Advocacy for the People with Pre-existing Medical Conditions
Abstract
The nursing profession is concerned with the care of the patients under the nurses’ supervision. However, the role of the nurse also extends to advocacy for the rights of the patients. The nurse’s purpose presents the medical professional with a chance to support patients’ rights. The advocacy is to the other medical professionals, the family, and the legislators and policymakers. One of the most vulnerable populations in this case in need of support is the people with existing medical conditions. The role of the Affordable Care Act in the mitigation of the discrimination that these patients faced from insurance companies has been decisive. However, this has not decimated the need for advocacy about the issue. The advocacy will involve doctors and medical facilities, families, legislators, and policymakers. In the advocacy process, various healthcare industry parties will play roles, including advocate, adversary, and intermediary.
Keywords: Advocate, advocacy, nurses, healthcare, ACA, pre-existing conditions.
Advocacy for the People with Pre-existing Medical Conditions
The role of structural discrimination in most parts of society is an established issue. Even in sectors that should be as opposed to prejudice like the health sector, some groups have faced historical discrimination in the healthcare industry, disadvantaging them and exposing them to more healthcare issues. They include minorities, the elderly, and low income and the homeless and people with chronic conditions. As a nurse, advocacy for such groups is essential to ensure that the healthcare sector becomes better at serving all people. It is evident that while the Affordable Care Act has played a significant role in the reduction of exclusion for those with pre-existing conditions, the role of the nurse in advocacy for the patients in so far as hospitals and doctors, families, legislators, and policymakers are imperative for the patient wellbeing.
The Vulnerable Population
One of the most vulnerable populations that face a history of discrimination in the health sector is those who suffer from pre-existing chronic conditions. People with pre-existing conditions are those who have prior medical conditions before they purchase their medical insurance. While the general presumption is that people who have pre-existing conditions are usually senior citizens, as much as 19% to 50% of non-elderly Americans suffer from these conditions. As a consequence, the issue is ubiquitous in the US health system.
Affordable Care Act
ACA deals with the issue by making the perception of such people illegal. Before the Act, insurance agencies could fail to cover such people because it would hot their bottom-line. The ACA has solved that question by making sure that all people are insurable. However, it also notable that the health insurance companies can refuse to cover pre-existing conditions for individuals to buy insurance themselves, as opposed to coverage through their employer. Such coverage, almost exclusively purchased before March 2020, excludes the patients from ACA protection (Fernandez, 2010). Thus, this segment of the population needs highlighting to ensure that their protection. As a consequence, while those with pre-existing have their conditions are now covered insurance coverage, some still suffer exclusion.
Advocacy
There are various procedures in the advocacy for this group. For the patients with chronic pre-existing issues, the first step in the support will inform hospitals and doctors about the various issues affecting the patients, advocating via legislators and other policymakers, and lastly, using the court system (DiCuccio et al., 2020). The first part of the plan, in this case, is via the cause of acting as mediators between the patients with pre-existing conditions and other medical practitioners. For instance, if the patient receives a diagnosis that is not correct or the requirements for his/her accommodation are unsafe, the nurse can advocate for them. In the same way, nurses can also assist in laying down safer conditions for self-care in cases where medical professionals use a language that is too technical for the patient to understand. The nurse can perform these advocacy activities by informing the doctors or the medical facility and making the issue known.
In the second of the plan, the nurse can also perform advocacy on behalf of patients with their families. Ultimately, if the patient becomes sick to the extent of being unable to make his/her own decisions, the family takes that mantle in most of the cases. Family members may fail to know the impact of their decisions on the patient (Roselle, 2018). Families may thus need information and convincing on specific medical issues. Hearing such matters from a person with a position of professional authority such as a nurse may assist in assuaging any doubts and clearing out information for the family members (Roselle, 2018). The need for advocacy with families has a basis on the fact that if a controlling family member is likely to make bad decisions, the nurse has a moral right to intervene. Thus, advocacy with families is imperative.
The third part involves advocacy within the legal system. People who have pre-existing conditions can be protected by stronger legal and policy protections that only people in power within the legal system can craft. Advocacy within the legal system involves advocating within the people who have political power (Lockhart, 2017). Chief among them are legislators. In the case of legislators, one of the positions would be to do a letter-writing campaign. However, politicians sometimes ignore the letters from their constituents as a nuisance, or the letters sometimes end up with aides who ignore them. Petitions to legislators are also an effective method of making them understand the plight of such patients. Direct lobbying of the legislators may also prove useful in some cases (Lockhart, 2017). In the same manner, lobbying the President and the Secretary for Health Services to control the policy implementation would be advisable (Lockhart, 2017). They cannot only influence legislation, but they have at their disposal power such as the Executive Orders to ensure implementation. These actions towards legislators can prove useful in some cs.
Lastly, the other advocacy method may involve the use of the legal system in an adversarial manner. Oudshoorn (2019) notes the centrality of courts in affirming the citizenry’s rights, both political and socio-economic. The US legal system does not allow for discrimination against some parts of the population. However, people with chronic conditions find themselves suffering discrimination from the healthcare industry, including the insurers. Thus, there is a need to have an effective suit against the institutions in the healthcare industry who discriminate against such patients. Such a lawsuit would, among others, ask the court to affirm the rights of the people with chronic pre-existing conditions to receive treatment and insurance without prejudice. While such a case may ultimately prove unsuccessful because insurers and other actors in the healthcare industry may argue that they have legitimate reasons to treat such people differently, its very institution would be competent advocacy. Thus, courts also provide an opportunity for support as their decisions bind the government in policymaking and members of congress in their legislative acts.
Roles in the Advocacy Process
There are various roles of the nurse can play in the advocacy process in this procedure. In this process, the nurse will be an advocate. Acting as an advocate is apparent as the nurse approaches the various parties to plead the patients’ case. There are multiple adversaries in the process of advocacy. These include the insurance companies who may be interested in keeping the status quo. In some instances, the hospital and other medical practitioners may also prove adversarial when they act malevolently. The nurse may address the media on the reasons for change and the problem the status quo presents. The media, in this case, will be the intermediary. Lastly, in the advocacy process, the people with pre-existing medical issues will be the recipient of the advocacy. Thus, various parties have roles within the policy process.
Conclusion
As it is apparent, the Affordable Care Act solves some of the issues that patients with chronic pre-existing conditions faced, but nurses still have an essential role in advocacy to doctors and facilities, families, legislators, and policymakers. The ACA helped reduce the discrimination of people based on their pre-existing medical conditions, ensuring that they can get healthcare insurance coverage. By engaging with doctors on behalf of patients, the nurse can provide the best possible outcomes. In the same way, the patients can also engage with the families to ensure the patients get appropriate care from their parents. Legislators pass the laws that govern healthcare issues, and consequently, lobbying them can provide requirements to protect this population. The executive can also play an essential role in this process.
References
DiCuccio, M. H., Colbert, A. M., Triolo, P. K., Schreiber, J. B., & Dean, B. (2020). Cracking the code for quality: The Interrelationships of culture, nurse demographics, advocacy, and patient outcomes. The Journal of Nursing Administration| JONA, 50(3), 152-158.
Fernandez, B. (2010, April). Grandfathered health plans under the Patient Protection and Affordable Care Act (PPACA). Washington, DC: Congressional Research Service, Library of Congress.
Lockhart, L. (2017). Be a legislative advocate. Nursing made Incredibly Easy, 15(1), 55.
Oudshoorn, A. (2019). A right to vote: A case study in nursing advocacy for public policy reform. Witness: The Canadian Journal of Critical Nursing Discourse, 1(2), 64-72.
Roselle, A. (2018). Using the patient–family–nurse triad to improve advocacy and patient care. Journal of psychosocial nursing and mental health services, 56(9), 2-3.