The Challenge of Access to Health Services in Miami

Issue Definition, Description, Stakeholders, and Background

The issue of access to health care services is one of the most critical ones in Miami, Florida. In particular, it seems essential to focus on oral health care that lacks to ensure children and families with an adequate level of access. One does not have to worry about accessing a dentist’s office if he or she has private medical insurance or can afford to pay a doctor. However, the low income or the residence in a remote area are the barriers that are likely to lead to the fact that a person and his or her children will postpone prophylactic oral care until it is too late. As noted by the Florida Dental Association (2012), “only 23.5 percent of Medicaid enrolled children and 11 percent of Medicaid adults receive any dental care annually” (p. 29). The number of children seeking help is growing, and some of them are already coming with dental infections.

It is not uncommon for children and families not to visit oral specialists because of the lack of access due to the shortage of funds. For some families living in Miami, Florida, going to a dentist is a real burden for the budget. Also, many elder people who retire and are deprived of medical insurance need qualified help from a dentist, but they cannot get it because of high prices (“Adequate insurance coverage,” 2015). Over the past decade, the situation has worsened. The recent survey showed that a large part of the population is forced to save money for a visit to a dentist, while social state programs are not able to provide free dental services for everyone (Bersell, 2017).

The private clinics are too expensive. The study showed that among adults who received assistance through government programs, where more than two-thirds were enrolled in the Medicaid state-federal insurance program for low-income people, 26 percent reported they were not satisfied with the quality of the oral services provided (“Children’s oral health,” 2014). As a rule, doctors are reluctant to participate in such programs, since their work is paid quite modestly, and it is much more profitable to accept private clients. Thus, there are federal, local, and private stakeholders providing oral care.

Issue Statement and Methods of Addressing It

The problem is quite widespread as more and more children and their families cannot afford a dentist that makes caries a chronic disease number one among children across the US. As the proposed solutions to the problem that can be effective, one may consider a federal change of oral health provision policy. In particular, it seems important to allow licensing of dental therapists who are mid-level specialists and able to help children and adults do without basic and preventive dental care. They will be able to perform the usual procedures, such as cleaning and sealing.

The suggested policy is based on a series of studies about access to dentistry. The first of a series of studies found that virtually all – 15 of the 16 – counties of Maine have a shortage of dental professionals. At the same time, 16 percent of the population of the state suffered from dental problems, and this result is in the 10th place of the highest morbidity rates among all states. Other studies have found that the availability of dental services can be improved by the increased access to preventive services, such as dentistry. It is significant not only to provide the antibacterial cleansing but also other related services because untreated dental diseases can become a serious problem and even lead to the death of a patient.

In the context of the mentioned facts, it is possible to suggest that a dental team of a therapist may charge a lower fee and pay more attention to the prevention of dental diseases. Doctors can clearly explain patients to brush their teeth with the floss and do it the required number of times. In other words, dental therapists and nurses are to be trained to take the initiative, make plans with patients to develop procedures, and follow-up diagnostics. At the same time, they would be expected to work in cooperation with local school systems and educational institutions.

Goals, Risks, Benefits, and Impact of Change

According to Florida’s Agency for Health Care Administration, “ensuring health care services are available to all Floridians, especially children” is the top priority (“Children’s health coverage in Florida,” 2014, para. 1). With this in mind, the core goal is to promote strategies to improve access to oral health care for children and families. The state is taking steps that will make it easier for some people to access dental services. For example, under the influence of trade unions, it was decided to expand the list of employees who are entitled to free medical insurance. Starting from 2014, more than thirty thousand people received additional oral care (“Free children’s dental health program launched,” 2015).

The new policy will offer several new strategies, such as the introduction of new payment methods to control price increases that could improve access. However, it is of great importance to guarantee that they will work in modern conditions. The impact of the proposed measures may be facilitated by encouraging dental clinics to strive to recruit more dental volunteers to serve uninsured patients and children from low-income families. The increasing number of consumers also face difficulties in finding a doctor, especially when emergency assistance is needed. As a rule, dental doctors prefer to treat their regular clients who need serious medical intervention, since they pay large money. This is a feature of private medicine, which is developed much better than the state one. The new policy is likely to address this issue as well. As for risks, the mentioned policy is rather safe.

Evaluation Methodology and Recommendations

The effectiveness of the proposed policy may be determined in both short-term and long-term perspectives via surveys and statistics review. In case of any positive or negative changes, it is important to consider the required options and either support or reject them. As noted by Arabi, Rafii, Cheraghi, and Ghiyasvandian (2014), the nursing policy is a powerful tool to promote access to health care services, thus ensuring timely and appropriate delivery of the necessary services. The role of family nurses with regards to the identified change is to seek for support to implement the suggested measures, explaining its importance, impact, and benefits (Zerwekh, 2017).

More to the point, family nurses are expected to explain to patients the necessity of oral care, focusing on children and family health. As for the nursing practice, the noted policy is likely to help nurses in improving access to health care and patients’ health statuses (“Person-and family-centered care,” 2015). I believe that the above policy will serve as a critical tool to help as many families as possible in accessing health care, working in collaboration with federal and local stakeholders.

References

Adequate insurance coverage. (2015).

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. Iranian Journal of Nursing and Midwifery Research, 19(3), 315-322.

Bersell, K. (2017). Access to oral health care: A national crisis and call for reform. Journal of Dental Hygiene, 91(1), 6-14.

Children’s health coverage in Florida. (2014).

Children’s oral health. (2014).

Florida Dental Association. (2012). Improving access to oral health care in Florida. Today’s FDA, 24(4), 29-40.

Free children’s dental health program launched. (2015)

Person-and family-centred care. (2015).

Zerwekh, J. (2017). Family nurse practitioner (3rd ed.). St. Louis, MI: Elsevier.