Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Prof. Name Date Lobbying for Change June 13, 2023 Department of Health and Human Services  200 Independence Avenue, S.W. Washington, D.C. 20201 Dear Committee. As a nurse working in a Minnesota hospital, I am writing you this letter with the aim of highlighting the issues of exponentially rising drug prices, the lack of individual affordability, and their impact on our work as well as the community.The rise in drug prices has impacted individuals’ willingness to find a cure and to take medication as they are unable to afford them, and it makes it even harder to manage their medication expenses while they are not fully insured, hence the nurses constant struggle to find ways to provide quality care regardless of patients’ inability to pay for their care. Along with that, the rising prices place a greater financial burden on the organizations. Hence, the aim of writing this letter is to address the issue of rising drug prices (Affair, 2022). The aim of highlighting this issue is to help people gain better healthcare access while being able to afford the care and regulate the policies regarding the Medicare price rate. However, if the issue is not dealt with as an immediate priority, then there are chances that it might impact an individual’s ability to seek out care, as affording medication would be a problem. There is a vast amount of literature that suggests that increased drug processing impacts patients’ adherence to medication and their perception of healthcare facilities (Rajkumar, 2020). According to the research, patients’ capacity to purchase medication and the healthcare system as a whole are both negatively affected by the high cost of drugs (Chisholm-Burns, et al., 2017). Another study looked at how drug prices affected research and distribution, finding that the nearly 9% annual increase in drug costs from 2008 to 2018 could be preventing many people from receiving treatment or sticking to their medication regimen (Kakkar, 2021). NHS FPX 6008 Assessment 4 Lobbying for Change Control measures include less research and development (R&D) and fewer medication approvals (Kesselheim et al., 2016), which another study found to have an effect on medical innovation. Similar to how these studies have shown the importance of implementing policies that prioritize community health and address these ethical and racial barriers to healthcare access, they have also shown the importance of designing interventions to address the issues of increased pricing, providing affordable medication options, and addressing these barriers (Philipson & Durie, 2021). Along with that, the current issue has been impacting our work as nurses, organizations, and the overall healthcare system as it limits access to medication and the healthcare system, making it hard for people to either reach out to us or adhere to medication. Therefore, as per my experience, the foremost solution to this problem is to provide a universal healthcare system to all individuals, regardless of their status, to help manage the gap and to provide policies through which medication prices are regulated and managed properly.Henceforth, for this purpose, I would like you to pay attention to this particular issue and provide us with ways to combat it and form universal yet equal policies for the healthcare system so that everyone can benefit from it. Hence, I strongly urge you to take action to manage the issue and work on the enhancement of the overall health care system. I am eagerly waiting for your positive response. Thank you in advance. Sincerely, A.B.C References  Affairs (ASPA), A. S. for P. (2022, September 30). New HHS Reports Illustrate Potential Positive Impact of Inflation Reduction Act on Prescription Drug Prices. HHS.gov. https://www.hhs.gov/about/news/2022/09/30/new-hhs-reports-illustrate-potential-positive-impact-inflation-reduction-act-prescription-drug-prices.html Chisholm-Burns, M. A., Spivey, C. A., Gatwood, J., Wiss, A., Hohmeier, K., & Erickson, S. R. (2017). Evaluation of racial and socioeconomic disparities in medication pricing and pharmacy access and services. American Journal of Health-System Pharmacy, 74(10), 653–668. https://doi.org/10.2146/ajhp150872 Kakkar, A. K. (2021). Pharmaceutical price regulation and its impact on drug innovation: mitigating the trade-offs. Expert Opinion on Therapeutic Patents, 31(3), 189–192. https://doi.org/10.1080/13543776.2021.1876029 Philipson, T., & Durie, T. (2021). ISSUE BRIEF: THE EVIDENCE BASE ON THE IMPACT OF PRICE CONTROLS ON MEDICAL INNOVATION SEPTEMBER 2021. Retrieved June 10, 2023, from https://cpb-us-w2.wpmucdn.com/voices.uchicago.edu/dist/d/3128/files/2021/08/Issue-Brief-Price-Controls-and-Drug-Innovation-Philipson.pdf Rajkumar, S. V. (2020). The high cost of prescription drugs: Causes and solutions. Blood Cancer Journal, 10(6). https://doi.org/10.1038/s41408-020-0338-x NHS FPX 6008 Assessment 4 Lobbying for Change

Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Prof. Name Date Slide 1: Hello everyone, this is megan. I would like to thank you for your presence and patience. My topic of presentation is the business case for change.  Slide 2:  Introduction  Healthcare in the US is largely dependent on insurance companies, and with the rising prices of medication and healthcare, maintaining the quality of care out of one’s pocket has become one of the most challenging tasks. Therefore, insurance companies play a significant role in ensuring the quality of care. The high cost of healthcare has become a burden on U.S. families, and the cost of healthcare has contributed largely to decisions about insurance coverage and care provision (Kearney et al., 2022). However, the cost of the insurance also causes financial worry, as either the installment is too much or the care provided is inadequate. Surveys have highlighted that around 43% of working adults had inadequate insurance in 2022, while 9% were uninsured and had a gap in coverage over the past year up to 11%, or either were underinsured, meaning that their coverage didn’t provide them with access to care (23%) (The Commonwealth Fund, 2022). Slide 3:  Impact on healthcare: The insurance issue is one of the most significant issues impacting the healthcare system, as we all know that insurance is one of the most frequently used ways to manage the cost of healthcare expenses. Therefore, its impact on my work as a nurse, my colleagues, the organization, and the overall community is interlinked and complex.  First of all, it impacts our work as nurses and healthcare providers, as insurance issues directly impact the work of nurses, doctors. The nurses respond to changes in the regulation and financing of healthcare with innovation and responsibility. Thus, my job is to help the client get healthcare within the limits of the insurance while influencing how it is viewed. The constant struggle of making the reading policies provide interventions within the limits of their standards of care as most time is invested in navigating the insurance policies and providing the quality of care with constrained resources and options that the insurance covers (Rudman, et al.,2020). Also, it leads to occupational stress and burnout from providing care when I have to refuse patients their right to care due to financial constraints. When the insurance doesn’t cover the patient’s full care, the organization or the patient must pay for it, which can put a strain on the organization’s finances. sources that could affect the company’s care (Laprise, 2023).  The organization struggles with insurance companies’ reimbursement rates and policies that don’t match its reimbursement rate, which affects its financial stability. This low insurance company reimbursement rate may cause economic difficulties and layoffs (Turale, & Kunaviktikul, 2019). When a health care issue occurs in society or the healthcare sector, it endures in the community, like how insurance coverage influences access to care. Due to insurance companies inability to cover their medical expenditures, older people often decline healthcare facilities. Slide 4:  Feasibility and Cost- Benefit Considerations The feasibility refers to the practicality and viability of implementing the insurance plan, which includes several factors such as healthcare insurance size and the nature of the organization, financial resources, insurance coverage details, and the requirement for the regulation of insurance. However, the cost and benefit analysis provides a unique yet practical picture of healthcare insurance. It involves comparing the cost and benefits of the insurance, such as the deductibles, payment methods, administration expenses, and insurance coverage. While the benefit includes the medical service plan, medication, preventive care, and financial protections. The selection of the insurance is strictly based on the weight the benefits have against the costs. Slide 5  Ways to mitigate Slide 6 Implementation Plan   Slide 7 Cultural Sensitivity and Ethical Equitability When it comes to insurance issues, there are many social, economic, and diverse perspectives on how insurance impacts people or particular groups or populations. These issues have made it clear that not everyone receives health care and that, in some areas, insurance has led to an economic gap between people, as a result of which some people have better access to the healthcare system than others. It also explains the difference between population growth and the experience of receiving health care, and the factors that may have influenced these differences are social differences (Sohn, 2016). Economic differences, ethnicity, and racial differences also contribute to creating that dispersion among people, such as poor people who have low income (Stansbury, 2022). People experience insurance issues because, in comparison to those with higher incomes, their insurance is either very limited or nonexistent. Their approach to health care would be completely different from that of those who have better income resources and can gain better coverage deals from insurance companies. Also, it could become a significant barrier to accessing healthcare services and may have led to poor healthcare outcomes.  Slide 8  Continued from previous slide Unfortunately, this economic gap in America has created a very different situation for the people because they receive care that causes harm to them or they do not receive care at all. The care that is being provided to people is either too late or not with full consideration of the patients’ preferences and values because their insurance does not equate with their preferences or values for the care that the day demands. This creates an environment of providing care either to the less fortunate or unjustly.  A  systematic review highlighted that public health insurance in low or middle-income countries has a significant impact on improving healthcare provision to patients and the utilization of healthcare facilities (Erlangga et al., 2019). Also, another study has shown that people who experience gaps in their health insurance coverage are less likely to have regular sources of care and may have delayed or missed appointments, while adults who lack insurance for a whole year have poor access to care and have more health