Discussion: Presidential Agendas
Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
Reference:
New York State Department of Health. (n.d.). Making New York the healthiest state: Achieving the triple aim. Retrieved June 21, 2021 from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf
To Prepare:
- Review the Resources and reflect on the importance of agenda setting.
- Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
By Day 3 of Week 1
Post your response to the discussion question: Consider a population health topic that rises to the presidential agenda level. How did two recent presidents handle the problem? What would you do differently?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
Discussion - Week 1
Healthcare in the United States is a complex and multi-faceted system that unfortunately does not always deliver or coordinate high quality care. It is stated that at least one in ten Americans do not have health insurance. Therefore, these individuals are less likely to visit a primary care provider due to the high cost of “out of pocket pay.” This will increase their risk of developing and not appropriately managing chronic illness, without proper monitoring, screenings and medications, we are more likely to become an unhealthy society (Health Care Access and Quality, 2020).
Furthermore, our vulnerable population is growing. Elderly, minority groups, and lower-income populations are at a greater risk of not receiving timely and essential care. This diminishes progress in health problems as a result of inadequate access to healthcare. Fortunately, the issue of healthcare has gained both momentum and national focus, allowing for more appropriate indicators to measure accessibility and produce tangible healthcare reform (Access to Health Care in America, 2013).
President Obama helped to decrease the rate of uninsured below 10% when the Affordable Care Act was passed. It was an incredible reform to the healthcare system that allowed at least another 20 million more individuals access to coverage. In addition, 129 million Americans no longer have to worry about being declined health coverage due to a pre-existing condition. The ACA allowed for more access to primary care visits for routine physicals, greater access to preventive healthcare and screenings (Improving Health for All Americans).
Rural communities have some of the worst outcomes regarding preventable health diseases, in-fact more than the 57 million Americans who reside in urban areas. This is a direct result of their having less access to transportation to receive high quality care. Rural communities have a shortage of providers and workforce, in 2010 more than 126 rural hospitals closed. President Trump’s initiative The Community Health Access and Rural Transformation (CHART) addressed this problem by attempting to increases health access and improve the quality of care. CHART also sent funding to promote higher use of telehealth and changing the structure of payments. Thus, the goal was to increase health choices with different delivery systems and at a lower cost (Press Release Trump Administration Announces Initiative to Transform Rural Health, 2020).
President Biden, since taking office has signed two executive orders that will strengthen the work that Present Obama began with ACA and Medicaid. Recently, President Biden and the Department of Health and Human Services (HHS) opened more access to health care, known as “Special Enrollment Period’ from February 2021 to May 15, 2021 to directly provide relief to Americans who lost health coverage due to the pandemic. Furthermore, the current administration will look at many policies that may hinder access to healthcare and reverse them, one such policy that the Biden administration is focusing on is improving access for women and reproductive health (FACT SHEET: President Biden to Sign Executive Orders Strengthening Americans' Access to Quality, Affordable Health Care, 2021).
It is difficult for me to determine exactly how I would go about to bring more access to healthcare that is both high quality and at the most minimum cost for all. I believe the key is not in any one particular idea, but a collection of ideas that can formulate a plan that best serves the American people. Unfortunately, healthcare policies many times are created based on political lines, but if our elected leaders can at least have a common goal then this issue can cross those political lines. As nurses, we have an advantage of directly serving these communities and working with clients and observing and understanding their needs. I think we also have an obligation to share their and our stories with policy leaders in an active forum to produce meaningful change.
References
Healthy People 2030. (2017). Health Care Access and Quality. Health Care Access and Quality - Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality.
National Archives and Records Administration. (n.d.). Improving Health for All Americans. National Archives and Records Administration. https://obamawhitehouse.archives.gov/the-record/health-care.
Press release Trump Administration Announces Initiative to Transform Rural Health. CMS. (2020, August 11). https://www.cms.gov/newsroom/press-releases/trump-administration-announces-initiative-transform-rural-health.
The United States Government. (2021, February 1). FACT SHEET: President Biden to Sign Executive Orders Strengthening Americans' Access to Quality, Affordable Health Care. The White House. https://www.whitehouse.gov/briefing-room/statements-releases/2021/01/28/fact-sheet-president-biden-to-sign-executive-orders-strengthening-americans-access-to-quality-affordable-health-care/.
(US), N. R. C. (2013). Public Health and Medical Care Systems. U.S. Health in International Perspective: Shorter Lives, Poorer Health. https://www.ncbi.nlm.nih.gov/books/NBK154484/.
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6 months ago
Shanaa Wheeler-Yard
RE: Discussion - Week 1
Great post,
The Affordable Care Act initiate by the President Obama’s administration significantly decreased the number of uninsured Americans in 2014 (Courttemanche et al., 2018). Although controversial and heavy criticized by former President Trump, many Americans have received health care services due to Affordable Care Act. Can you recall experiencing patient encounters with individuals who may have personally benefited from The Affordable Care Act?
References
Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2018). Effects of the Affordable Care Act on Health Care Access and Self-Assessed Health After 3 Years. Inquiry: a journal of medical care organization, provision and financing, 55, 46958018796361. https://doi.org/10.1177/0046958018796361
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6 months ago
Orsela Younano
RE: Discussion - Week 1
6 months ago
Scott Lamprecht
RE: Discussion - Week 1
6 months ago
Idowu Oshokoya
RE: Discussion - Week 1
Orsela,
You are correct that citizens without healthcare plan are constantly risen in the United States, and care providers needs to render more high-quality care. Individuals without health insurance do not visit a primary care because they cannot afford the bill. Therefore, secondary prevention is not followed. Lack of early disease detection will put most these individuals to be a high risk for chronic diseases or lead to poor management of illness. preventing diseases is the best way to increase quality of life and recommending service is the key to improving health (Healthy People, 2021).
Also, the Executive order that was signed by President Biden is to support the Affordable Care Act and to grant healthcare coverage for the Americans. According to the White House (2021), “A Special Enrollment Period will give Americans that need health care coverage during this global pandemic the opportunity to sign up.” it will strengthen the affordable care act and reconsider most people.
References
Healthy People 2030. (2021). Goal: Improve healthcare. Retrieved from
https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care
The White House. (2021). FACT SHEET: President Biden to Sign Executive Orders Strengthening Americans’ Access to Quality, Affordable Health Care. Retrieved from:
https://www.whitehouse.gov/briefing-room/statements-releases/2021/01/28/fact-sheet-president-biden-to-sign-executive-orders-strengthening-americans-access-to-quality-affordable-health-care/
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6 months ago
Cynthia McDonald
RE: Discussion - Week 1
Nurses play a pivotal part in advocating for change regarding health and social policies. Nurses often find themselves fulfilling many roles such as care providers, educators, administrators, consultants, researchers, political activist, and policymakers (Milstead & Short, 2019). Today the issue that our country is currently facing is the COVID-19 pandemic. Former President Donald Trump and current sitting President Joseph Biden have different political views on how to effectively manage the pandemic. The uncertainly of this virus has Americans scared and looking to our leaders for answers on how to navigate through this pandemic safely.
The Trump administration had the daunting task of being faced with this crisis while in office. The administration seen how the virus was affecting China and made a swift first action to stop travel between China into the United States (The White House, 2020). In his February 4th State of the Union address, President Trump pledged to “take all necessary steps to safeguard our citizens from the virus,” (The White House, 2020). His administration worked hard to establish the world’s best testing system, released guidance recommending mitigation measures to slow disease progression, help increase supplies such as PPE and ventilators, and launched a historic effort to develop a vaccine in record time (The White House, 2020). Luckily for Biden’s administration the trump administration laid out a lot of the groundwork for the fight against COVID-19. Biden’s administration faced the challenges of continuing the efforts to slow the progression of the disease such as enforcing mask mandates and the continued push for vaccinations, and school re-openings (The White House, 2021).
To answer the question as to how I would have handled this pandemic response differently would be to not have closed businesses and schools. It appears decisions were brought on to quickly without first thinking of the repercussions it would have on our society. At the time when schools were being closed there wasn’t even an issue with school aged children getting the virus. I feel that mask mandates are imperative to help in slowing the progression of this virus if one isn’t vaccinated but feel as though if someone is vaccinated that masks should be a choice and not mandated.
References
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse's guide (6 ed.). MA, Burlington: Jones & Bartlett Learning.
The White House. (2020, August 10). trumpwhitehouse.archives.gov. Retrieved from President Trump's historic coronavirus response: https://trumpwhitehouse.archives.gov/briefings-statements/president-trumps-historic-coronavirus-response/
The White House. (n.d.). Priorities. Retrieved from COVID-19: https://www.whitehouse.gov/priorities/covid-19/
REPLY QUOTE
6 months ago
Orsela Younano
RE: Discussion - Week 1
6 months ago
Jessica Ferrin
RE: Discussion - Week 1
Cynthia,
I enjoyed your post. I agree that the decisions made at the beginning of the pandemic were some of the toughest an administration could have to make. I applaud the Trump administration for swiftly acting and shutting down travel from China, and launching the vaccine efforts amongst other things (The White House, 2020). Since you stated you feel the school closings were done in haste, how do you feel schools should be handled at this particular point in time? As of August 29 2021, my home state of South Carolina had over 2,000 school-aged student cases of COVID-19 (S.C. Department of Health and Environmental Control, 2021). My entire family is vaccinated, we religiously wear masks, my youngest son only goes to and from school yet he tested positive for COVID yesterday. I am furious that schools aren’t closed at this particular point in time, especially when numbers are currently higher.
The Centers for Disease Control and Prevention (CDC) issued updated guidance for school-aged children K-12 in August, 2021. Due to increasing cases from the Delta variant of COVID-19, the CDC recommends school-aged children, visitors, and teachers wear masks while indoors at all times (Centers for Disease Control and Prevention, 2021). Unfortunately, my son’s school does not mandate masks at this time. Do you agree with the CDC guidance, and do you feel schools should adhere to them?
References
Centers for Disease Control and Prevention. (2021, August 5). K-12 guidance. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-guidance.html
S.C. Department of Health and Environmental Control. (2021, August 29). Resources for your home & community (COVID-19). Retrieved from Coronavirus Disease 2019 (COVID-19): https://scdhec.gov/covid19/resources-community-covid-19/covid-19-cases-associated-staff-students
The White House. (2020, August 10). trumpwhitehouse.archives.gov. Retrieved from President Trump's historic coronavirus response: https://trumpwhitehouse.archives.gov/briefings-statements/president-trumps-historic-coronavirus-response/
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6 months ago
Betsy Koplin
RE: Discussion - Week 1
Hi Cynthia,
I agree with you on your views with Trump’s initial reactions to the pandemic. This country has been faced with so many decisions over the last 18 months that have been both difficult and controversial. Trump immediately halted travel from China to the United States as well as enhance screening processes for travel (The White House, 2020). Closing businesses and schools have proven to be negative in many ways but did assist in stopping the spread of the virus along with the travel restrictions. Unfortunately, so many business owners had to close their doors for good and we have seen negative outcomes from this. The closing of schools has also caused many kids to suffer from mental health issues due to being isolated at home for over a year.
Unfortunately, it seems like we are heading into another difficult fall and winter with rising cases, return of mask mandates and schools unsure of how to operate. I work in a hospital that had gotten to the point where if you were vaccinated you did not have to wear a mask. We have since returned to almost all the same restrictions we had in place a year ago. It is disappointing and scary to see where we are at right now and have so many unknowns ahead of us. Our biggest challenge is lack of available beds in our rural area and not from covid patients but just very sick patients. Even if facilities have open beds, they do not have the staff to care for these patients. We are a small critical access hospital and had to call 16 hospitals before finding one with an open bed to transfer to. Nurses must play a role in advocating for patients as well as bring research and creativity into policy and public health issues (Milstead & Short, 2019). I think we will find that nurses in this pandemic have played a vital role in the safety and advocacy of people suffering during this pandemic. I saw it this past weekend with the critical patient who needed to be transported.
References:
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
Jones & Bartlett Learning.
The White House. (2020). trumpwhitehouse.archives.gov. Retrieved from President Trump's historic coronavirus response: https://trumpwhitehouse.archives.gov/briefings-statements/president-trumps-historic-coronavirus-response/
-Betsy
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6 months ago
Scott Lamprecht
RE: Discussion - Week 1
Nurses have played a major role, but I have seen several hospitals in my area give very little support to the nurses. One hospital is cutting health benefits and increasing costs several hundred per month stating the lost money during COVID. This is after the published announcement the hospital system brought in over 4.8 billion dollars in just COVID relief funds.
REPLY QUOTE
6 months ago
Betsy Koplin
RE: Discussion - Week 1
That is so sad to hear! Fortunately, we have not had that happen at my hospital, hopefully it stays that way, but with everything that has happened over the last year and a half, I am not confident.
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6 months ago
Michael Collins
RE: Discussion - Week 1
My Success with Walden University’s Vision and Mission
“The meaning to life is to find your gift. The purpose of life is to give it away”(University of St. Augustine, 2020) This quote by William Shakespeare resonates with me and the way I view my career and values as a nurse. My name is Michael Collins and as a nurse for a short three years, I have come to find that the more passion and caring you put into your work on a daily basis, the more enjoyable and rewarding your job will be. I am currently a Psychiatric Mental Health Registered Nurse in Pittsburgh, Pennsylvania. I found my true interest in nursing when I began working in the mental health field, leading to the reason I am currently enrolled in Walden University’s Psychiatric Mental Health Nurse Practitioner program. My goal upon successfully completing this program is to be able to work along side the MD Psychiatrist at my current place of employment through his private practice which reaches into a vulnerable community within the Pittsburgh area more than an inpatient setting can. I would define success in this journey as being able to reach out to communities who don’t have the resources or proper education when it relates to Mental Health and be able to bring quality care to these areas. Mental health hides from nobody, and there is an ever growing need in the media and in local communities for attention to mental health.
Success through Social Change
After spending some time as a mental health nurse, I knew I wanted to pursue higher education in this field of study. Upon researching for highly accredited schools, preferably online, that would be able to accommodate my full time work schedule, I easily found Walden University. I read through the website to gather some information to determine if it would be a fit for my needs and I decided right then I no longer was on the hunt for a school. Walden fit everything I needed along with their mission and visions correlating with my person goals and mission upon completing the practitioner program. Like myself, the Walden University College of Nursing (Walden University, 2018) has a vision of providing nursing services through nursing care to meet the needs of all individuals and communities. The common theme of Walden’s mission, vision, and goals that captivated me was the importance of social change related to the community. The academic community at Walden was created through their definition of positive social change. Walden University defines their goal towards positive social change as a “deliberate process of creating and applying ideas, strategies, and actions to promote the worth, dignity, and development of individuals, communities, organizations, institutions cultures, and societies” (Walden University, 2018, para. 4). What I found most appealing in the list of MSN Learning Outcomes at Walden was that at the end of this program students will be able to “demonstrate ability to effectively communicate using audience-specific oral, written, and information technology for professional delivery of specialist nursing care”(Walden University, 2021). This one struck as the most important specific to my field of study because I often see the communication barrier associated with mental health. All too often patients can’t portray how they’re feeling or make their needs known especially in the inpatient setting where the psychiatrist has a short amount of time with each patient on a daily basis. On the same note, healthcare professionals communicate poorly to the patients whether it be through advanced vocabulary or unwelcoming body language which can be detrimental to care in a mental health setting.
Networking towards your Goals
Very early on into my career as a nurse, I realized networking and who you knew played a large roll in successfully achieving higher goals. With proper networking, doors will open and opportunities will present themselves. As anywhere I have ever worked, I came into this job extremely determined to not only succeed but to excel. My work ethic in my day to day tasks were clear and through this effort I have become personally close with the head MD whom also is the Psychiatrist at the hospital. I also work along side the head Psychologist who also is a professor at a prestigious university here in Pittsburgh. With these connections through networking, my door of opportunity is wide open. I have just begun this Nurse Practitioner program, but the two Doctors listed have already welcomed me to join them for whatever clinical, preceptorship, or shadowing that my schooling will require. They have also offered me to work with any of their colleagues as well if our schedules wouldn’t happen to match up. This all didn’t happen through a chance of luck, but rather through strategic networking with those whom I sought to be able to help me with my future success the most.
References
University of St. Augustine. (2020, October). 85 Nursing Quotes: Words of Wisdom for Nurses.
https://www.usa.edu/blog/nursing-quotes/
Walden University Catalog. (2018, March) Vision, Mission, and Goals.
https://catalog.waldenu.edu/content.php?catoid=153&navoid=49950
Walden University. Catalog. (2021, March) Master of Science in Nursing (MSN): https://catalog.waldenu.edu/content.php?catoid=153&navoid=49950 MSN Learning Outcomes
https://catalog.waldenu.edu/preview_program.php?catoid=179&poid=72167&returnto=65560
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6 months ago
Michael Collins
RE: Discussion - Week 1
Please disregard this post, I have reposted the correct discussion. I am sorry for this error.
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6 months ago
Angela Sullivan
RE: Discussion - Week 1
"Drug overdose deaths rose by close to 30% in the United States in 2020, hitting the highest number ever recorded" (Fox, 2021). "This is the highest number of overdose deaths ever recorded in a 12-month period, and the largest increase since at least 1999" (Fox, 2021).
"The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place. If they don't start, they won't have a problem." - President Donald J. Trump" (President Donald J. Trump Taking Action, n.d.). In October of 2017, President Trump declared the opioid crisis a public health emergency. "In March of 2017, President Trump established the President's Commission on Combating Drug Addiction and the Opioid Crisis...to study the scope and effectiveness of the Federal Response to drug addiction and the opioid crisis" (President Donald J. Trump Taking Action, n.d.), "The President's Opioid Initiative will reduce drug demand through education, awareness, and preventing over-prescription, cut off the flow of illicit drugs across our borders and within communities, and save lives now by expanding opportunities for proven treatments for opioid and other drug addictions" (National Archives, n.d.)
At the end of 2019, COVID-19 cases ravaged the world leading to the world's first pandemic in almost 100 years. This led to an uprooting of our normal routines and lifestyles here in the United States. We lost jobs, were unable to see family and friends, businesses closed. People became isolated and lonely. I, myself, had a very difficult time for the first few months. Due to the major shift in the economy as well as the increased isolation, people became more depressed. During 2020, the overdose rates increased and it is believed that the pandemic itself is a major factor behind the drastic increase in drug use and overdose deaths. Because of the pandemic and limited availability for people to seek assistance, President Trump encouraged the use of telehealth for appointments as well as developed a waiver that providers could start medication-assisted treatment for detox via the telehealth platform, allowing for those wanting help to get clean receive it via an X-waiver. "The X-waiver is a federal license that permits clinicians to prescribe buprenophine for opioid addiction treatment" (Gomez, 2021). Buprenorphine is a front-line, medically-assisted treatment for detox that reduces the craving for opioids and helps to avoid relapses.
During President Biden's campaign for presidency, he had his own plan to tackle the opioid crisis. "Making sure people have access to high quality health care - including substance use disorder, treatment and mental health services" (The BIden Plan to End the Opioid Crisis, 2020). At the time of Obamacare, when President Biden was VP under President Obama, Obamacare specified that insurers must cover substance use disorder as well as mental health. The Biden administration became concerned that X-waiver was leading to an increase in the addiction rates. "On January 14, 2021, there was a White House press release announcing new guidelines. The change was in response to a 21% increase in opioid-related deaths over the past 12 months" (Gomez, 2021). Initially, "the Biden administration drew criticism earlier this year after it canceled a plan to ease buprenorphine rules, unveiled by President Trump in January" (Gomez, 2021). These new guidelines allow for more providers to prescribe the medically-assisted medication for detox. "Health care workers will still need additional training and federal waivers if they plan to treat more than 30 patients with the medication" (Mann, 2021).
I currently work in a residential drug and alcohol treatment facility. We use the telehealth option a lot, but many barriers to that are the client having access to a phone, computer and/or WiFi. We did have a provider meeting today and one of our physicians relayed that the X-waiver is in effect at least until December of this year due to the rise in the COVID-19 Delta variant. This will allow those who still can not get out due to COVID restrictions a way to continue receiving treatment.
Every once in a while I will pick up in the ER. When I am there I often have patients who have overdosed or are chemically impaired. I can be a voice for patients who want that help and explain what treatments and care my facility has to offer as we are a direct extension of the hospital corporation.
Fox, M. (2021, July 17). Drug overdose deaths hit highest number ever Recorded, CDC data shows. CNN. https://www.cnn.com/2021/07/14/health/drug-overdose-deaths-2020/index.html. Retrieved September 1, 2021.
Gomez, S. (2021, March 10). Biden canceling Trump's plan on Opioid treatment Prescriptions. Addiction Center. https://www.addictioncenter.com/news/2021/01/biden-canceling-trumps-opioid-treatment-prescriptions/. Retrieved September 1, 2021.
Mann, B. (2021, April 27). As opioid deaths surge, Biden team moves to make buprenorphine treatment mainstream. NPR. https://www.npr.org/2021/04/27/990997759/as-opioid-deaths-surge-biden-team-moves-to-make-buprenorphine-treatment-mainstre. Retrieved September 1, 2021.
National Archives and Records Administration. (n.d.). President Donald Trump's Initiative to Stop Opioid Abuse and Reduce Drug Supply and Demand. National archives and Records Administration. https://trumpwhitehouse.archives.gov/briefings-statements/president-donald-j-trumps-initiative-stop-opioid-abuse-reduce-drug-supply-demand-2/. Retrieved September 1, 2021.
PRESIDENT donald j. Trump is taking action on drug ... (n.d.). https://dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Resources/opioids/Background%20on%20PH%20Emergency%20Declaration.pdf. Retrieved September 1, 2021.
The Biden plan to end the opioid crisis. Joe Biden for President: Official Campaign Website. (2020, August 3). https://joebiden.com/opioidcrisis/. Retrieved September 1, 2021.
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6 months ago
Sophie Enjema Ndumbe
RE: Discussion - Week 1
Hi Angela,
Nice post. Drug overdoses is also a huge issue, people take drugs which are not necessary for them. Drug overdose leads to increase morbidity and mortality, the country continues to see an increase in the use of drugs every day. According to Friedman & Akre (2021) it was noted that in May 2020, 57.7% of people died from drug overdose and it was considered the deadliest month.
There are various reasons why people overdose on drugs, these might include the following: lack of knowledge, a disease condition, intentional or accidental use. Measures should be put in place to help combat the issue of drug overdose. President Biden and his administration have also realized that drug overdose is a serious issue, they are trying to find ways to save people from drug overdose (The white house, 2021). Some strategies to prevent drug overdose includes prevention programs, treatments, educating the population on the risks of drug overdose.
References
Friedman, J., & Akre, S. (2021). COVID-19 and the drug overdose crisis: uncovering the deadliest months in the United States, January‒July 2020. American Journal of Public Health, 111(7), 1284–1291. https://doi-org /10.2105/ajph.2021.306256
The white house (2021). Statement from acting director Regina LaBelle on today’s CDC overdose death data
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6 months ago
Angela Sullivan
RE: Discussion - Week 1
thank you for you input!
REPLY QUOTE EMAIL AUTHOR
6 months ago
Roseline Evans
RE: Discussion - Week 1-Initial post
According to The American Psychiatric Association, mental illnesses are those health conditions that affect emotion, thinking or behavior (or a combination of these). Mental illnesses can also cause distress and/or problems in social, work or family activities (The American Psychiatric Association, 2018). In research from The American Psychiatric Association (2018), nearly one in five (19 percent) U.S. adults experience some form of mental illness while one in 24 (4.1 percent) has a serious mental illness. One of the major contributors to the mental health crisis is the lack of access to healthcare and programs. To help combat the mental health crisis and improve access to mental health care, various reforms have been established by previous and current presidents.
For example, going back to 2001, President Bush announced his New Freedom Commission Report initiative. This was established to acknowledge and address issues regarding the care and treatment of those who have this disability and to provide them with the necessary means to receive appropriate healthcare services while helping to remove the stigma associated with mental health disease. President Bush’s New Freedom Commission suggested new ways to improve Americans' delivery of mental health care. Bush recommended reshaping the system to where individuals were able to receive continued continuity of care while receiving the latest treatment options and support measures. (President’s New Freedom Commission on mental health, n.d., p. 1).
Fast forward to March 2010 when President Obama enacted the Affordable Care Act (ACA). President Obama stated during his administration that “a major priority would be healthcare for all” (Milstead & Short, 2019, p. 11). The ACA was established to provide affordable access to healthcare and provide insurance for the uninsured. It prevented Americans from being denied health coverage due to pre-existing conditions or mental health issues (The White House, 2016). People with mental health disease would thereby benefit from ACA as provisions were made to allow mental health coverage to align with their medical and surgical coverage, thus providing early identification and treatment measures for mental health issues (The White House, 2016). Obama’s administration also declared May as the official mental health awareness month with the aim of bringing awareness and support to those affected by mental disease (The White House, 2016).
Trump’s administration on the other hand while acting with bipartisan support in Congress, increased spending on a major mental health concern: opioid addiction. Funding for treatment and recovery rose from $559 million to $2.12 billion between fiscal year 2017 and fiscal year 2018. Trumps administration also handed out nearly $2 billion in grants to boost treatment and services in communities hit hard by opioid addiction (Jacobson, 2020)
Preseident Biden’s administration is also currently working with the Substance Abuse and Mental Health Services Administration (SAMHSA) at the U.S. Department of Health and Human Services (HHS) to provide nearly $2.5 billion in funding to states and territories to address the nation’s mental illness and addiction crisis, which has worsened during the COVID-19 pandemic. As such, $1.65 billion will be directed in Substance Abuse Prevention and Treatment Block Grant funding and $825 million in Community Mental Health Services Block Grant funding to states and territories. The Community Mental Health Services Block Grant program allows states and territories to provide comprehensive community mental health services and address needs and gaps in existing treatment services for those with severe mental health conditions (U.S. Department of Health & Human Services, 2021)
As a healthcare provider, I would focus on increasing awareness to mental health disease and providing access to affordable mental health services as this is a disease that affects everyone, regardless of race, gender, or even socio-economic status. To achieve this, I would work to increase funding to agencies that provide mental health support such as such as the Substance Abuse and Mental Health Services Administration (SAMHSA) among others to ensure that everyone who needed these services had easy access to them.
References
The American Psychiatric Association. (2018, August). What Is Mental Illness? https://www.psychiatry.org/patients-families/what-is-mental-illness
Jacobson, L. J. (2020, July 15). Trump-O-Meter: | PolitiFact. Politifact. https://www.politifact.com/truth-o-meter/promises/trumpometer/promise/1361/expand-mental-health-programs/
Kilbourne, A. M., Beck, K., Spaeth-Rublee, B., Ramauj, P., O'Brien, R. W., Tomoyasu, N., & Pincus, H. A. (2018). Measuring and improving the quality of mental health care: A global perspective. World Psychiatry, 17(1), 30–38. https://doi.org/10.1002/wps.20482
Milstead, J. A., & Short, N. M. (2019). Informing public policy: An important role for registered nurses. In Health policy and politics: A nurse's guide (6th ed., p. 11). Jones & Bartlett Learning.
President’s New Freedom Commission on mental health. (n.d.). Achieving the promise: Transforming mental health care in America. Mental Health Commission.
https://govinfo.library.unt.edu/mentalhealthcommission/reports/FinalReport/FullReport- 1.htm
The White House. (2016). Making healthcare better. Addressing mental health: Progress in research, prevention, coverage, recovery and quality
https://www.whitehouse.gov/sites/whitehouse.gov/files/images/Documents/Men
The White House. (2016, April 28). Presidential Proclamation: National mental health awareness month. whitehouse.gov.
https://obamawhitehouse.archives.gov/the-press-office/2016/04/28/presidential- proclamation-national-mental-health-awareness-month-2016
U.S. Department of Health & Human Services. (2021, March 11). With Pandemic Worsening the Mental Illness and Addiction Crisis, Biden Administration to Provide Nearly $2.5 Billion to States, Territories for Treatment, Prevention Aid. Www.Samhsa.Gov.https://www.samhsa.gov/newsroom/press-announcements/202103110230
World Federation for Mental Health. (2012, October). Depression: A global crisis. World Health Organization.
REPLY QUOTE EMAIL AUTHOR
6 months ago
Michael Collins
RE: Discussion - Week 1-Initial post
Hello Roseline,
I quickly found interest in your post the moment I saw American Psychiatric Association In your first sentence! My focus on this discussion was also about mental illness because it relates to my program of choice as PMHNP. You made some amazing points regarding what the leaders of our nation have done throughout the years, and what they could have done better. As you said, not only do nearly one in five adults in the U.S experience some form of mental illness, but they do so in a country with a shortage in mental healthcare. On top of the shortage of care, the United States has the highest price for healthcare per capita in the entire world (Milstead & Short, 2019, pp.175). This is unsettling for a country so advanced as our own. Not only is care scarce, but it is impossible to afford for some populations.
The Trump Administration made huge strides in trying to get the opioid crisis more under control which goes hand in hand with other psychiatric disorders. It’s stated that people with substance use disorders are twice as likely to have a psychiatric illness like mood and anxiety disorders which are associated with increased suicide risk. The same is true the other way around. Half of all people with mental illness in their lifetime have a substance use disorder (Gordon, J., Volkow N, 2019). The Trump Administration actually helped a much broader spectrum when it comes to mental illness than just the opioid crisis.
As you stated, providing the access to quality and affordable mental health services is of utmost importance. Mental health hides from nobody and can affect any population of any age. Taking this access to care to the local community level is needed. Early education on mental illnesses can help raise the awareness to seek the help needed before it becomes to late. Funding local agencies and programs like you said needs to be on every presidential agenda.
References
Gordon, J., & Volkow, N. (2019, September 19). Suicide Deaths Are a Major Component of the Opiod Crisis that Must Be Addressed.
Milstead, J. A., & Short, N. M. (2019) Health Policy and Politics: A Nurse’s Guide Sixth Edition. Jones & Bartlett Learning.
REPLY QUOTE EMAIL AUTHOR
6 months ago
Angela Sullivan
RE: Discussion - Week 1-Initial post
6 months ago
Cyrin Natividad
RE: Discussion - Week 1
6 months ago
Andrea Cholagh
RE: Discussion - Week 1
Hi Cyrin, great post! Opioid abuse is a severe public concern! I do agree with you when you say that everyday, we face people in the health care system who are addicted to opioids and/ or other drugs. The fact that 42, 000 Americans died from overdoses in Trump’s first year of office should be enough of a statistic to being this up the political agenda (Noam Levey, L. A Times). I love that you take the time to try and help the patient’s cope in other ways and are putting effort towards helping with the opioid crisis. I also think it’s a great thing that President Biden is trying to offer treatment to those abusing drugs (White House, 2021). I know that at times, some health care professionals cannot tell if someone with a history of drug abuse is in pain or trying to get opioids. Do you think that people with history of drug abuse are treated differently by health care professionals?
References
Levey, N. (2020, August 23). Before coronavirus failures, Trump struggled to slow drug overdoses. Los Angeles Times. https://www.latimes.com/politics/story/2020-08-23/trump-failure-opioids-foreshadowed-coronavirus
White House (2021). The Biden-Harris Administration’s Statement of Drug Policy Priorities. https://www.whitehouse.gov/wp-content/uploads/2021/03/BidenHarris-Statement-of-Drug-Policy-Priorities-April-1.pdf
REPLY QUOTE EMAIL AUTHOR
6 months ago
Jessica Ferrin
RE: Discussion - Week 1
Cyrin,
I enjoyed your post discussing opioid abuse in the United States. I find it interesting you mentioned the COVID-19 pandemic having a negative impact on mental health. I am seeing this first-hand with my youngest son. He tested positive for COVID this week, and I have him isolated in his room. Last night he came to me crying because he is lonely in his room, as he is not used to being secluded. I can only imagine how more lonely our elderly patients are, and ill patients hospitalized under quarantine are during this time. Among quarantined individuals, loneliness, frustration, and anger can all be experienced by those who are quarantined (Nochaiwon et al., 2020).
A positive aspect of telemedicine is that mental health patients will have access to mental health interventions twenty four hours a day allowing support and monitoring during crisis care (Cortelyou-Ward et al., 2018). I think that this comparison between the Trump and Biden administration response gets muddy due to the pandemic. In-home visits become difficult with COVID-19 concerns so I feel telemedicine is a great option especially if the patient has access to video conferencing. I agree regular emotional support is needed during this time.
References
Cortelyou-Ward, K., Rotarius, T., & Honrado, J. C. (2018). Using Technology to Improve Access to Mental Health Services. Health Care Manager, 37(2), 101–108. https://doi-o rg.ezp.waldenulibrary.org/10.1097/HCM.0000000000000211
Nochaiwong, S., Ruengorn, C., Awiphan, R., Ruanta, Y., Boonchieng, W., Nanta, S,, Kowatcharakul, W., Pumpaisalchai, W., Kanjanarat, P., Mongkhon, P., Thavorn, K., Hutton, B., Wongpakaran, N., Wongpakaran, T. (2020). Mental health circumstances among health care workers and general public under the pandemic s ituation of COVID-19. Medicine, 99(26). https://journals.lww.com/mdjournal/Fulltext/2020/06260/Mental_health_circumstances _among_health_care.26.aspx
REPLY QUOTE EMAIL AUTHOR
6 months ago
Cyrin Natividad
RE: Discussion - Week 1
Hi Jessica,
Thank you for your input! I hope your son is doing okay; he is lucky to have a mother like you who can give him emotional support. During the pandemic's peak in 2020, I worked in a skilled nursing facility, and no one is allowed to visit any family member. It is truly heartbreaking, but I'm glad that I've collaborated with health care professionals that genuinely care for these elderly.
I wish you and your son well!
REPLY QUOTE EMAIL AUTHOR
6 months ago
Faith Momodu
RE: Discussion - Week 1- Initial Post
Before 2020 the crisis in the United States of America was the opioid crisis. “Opioid overdose deaths quadrupled from 1999 to 2015 and accounted for almost all of the increase in overdose deaths over the past decade” (Grogan et al., 2019, p. 278). The opioid crisis hit every state hard and needed to be dealt with on a federal level. What are opioids? “Opioids are a class of drugs that can produce analgesic, depressant, and euphoric effects on the central nervous system” (Li & Wang, 2020, p. 1325). What has been done on a federal level to battle this ongoing crisis?
The past and present administration have both tackled the opioid crisis in their ways. “On October 24, 2018, President Donald Trump signed the HR 6—the SUPPORT for Patients and Communities Act…to combat the opioid crisis” (Ballotpedia.org n.d.). This bill included a $500 million fund for the opioid crisis. It made Medicaid funding more accessible for use, created grants and mandated the U.S postal service to monitor mails for opioid abuse. While the Biden administration seeks to make overdose medications and opioid addiction medications more accessible to patients.
These approaches are great for combating the opioid crisis, but I would have included other pain management access. That is, making other pain management interventions more accessible or making it a requirement for physicians to educate patients on other forms of pain management first before prescribing pain medications. There are other options for pain instead of opioids that can be initiated before prescribing medications. For example, physical therapy, acupuncture, massage, or other therapies.
In conclusion, each administration have done something to combat the opioid crisis. It is also important to include healthcare professionals in their conversations so policies can also target things that they handle day in and out in their professional lives. This crisis is not something that can be fixed over these two administrations, it will be an ongoing battle.
Reference
Federal policy on healthcare, 2017-2020. Ballotpedia.org. (n.d.). https://ballotpedia.org/Federal_policy_on_healthcare,_2017-2020#June_22.2C_2018:_Bipartisan_bill_to_slow_opioid_crisis_passes_the_House.
Grogan, C. M., Bersamira, C. S., Singer, P. M., Smith, B. T., Pollack, H. A., Andrews, C. M., & Abraham, A. J. (2019). Are policy strategies for addressing the opioid epidemic partisan? A view from the states. Journal of Health Politics, Policy and Law, 45(2), 277–309. https://doi.org/10.1215/03616878-8004886
Li, Z., & Wang, P. (2020). Point-of-care drug of abuse testing in the opioid epidemic. Archives of Pathology & Laboratory Medicine, 144(11), 1325–1334. https://doi.org/10.5858/arpa.2020-0055-ra
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6 months ago
Annisha Mcgowan
RE: Discussion - Week 1
6 months ago
Roseline Evans
RE: Discussion - Week 1-Response #1
Hello Annisha,
I enjoyed reading your post and completely agree with you that the Opioid crisis is a huge problem with no clear solution in sight. In a previous report from the CDC, it was estimated that around 450,000 people have died from an opioid overdose between 1999 and 2018 (Opioid data analysis and resources - drug overdose - CDC injury center, 2020). I can imagine that these numbers have gone up since then, especially with the Covid pandemic in the past year.
You mentioned that “President Obama presented in his campaign that he will help the American people by addressing the opioid epidemic” President Obama implanted the Affordable Care Act (ACA). The ACA enabled states to address the opioid crisis through insurance coverage expansions and regulatory insurance reforms that required the inclusion of substance use disorder) treatments, enhanced equality, and opportunities to integrate SUD treatment and mainstream health care (The Affordable Care Act Transformation of Substance Use Disorder Treatment, 2017). This placed the burden of substance abuse treatments on the states themselves.
During President Trump’s administration, an initiative known as Stop Opioid Abuse was formed in 2018. The initiative received $6 billion in new funding to aid in fighting Opioid abuse and to curb over-prescription by one- third (Ending America's Opioid Crisis - the White House, n.d.).
Under Biden’s administration, we have seen the FDA approve a higher dose of naloxone, to help counteract the increasingly lethal and illicitly manufactured fentanyl and fentanyl analogs (American Medical Association & Robeznieks, 2021).
References
American Medical Association, & Robeznieks, A. R. (2021, June 3). Biden administration boosts access to overdose prevention, treatment. American Medical Association. https://www.ama-assn.org/delivering-care/opioids/biden-administration-boosts-access-overdose-prevention-treatment
Ending America's opioid crisis - The White House. (n.d.). The White House. Retrieved August 28, 2020, from https://www.whitehouse.gov/opioids/
Opioid data analysis and resources - drug overdose - CDC injury center. (2020, March 19). Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/data/analysis.html
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6 months ago
Lyndsey Cline
RE: Discussion - Week 1
6 months ago
Scott Lamprecht
RE: Discussion - Week 1
6 months ago
Faith Momodu
RE: Discussion - Week 1-Response 2
6 months ago
Michael Collins
RE: Discussion - Week 1
Presidential Agenda in Mental Health
With the rise of mental health awareness in the United States in recent years, this topic has become a crucial component to political agendas for recent presidents and candidates alike. As of March 2021, the National Alliance on Mental Illness [NAMI] estimates that one in every five adults in the United States experience some form of mental illness each year (NAMI, 2021). This number is staggering especially in a country where health care is the most expensive per capita in the entire world causing healthcare to be difficult for many to afford (Milstead & Short, 2019, pp. 175). Working in the mental health field as a registered nurse, it is all to common to see patients get admitted for reasons that seem very preventable had the correct measures and care for their mental health had been taken prior to the event occurring causing the admission. Mental health is gaining the momentum it has long deserved as it becomes more and more prevalent in the media. With this rise in awareness in a continuous upward trend, Presidents of the United States have to ensure their political agendas encompass this major topic.
It is an understatement to say that former President Barack Obama made significant strides towards affordable healthcare for all citizens with the Affordable Care Act during his term in office. In 2016 as his term was coming to an end, President Obama proposed a $74 billion budget increase to assist in mental health treatment and research (Sperling, 2015). Under this budget increase one specific category stood out to me more than others that I believe deserved even more attention. Barack Obama proposed ending the 190 day lifetime limit of inpatient psychiatric care under Medicare and Medicaid (Sperling, 2015). Working in an inpatient mental health facility in the inner city, it is very common to see coverage via Medicare and Medicaid with this population. When patients have Medicare or Medicaid, it increases the difficulty to place these patients to facilities upon leaving our facility. This causes patients to end up having an unintentional extended stay at these inpatient facilities. To this day, the lifetime limit for inpatient care remains. This is a vicious cycle that is unfair to patients who don’t meet the insurance criteria for many care facilities or group homes causing their 190 lifetime days to dwindle as the search for placement continues. With this lifetime limit remaining in effect, leads to the point that I don’t believe President Obama pushed hard enough for change on this specific topic. Having made such amazing accomplishments with healthcare during his term and increasing the coverage to Americans astronomically, I don’t see why he couldn’t have made this change happen. One way this could have been changed is through more funding. It was projected that making this change occur would have cost approximately $5 billion over the following 10 years, which in comparison to the total proposed budget for one year of $74 billion seems minuscule.
Jumping ahead five years, current President Joe Biden took office in 2021. It seems as though by this point, President Biden is riding the wave of mental health awareness and knows that any additional funding in this category will only increase his popularity. One positive that President Biden quickly showed was funding $825 million to the Community Mental Health Services Block Grant. This program allows all states and US territories to provide complete and quality community mental health services and addresses needs in existing treatment services for people with severe mental health conditions (Substance Abuse and Mental Health Services Administration [SAMHSA], 2021). This is clearly a positive agenda because it will result in more mental health care for those in need. This also nearly doubles the amount of funding, $482.5 million, that President Obama proposed to fund just five years earlier (Sperling, 2015). However, the big takeaway from President Biden’s accomplishments, or lack there of, that is still of utmost importance is the fact that there is still the same 190 day lifetime limit of psychiatric inpatient days through Medicare and Medicaid. Until this topic receives the proper attention and funding it needs to do away with this limit, patients will unfairly be limited to the care they need and deserve. Mental health illnesses has no targeted age. These illnesses can start at any age and continue for a lifetime. It is unjust and unfair to limit those in need of care they deserve and to limit their chance of getting help.
References
Milstead, J. A., & Short, N. M. (2019) Health Policy and Politics: A Nurse’s Guide Sixth Edition. Jones & Bartlett Learning.
National Alliance on Mental Illnes. (2021, March). Mental Health by the Numbers.
Sperling, A. (2015, March 20). President Obama’s 2016 Budget: What Does it Mean For Mental Health?
https://www.nami.org/About-NAMI/NAMI-News/2015/President-Obama-s-2016-Budget-What-Does-It-Mean-f
Substance Abuse and Mental Health Services Administration. (2021, March 11). With Pandemic Worsening the Mental Illness and Addiction Crisis, Biden Administration to Provide Nearly $2.5 Billion to States, Territories for Treatment, Prevention Aid.
https://www.samhsa.gov/newsroom/press-announcements/202103110230
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6 months ago
Betsy Koplin
RE: Discussion - Week 1
6 months ago
Lyndsey Cline
RE: Discussion - Week 1
6 months ago
John Michael Natividad
RE: Discussion - Week 1
6 months ago
Shelley Lalush
RE: Discussion - Week 1
6 months ago
Misty Williams
RE: Discussion - Week 1
6 months ago
Lucy Njogu
RE: Discussion - Week 1
6 months ago
Shelley Lalush
RE: Discussion - Week 1
6 months ago
Lucy Njogu
RE: Discussion - Week 1
6 months ago
Cyrin Natividad
RE: Discussion - Week 1
Hi Lucy,
Your post is interesting! I can recall the H1N1 (Swine Flu) Pandemic in 2009 that primarily affected children and young and middle-aged adults (CDC, 2009). During that time, I was still in school and working on my BSN and developed a fever. Our school made the right move to scan the temperature of everyone who will enter the premises. I missed my class that day, but health is wealth.
I agree with you that President Trump would have been more firm on implementing health protocols at the federal level not to cause any confusion, especially those who travel from one state to another (examples are travel nurses). On a positive note, I applauded his administration for taking quick action on providing the vaccine. So far, 169,592,873 Americans — or 51.1% of the total population — have received the entire course of vaccinations needed to protect against Covid-19 (USA Today, 2021).
Resources:
Centers for Disease Control and Prevention, 2009 H1N1 Pandemic, 2009
https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html
Samuel Stabbins, USA Today, August 21,2021
https://www.usatoday.com/story/news/health/2021/08/21/covid-vaccination-hesitancy-rates-state/8210703002/
REPLY QUOTE EMAIL AUTHOR
6 months ago
Ahou Karelle Koffi
RE: Discussion - Week 1
According to Anderson, DeLeo, and Taylor (2020), agenda-setting is a crucial aspect of policymaking. For issues to advance into the following stages of policymaking, they must be termed as agenda items for bodies such as administrative agencies and legislatures. The opioid epidemic began to gain national attention in the late 1990s after opioid prescriptions exploded (Morland, 2019). According to the Centers for Disease Control and Prevention, opioid prescribing between 1999 and 2013 increased four times, thus leading to opioid overdose rise fourfold. The George W. Bush administration did not pay much attention to the opioid epidemic except by publicly condemning the increased access to naloxone (Morland, 2019). After deaths linked to opioid overdose increased, President Barack Obama’s administration started responding to the opioid epidemic an agenda. After state legislators and governors opposed the expansion of access to naloxone saw the federal government’s stance, they began to revise their position (Morland, 2019).
In the July of 2016, President Barack Obama signed the Comprehensive Addiction and Recovery Act into law (Gilmore, 2018). This law offers a multifaceted federal response to the opioid epidemic that claims about 30,000 Americans every year. The Comprehensive Addiction and Recovery Act expanded the efforts towards preventing the misuse of opioids and offering individuals with opioid use disorders more access to effective treatment (Gilmore, 2018). One of the focuses of this act is to give prescription drug plan sponsors permission to implement safe prescribing and dispensing programs for persons at the risk of misusing opioids. The second focus is to reauthorize grant programs to assist states in implementing and improving prescription drug monitoring programs (Gilmore, 2018). The third focus is to make evidence-based therapies for substance use disorders and medication-assisted treatment more accessible (Gilmore, 2018).
President Trump also made the opioid epidemic a federal agenda in his administration by agreeing that it is a national crisis that needs significant nationwide attention. In the October of 2018, President Trump signed the Support for Patients and Communities Act into law (Wen & Sadeghi, 2020). This legislation aimed to address the opioid crisis that the country has been facing by reducing opioid overdose-related deaths. This law is multifaceted and focuses on preventing the misuse of opioids and the agitation for increased access to effective treatment for persons with opioid use disorder (Wen & Sadeghi, 2020). The Support for Patients and Communities Act contains multiple provisions for ensuring that persons with opioid use disorder access evidence-based treatment. Furthermore, it prioritizes better coordination of care and facilitation of access to appropriate treatment for patients with unique needs (Wen & Sadeghi, 2020). Unlike the Comprehensive Addiction and Recovery Act, the Support for Patients and Communities Act offered solutions like ensuring that opioid users access Medicare coverage of methadone, expanding the prescribing of buprenorphine, reforming Medicaid to increase inpatient treatment for persons with opioid use disorder, and increasing the support offered to persons with opioid use disorder as they transition from treatment facilities (Wen & Sadeghi, 2020).
I would handle the opioid epidemic differently by focusing on three aspects. First, I would prioritize access to treatment and recovery services by ensuring that overdose-reversing drugs are readily available to the public. The other areas that I would focus on would be increasing and improving public health surveillance. Surveillance would help the public better understand the dangers and strategies of preventing opioid use disorders. Research is a crucial aspect of understanding problems that humans face. I would invest in and increase the support for cutting-edge research on pain and addiction to learn how chronic pain can be managed safely, effectively, and in a non-addictive way. The research would seek to develop new medications and technologies for treating opioid disorders and methods to improve overdose prevention and reversal interventions.
References
Anderson, S. E., DeLeo, R. A., & Taylor, K. (2020). Policy entrepreneurs, legislators, and agenda-setting: information and influence. Policy Studies Journal, 48(3), 587-611.
Morland, R. (2019). Evolution of the national opioid crisis. Nursing2021, 49(5), 51-56.
Gilmore, B. G. (2018). Washington, DC's Heroin Epidemic of the 1970s and Today's Opioid Crisis: A Comparative History of Government Policy Responses. SCL Rev., 70, 669.
Wen, L. S., & Sadeghi, N. B. (2020). The opioid crisis and the 2020 US election: Crossroads for a national epidemic. Lancet (London, England), 396(10259), 1316.
REPLY QUOTE EMAIL AUTHOR
6 months ago
Roseline Evans
RE: Discussion - Week 1-Response #2
Hello Ahou,
Great Post on the opioid crisis. I was drawn to your comments about how you would have handled the opioid epidemic. You said "First, I would prioritize access to treatment and recovery services by ensuring that overdose-reversing drugs are readily available to the public" According to American Medical Association (AMA), nearly 90,000 overdose deaths occurred in the U.S. between September 2019 and September 2020 (American Medical Association & Robeznieks, 2021). To help reduce overdode deaths, the FDA ) recently approved a new nasal spray that delivers 8 milligrams of naloxone. In addition, Biden's administration is also working to ban manufacturers of these drugs from paying physicians to precsribe their products (Biden For President, 2020). Furthermore, these pharmaceutical companies will also be held responsible for their role in triggering the opioid crisis. I do hope that these measures among may more will aid in combating the opioid crisis.
American Medical Association, & Robeznieks, A. R. (2021, June 3). Biden administration boosts access to overdose prevention, treatment. American Medical Association. https://www.ama-assn.org/delivering-care/opioids/biden-administration-boosts-access-overdose-prevention-treatment
Biden For President. (2020, August 3). The Biden Plan to End the Opioid Crisis. Joe Biden for President: Official Campaign Website. https://joebiden.com/opioidcrisis/
REPLY QUOTE EMAIL AUTHOR
6 months ago
John Michael Natividad
RE: Discussion - Week 1
We've seen the number of Covid patients rise recently; meanwhile, hospitals can accommodate the influx of patients seeking help with adequate hospital beds and equipment but lack highly skilled healthcare providers (Green and Spiegel, 2020). The lack of experienced providers leads to inadequate nursing care, misdiagnosis of disease, and ill-treatment of presenting symptoms leading to patients' demise. During this unprecedented time in history, hospitals resort to previously unheard of and would never be accepted before the pandemic. Assigning unlicensed nurse interns to care for Covid patients, luring nurses and doctors out of retirement and reemploying them, extending job offers to nurses and others with much unusual screening and onboarding being set aside (Ron Hoppe, 2020). I have personally experienced working with student nurses who are new to the field and have seen the different mishaps and near misses, and I am scared for their future patients' sake. It takes a great deal of time and experience to consider ourselves as experienced healthcare providers. A great example is me; being in healthcare, I have accumulated 15 years of experience in various specialties and still am learning new education on the field. No healthcare system can function without skilled nurses (University of St. Augustine, May 2021).
We've seen the number of Covid patients rise recently; meanwhile, hospitals can accommodate the influx of patients seeking help with adequate hospital beds and equipment but lack highly skilled healthcare providers (Green and Spiegel, 2020). The lack of experienced providers leads to inadequate nursing care, misdiagnosis of disease, and ill-treatment of presenting symptoms leading to patients' demise. During this unprecedented time in history, hospitals resort to previously unheard of and would never be accepted before the pandemic. Assigning unlicensed nurse interns to care for Covid patients, luring nurses and doctors out of retirement and reemploying them, extending job offers to nurses and others with much unusual screening and onboarding being set aside (Ron Hoppe, 2020). I have personally experienced working with student nurses who are new to the field and have seen the different mishaps and near misses, and I am scared for their future patients' sake. It takes a great deal of time and experience to consider ourselves as experienced healthcare providers. A great example is me; being in healthcare, I have accumulated 15 years of experience in various specialties and still am learning new education on the field. No healthcare system can function without skilled nurses (University of St. Augustine, May 2021).
The Biden administration has recently Ordering an Amendment to the Public Readiness and Emergency Preparedness (PREP) Act Declaration to Allow More Qualified Professionals to Serve as Vaccinators. (The White House, 2021). This action frees skilled providers to care for acute patient care where it's needed the most - the frontlines. Other healthcare providers underutilized can now be the front liner for the vaccination effort to alleviate the burned imposed on the healthcare systems providers. Biden willfully and rapidly implements the CARES Act, which allocated nearly $1 billion over four years to address nursing burnout, faculty recruitment, and retention and increase nursing workforce diversity. Biden Administration is building up the training, clinical and educational capacity to welcome - not turn away - the qualified individuals interested in nursing education and bolstering the nursing profession for years to come (The Biden Plan). I would have place efforts earlier to recruit and train future nurses who will eventually care for me as proficiently as I cared for my community.
References:
Green and Spiegel, (2020). Biden Administration: Expansion to the Ability of Physicians and Nurses to Obtain Permanent Residence and Reduction of H-1B Restrictions. Retrieve from: https://www.lexology.com/library/detail.aspx?g=a8c3bbe4-0a22-4341-9213-1c75ce881869
Ron Hoppe, (2020). Healthcare Immigration in a Biden Administration.Retrieve from: https://healthstaff.org/healthcare-immigration-in-a-biden-administration/
University of St. Augustine, (2021). The 2021 American Nursing Shortage: A Data Study. Retrieve from: https://healthstaff.org/healthcare-immigration-in-a-biden-administration/
The White House, (2021). Fact Sheet: President Biden Expands Efforts to Recruit More Vaccinators. Retrieve from: https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/12/fact-sheet-president-biden-expands-efforts-to-recruit-more-vaccinators/
The Biden Plan for Mobilizing American Talent and Heart to Create a 21st Century Caregiving and Education. Retrieve from: https://joebiden.com/caregiving/
REPLY QUOTE EMAIL AUTHOR
6 months ago
Cyrin Natividad
RE: Discussion - Week 1
Hi John Michael,
Your post is insightful! I'm in the same boat as you when you mentioned that hospitals lack skilled health care professionals, especially in this unprecedented time. Unfortunately, most academic programs drove them to remove students from clinical practicums (NCBI,2020). It is a difficult decision to reduce the students' hours on the floor, and I realized that it would take a while for the hospital staff ratio to be adequate for the most part. It is vital to have proper nurse staffing to deliver timely and high-patient care (Sean P. Clarke; Nancy E. Donaldson, NCBI).
You mentioned that you would exert efforts earlier to train future nurses to care for patients. What is your take on the best training program these future nurses should experience to be skilled and qualified health care professionals?
Resources:
NCBI, Nurse Educ Today. 2020 Sep
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263267/
NCBI, Sean P. Clarke; Nancy E. Donaldson, Nurse Staffing and Patient Care Quality and Safety, Chapter 25
https://www.ncbi.nlm.nih.gov/books/NBK2676/
REPLY QUOTE EMAIL AUTHOR
6 months ago
Jummy Awe-Owoseni
RE: Discussion - Week 1
Though while the benefits of having a healthcare plan outweighs the disadavantages, there are still some politics that plays in, when it comes to this topic, very broad and in-depth that it cant be discussed all at once in a post thread. My choice of topic that i will be discussing is " insurance and its usage". While its good to have insurance, often times the cost of health care services to the uninsureed is insane.The cost benefit analysis will continue to play a huge role in which bill become a law based on what matters the most to the legislator and which bill does he need to support in other to stay in position. According to (Feldstein, 2008), the primarily goal of a legislator is to get re-elected in office and keep its power and position not necessarily to solve problem that is or her constituents are experiencing
The cost benefit analysis was seen in the effort to repeal/replace the Affordable care ACA at the senate level. Senator John McCain was the only republican who voted against the bill. He voted against it because he has nothing to lose, he was sick and not running for reelection of office. Based on the cost benefit analysis, voting against bill was not going to have any direct effect on his political career, which was already coming to an end.
Cost benefit analysis will always have a negative impact on what bill eventually becomes a law because only the interest of a few people (lobbyist or special interest) will be considered while the opinion of the general public will be ignored. Lobbyist tend to manipulate not only media but also the candidate or member (s) that are working with in other to get a favorable outcome (Levine, B. J. (2009, p.14). For example, one of the reasons why insulin that should cost $90.00 is costing $290.00 is because of the big donation and financial contribution that the pharmaceutical companies are making to the legislator.
However, this will continue to be a problem until the American political system can change and special interest groups or lobbyist are no longer allowed to influence politician either through hard money donation or promised of reelection.
In conclusion, there are several other things needed to be checked in place inorder for the system to be fully functioning in favor of and having igood interests of her citizens at heart. Till then only we can hope and wish to make the absolute best out of what we have now.
References
Feldstein, P. J., & Feldstein, P. (1988). The politics of health legislation: An economic perspective. 204-5). Ann Arbor, Mich: Health Administration Press Perspectives.
Levine, B. J. (2009). The art of lobbying. SAGE.
Protection, P., & Act, A. C. (2010). Patient protection and affordable care act. Public law, 111(48), 759-762.
REPLY QUOTE
6 months ago
salome ugwu
RE: Discussion - Week 1
WEEK 1 MAIN DISCUSSION POST
While working in the emergency room, I learned that the main reason most patients remain at home until their illnesses become unbearable before they seek help is the cost involved. Most Americans refuse to seek early detection, prevention, and treatment because of this. Health care affordability has been a key component of each administration’s health care reforms. A poll done by Reuters/Ipsos found that most Americans regardless of their political affiliations had concerns about the position of presidential candidates on health care affordability. (Health Affairs Blog, 2016).
President Obama's Affordable Care Act
The first thing that comes to mind when you see a health care policy with the word "Affordable" is low cost. Many people including I assumed that as the name goes, health care will finally be affordable to all of us. But just like any health care reform, this policy is also very complex. During his first term in office, President Obama decided to work with congress to create a health care reform plan. Originally, he wanted to improve quality and lower the costs of health care without a “mandate” that required all people to have medical insurance and without a health insurance penalty. However, he was later persuaded to accept congressional proposals that included a mandate for Obama Health Care Reform to work and to gain necessary votes for passage of the bill. (HFC, n.d.). Although health care has become more affordable and accessible for lower income Americans and for individuals with pre-existing conditions, for middle class and upper class Americans, health insurance premiums have risen due to guaranteed issue coverage and the increased red tape associated with Obamacare. (HFC, n.d.). I believe affordable health care is a basic need and right for all Americans. The middle class especially should not have to have higher premiums. I speak for the middle class because I am considered as part of the middle class and know too well the effects of high premiums to my health care. The middle class pays so much in taxes and yet receives minimum benefits in all areas even outside of health care. What I would have done was to include a plan that makes health care cost sustainable and affordable for not just the low income but for the middle class as well as the upper class. I know the low income should come first but this kind of incentives is what prevents people from moving from low income to middle class. Every American should be able to strife to move forward in life without the fear of higher premiums or higher taxes.
Reference
Health Affairs Blog. February 29, 2016. Affordability: The Most Urgent Health Reform Issue for Ordinary Americans. Available from https://www.healthaffairs.org/do/10.1377/hblog20160229.053330/full/ DOI: 10.1377/hblog20160229.053330 (Accessed: August 31, 2021).
Health for California. N.d. Barack Obama’s Health Care Reform Bill Explained. Available from https://www.healthforcalifornia.com/obamacare/explained (Accessed: August 31, 2021).
White House. May 1st, 2018. Ending America’s Opioid Crisis. Available from https://www.whitehouse.gov/opioids/ (Accessed: August 31, 2021).
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6 months ago
Angela Sullivan
RE: Discussion - Week 1
"If you are buying an ACA plan as non-subsidized health insurance for a family of 4, you can expect to pay about $25,000 for the year in premiums and deductibles" (Davalon, 2020). That breaks down to an average of $17,000 yearly in premiums and almost $8,000 in deductibles. "In 2018, the average cost per month for family coverage was $1,168" (Porretta, 2018). . The average family deductible expense was around $8,000. Through my employer, I'm paying about $200 every 2 weeks for a family plan with a $5,000 deductible, and I think that's unacceptable. I won't go to the ER because the copay is $350. I cringed yesterday when my daughter had to have MRIs and arthrograms of both hip. I did not want to see the bill. It was less than $2,000 so a lot better than I was imagining. I really try not to even go to the doctor unless absolutely needed. I can't even imagine paying out of pocket for such high premiums and deductibles.
Davalon. (2020, November 23). How much does health insurance cost without a subsidy ... https://www.ehealthinsurance.com/resources/affordable-care-act/much-health-insurance-cost-without-subsidy.
Porretta, A. (2019, December 18). What is a family health insurance plan? - ehealth. https://www.ehealthinsurance.com/resources/individual-and-family/what-is-a-family-health-insurance-plan. Retrieved September 2, 2021.
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6 months ago
Sophie Enjema Ndumbe
RE: Discussion - Week 1
6 months ago
Angela Sullivan
RE: Discussion - Week 1
6 months ago
Annisha Mcgowan
RE: Discussion - Week 1
6 months ago
KAREN MARUYAMA
Reply to Main Post: Discussion - Week 1
6 months ago
John Michael Natividad
RE: Discussion - Week 1
6 months ago
Scott Lamprecht
RE: Discussion - Week 1
6 months ago
Shanaa Wheeler-Yard
RE: Discussion - Week 1
6 months ago
Misty Williams
RE: Discussion - Week 1
6 months ago
Angela Sullivan
RE: Discussion - Week 1
I work in a drug and alcohol rehab facility. We specialize in medication-assisted therapy. Each pt has a medication plan specific for type of abuse, whether it be opioid or alcohol, etc. However, each has their own individual plan re: group therapy, peer support groups, psychotherapy, etc. Our goal is to get them through detox, then they can move to our 30 day residential program. After that, they can go to our sober living facility or continue treatment on an outpatient basis.
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6 months ago
Shanaa Wheeler-Yard
RE: Discussion - Week 1
The opioid crisis in America has caused death at alarming rates. Misuse of prescribed and street purchased medication has led to a large number of young adults and working class individuals to fall victim to drug addiction and overdoses. Preventative eduction has been effective in improving the addiction crisis (Sun et al., 2020). Effective education at the middle school level has assisted with drug prevention methods.You are correct both current and former presidents have acknowledged the opioid crisis in the United States.
References
Sun, T., Buchanan, A. L., Bratberg, J. P., Patry, E., & Matson, K. L. (2020). Rx for Addiction and Medication Safety (RAMS-PEER): Evaluation of an Education and Peer Program on Opioid Misuse. Preventing chronic disease, 17, E37. https://doi.org/10.5888/pcd17.190380
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6 months ago
Annisha Mcgowan
RE: Discussion - Week 1
Hi Shanaa, I enjoyed reading your post. Covid-19 has changed our lives. Just when we thought our lives were getting back to normal we started to see a spike in a new strand of the virus. The spread of novel coronavirus (COVID-19) across the globe and its associated morbidity and mortality has impacted and challenged society in many ways, which resulted in adapting to a new way of life (LoPorto & Spina, 2021). I believe this was due to our leadership becoming relaxed in precautionary measures. Social distancing, proper hand hygiene and mandatory mask were no longer in place to help protect us from the virus. Former president Trump recommendations to the American people were not helpful in stopping the spread of the virus. President Biden recommendation to get vaccinated will help slow or stop the spread of the virus therefore decreasing the morbidity and mortality rate. I do agree with you that a better approach from both presidents could have been different to inform and educate. The question is if both presidents knew more about Covid would that have changed the course of action and response.
References
LoPorto, J., & Spina, K. E. (2021). Risk Perception and Coping Strategies among Direct Support Professionals in the Age of COVID-19. ScholarWorks.
Gostin, L. O. (2021). A 7-Point Action Agenda to End the COVID-19 Pandemic for President-elect Biden. JAMA, 325(1), 17–18. https://doi-org.ezp.waldenulibrary.org/10.1001/jama.2020.23848
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6 months ago
Scott Lamprecht
RE: Discussion - Week 1
6 months ago
Misty Williams
RE: Discussion - Week 1
6 months ago
Michael Collins
RE: Discussion - Week 1
6 months ago
Betsy Koplin
RE: Discussion - Week 1
Hi Misty,
You make some very interesting points in your post. I too researched a little bit about both Biden and Trumps efforts on the opioid crisis for this week’s post and learned a bit about each. There is a happy medium in targeting this current crisis we are in. One that focuses on both targeting the flow of drugs into our country as well as dedicating resources to expanding on treatment and recovery. An article I found stated that in 2018 Trump signed a bill that increased funding for the opioid crisis to record levels. Additionally, before getting out of office he continued this by requesting 1.5 billion dollars more in state grants towards prevention education, treatment, and law enforcement efforts (Amiri & Mulvihill, 2020).
Biden’s efforts to make healthcare more accessible is another great way to assist with people currently addicted to drugs, whether this gives them access to more treatment options or therapy. It is no doubt that regardless of what the efforts are for our current president, this crisis is not going away. In 2019, with over 70,000 deaths related to opioids, and costing trillions of dollars in relief efforts, there definitely must be a targeted plan that focuses on treatment and prevention (Schwartzbach, 2020).
References:
Amiri, F., & Mulvihill, G. (2020). Worsening opioid crisis overshadowed in presidential race. AP News. https://apnews.com/article/election-2020-virus-outbreak-joe-biden-donald-trump-columbus-fc038266021cfa642b462997868d857b.
Schwartzbach, K. (2020). Joe Biden's and Donald Trump's Presidential Opioid Policies. American Addiction Centers. https://americanaddictioncenters.org/blog/presidential-opioid-policies.
-Betsy
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6 months ago
Misty Williams
RE: Discussion - Week 1
Hi Betsy,
Thank you for responding to my post. I became extremely interested in one of the articles that you sited, “Worsening opioid crisis overshadowed in presidential race “. This article shares a personal experience by a mother that lost her son and it resonated within me. My best friend of 38 years has addiction issues that has been absolutely heart wrenching. Watching her self-destruct on and off for the past 20 years have been devastating, to the say the least. I could relate to the article when I read that “parents even reserve a casket while their child is alive so they are prepared for what they believe is inevitable.” I recently spoke with my husband and said I know the phone call is coming that she finally lost her battle. I hope I am wrong, but is a hard reality that I may one day have to succumb.
I do not know what the solution is but the first step is recognition that there is a problem. Both Biden and Trump have addressed the fact that we are in a crisis and have contributed to reducing the number of deaths taking different actions to alleviate the crisis. There is a stigma in addiction and emphasizing punishment can run counteractive to a key goal for many recovery advocates (Amiri & Mulvihill, 2020). According to the CDC (Center for Disease Control) (Center for Disease Control) the drug overdose death tolls rose by close to 30 percent in the U.S. in 2020(Hashem, 2021). It is no doubt that the drug epidemic deserves presidential attention at the rate we are climbing.
References
Amiri, F., & Mulvihill, G. (2020). Worsening opioid crisis overshadowed in presidential race. AP News. https://apnews.com/article/election-2020-virus-outbreak-joe-biden-donald-trump-columbus-fc038266021cfa642b462997868d857b.
Hashem, S. (2021, July 15). Drug Overdose Deaths Accelerated and Broke Records in 2020 -. Occupational Health & Safety. https://ohsonline.com/articles/2021/07/15/drug-overdose-deaths-accelerated-and-broke-records-in-2020.aspx
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6 months ago
salome ugwu
RE: Discussion - Week 1
Hi Misty!
Thank you for this well said post, opioid epidemic is no doubt a big debate in America and a big challenge to healthcare system. The opioid epidemic continues to be a serious public health crisis in the United States. One way to address this issue is to effectively educate future healthcare providers, especially nurses, who play a key role in managing pain and improving opioid-related outcomes. In contrast to the Affordable Care Act, some have suggested the opioid epidemic represents an area of bipartisanship. This raises an important question: to what extent are Democrat-led and Republican-led states different or similar in their policy responses to the opioid epidemic. President Trump designated opioid epidemic as a public health emergency in America in October 26, 2017, and it mentioned crisis response-related flexibility for the U.S. Department of Health and Human Services and federal and state health agencies
References
Kuehn, B. (2017). Opioid Emergency Declared. JAMA: Journal of the American Medical Association, 318(24), 2418. https://doi-org.ezp.waldenulibrary.org/10.1001/jama.2017.19014
Meadows, C., Martin, D., & LeBaron, V. (2021). A Cross-Sectional Survey Exploring Nursing Students’ Knowledge and Attitudes Regarding Opioids and the Opioid Epidemic. Pain Management Nursing, 22(4), 539–548. https://doi-org.ezp.waldenulibrary.org/10.1016/j.pmn.2021.01.015
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6 months ago
Scott Lamprecht
RE: Discussion - Week 1
I agree, but Providers should also be included. Nurses can work with patients all day long but if Providers are writing for Dilaudid and Oxys and Percocets, the nurse will not be able to make a difference. It has to be a team effort!!