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NURS FPX 6008 Assessment 1 : Identifying a Local Health Care Economic Issue

Assessment 1: Identifying a Local Health Care Economic Issue


Capella University

FPX 6008 


April, 2024

Identifying a Local Health Care Economic Issue

Healthcare accessibility and robust health insurance coverage play a crucial role in promoting the health and well-being of individuals, medical professionals, and healthcare institutions. When health insurance is lacking, it can lead to economic difficulties by restricting access to prompt, high-quality healthcare services, while also placing additional financial stress on healthcare systems. This paper explores a specific healthcare economic problem at the local level: the repercussions of insufficient insurance coverage for individuals, healthcare practitioners, and medical facilities. The goal is to examine the root causes of this issue, evaluate its impact on the provision of healthcare, and suggest potential solutions to overcome these challenges. The ultimate goal is to improve access to care, promote equitable health outcomes, and support the sustainability of healthcare services in the community. The research highlights the importance of addressing this issue to ensure everyone has access to the healthcare they need, regardless of their financial situation (Mukwena & Manyisa, 2022). Ultimately, the aim is to improve access to care, promote equitable health outcomes, and support the sustainability of healthcare services in the community.

Reasons for Inadequate Healthcare Insurance

Inadequate health insurance coverage can be due to economic, social, and structural factors, including high premiums and lack of access to employer-sponsored insurance. This makes it difficult for people to access comprehensive health care, especially those with low incomes. Small businesses and the gig economy also contribute to the problem. Health insurance can be complex and confusing, deterring individuals from obtaining adequate coverage. Pre-existing health conditions and risk factors can result in limited insurance options and inadequate coverage. These issues contribute to inadequate health care insurance, affecting individual health outcomes and placing a strain on the overall health care system (Huguet et al., 2023). Comprehensive reforms are required to ensure everyone has access to adequate health insurance coverage.

Challenges Arising from Insufficient Health Insurance Coverage

Inadequate health insurance coverage refers to a situation where people have limited coverage that fails to meet their medical needs. Such a scenario may lead to high costs, insufficient benefits, and gaps in coverage, which can make it difficult for individuals to access medical services. Furthermore, inadequate health insurance affects healthcare providers and institutions, leading to higher costs and unequal access to care (Nicholas & Deji, 2023). It highlights the need for comprehensive health care policies and solutions that ensure affordable and quality care for all. Inadequate health insurance coverage can have significant impacts on individuals, healthcare providers, and the broader healthcare system. It can limit access to healthcare services, including preventive care, and lead to financial strain for individuals, families, and providers. In addition, it perpetuates existing healthcare disparities, adversely affecting the health and well-being of vulnerable populations (Dugan & Booshehri, 2021). Comprehensive policy solutions are necessary to ensure adequate health insurance coverage for everyone.

Rationale for Choosing Health Care Insurance as an Economic Issue

Health care insurance is critical for ensuring access to health services and has a significant impact on individual and societal well-being. Inadequate insurance coverage can lead to delayed treatment, financial strain, and increased health disparities. Personal experiences often shape the decision to examine health care insurance as a key economic issue, highlighting the importance of comprehensive coverage. Health care insurance is a significant focus in terms of values. It is important to address insurance-related economic issues to promote fairness and reduce health disparities (Giang et al., 2022). By exploring this issue, we can identify and address the factors contributing to inadequate coverage and its broader implications for health care outcomes and social equity.

Reasons for Selecting Health Care Insurance as a Focus

Choosing the right health care insurance is extremely important. It plays a crucial role in ensuring that individuals and families access necessary medical services while significantly impacting their financial stability. Inadequate insurance coverage can result in delayed medical care, high out-of-pocket expenses, and even medical bankruptcy. Personal experiences, such as witnessing family or friends struggle with insufficient coverage, highlight the importance of exploring this issue. Choosing this topic reflects a commitment to social justice, emphasizing the need for equitable access to health care for all (Barker & Li, 2020). Examining health care insurance allows us to identify gaps, understand the underlying causes of inadequate coverage, and propose solutions that promote better health outcomes and reduce disparities.

Significant Impacts of Healthcare Insurance on Diverse Groups

Inadequate health care insurance can have significant impacts on various groups, especially those from lower socio-economic backgrounds.Inadequate insurance coverage can have significant consequences, including reduced productivity and increased absenteeism in the workplace. It can also increase uncompensated care for healthcare organizations, leading to financial pressure and resource shortages. Healthcare workers may experience burnout and high turnover due to insufficient insurance coverage. It also disproportionately impacts diverse groups, resulting in health disparities and poorer health outcomes (Hooley et al., 2022). Addressing these issues requires a comprehensive approach that aims to reduce health disparities across the board.

Gap Contributing to the Adequate Healthcare Insurance 

The lack of affordable health insurance options is a significant issue, especially for people with low to moderate incomes. This creates a barrier to accessing health care, leading to inadequate coverage and high out-of-pocket costs. Increasing health care premiums have made it difficult for many workers to afford comprehensive insurance, causing them to opt for high-deductible plans or forego insurance altogether. Unequal access to employer-sponsored health insurance contributes to the gap in health care coverage (Chauluka et al., 2022). Smaller businesses and those in the gig economy often do not provide health insurance benefits, forcing workers to navigate the costly and confusing individual insurance market. Consumers’ struggle to understand insurance plan terms and concepts exacerbates the problem. To address this issue, we need to control premium costs, expand access to employer-sponsored insurance, and improve consumer education (Sriram & Khan, 2020). 

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue Conclusion :

Inadequate healthcare insurance presents challenges for individuals, providers, and the healthcare system. High premiums, limited coverage, and complex plans create a gap in affordable insurance, leading to delayed care, financial strain, and health disparities. We need to make insurance more affordable, increase access through employer plans, and educate consumers 

(Thokala et al., 2023). By closing this gap, we can promote better health outcomes, reduce disparities, and ensure everyone can access care.

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue References :

Barker, A. R., & Li, L. (2020). The cumulative impact of health insurance on health status. Health Services Research, 55 Suppl 2, 815–822. https://doi.org/10.1111/1475-6773.13325

Chauluka, M., Uzochukwu, B. S. C., & Chinkhumba, J. (2022). Factors associated with coverage of health insurance among women in malawi. Frontiers in Health Services, 2, 780550. https://doi.org/10.3389/frhs.2022.780550

Dugan, J. A., & Booshehri, L. G. (2021). Effects of inadequate coverage on healthcare utilization: A regression discontinuity analysis. Medicine, 100(20), e25998. https://doi.org/10.1097/MD.0000000000025998

Giang, N.H., Vinh, N.T., Phuong, H.T. (2022). Household financial burden associated with healthcare for older people in Viet Nam: a cross-sectional survey. Health Res Policy Sys 20 (Suppl 1), 112. https://doi.org/10.1186/s12961-022-00913-3

Hooley, B., Afriyie, D. O., Fink, G., & Tediosi, F. (2022). Health insurance coverage in low-income and middle-income countries: progress made to date and related changes in private and public health expenditure. BMJ Global Health, 7(5), e008722. https://doi.org/10.1136/bmjgh-2022-008722

Huguet, N., Hodes, T., Liu, S., Marino, M., Schmidt, T. D., Voss, R. W., Peak, K. D., & Quiñones, A. R. (2023). Impact of health insurance patterns on chronic health conditions among older patients. Journal of the American Board of Family Medicine : JABFM, 36(5), 839–850. https://doi.org/10.3122/jabfm.2023.230106R1

Mukwena, N. V., & Manyisa, Z. M. (2022). Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa. BMC Health Services Research, 22(1), 1006. https://doi.org/10.1186/s12913-022-08367-7

Nicholas, A., & Deji, O. (2023). Invisible illness: The consequences of limited health insurance in Africa. Health Science Reports, 6(6), e1313. https://doi.org/10.1002/hsr2.1313

Sriram, S., & Khan, M. M. (2020). Effect of health insurance program for the poor on out-of-pocket inpatient care cost in India: evidence from a nationally representative cross-sectional survey. BMC Health Services Research, 20(1), 839. https://doi.org/10.1186/s12913-020-05692-7

Thokala, P., Srivastava, T., Smith, R., Ren, S., Whittington, M. D., Elvidge, J., Wong, R., & Uttley, L. (2023). Living health technology assessment: Issues, challenges and opportunities. PharmacoEconomics, 41(3), 227–237. https://doi.org/10.1007/s40273-022-01229-4

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