The healthcare in the United States is ever-changing especially in terms of organizational structure and delivery.  We must continually evolve to make the best experience for each patient no matter what their health issues are while being innovative and making it convenient for them to seek care.

The healthcare in the United States is ever-changing especially in terms of organizational structure and delivery.  We must continually evolve to make the best experience for each patient no matter what their health issues are while being innovative and making it convenient for them to seek care.  There is a debate if America should consider having national health coverage for all due to high costs, poor access to care, and the worry over the quality of healthcare (Maurer & Smith, 2013).  It is my belief as nurses that we should continue to have a voice until every U.S. citizen has health care coverage that is equal.  All stakeholders in the U.S. know that health is core to the vitality of the country, but exactly how to achieve this is going to be a debate as seen with our last presidential election.  In the past, responses to patient and population health demands have influenced continued changes.  For example, in 1972 the Social Security Act was amended to include coverage for the disabled and patients with end-stage renal disease (ANA, 2017).  Later, in the 1990’s we saw numerous Medicare and Medicaid changes including the HIPPA laws which now protect our patient’s information today.  In 2010, the Patient Protection Affordable Care Act enacted many provisions, direct changes to statute, and new programs.  Many with large financial implications causing provisions that were linked to discretionary spending and never being funded (ANA, 2017).  Despite many changes in the past and present to healthcare, it is the coverage, cost, and quality that have dominated policy change for decades. The insurance companies currently base reimbursement in the U.S. according to illness, and I would like to see this shift to wellness promotion.  I personally look forward to seeing how healthcare reform unfolds in the next decade and hope it is for the benefit of all citizens in this country.

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