The State of Healthcare in the United States

Health Care Coverage

Despite health care system organizations and facilities functioning openly, there is a great debate on the availability of healthcare practices and other related topics. An article by Sommers (2015) describes in great detail how the coverage became less broad because of the affordable care act (ACA) and how gaining access to treatment becomes more and more problematic for certain strata of society.

However, health care must remain a commodity stipulated by the influences of economic, social, and market demand (supply and demand), and there are some reasons for that. Firstly, there are simply no resources available to provide treatment to all who desire it. However cruel this may sound, such approach to health care is the most efficient and rational one. Moreover, doctors and nurses are people with their needs, too, and the equipment required to perform particular types of treatment is costly indeed. Therefore, a lot of input is required to make health care system function as it does right now. Without proper reimbursements, there would be no health care to begin with.

There are, of course, certain shortcomings of the current health care system. Amongst the most expensive health care systems in the world, USA holds the first place. However, life expectancy does not even reach eighty years. This is most troublesome since other countries have much cheaper systems that perform better and provide higher life expectancy. Furthermore, the obesity rates are getting higher each year, which is a very problematic issue, too. However, all of this does not have anything to do with coverage and availability of treatment. Moreover, one must consider that other countries have a lot fewer territories to cover and, therefore, a much less population that requires treatment.

Barriers to Nurses’ Participation in Health Care Policy

According to Hain and Fleck (2014), the most significant barriers to nurses’ involvement in the development of health care system are state practice and licensure barriers, barriers connected to physician related issues, and barriers occurring in payer policies. There are, of course, other obstacles that do not arise so often.

State practice and licensure create a significant number of barriers that stand in the way of nursing practitioners (NPs) and prevent them from implementing their training to the fullest. Although licensure and state practices are different in various states, they all remain under a common goal of holding a complete authority over the NPs practices. In other words, licensure and state practices govern the NPs’ ability to evaluate patients’ condition upon arrival to the facility, their treatment, and diagnoses. Thus, NPs have to deal with a number of probably unneeded regulations.

Physician-related issues are the ones that one is able to understand quickly. Health Care organizations view physicians as a more skilled and trained personnel than NPs. Therefore, NPs are often prevented from carrying out their full duties because all the staff focuses on what doctors recommend and what they suggest will be better for the patient. Needless to say, that this creates a number of difficult to solve situations for NPs.

Payer policies are often tightly connected to the licensure and state practices regulations. Strict payer policies limit NPs and yet again prevent them from fully participating in the patient’s treatment.

However, Xue, Ye, Brewer and Spetz (2016) in their research conclude that there are indeed certain improvements in health care system, and there is a visible positive trend of reducing NPs’ restrictions. This allows one to suggest that the changes will soon enter into force, which will create a better environment for nurses.


Hain, D., & Fleck, L. M. (2014). Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). Web.

Sommers, B. D. (2015). Health care reform’s unfinished work — remaining barriers to coverage and access. The New England Journal of Medicine, 373(25), 2395-2397.

Xue, Y., Ye, Z., Brewer, C., & Spetz, J. (2016). Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review. Nursing Outlook, 64(1), 71-85.

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