the single-payer system and universal coverage. The concept of universal health coverage holds that health care services should be offered as a human right without limiting access due to financial challenges. The commercialization of health services currently has been the driving factor in emerging health disparities where individuals fail to adhere or seek preventive health services due to limited financial capabilities and shortcomings in health insurance providers. Implementing a single-payer system that offers free access to primary health services would drive up health consumption following the basic principles of costs and demand. Lougarre (2016) noted that current practices characterized by multi-payer systems and narrow coverage practices not only hinder millions of immigrants from accessing better health services but also affect other Americans expected to make copayments in the management of chronic conditions. The adoption of universality at the federal level would ensure that all Americans have the right to better and easily accessible health services and act towards eliminating vulnerabilities of certain populations due to higher costs.
Expansion of Nurses' Scope of Practice
Shortages in health care providers and physicians can be eliminated through the expansion of the nurses' scope of practice and the formulation of policies that promote nursing autonomy. According to Gadbois, Miller, Tyler, and Intrator (2015), the primary care setting is one of the essential sources of health care services at the community level. However, the sector is associated with huge gaps between care capacity and service needs due to traditional beliefs that shape health reform and hinder the scope of practice for nurses. Nurses form the largest workforce in the healthcare sector as more and more people enroll in the nursing programs attaining different academic qualifications and professional levels. Using the advanced nurse practitioners with a master's qualification to fill the gap between the care capacity and service need would be an excellent step towards alleviating the primary care crisis and avoiding some challenges associated with physician shortage in the United States. Currently, nurses are mostly expected to serve with the guidance of the supervising physician and their autonomy to practice separately is limited by different state policies. However, evidence suggests that advanced nurse practitioners can provide quality care at a more affordable rate without direct supervision from the physicians. The study published by Gadbois et al. (2015) determined that approximately 84 percent of nurse practitioners had a master's degree while 4 percent had a doctorate and the remaining percentage had a bachelor's degree. Further, the study determined that less than 30 percent of physicians enter the primary care field compared to 52-60 percent of nurse practitioners. Increasing the nurse practitioners' autonomy and scope of practice will promote better services in the primary care setting encouraging preventive medical services. Nurses are also some of the leading healthcare providers in rural regions and are associated with a higher patient satisfaction rate compared to physicians. As such, expanding their practice will not only eliminate the burden of physician shortages but also improve quality of care measured through patient satisfaction, and lead to lower health care costs by eliminating the physician fees incurred through their supervisory roles.
Promoting Integrative Preventive Medicine
Curative medicine has been the norm in the traditional and contemporary society and is a hindrance to attaining optimal public health in the United States. Most Americans use health services to address problems rather than prevent health problems. One of the factors promoting this culture is the lack of adequate community programs that encourage and educate the people on the important benefits associated with preventive health care. According to Ali and Katz (2015), integrating the fields of public health and preventive medicine at the community level can help achieve the objectives of promoting general health, applying epidemiologic techniques, and preventing diseases especially those associated with modifiable risk factors. Preventive health services focus on both lifestyle risks and reduction of over-medicalization while protecting the patients and the public from excessive and unnecessary invasive treatment interventions. Some of the common societal structures that affect the risks for diseases include environmental variables such as pollution, economic factors, social factors, and behavioral factors including dietary and other lifestyle aspects. Encouraging a nationwide advocacy program that offers education in both rural and urban areas will create awareness and foster the fusion of conventional and contemporary medicine aimed at producing better public outcomes in terms of cost-effectiveness, functional status, and relief of symptoms and diseases. The study by Ali and Katz (2015) illustrated that health-promoting lifestyle implemented at the community level addressing unique population characteristics such as regular exercising, infrequent and reduced alcohol consumption, and better dietary consumption reduced modifiable risk factors significantly and prevented costs associated with pharmacological interventions. The authors concluded that tobacco use, lack of physical activity, and poor diet contributed to over 835,000 deaths in the year 2010. Such problems and associated diseases can be eliminated with the promotion of preventive health services as the domain towards improving public health through advocacy from health providers and policies favoring patient education and awareness.
Conclusion
Public health can be made better in the United States through the implementation of universal health single payer system, expanding the nurses' scope and roles, and the promotion of a culture of integrative preventive medicine. The measures ensure that people have access because the single-payer structure in universal care offers health as a human right and more individuals regardless of their financial situation can access health services. The model can also increase the availability of health providers especially in the rural areas and the primary care setting with an enhanced scope of practice for nurses. Nurses are better positioned to address the growing demand for health services in a society facing physician challenges and the need for patient-centered care. Additionally, advocacy and structural implementation of preventive medicine including appropriate lifestyle, environmental, and economic considerations can bolster access, quality, and prevent common conditions leading to mortality and morbidity.
References
Ali, A., " Katz, D. (2015). Disease prevention and health promotion: How integrative medicine fits. American Journal of Preventive Medicine, 5(3), 230-240.
Christopher, A., " Caruso, D. (2015). Promoting health as a human right in the post-ACA United States. AMA Journal of Ethics, 17(10), 958-965.
Gadbois, E., Miller, E., Tyler, D., " Intrator, O. (2015). Trends in state regulation of nurse practitioners and physician assistants, 2001 to 2010. Medical Care Research and Review: MCRR, 72(2), 200-219.
Lougarre, C. (2016). Using the right to health to promote universal health coverage: A better tool for protecting non-nationals’ access to affordable health care? Health and Human Rights, 18(2), 35–48.
