Focused Exam: Chest Pain, Brian Foster Shadow health transcript

May 30, | nursing, med, NURS, Paper

Focused Exam: Chest Pain, Brian Foster Shadow health transcript
Focused Exam: Chest Pain, Brian Foster Shadow health transcript
Transcript

Hello

Greet

04/15/23 1:09 PM EDT

Good morning.

What brings you in today?

Question

04/15/23 1:09 PM EDT

I have been having some troubling chest pain in my chest now and then for the past month.

Sorry for the chest problem

Empathize

04/15/23 1:10 PM EDT

Thanks. I appreciate that.

When did the chest pain start?

Question

04/15/23 1:11 PM EDT

I first noticed it earlier this month. I thought it might just be heartburn and it passed after a couple of minutes.

How is the pain like

Question

04/15/23 1:13 PM EDT

Well, it doesn’t hurt right now, but I have been having chest pain now and then for the past month.

Where is the pain located?

Question

04/15/23 1:13 PM EDT

When the pain happens, I feel it mostly in the middle of my chest, over my heart.

Does the chest pain radiate?

Question

04/15/23 1:14 PM EDT

The pain doesn’t radiate anywhere. It’s mostly just right in the middle of my chest.

Do you have back pain?

Question

04/15/23 1:15 PM EDT

I haven’t had back pain, no.

How frequent are the chest pains?

Question

04/15/23 1:16 PM EDT

Well, it has happened three times the past month. It usually goes away after about a couple of minutes.

What relieves the chest pain?

Question

04/15/23 1:17 PM EDT

I’m not sure. I think lying still seems to help a little.

What makes the pain worse

Question

04/15/23 1:17 PM EDT

Well, I think it’s when I’m doing something physical most of the time. The first time it happened, my chest started hurting after I was doing some yard work. The second time happened when the elevator broke at work so I had to take the stairs. My office is on the 5th floor.

can you rate the pain on a scale

Question

04/15/23 1:18 PM EDT

I’d say maybe a . . . 5? It’s just really uncomfortable . . . like there’s nothing I can do about it. Right now it’s like a zero though.

Have you taken any medications for the chest pain

Question

04/15/23 1:20 PM EDT

No, not yet.

Which medications do you take currently (Clarified to What medications do you take?.)

Question

04/15/23 1:21 PM EDT

Yeah, let’s see, I take atorvastatin for cholesterol, lisinopril for blood pressure. . . Oh yeah, and I take fish oil too. I hear that’s good for your cholesterol. (Clarified to what medications I am taking.)

Thats good for your cholesterol, continue taking it

Educate

04/15/23 1:22 PM EDT

Good to know. Thank you. Focused Exam: Chest Pain, Brian Foster Shadow health transcript

Any allergies

Question

04/15/23 1:23 PM EDT

No, well . . . I’ve had a bad reaction to codeine before, but that is all I know of.

Any history of chronic illness?

Question

04/15/23 1:24 PM EDT

Besides a little high blood pressure and cholesterol, no.

Have you done EKG test recently?

Question

04/15/23 1:24 PM EDT

I had one about three months ago. They usually put one on me at my annual physical.

What were the results of the EKG?

Question

04/15/23 1:25 PM EDT

I don’t remember the actual results, but as far as I know, it was normal.

Do you have a primary care provider?

Question

04/15/23 1:25 PM EDT

Dr. Melinda Smith.

Great

Educate

04/15/23 1:26 PM EDT

Good to know. Thank you.

When did you last visit your care provider

Question

04/15/23 1:26 PM EDT

I had a physical about 3 months ago.

Any palpitations?

Question

04/15/23 1:27 PM EDT

I don’t think so. I haven’t noticed any.

Any history of heart illness? (Clarified to Do you have a history of heart problems?.)

Question

04/15/23 1:27 PM EDT

All I know is I have high blood pressure and cholesterol, but that’s pretty well-controlled by medicine as far as I know. (Clarified to if I have a history of heart problems.)

Do you feel stressed?

Question

04/15/23 1:28 PM EDT

Not usually, but I’m feeling pretty anxious not knowing what’s going on with my chest.

I’m sorry about that

Empathize

04/15/23 1:28 PM EDT

Thanks. I appreciate that.

Do you have hypertension?

Question

04/15/23 1:29 PM EDT

Yes, I supposedly have moderately high blood pressure.

Do you exercise?

Question

04/15/23 1:29 PM EDT

Well I used to ride my bike a lot but it got stolen a couple years ago. I guess I haven’t had much regular exercise since then. I want to get a new bike if the doctor says it is OK to exercise with this chest pain I’ve been having.

I’m sorry you’ve not been able to exercise

Empathize

04/15/23 1:29 PM EDT

Thanks. I appreciate that.

What is your typical diet

Question

04/15/23 1:30 PM EDT

I try to stay conscious of my diet. You know, I watch the fat. I watch the sodium . . . but I’m a dyed-in-the-wool carnivore too. Steaks and burgers find their way in there every once in a while.

Do you drink water regularly?

Question

04/15/23 1:30 PM EDT

I usually drink water all day at work. At least four glasses, probably more.

Do you smoke cigarette?

Question

04/15/23 1:31 PM EDT

Nope, I had a lot of friends who did but I never started.

Smoking is bad for the health

Educate

04/15/23 1:32 PM EDT

Good to know. Thank you.

Do you take alcohol? Focused Exam: Chest Pain, Brian Foster Shadow health transcript

Question

04/15/23 1:32 PM EDT

Sure, but never more than two or three beers on a weekend.

Do you feel fatigued?

Question

04/15/23 1:33 PM EDT

I’m not more tired than normal.

Any dizziness?

Question

04/15/23 1:33 PM EDT

No, I haven’t felt dizzy.

Do you have Angina?

Question

04/15/23 1:33 PM EDT

I’ve never been diagnosed with angina.

Do you have edema?

Question

04/15/23 1:34 PM EDT

I haven’t noticed any swelling.

Have you has blood clots?

Question

04/15/23 1:34 PM EDT

Not that I know of.

Any fever?

Question

04/15/23 1:35 PM EDT

I haven’t had a fever, no.

Do you cough?

Question

04/15/23 1:35 PM EDT

I don’t have a cough.

Any difficulty breathing?

Question

04/15/23 1:35 PM EDT

My breathing’s fine.

Any sore throat?

Question

04/15/23 1:35 PM EDT

I haven’t had a sore throat in a long time.

Do you have diarrhea?

Question

04/15/23 1:36 PM EDT

I have, but it is very rare for me.

Do you have constipation?

Question

04/15/23 1:37 PM EDT

I haven’t had problems with that. I wish it were only that.

Any heartburn?

Question

04/15/23 1:37 PM EDT

No, I’ve never had problems with heartburn. I sure hope that’s all this is, but it’s pretty intense if it’s heartburn.

Any family history of hear attack?

Question

04/15/23 1:37 PM EDT

No, nobody had that.

Have you been monitoring your blood pressure?

Question

04/15/23 1:38 PM EDT

Not usually. They check it when I get checkups. My doctor has never seemed overly concerned about it.

 Measured vitals

Exam Action

04/15/23 1:39 PM EDT

 Tested blood pressure in left arm with cuff

Exam Action

04/15/23 1:39 PM EDT

 Tested blood pressure in right arm with cuff

Exam Action

04/15/23 1:39 PM EDT

 Measured vitals

Exam Action

04/15/23 1:39 PM EDT

 Inspected face

Exam Action

04/15/23 1:39 PM EDT

 Inspected for jugular venous distension: No jugular venous distention; JVP 3 cm above sternal angle

Exam Action

04/15/23 1:40 PM EDT

 Inspected anterior chest wall

Exam Action

04/15/23 1:40 PM EDT

 Inspected right side chest wall

Exam Action

04/15/23 1:40 PM EDT

 Inspected posterior chest wall

Exam Action

04/15/23 1:40 PM EDT

 Inspected left side chest wall

Exam Action

04/15/23 1:40 PM EDT

 Inspected left side of abdomen

Exam Action

04/15/23 1:40 PM EDT

 Inspected front of abdomen

Exam Action

04/15/23 1:40 PM EDT

 Inspected right hand: no visible abnormal findings

Exam Action

04/15/23 1:41 PM EDT

 Inspected left hand: no visible abnormal findings

Exam Action

04/15/23 1:41 PM EDT

 Inspected fingernails of left hand Focused Exam: Chest Pain, Brian Foster Shadow health transcript

Exam Action

04/15/23 1:41 PM EDT

 Inspected right hand: no visible abnormal findings

Exam Action

04/15/23 1:41 PM EDT

 Inspected left hand: no visible abnormal findings

Exam Action

04/15/23 1:41 PM EDT

 Inspected fingernails of right hand

Exam Action

04/15/23 1:41 PM EDT

 Inspected left leg

Exam Action

04/15/23 1:41 PM EDT

 Inspected right leg Focused Exam: Chest Pain, Brian Foster Shadow health transcript

Exam Action

04/15/23 1:41 PM EDT

 Inspected toenails on left foot

Exam Action

04/15/23 1:41 PM EDT

 Inspected toenails on right foot

Exam Action

04/15/23 1:41 PM EDT

 Inspected left leg

Exam Action

04/15/23 1:41 PM EDT

 Inspected right leg

Exam Action

04/15/23 1:41 PM EDT

 Inspected right leg for edema: No edema

Exam Action

04/15/23 1:42 PM EDT

 Inspected left leg for edema: No edema

Exam Action

04/15/23 1:42 PM EDT

 Checked capillary refill in fingernails

Exam Action

04/15/23 1:42 PM EDT

 Checked capillary refill in fingernails

Exam Action

04/15/23 1:42 PM EDT

 Checked capillary refill in fingernails

Exam Action

04/15/23 1:42 PM EDT

 Auscultated right carotid pulse: Bruit present

Exam Action

04/15/23 1:43 PM EDT

 Auscultated left carotid pulse

Exam Action

04/15/23 1:43 PM EDT

 Auscultated aortic area with the bell

Exam Action

04/15/23 1:43 PM EDT

 Auscultated aortic area with the diaphragm

Exam Action

04/15/23 1:43 PM EDT

 Auscultated pulmonic area with the diaphragm

Exam Action

04/15/23 1:43 PM EDT

 Auscultated pulmonic area with the bell

Exam Action

04/15/23 1:43 PM EDT

 Auscultated Erb’s point with the bell

Exam Action

04/15/23 1:43 PM EDT

 Auscultated Erb’s point with the diaphragm

Exam Action

04/15/23 1:43 PM EDT

 Auscultated tricuspid area with the diaphragm

Exam Action

04/15/23 1:43 PM EDT

 Auscultated tricuspid area with the bell

Exam Action

04/15/23 1:43 PM EDT

 Auscultated tricuspid area with the diaphragm

Exam Action

04/15/23 1:43 PM EDT

 Auscultated mitral area with the diaphragm

Exam Action

04/15/23 1:43 PM EDT

 Auscultated mitral area with the bell

Exam Action

04/15/23 1:43 PM EDT

 Auscultated breath sounds in anterior right upper lobe

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in anterior left upper lobe

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in anterior right middle lobe

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in anterior left mid-chest (upper lobe)

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in anterior right lower lobe

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in anterior left lower lobe

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in posterior left upper lobe

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in posterior right upper lobe

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in posterior left mid-back (lower lobe)

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in posterior right mid-back (lower lobe)

Exam Action

04/15/23 1:44 PM EDT

 Auscultated breath sounds in posterior left lower lobe

Exam Action

04/15/23 1:45 PM EDT

 Auscultated breath sounds in posterior right lower lobe

Exam Action

04/15/23 1:45 PM EDT

 Auscultated breath sounds in posterior left lower lobe on side

Exam Action

04/15/23 1:45 PM EDT

 Auscultated breath sounds in posterior right lower lobe on side

Exam Action

04/15/23 1:45 PM EDT

 Auscultated aorta in abdomen

Exam Action

04/15/23 2:12 PM EDT

 Auscultated right renal pulse

Exam Action

04/15/23 2:13 PM EDT

 Auscultated left renal pulse

Exam Action

04/15/23 2:13 PM EDT

 Auscultated right iliac pulse

Exam Action

04/15/23 2:13 PM EDT

 Auscultated left iliac pulse

Exam Action

04/15/23 2:13 PM EDT

 Auscultated right femoral pulse

Exam Action

04/15/23 2:13 PM EDT

 Auscultated left femoral pulse

Exam Action

04/15/23 2:13 PM EDT

 Auscultated right upper quadrant

Exam Action

04/15/23 2:13 PM EDT

 Auscultated left upper quadrant

Exam Action

04/15/23 2:13 PM EDT

 Auscultated right lower quadrant

Exam Action

04/15/23 2:13 PM EDT

 Auscultated left lower quadrant

Exam Action

04/15/23 2:13 PM EDT

 Auscultated over liver Focused Exam: Chest Pain, Brian Foster Shadow health transcript

Exam Action

04/15/23 2:13 PM EDT

 Auscultated over spleen

Exam Action

04/15/23 2:13 PM EDT

 Palpated right carotid pulse: Thrill, 3+

Exam Action

04/15/23 2:14 PM EDT

 Palpated right carotid pulse: Thrill, 3+

Exam Action

04/15/23 2:14 PM EDT

 Palpated PMI: Displaced laterally; brisk and tapping; less than 3 cm

Exam Action

04/15/23 2:15 PM EDT

 Palpated right brachial pulse: No thrill, 2+

Exam Action

04/15/23 2:15 PM EDT

 Palpated left brachial pulse: No thrill, 2+

Exam Action

04/15/23 2:15 PM EDT

 Palpated right radial pulse: No thrill, 2+

Exam Action

04/15/23 2:15 PM EDT

 Palpated left radial pulse: No thrill, 2+

Exam Action

04/15/23 2:15 PM EDT

 Palpated right femoral pulse: No thrill, 2+

Exam Action

04/15/23 2:16 PM EDT

 Palpated left femoral pulse: No thrill, 2+

Exam Action

04/15/23 2:16 PM EDT

 Palpated right popliteal pulse: No thrill, 1+

Exam Action

04/15/23 2:16 PM EDT

 Palpated left popliteal pulse: No thrill, 1+

Exam Action

04/15/23 2:16 PM EDT

 Palpated right tibial pulse: No thrill, 1+

Exam Action

04/15/23 2:16 PM EDT

 Palpated left tibial pulse: No thrill, 1+

Exam Action

04/15/23 2:16 PM EDT

 Palpated right dorsalis pedis pulse: No thrill, 1+

Exam Action

04/15/23 2:17 PM EDT

 Palpated left dorsalis pedis pulse: No thrill, 1+

Exam Action

04/15/23 2:17 PM EDT

 Palpated right upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension

Exam Action

04/15/23 2:17 PM EDT

 Palpated left upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension

Exam Action

04/15/23 2:17 PM EDT

 Palpated right lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension

Exam Action

04/15/23 2:17 PM EDT

 Palpated left lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension

Exam Action

04/15/23 2:17 PM EDT

 Palpated right upper quadrant with deep pressure: No masses

Exam Action

04/15/23 2:18 PM EDT

 Palpated left upper quadrant with deep pressure: No masses

Exam Action

04/15/23 2:18 PM EDT

 Palpated right lower quadrant: with deep pressure: No masses

Exam Action

04/15/23 2:18 PM EDT

 Palpated left lower quadrant with deep pressure: No masses

Exam Action

04/15/23 2:18 PM EDT

 Palpated liver: Palpable 1 cm below right costal margin

Exam Action

04/15/23 2:18 PM EDT

 Palpated for spleen: Not palpable

Exam Action

04/15/23 2:19 PM EDT

 Palpated for right kidney: Not palpable

Exam Action

04/15/23 2:19 PM EDT

 Palpated for left kidney: Not palpable

Exam Action

04/15/23 2:19 PM EDT

 Tested skin turgor

Exam Action

04/15/23 2:19 PM EDT

 Percussed right upper quadrant

Exam Action

04/15/23 2:20 PM EDT

 Percussed left upper quadrant

Exam Action

04/15/23 2:20 PM EDT

 Percussed right lower quadrant

Exam Action

04/15/23 2:20 PM EDT

 Percussed left lower quadrant

Exam Action

04/15/23 2:20 PM EDT

 Percussed spleen

Exam Action

04/15/23 2:21 PM EDT

 Percussed for liver span: 7 cm in the mid-clavicular line Focused Exam: Chest Pain, Brian Foster Shadow health transcript

Exam Action

04/15/23 2:21 PM EDT

NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example

May 30, | nursing, med, NURS, Paper

NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example
NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example
Post an explanation for how you think the cost-benefit analysis in the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA. Then, explain how analyses such as the one portrayed by the Feldstein statement may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid).
Assignment: Legislation Comparison Grid and Testimony/Advocacy Statement
As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.
ORDER A PLAGIARISM-FREE PAPER HERE
Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.
The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)
Part 1: Legislation Comparison Grid
Based on the health-related bill you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.
Identify the proponents/opponents of the bill.
Identify the target populations addressed by the bill.
Where in the process is the bill currently? Is it in hearings or committees?
Is it receiving press coverage?

Part 2: Legislation Testimony/Advocacy Statement
Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.
Describe how you would address the opponent to your position. Be specific and provide examples.
Recommend at least one amendment to the bill in support of your position. NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example

 
Legislation Comparison Grid and Testimony/Advocacy Statement

Legislation Comparison Grid Template

Legislation Comparison Grid Template
 
Use this document to complete Part 1 of the Module 2 Assessment Legislation Comparison Grid and Testimony/Advocacy Statement

Health-related Bill Name
 
H.R.1390 – Mobile Health Record Act of 2019

Description
 
The bill was introduced in the house on 27th February 2019 under the sponsorship of Susan Brooks the representative from Indiana and co-sponsorship of New York representative Yvette Clarke.
 

Federal or State?
Federal

Legislative Intent
 
The legislation aims to amend the Social Security Act, titles explicitly XVIII and XIX. The objective is to provide to benefit from part A or part B if the Medicare programs. This also includes individuals who have enrolled under a State program under Medicaid all of who will be empowered to access personal medical data including prescriptions, providers, diagnosis and tests through the mobile health record application of their choice. NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example

Target Population
 
Beneficiaries of Medicaid

Status of the bill (Is it in hearings or committees? Is it receiving press coverage?)
 
The bill was introduced to Congress on February 27, 2019, and as later referred to the Committee on Energy and Commerce as well as the House Committee on Ways and Means. It is still at this stage of legislation.
This is a relatively new bill given it was introduced less than a month ago, hence it has not received significant news coverage.
 
 

General Notes/Comments
 
 
 
Universal health coverage is a significant issue in the United States. Considerable efforts have been placed in enhancing access to not only quality care but also healthcare information. This bill seeks to improve such access by allowing Medicaid beneficiaries to access personal health information through the mobile platform. NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example

 
 
 
Legislation Testimony/Advocacy Statement
Access to healthcare has been one of the fundamental goal for different administrations. However, the cost associated  to delivery of healthcare to all is immeasurable. Different health insurance programs have been put in place. Healthcare insurance for all has been an essential agenda for different regimes in the United States history. Subsequent governments have attempted to improve the level of access to quality healthcare services, universal coverage, especially among the vulnerable populations, and enhanced access to care information. The H.R.1390 – Mobile Health Record Act of 2019 aims to improve access to care information at a personal level through the adoption of novice technology. In his assessment Dameff, Clay, and Longhurst (2019) argues that the mobile health records platform is yet to prove its usefulness, scalability, sustainability, and its capacity to improve health delivery and outcomes.
The main question is whether the platform through the provision of personal health information can enhance care outcomes at minimal costs while maintaining the quality of services delivered. However, it should be considered that the advent of electronic health records combined with the increased adoption of internet platforms as well as smart technologies have facilitated to flow of crucial clinical information across care organizations and providers (Dameff, Clay, &Longhurst, 2019) NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example. The same, if achieved at the individual level, will improve patient inclusion in decision making and also enhance the people’s ability to make informed medical decisions with regards to their consumption of healthcare.
Opposition to this Act can result from the unproven status of such technology in enhancing access and quality of care services. Such concerns can be quelled through referencing the success achieved through Electronic Health Records which according to Bouayad, Ialynytchev, and Padmanabhan (2017), have made significant achievements in the improving quality and reducing errors. The same can be delivered through the proposed platform by enhancing how information is shared between care providers and patients.
Same with other information technologies adopted in the healthcare industry, mobile patient health information systems are susceptible to ethical concerns with regards to the safety of this information and the protection of individual rights to privacy. According to Bouri and Ravi (2014), such matters are compounded by the role played by third-party vendors who might mine or store patient information for alternative uses other than the individual’s care needs. As such, the legislators need to include amendments that clarify the accountability, rights to access, liabilities, and obligations of the parties involved in the input, storage, and transfer of patient information NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example.
References
All Information (Except Text) for H.R.1390 – Mobile Health Record Act of 2019. (2019). Retrieved https://www.congress.gov/bill/116th-congress/house-bill/1390/all-info?r=1
Bouri, N., & Ravi, S. (2014). Going mobile: How mobile personal health records can improve health care during emergencies. JMIR mHealth and uHealth, 2(1), e8.
Bouayad, L., Ialynytchev, A., & Padmanabhan, B. (2017). Patient health record systems scope and functionalities: Literature review and future directions. Journal of Medical Internet Research, 19(11), e388.
Dameff, C., Clay, B., Longhurst, C. A. (2019). Personal Health Records: More Promising in the Smartphone Era? JAMA, 321(4):339–340. NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example.
 
Legislation Comparison Grid and Testimony/Advocacy Statement

Legislation Comparison Grid Template

Legislation Comparison Grid Template
 
Use this document to complete Part 1 of the Module 2 Assessment Legislation Comparison Grid and Testimony/Advocacy Statement NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example
 

Health-related Bill Name
 
H.R.1346 – Medicare Buy-In and Health Care Stabilization Act of 2019

Description
 
The legislation was introduced to the House by New York district 26 representative Brian Higgins on February 25, 2019.
 

Federal or State?
Federal

Legislative Intent
 
The legislation intends to amend title XVIII of the national Social Security Act to allow people aged between fifty and sixty-four to buy into Medicare. In addition to this, the bill aims to enhance the stability of the nation’s health insurance market. In this light, the bill seeks to mitigate gaps within Medicare to improve coverage for medical need linked to dental, vision and hearing care. Further, it aims at introducing a buy-in clause for persons facing financial challenges in securing coverage for Medicare, and individuals aged between 50 and 64 by making them eligible for enrolment.
 

Target Population
Vulnerable populations
Individuals aged 50 to 64
 

Status of the bill (Is it in hearings or committees? Is it receiving press coverage?)
 
The bill was introduced to the floor of the house on 25th February 2019. It has been subsequently referred to the Committee on Ways and Means and the Committee on Energy and Commerce. It has yet to receive considerable media coverage NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example.
 

General Notes/Comments
 
Various gaps have been identified in Medicare provisions. Among other factors, the differences mean that beneficiaries do receive coverage on hearing, vision, and dental care resulting in high off-the-pocket costs. The proposed bill will go a long way in addressing these gaps as well as stabilizing the nation’s care insurance market.

 
Legislation Testimony/Advocacy Statement
As a care provider, I am in support of the H.R.1346 – Medicare Buy-In and Health Care Stabilization Act of 2019 given its potential effects in sealing gaps within Medicare that result in higher costs for the consumers and the program itself. Willink, Shoen, and Davis (2018) positions that when it was created almost fifty years ago, Medicare did not include provisions to cover the expenses associated with dental, vision, and hearing care. As a result, the program has had to pay for much higher amounts on severe illnesses and complications arising from or aggravated by the inadequacies in hearing, vision and dental coverage. NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example.
The impact of this gap is compounded when one considers the number of individuals suffering from these problems but could not receive the needed care. In 2017, 70%, 43% and 75% of people with difficulties in eating, trouble in seeing, and those who required hearing aids respectively did not receive treatment for their respective issues (Willink, Shoen, & Davis, 2018). The proposed bill, if passed, will provide a considerable reprieve for these individuals as well as significantly reducing the consequential costs linked to the impact of these conditions on Medicare and the public NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example.
Advocacy for the passage of the Medicare Buy-In and Health Care Stabilization Act of 2019 should also consider potential opposition to its passage. To alleviate this challenge, it is advisable to conduct educative programs on how the bill will benefit the nation in addition to Medicare beneficiaries. However, as advised by Burke, Crist, and Goldberg (2019), it is also vital for the legislators to consider real-life consequences of Medicare beneficiaries, especially older adults, who have difficulties in accessing oral, visual, and hearing care because of the expensive nature of paying for these services from their pockets. As it stands, the proposed act does not mention individuals older than sixty-five years. This points to an overlook over a patient population that significantly suffer from these problems. NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example.
References
Burke, G., Christ, A., & Goldberg, J. (2019). Creating an oral health benefit in Medicare: A statutory analysis. Issue Brief, 2019(1), 1-7.
H.R.1346 – Medicare Buy-In and Health Care Stabilization Act of 2019. (2019). Retrieved from https://www.congress.gov/bill/116th-congress/house-bill/1346/text?q=%7B%22search%22%3A%5B%22GAPS+IN+MEDICARE%22%5D%7D&r=2
Willink, A., Shoen, C., & Davis, K. (2018). How Medicare could provide dental, vision, and hearing care for beneficiaries. Issue Brief (CommonWealth Fund), 2018(1), 1-12. NURS 6050 Legislation Comparison Grid and Testimony/Advocacy Statement Example