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Health Care immigration
Transcript of Health Care immigration
-How has the media's influence shaped the policy?
-What could you do to modify or introduce the policy at your workplace?
-How do changing health policies affect the advanced practice nurse ? There are an estimated 12 million unauthorized immigrants on the United States (Zuckerman, Waidman, lawton, 2011).
They are ineligible for Medicaid and other means of federal benefits, though hospitals may be reimbursed thru Medicaid for providing emergency services. Immigrant Health Care Coverage A summary table of selected proposed eligibility rules for non citizens and congressional Health Care Reform proposals Stakeholders Effects with Health care issues in the United States with immigration Advance Practice nurses Thanks for watching Taxpayers
Health Care providers Taxpayers: The underline payer of all health care received by immigrants that have no ability to pay. Federal Government: Tax money is used to care for immigrants. State Government: Tax money is used to care for immigrants. Hospitals: Must treat any emergent person regardless of immigration status or ability to pay. This has a butterfly effect on the healthcare system as a whole. Health Care providers: Every healthcare policy change affects the provider in some manner (i.e. reimbursement, practice guidelines). The media has a direct influence on policy as the public tends to take information provided by the media as solid truth. Most individuals fail to research the policies on their own time and tend to follow party beliefs Changing health policies affect the Advanced Practice Nurse (APN) in many different manners, but immigration related reform may potentially put the APN in a situation that they are not accustom to. Refusal to see a patient due to immigration status is a potential issue that may be seen by APN’s. Health Care Reform impacts the unauthorized immigrants Health Insurance Reform would exclude unauthorized immigrants still dependent on emergency rooms, community health centers, and other public health facilities, and would discourage early detection and management of chronic conditions These undocumented immigrants would not be eligible for public insurance or any type of private coverage obtained through exchanges under the Affordable Care Act of 2010. (Capps, Rosenblum, & Fix, 2009). (Ng'andu, Ryan, & Munoz. 2012). Immigrants and Health Care Facts Cost to American Economy •Lack of safe affordable housing •Non qualifying funds Cost to American Economy Suffer disproportionately from chronic illnesses Social Services Federal Inaction Due to federal inaction more states are defining how or whether immigrants will have access to health care. Expensive ER visits (numerous)
Little or no access to preventative or primary health care •Affect health care outcomes in immigration
•Access to social services lack causing them to be vulnerable to exploitation and poverty Barriers to health services •No health care coverage
•Unable to take off work
•Long work hours
•Lack of transportation
•Language Mental Health-Cultural Stigma DMV
Drivers license with undocumented workers •Asthma
•Obesity Stress All these barriers lead to stress and cause serious health issues •Trauma
•Lack of agencies after screening workers Social Issues In 2010 Immigrant population in both legal and illegal peak at a historic record 40 million which equals 13% of the total population. The question of whether illegal immigrants should be entitled to some form of health coverage in the United States sits at the uneasy intersection of two contentious debates: health reform and immigration reform. Illegal immigrants in the United States are generally excluded from government benefits programs. public insurance programs, such as Medicaid, generally require proof of citizenship or legal residency also excluded from the individual mandate requirement of the PPACA, which restrictively defines “applicable individual. National Immigrant Policy on Health Care Health policies are needed to expand access to health insurance and to community clinics and other care venues.
Useful to expand outreach efforts through trusted sources such community based organizations whose culturally competent staff can help immigrants accessing resources
A national immigration policy on health care that balances the needs of the country to control its borders, provides access to health care equitably and appropriately , and protects the public’s health (Kline, 2011). Access to Care -Access to health care for immigrants is a national issue and needs to be addressed with a national policy. Individual state laws will not be adequate to address this national problem and will result in a patchwork solution (Kline, 2011)
-Access to health care should not be restricted based on immigration status, and people should not be prevented from paying out of pocket for health insurance coverage (Kline, 2011)
-U.S. born children of parents who lack legal residency should have the same access to health coverage and government-subsidized health care as any other U.S. citizen (Kline, 2011).
-The federal government should develop new and innovative strategies to support safety-net health care facilities . Delivery of Care -Increased access to comprehensive primary care, prenatal care, injury prevention initiatives, toxic exposure prevention, and chronic disease management
- Encourage all residents to obtain clinically vaccinations and screening for prevalent infectious disease. Eliminating Discrimination in Health Care and Professionalism -Physicians and health care professionals have an ethical and professional obligation to care for the sick.
-Immigration policies should not foster discrimination against a class or category of patients in the provision of health care The Media’s Influence on Health Care Policy Making Advanced practice nurses are ideal agents to influence change. APN can make a significant impact on health care with a wide range of skills, knowledge, and experience.
Media such news reporters, radio broadcasting , websites, and public forums influence policy making and changes.
The immigration policy has gained a very negative impression on the immigrants The Media’s Influence on Health Care Policy Making Implementation of Policy Political Participation The APN is skilled in political participation. Nurses can donate their services to politicians who support their interest , attend local and national political meetings where they can interface with decision makers. Lobbyist Advocacy APN can be health policy advocates, active, ongoing supporters of ther issues that matter to them. APN can write policy concerns in newspaper articles or speak at public forums. Membership of professional organizations Communication Raising their voices thru media and public forums and become vocal advocates for a change The major effect that the APN will have with the immigration policy laws may conflict with the health care provider – patient confidentiality and privacy of medical records obligation Reimbursement Issues APN and any health care provider have an ethical obligation to treat every human being regardless of their legal status Under this new law, healthcare coverage will be extended to 32 million people, a goal to be achieved through new mandates for individuals and employers, subsidies for people who can’t afford coverage on their own, consumer-friendly rules clamped on insurers, tax breaks and marketplaces to shop for health plans. When health reform legislation was in development, the following were identified as key issues for NPs by the The Nurse Practitioner Roundtable (a collaboration of the AANP, ACNP, GAPNA, NAPNAP, NPWH, and NONPF).
•Full recognition and utilization of nurse practitioners as primary care providers in all health care systems/ models
•Full recognition of nurse practitioner practices in coordinated care models such as Medical/Health Homes.
•Full participation of nurse practitioners and nurse practitioner practices in Accountable Care Organizations
•Full participation of nurse practitioners and nurse practitioner practices in chronic care and transitional care models included in the legislation
•Maintenance of the nondiscrimination language contained in the Senate Finance Bill
•Maintenance of the funding stream for Nurse Managed Clinics in the HELP bill.
•Maintenance of the Graduate Nurse Education Funding Stream as proposed in the Senate Finance Bill
•Authorization of nurse practitioners to certify patients eligible for home health care services.
Some of these issues were addressed in the Patient Protection and Affordable Care Act and some require further work. The NP Roundtable continues to work collaboratively on promoting these issues and seeking action to reduce and/or eliminate barriers to NP practice Health care
issues within United States related with immigration is another topic that separate or unified the country References Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2007). Policy & politics in nursing and health care (5th ed.). St. Louis, MO: Saunders Elsevier. Davidson, P., & Page, K. (2012). Research participation as work: Comparing the perspectives of researchers and economically marginalized populations. American Journal of Public Health, 102(7), 1254-1257. Capps, R, Marc R.R., Fix, M., 2009. Immigrants and health care reform. What’s really at stake?
Washington, DC: Migration Policy Institute. Kline, M., 2011. American College of Physicians. National immigration policy and access to
health care. Ryan, K., Kg’andu, J., 2012. National council of La Raza. Fast facts immigrants and health care. Zuckerman, S., Waldmann, T.A., Lawton, E., 2011. Health Affairs. Undocumented immigrants,
left out of health reform, likely to continue to grow as share of the uninsured. 30(10) 1-2. Leonard Atencio
Carlos Rivera University Of Phoenix
Nur 550 Issues in advance practice Limited proficiency in english with reading and writing Access to social services lack causing them to be vulnerable to exploitation and poverty Education Economic Issues Emotional Issues Discrimination