What the Election Means for Health and Health Care… The Country Needs More Providers, Better Mental Health and Elder Care, and an End to Poverty
Carolyn Montoya, RN, MSN, CPNP, is a fellow with the Robert Wood Johnson Foundation (RWJF) Nursing and Health Policy Collaborative at the University of New Mexico. A PhD Candidate, Montoya serves on the New Mexico Medicaid Advisory Committee, an advisory body to the Secretary of the state’s Human Services Department and the Director of the Medical Assistance Division Director. The RWJF Human Capital Blog asked scholars and fellows from a few of its programs to consider what the election results will mean for health and health care in the United States.
Human Capital Blog: Do you think there will be fewer challenges to the Affordable Care Act and more attention to how to implement it?
Montoya: Now that the election is over, the reality is that the Affordable Care Act (ACA) will not be repealed. As we go forward with the ACA in place, a strong emphasis should be placed on evaluation. Outcome measures, such low rates of diabetes complications or increased immunization rates, will be essential in terms of being able to establish what aspects of the ACA are working and which ones need to be revised.
HCB: Do you think the influx of previously uninsured patients into the health care system will materialize and if so, are there enough providers to care for them and is the system ready to provide quality care?
Montoya: I absolutely think that there will be an influx of previously uninsured patients. Just imagine how many individuals have delayed medical treatment due to lack of insurance. Think about the diabetics who have suffered complications from lack of care and the children whose parents have delayed “well child” visits due to lack of insurance. Do we have enough health care providers to meet the demand – absolutely not! We need to continue programs that expose students to the rewards of a health career and offer incentives for completing the necessary education and for working in areas that have the most severe shortages of providers.
HCB: If you had the ear of President Obama and congressional leaders, what would you suggest their health-related priorities should be in the next few years?
Montoya: Mental health issues for both children and adults have risen dramatically in the past 20 years, yet we have many areas of the country where there is limited access to psychiatric services. Primary care providers need additional education in the recognition and management of mental health disorders. We need to be able to utilize technologies such as tele-health in order to consult with mental health experts regarding complex psychiatric issues.
As the population of elderly increases, we also need to think about strategies other than “housing” our elderly in nursing homes. I recently read about a program that offers foster care for veterans. Rather than living in a nursing home, this program pays families for caring for veterans in their homes – a “foster care” model. The program, which has been in place since 2000, may be a viable alternative to nursing homes for the general population of elderly who are unable to live on their own.
Most importantly, we need to restore the economic well-being of the country. So much of “good” health is determined by where a person is born and raised, the so-called social determinants of health. Every child who remains in poverty runs the risk of poor health and poverty affects their ability to learn. If we want to continue to be world leaders, we need to protect our future by ensuring that our children have the opportunity to develop to their full potential. It is time to resurrect President Johnson’s “War on Poverty.”
Learn more about the RWJF Nursing and Health Policy Collaborative at the University of New Mexico.