Understanding the complex relations of how policy decisions interrelate with the funding made available and how these decisions result in the consequent impact on community health lies at the core of the assessment of the effects of health policy and financial implications on the delivery of health care at an international, national, state, and local level. This would be succeeded by evaluating these components, supported by an actual instance from the nursing practice that substantiated each concept.
Health policy at various levels deeply moulds the delivery of health care. National and local policy planning relies on global principles and frameworks from institutions such as the World Health Organization (WHO). Health policies often serve as the base of programs to control illness or make everyone eligible for health care. The policies may have financial consequences, such as aid from international organizations, relief agencies, or resource transfers between countries.
At the national level, legislatures set policies and establish regulations for health care delivery, quality standards, and public health issues. These policies largely determine the structure of healthcare systems, including public versus private provision, insurance coverage, and mechanisms for reimbursement (Stanhope & Lancaster, 201). Their financial implications may come from budget allocations, taxation, insurance premiums, and even subsidies. For example, in the United States, the Affordable Care Act (ACA) aimed to extend insurance coverage to the people, improve access to healthcare, and prevent such illegal acts by controlling costs through reforms, including Medicaid expansion and insurance market reforms.
States should deliver federal policies that can be developed at a state level, tailored to local context and cater to community-specific health issues. State fiscal concerns include resource utilization, Medicaid policies, and state-based efforts. For example, states’ allocations of resources may support the local combating of the epidemic, the construction of infrastructures, or the provision of grants to stimulate the development of the healthcare workforce.
It is assumed that the said local policies and programs, such as disease prevention and health promotion programs, community-based services, and so forth, will respond to the particular needs and challenges of the population and the communities. At the local level, it consists of local budget allocations, grants, and partners’ contributions at any level, right from healthcare providers, other local service providers, community organizations, and businesses (Smith et al., 2019). For example, health policy intervention can range from local government-set policies to increase good food access in low-income neighbourhoods through subsidizing farmers’ markets or zoning laws limiting fast-food entities’ establishment to go up in large numbers.
Significant issues related to the community’s health included policy and financial factors, which were exhibited in my nursing practice. I served as a nurse in a rural community and noticed the impacts of the Medicaid expansion under ACA. Before the expansion of Medicaid, tight eligibility criteria meant that most residents in the community could not be under health insurance coverage. The result was delayed or missed health care, which only worsens their health conditions and drives up health care costs in the long run. Underuse of preventive services was common; preventive services and poor management of chronic conditions led to high emergency department visits for preventable conditions.
On the other hand, expansion of Medicaid eligibility criteria comprised a significant share of the previously uninsured population. This has led to better access to primary care, prevention services, and chronic disease management. The patients can now afford to pay for the medications and the different forms of screenings and go in for the required checkups. It would improve their health and decrease healthcare costs due to preventable hospitalizations and emergency care.
The policy change also had a bearing on our community’s providers’ finances. More patients covered under Medicaid translated into a shift in the payer mix to the provider, translating to increased reimbursements for services rendered to Medicaid beneficiaries. This helped to sustain healthcare facilities financially for the continuity of healthcare services in the community. Additionally, Medicaid expansion pumped massive federal funds into the local economy. Health expenditures from Medicaid expansion increased employment at health facilities, while disposable income from patients increased spending on goods and services that otherwise benefit businesses in the local area.
Reference
Stanhope, M., & Lancaster, J. (2015). Public health nursing: Population-centered health care in the community. Elsevier Health Sciences.
Smith, S. A., Mays, G. P., Collins, T. C., & Ramaswamy, M. (2019). The role of the community health delivery system in the health and well-being of justice-involved women: A narrative review. Health & Justice, 7, 1-26.Nursing, Economics, Government and Law
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