Mock Hearing: Increasing Access to Care for the Uninsured
Directions
Hearings are a formal way by which Congressional committees collect and analyze information in the early stages of legislative policymaking. When considering a bill, Congress may hold hearings to find out more about the subject matter of the legislation or to determine how different interest groups feel about the issues involved. Committee hearings can be good sources of information on a particular topic, but they are less useful in determining Congressional intent because the views presented in a hearing are the views of the witnesses rather than members of Congress. Hearings consist of transcripts of oral testimony and may also include prepared statements or written reports or studies presented to the committee by the witness. Congressional hearings are usually printed by the Government Printing Office and contain all witness testimony, the question-and-answer portion of the hearing, and any other material requested of the witness by the committee.
Nurses must broaden their influence in creating a healthier society from state legislatures to the White House. Thus, it is important for all nurses to gain an understanding of policy development. This action is consistent with the call by the Institute of Medicine for more nurses to lead. The second recommendation of the Institute of Medicine Report on the Future of Nursing2 states:
Recommendation2
: Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. Private and public funders, health care organizations, nursing education programs, and nursing associations should expand opportunities for nurses to lead and manage collaborative efforts with physicians and other members of the health care team to conduct research and to redesign and improve practice environments and health systems. These entities should also provide opportunities for nurses to diffuse successful practices.
This assignment is also congruent with the American Organization of Nurse Executives (AONE) core competency related to knowledge of the health care environment. According Richard M.J. Bohmer, MD, a Harvard Business School (HBS) professor and author of the book, Designing Care: Aligning the Nature and Management of Health Care, health care managers are the missing link in debate over health reform. Their skills and ideas are needed to sustain and improve upon multiple advances in the delivery of health care for the benefit of patients. As such you must commit to not only changing nursing but the entire health care system.
This assignment requires you to pull together the most cogent data and arrange evidence in a way that is meaningful to public policymakers like legislators and Congressional representatives. To be successful, you must learn to address the questions policymakers are interested in and tell the stories that best illustrate health and health care needs.
Sources:
1 Committee Hearing http://www(dot)lib(dot)uchicago(dot)edu/e/law/db/ref/hearings.html
2 IOM (Institute of Medicine). 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.
Mock Testimony Format:
You will select a healthcare topic and conduct research to present testimony. Testimony presentation topics may include but are not limited to:
☐ Access to Care for the Uninsured
☐ Expansion of Medicare Prescription Coverage
☐ Impact of the ACA on healthcare status
☐ Healthcare and the aging population
☐ Emerging Healthcare technologies
☐ Electronic Health Records
☐ Value- Based Purchasing
*** Additional records of testimony can be found on the American Nurses Association website
https://www(dot)nursingworld(dot)org/under the Government Affairs section
Mock Hearing: Increasing Access to Care for the Uninsured
Student’s Name
Institution
Course Number and Name
Instructor’s Name
Date
Mock Hearing: Increasing Access to Care for the Uninsured
Chair and committee members, thank you for holding this hearing today and allowing me to share my testimony on increasing access to care for the uninsured. My name is (student name), and I am a registered nurse with experience working with diverse patients. I have seen first-hand the effects of a lack of access to care among uninsured patients. My testimony will be divided into parts. In the first part, I will demonstrate how the current health insurance coverage in the US has been insufficient in providing healthcare coverage to all Americans. In the second part, I will show that universal health coverage is the only way to increase healthcare access for the uninsured.
To start, I will share examples of some of my patients who failed to access healthcare because they were uninsured and what that did to them and their families. As a newly registered nurse, my first encounter with a diabetic patient was horrifying. The patient came in with severe foot infections, which were a result of untreated diabetes. The patient's foot had developed ulcers, and these wounds had become infected. Even though the patient had noticed the ulcers, he had continued his life as usual because he was uninsured and could not access healthcare. The fact that he was in no pain made it easier for him to go on with life with an infected foot. He only came to the hospital because his wounds were not healing, and his entire leg had become numb, limiting his movement. However, it was too late for him, and amputation was the only option. The out-of-pocket cost of care drove him into medical debt. This is not a unique case. According to Hughes et al. (2019), uninsured people are more likely to have a diabetic-related amputation because they seek healthcare when it is too late. Even when patients learn about their condition and are advised on how to manage it, their uninsured status makes it difficult for them to obtain medication. As a result, they live with uncontrolled diabetes because they cannot afford medication, which exposes them to serious complications and disability, as was the case with my patient.
The damage caused by a lack of access to care among uninsured patients with chronic conditions brings me to my next example. A couple of months ago, a patient walked into the emergency room (ER) with a hypertensive emergency. He complained of chest pain and was unresponsive soon after arriving at the ER. Our attempts to administer treatment and save his life were futile. He experienced a heart attack and died while receiving treatment. A conversation with his wife revealed that the patient had been diagnosed with hypertension a few years ago and had been going for regular check-ups and medication at a free clinic in their neighborhood. However, the clinic recently closed down due to a lack of funding, and the patient could not afford his medication, resulting in non-adherence. He left behind a family that needed him for provision, which could have been prevented if he had access to care. Non-adherence to antihypertensive medication is common in the US, especially among the uninsured who cannot afford the high out-of-pocket cost of the required medication (Tajeu & Muntner, 2020). As a result, many patients with hypertension have to deal with complications that could have been prevented if they had access to adequate care and medication.
The impact of lack of access to healthcare due to uninsured status is not only limited to chronic conditions. It can be seen in many health conditions that can be prevented through access to preventative and promotive care. The two examples I have shared perfectly illustrate how the current health insurance coverage has failed to ensure access to care for all Americans. When the Affordable Care Act (ACA) was implemented, more Americans had access to healthcare. However, the number of uninsured Americans is still high. According to a report by the US Census Bureau, about 28 million Americans are uninsured, and this number does not include people who lost their coverage due to the COVID-19 pandemic and related unemployment (Keisler-Starkey & Bunch, 2021). Working adults account for the largest number of uninsured adults in America. The lack of health insurance coverage limits their ability to receive preventative and follow-up care. According to an analysis by Kaiser Family Foundation (KFF), most uninsured working adults are more likely to postpone seeking healthcare, delay filling up their prescriptions, or go without follow-up care because of the high cost of care (Tolbert et al., 2022). As a result, uninsured people are more likely to experience worse healthcare outcomes (Seo et al., 2019), as demonstrated in the examples I have shared with this committee. Further, when the...