NURS 6050 : Global Health Comparison Matrix

NURS 6050 : Global Health Comparison Matrix

To Prepare:

• Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
• Select at least one additional country to compare to the U.S. for this Assignment.
• Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
• Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

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Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

• Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
• Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
• Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
• Explain how the health policy you selected might impact the role of the nurse in each country.
• Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

• Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.
• In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.
• Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples

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Global Health Comparison Matrix Between the United States and the United Kingdom on Access to Healthcare

Part 1: Global Healthcare Comparison Matrix and Narrative Statement

Global Healthcare Issue	Tackling Health Inequities: Universal Health Coverage (UHC) or Insurance
Description	Social justice and disparities in health services access
Country	United States	United Kingdom
Describe the policy in each country related to the identified healthcare issue	The Centers for Medicare and Medicaid Services (CMS) as a payer together with the Patient Protection and Affordable Care Act (2010) are the two frameworks in the US that give a semblance of UHC. However, there are still great disparities despite these and the US does not really have a “Health for All” program (Holder et al., 2017). The CMS takes care of the old and infirm while the ACA 2010 has brought into coverage millions more disadvantaged citizens especially those who had pre-existing conditions (Donkin et al., 2017; Kominski et al., 2017).	Unlike the US, the UK is more equitable and inclusive in terms of access to quality healthcare for all its citizens. It has the National Health Service or NHS program that is funded by taxpayers and caters for everyone including those that are unemployed (The World Bank, 2018; WHO, 201). According to Full Fact (2019), citizens only pay the remaining twenty percent as insurance premiums.
What are the strengths of this policy?	The overriding advantage of the ACA 2010 is its use of economies of scale. With everyone mandated to take cover at low premiums, the huge numbers make it affordable especially for those in the lower socioeconomic status population. Other benefits include provisions such as the coverage of pre-existing conditions that ere hitherto uncovered by health insurance providers.	The strengths of the NHS are that it is funded by taxes from those who are working at the ratio of 4:1 to premiums; but covers everyone equally irrespective of employment status.
What are the weaknesses of this policy?	The provision for individual mandate with its penalty runs counter to the intention of the program which was to empower the underprivileged to access care. Penalizing the poor for not taking cover increases inequity.	As long as the bulk of the NHS budget is funded by taxes, an increase in the unemployment rate will affect its ability to cater for the healthcare expense of everyone.
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)	In the US the social determinants of health impacting health inequality are socioeconomic status (family income) and access to quality healthcare (Powell, 2016). The US healthcare system is arguably the most expensive in the world and this makes many unable to afford the services (Sultz & Kroth, 2018). Because of the other obstacles such as the individual mandate, even more ordinary citizens find themselves unable to access healthcare when unemployed (Kickbusch, n.d.).	Access to quality healthcare services and socioeconomic status do not negatively impact the healthcare issue of UHC coverage as the NHS is funded by taxes at 80% and caters for everyone.
How has each country’ government addressed cost, quality, and access to the selected global health issue?	For the US, the ACA 2010 addressed to some extent the cost and accessibility issues. More persons can now get health insurance including for pre-existing conditions. According to Safran and Higgins (2019), the ACA 2010 also introduced the pay-for-performance requirement that focuses on quality instead of volume. With this, only quality care is reimbursed.	The NHS has effectively addressed the aspects of cost and access by only requiring individuals to pay for 20% of the insurance for their health. This is quite affordable. Quality is ensured by only using accredited providers to offer healthcare services.
How has the identified health policy impacted the health of the global population? (Be specific and provide examples)	With countries having different healthcare policies, it has become very difficult to effectively combat together global threats such as the recent Covid-19 pandemic. Citizens in the countries without UHC get affected most as they have to foot most of the healthcare bills themselves. This helps the pandemic to spread faster and become deadlier.	Contrary to those countries without a semblance of UHC, the UK is able to effectively deal with global threats as was recently seen with the novel coronavirus pandemic.
Describe the potential impact of the identified health policy on the role of nurse in each country.	The potential impact of this health policy (ACA 2010) in the US on the nurse’s role is that the nurse must grasp every opportunity to educate those patients who have not yet implemented the individual mandate to do so. They must therefore explain to them the benefits they stand to gain, such as coverage for re-existing conditions.	In the UK as in the US the nurse’s role is also that of advocacy as impacted by the NHS policy. The nurse has to encourage those without jobs to continue seeking treatment and also those not paying the 20% premiums to do so.
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)	The impact of the ACA 2010 on local healthcare organizations in the US is that they must offer quality to be reimbursed and they must also provide services for pre-existing conditions.	Accreditation of healthcare providers in the UK for NHS patients will only take place if they are providing quality services.
General Notes/Comments	The ACA 2010 is a policy move designating progress towards “Healthcare for All” in the US.	The NHS is only 20% away from being a full Universal Healthcare Program (UHC) that is free.

 

Part 2: Agenda for Social Change

To advocate for the incorporation of a global perspective into local practice, as a nurse I would lobby legislators in my personal capacity but also collectively with my professional nursing organization colleagues. This advocacy approach would be the most useful tactic to ensure this happens as it is all about policy (Milstead & Short, 2019; Rafferty, 2018). Being a nurse leader the role is also to motivate and educate those nurses that I lead about the importance of advocacy in achieving the above goal. The advocacy in this case as outlined above will take place in the form of writing letters to legislators, writing emails to them, and also booking appointments for face-to-face engagements with the law-makers.

The incorporation of a global lens into the local practice also contributes to social change for me as a nurse leader. The reason is that implementing policies that have worked elsewhere in the world such as UHC into local practice positively impacts the community and improves their health status. This is the essence of social change since individuals within the community are positively impacted by this local implementation of a global perspective.

 

References

Donkin, A., Goldblatt, P., Allen, J., Nathanson, V. & Marmot, M. (2017). Global action on the social determinants of health. BMJ Global Health, 3(e000603). http://dx.doi.org/10.1136/bmjgh-2017-000603

Full Fact (2019). How is the NHS funded? https://fullfact.org/health/how-nhs-funded/

Holder, J., Torprey, P. & Cage, F. (July 25, 2017). How does the US healthcare system compare with other countries? https://www.theguardian.com/us-news/ng-interactive/2017/jul/25/us-healthcare-system-vs-other-countries

Kickbusch, I. (n.d.). Advancing the global health agenda. UN Chronicle. https://www.un.org/en/chronicle/article/advancing-global-health-agenda

Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. http://dx.doi.org/10.1146/annurev-publhealth-031816-044555

Milstead, J. & Short, N. (2019). Health policy and politics: A nurse’s guide, 6^th ed. Jones & Bartlett Learning.

Powell, D.L. (2016). Social determinants of health: Cultural competence is not enough. Creative Nursing, 24(1), 5-10. http://dx.doi.org/10.1891/1078-4535.22.1.5

Rafferty, A. M. (2018). Nurses as change agents for a better future in health care: The politics of drift and dilution. Health Economics, Policy and Law, 13(3-4), 475-491. http://dx.doi.org/10.1017/S1744133117000482

Safran, D.G. & Higgins, A. (2019). Getting to the next generation of performance measures for value-based payment. Health Affairs. https://doi.org/10.1377/hblog20190128.477681

Sultz, H.A., & Kroth, P.J. (2018). Sultz and Young’s health care USA: Understanding its organization and delivery, 9^th ed. Jones & Bartlett Learning.

The World Bank (2018). Universal Health Coverage. https://www.worldbank.org/en/topic/universalhealthcoverage

World Health Organization [WHO] (2019). Universal Health Coverage. https://www.who.int/healthsystems/universal_health_coverage/en/