Reply to A with 200 words
One of the challenges that our healthcare system is currently facing is attempting to improve the overall health and well being of our communities as a whole. There is a huge push to improve population health in order to improve our healthcare system and it is very important that these defined vulnerable populations are included in this plan. These are the populations of people who have less access to health care and are at a higher risk for overall health status (Nickitas et al., 2020). This definition can apply to a few different subsets of the population, one of them being those individuals with mental illness.
When examining these vulnerable populations there are huge discrepancies related to mental illness. The mental health parity act of 2008 was legislation that ultimately went into effect officially in 2014 in order to try and level the playing field when it came to mental health care (Goodman, 2015). This legislation was focused on employers and their benefits or insurance plans and designated that mental health needed to be held to the same standard as other classified medical care. The ways in which individuals can access their health care benefits must be equally represented across mental health care as well as medical care. This was hopefully to ensure that people were not in any way hindered from seeking out appropriate treatment. These provisions would apply to prescriptions, co-pays, and reimbursements. One thing that this was hoping to help with was the problem that there was limited access to mental health care throughout our country (Nickitas et al., 2020). It was also hoping to make it more appealing for students to pursue being mental health providers because they would be compensated and reimbursed accordingly for their services. It is estimated that in our healthcare system we only have one half the number of mental health providers that we truly need for everyone to access appropriate care.
Although there are laws and new regulations that are working to assist vulnerable populations within our healthcare system there also needs to be a shift in many people values, and beliefs. It is our ethical duty as healthcare providers to provide comprehensive and equal care to all individuals seeking it. This leaves no room for discrimination of services, yet we have populations of people who are having difficulty accessing their healthcare needs. People with mental illness are often overlooked as well as those who suffer from drug addiction and / or are in a lower socioeconomic bracket. This open the ethical dilemma and age old debate of universal healthcare and how that will affect all populations within our country.
Goodman, S. M. (2015). Mental Health Parity and Addiction Equity Act of 2008–The “Other” Health Care Reform. Benefits Magazine, 52(3), 20–25.
Nickitas, D. M., Middaugh, D. J., & Feeg, M. D. (2019). Policy and politics for nurses and other health professionals: Advocacy and action. (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers.
Reply to B with 200 words
There are many vulnerable populations in healthcare, such as children, minorities, non-English speakers, the un-insured, the homeless, people in low SES households and those who struggle with mental health issues. Mental health conditions are perhaps some of the most misunderstood areas of medicine. Despite years of study, science still has not been able to come close to what is going on in the human mind. Mental health conditions can be difficult to treat and for people like nurses who care for patients, also very difficult to take care of. For many years, it was difficult to get insurances to cover any mental health benefits for patients in need. Other medical needs and conditions were covered, but not mental health services and medications. The Mental Health Parity Act of 2008 was passed to prevent insurance providers from offering less favorable benefits to patients seeing mental health care (Centers for Medicare and Medicaid Services, n.d.). According to the act, insurance companies cannot impose limitations on payouts for mental healthcare services. This created a more equal playing field in healthcare for people with mental health conditions who before the act had no way to help cover service expenses. The Mental Health Parity Act has improved healthcare by creating a more equal balance between mental health and other medical conditions. The hospital I work at has a large demand for inpatient psychiatric treatment and often times, we run out of beds and have to wait to transfer patients out to other facilities. Patients no longer have to feel shamed or worry about if their insurance will pay for their ED visit for a psychiatric crisis. Parents of children with special needs are rarely turned away from child psychiatrists and psychologists for diagnosis and treatments because insurances can no longer deny paying for the services. As a parent of an autistic child who is now in college, our insurance plans when he was younger did not cover mental health. I would call offices for hours and never find a single provider who would take our insurance. I was poor and unable to pay for the visits myself, so my child went without care. It is nice that there is much more of a focus today on total health that doesn’t discriminate against mental health services when so many people need and rely on them.
As healthcare providers, we all must strive to create and deliver fair and equitable care to our patients, regardless of their race, ethnicity, religion, insurance status, or any other factor. Vulnerable populations are at the most risk for receiving unfair treatment both in healthcare and outside in the community. Two of the biggest principles in medical ethics are to do no harm to do what is right for the patients (McLean, 2016). This particularly applies to those who are vulnerable patients who may or may not have the ability to speak and decide for themselves. I have seen this play out in difficult ethics committees at my hospital, where a family member cannot let go of a patient who is in extreme suffering and refuses to honor the patient’s POLST-DNR-DNI. The hospital has to make difficult decisions to show the patient the most compassion and mercy, so that the interventions we do as providers are not causing them more harm. It serves as an important reminder to all of us that we must always act and perform our job duties in an ethical manner that aims to serve the patient for the greater good of their health.
Centers for Medicare and Medicaid Services. (n.d.). The Mental Health Parity and Addiction
Equity Act (MHPAEA). CMS. Retrieved January 6, 2022, from https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet
McLean, S. A. (Ed.). (2016). First do no harm: Law, ethics and healthcare. Routledge.
Reply to A with 200 words