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Introduction

            The generally accepted process of making a topic/bill is usually described in the constitution.  However, in most cases, the constitution leaves most of the minute details to the people dictating just the overall picture. Before delving into details, one has to look at the general process of making a law.

            The first step, the bill/topic has to pass through both houses of the Congress and be voted for by the majority. After passing through this process, it is sent to the president for an approval, and once the president signs it, the bill becomes a law. However, the president may not sign the bill, but if it is specifically rejected, it is returned to the Congress. At this point, it is voted for again, and in case when both houses pass the bill with a two-third majority, the bill becomes the law automatically even without the presidential assent.

            On the other hand, the president might sit on the bill, by refusing to take any action on it. If this happens till ten days lapse, the bill becomes the law automatically without his assent. Nevertheless, if the Congress is adjourned before the tenth day without the signature of the president, the bill fails and it is known as the pocket veto. The law is then transmitted to the Archivist. It is then published on its own as a pamphlet which contains a lot more than the law text and is ten inserted in the United States code.

The Origin of the Bill

            The bill comes from several sources, but it primarily begins as a topic from the members of the Congress. It may also be brought by the by a single constituent or a group of them. It can be submitted to a Congress member by one or more legislatures; the president or his administrators may also suggest a bill. However, after the bill is brought in to the attention of the members, the members should consider it. Bills can be introduced in any of the two houses, as noted. However, a bill have to pass the two houses to become a law with an exception of bills involved in raising revenue which must originate in the House and never in the Senate.

Healthcare Reforms in the United States

            Impacts of health policies on the daily life of the federal and state policies on the nursing and health profession cannot be ignored at all. Issues that surround healthcare are always complicated and involve the fields of medicine and economics. These two disciplines affect individuals, as well as their rights to access the affordable healthcare. The corporations and sole providers are concerned with the economic survival, while the individuals are mostly concerned with the quality.

            The major impact of these trends is on the health care delivery. This is due to an increase in regulations, as the managed healthcare continues to expand and costs increase. Along with them, there has been a tendency to shift the subsidized set up and allow the market force to restrain the costs.

            In the United States, everyone seems to have an idea of the challenges that affect the healthcare system and the possible reforms that ought to be done. The topic changes are mostly focusing on about fifty million Americans who have no insurance cover. The other issue is focused on those others though insured, suffering substantially due to an increased premium on an alarming rate.

            The United States’ Congress and the Obama administration have devised new ways to reinvest the funds in a bid to reduce the number of citizen without an insurance cover. It has also significantly addressed shortfalls that arise from quality and efficiency of care that results in poor health and higher costs. There is notable evidence that most Americans do not get the health care they need, despite the government spends the most amounts per person on the healthcare.

            Underutilization of preventive healthcare has resulted in high spending to advanced and complex diseases. Moreover, patients with chronic diseases like hypertension, diabetes, heart disease have mostly received ineffective treatment, such as drug therapy and self-management services that ought to reduce their conditions. Most patients do not receive medically important care, while other services are even harmful. The government supports regulation that has been put forward to reduce the effective cost, and improving the healthcare service is to ensure that all people get quality health care, regardless of their financial status.

            However, limited evidence on which procedures and treatments is the most effective, it contributes to the gaps in quality and efficiency of healthcare. Therefore, these issues are specifically relevant to Americans of low income and members of different ethnicities and demographic groups who are challenged with facing great disparities in health. There is a never-ending debate on the ability of delivery of system reforms that increase the value and clear attributes of approaches to improve the healthcare. At the same time, these reforms are:

            As the government seeks to find the promising evidence that the delivery system interventions could help to decrease the growth of health costs, one should consider achieving more savings by means of having the significant risk-adjusted incentives in place. These requirements and incentives should be tied to specific quality improvement. Such steps include the following:

1. Comparative Effectiveness Research in order to undertake the improvement in the value of healthcare for a longer term. This also focuses on supporting and disseminating more trials for the particular treatments and having a much larger impact, if focused more broadly on

•Comparison of risks and benefits, as well as costs of distinct health care practices

•Evaluation and revision of policies that affect practices

•Developing sound strategies that target good practices to particular groups of patients.

2. Providing interventions that target the specific patient population and clinical areas that typically have a significant impact on improvement of quality and cost management than has broader approaches. This target treatment to patients is becoming increasingly important in the field of medical science, particularly by promoting quality and value.

3. The delivery of system reforms is also being emphasized as the most effective, if the reforms are integrated to ensure the real accountability from providers. Attempts to coordinate healthcare are not so effective without the appliance of comprehensive decision support systems and electronic medical records for both provider and patient.

4. Other reforms in healthcare transition.

Changing provider reimbursement is moving the focus away from volume and intensity of services to accountability in overall quality and cost. It is important for supporting the integrated system delivery reforms. Without proper remuneration, reforms that are accountable for delivering better healthcare at low cost are unlikely to be adequate, if the major gaps in value and quality that currently abide in the U.S. healthcare system are not addressed.

Changing designed benefit assurance that cost is not an obstacle to healthcare is important in designing health benefits. Cost-sharing requires a design to encourage patients in utilizing cost-effectiveness, in primary and preventive healthcare services that may delay the onset of costly and chronic conditions.

Conclusion

The process of making better healthcare services in the United States has been a process of reforms that each of them is critical in achieving the other. On the other hand, successful topics in the reform agendas depend on the ranking of the person who introduces the topic and chances of getting voted for in the two houses.

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