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1. Evidenced-Based Change Proposal Essay Discussion Paper
Evidenced-Based Change Proposal Essay Discussion PaperExecutive SummaryThe USA
health care system has significant failures that are worsening over time. About 47 million
Americans do not have health care coverage, and 21% have difficulty paying for health care
needs. On average, the USA pays higher price per unit of health care services when
compared to other developed countries. Comparisons with UK and Sweden reveal that
although the USA system spends more on health care, the UK and Sweden that spend less
report better health outcomes. This is blamed on the fragmented investor-driven health
care system that is faulted for making health care inaccessible and lacking control over
costs. it includes profit-driven middlemen who negotiate for prices and add to the public
health bill. A single-payer system is proposed as better for the USA as it would reduce health
care costs and improve public health outcomes through sustainable cost control and
improve accessibility through universal coverage Evidenced-Based Change Proposal Essay
Discussion Paper.ORDER YOUR PAPER HEREProposed ChangeDespite spending higher on
average than other developed countries, the USA health care system has failed to provide
coverage for all residents. This is a crisis that is worsening as the economy slows down.
About 47 million Americans do not have health care coverage, and 33% of Americans
younger than 65 years of age are without insurance coverage. In addition, 21% of
Americans have difficulty paying for health care needs. The issue is exacerbated by the fact
that the economy is growing at a slower rate that the rate at which health care expenditure
is increasing. This state of affairs is blamed on the fragmented investor-driven health care
system applied in the USA. This has resulting in higher price per unit of health care services
when compared to other developed countries. This makes it clear that the US health care
system is faulty because it is not available to all Americans and there is no system in place to
control costs (Rice et al., 2021) Evidenced-Based Change Proposal Essay Discussion
Paper.Most other developed countries have some government involvement in health care
delivery to ensure that costs are controlled and coverage is universal. Compared to the USA,
these countries spend less and have better coverage. Also, they have better outcomes when
compared to the USA. The fragmented investor-driven US public health system must be
reformed if costs are to be controlled and outcomes improved. The US system has
commercial, profit driven providers providing care and this sees costs rising (Thomas,
2021). The proposed change is to apply a single-payer public health system that leverages
the power of the government to negotiate affordable prices thereby control costs. This
would make health care more accessible and help in improving public health outcomes

2. Evidenced-Based Change Proposal Essay Discussion Paper.Desired OutcomesAs earlier
indicated, the fragment investor-driven US public health system is ineffective and inefficient
as it is unable to control costs. The system has been able to realize savings from improving
quality of care and health status. However, these savings are diverted to charging higher
prices for health services and products, higher profits, and higher administrative costs. A
single-payer system helps to address this problem by reforming the financial system and
ensuring that the government pays directly for all health care costs. All Americans would be
automatically eligible for coverage as a condition of this single-payer system. In essence, the
proposed change is expected to successfully achieve sustainable cost control and universal
coverage (Shi & Singh, 2022).The proposed single-payer system leverages the power of the
government to negotiate affordable prices with the pharmaceutical industry and health care
providers. In fact, it eliminates the need for middlemen who have been pushing health care
prices up through administrative costs. Some of the eliminated middlemen include private
health insurers. With this change, the administrative costs of health care would also reduce.
In this respect, the proposed change from fragmented investor-driven public health system
to single-payer system is expected to reduce health care costs and improve public health
outcomes through sustainable cost control and improve accessibility through universal
coverage (Sabrin, 2021)Evidenced-Based Change Proposal Essay Discussion Paper.Health
Care System Comparative AnalysisA comparison between the US health care system and
United Kingdom (UK) and Sweden’s health care systems reveals significant shortcomings in
the US system. The average annual health care expenditure per person in the US is at least
double what is spent in each of the two countries. The US figure is estimated at $12,530, a
figure that is significantly higher than Sweden’s system at $5,819 and UK system at $4,400.
Despite spending more than double what residents in other countries spend, the US reports
less favorable health outcomes. First, the US reports higher mortality from preventable
causes when compared to the UK and Sweden. The US reports a figure of 175 per 100,000
population, a figure that is higher than UK at 119 per 100,000 population, and Sweden at 93
per 100,000 population. Second, the US reports higher mortality from treatable causes
when compared to the UK and Sweden. The US reports a figure of 88 per 100,000
population, a figure that is higher than UK at 69 per 100,000 population, and Sweden at 51
per 100,000 population. Third, the US reports higher infant mortality rate when compared
to the UK and Sweden. The US reports a figure of 5.8 deaths per 1,000 live births, a figure
that is higher than UK at 3.9 deaths per 1,000 live births, and Sweden at 2.4 deaths per
1,000 live births. Fourth, the US reports higher obesity prevalence when compared to the
UK and Sweden. The US reports a figure of 30.9% of adults are obese, a figure that is higher
than UK at 20.1%, and Sweden at 13.1%. Fifth, the US reports lower life expectancy at birth
when compared to the UK and Sweden. The US reports a life expectancy figure of 78.6 years,
a figure that is lower than UK at 81.3 years, and Sweden at 82.5 years. Finally, the use has
lower health care spending efficiency when compared to the UK and Sweden. The USA
spends 19.7% of the GDP on health, a higher figure when compared to the UK at 10.43%
and Sweden at 10.9% (see Table 1). Based on this comparative analysis, it is clear that
although the USA system spends more on health care, the UK and Sweden that spend less
have better health outcomes Evidenced-Based Change Proposal Essay Discussion

3. Paper.ORDER YOUR PAPER HERERationale for the Proposed ChangeThe proposal is to
apply a single-payer system in the USA. Currently, the USA applies a fragmented investor-
driven public health system. This has been faulted for being ineffective in providing
universal care, and being inefficient in controlling costs. The system has been able to
improve quality of care and health status while saving costs. However, the savings are
diverted to charging higher prices for health services and products, higher profits, and
higher administrative costs. The result is that health care is not accessible to all Americans
and is very costly. As such, there is a need to improve health care access while controlling
and reducing costs. Towards this end, a single-payer public health system has been
proposed. This system leverages the governments financial power to negotiate affordable
health care costs for the public with the pharmaceutical industry and health care providers.
Also, it reduces the unnecessary administrative costs by eliminating the middlemen, such as
public health insurers. In this respect, the change from fragmented investor-driven public
health system to single-payer system is expected to reduce health care costs and improve
public health outcomes through sustainable cost control and improve accessibility through
universal coverage (Heitkamp, 2019)Evidenced-Based Change Proposal Essay Discussion
Paper.Financial and Health ImplicationsThe fragmented investor-driven public health
system lacks coordination and incentives are misaligned, resulting in inefficient allocation
of resources, especially when it comes to cost savings. The fragmented system has saved on
costs through improving health care quality and health status. However, it has many
unnecessary ‘players’ so that any savings made are spent on the ‘players’. To be more
precise, the fragmented system has many unnecessary middlemen who target the cost
savings to increase their financial take through higher prices for health services and
products, higher profits, and higher administrative costs. The result is that the USA spends a
lot on health care but reports less favorable outcomes and low access. In continuing to use
the fragmented investor-driven public health system, the USA should expect the health care
costs to grow while accessibility reduces (Rice et al., 2021).The fragmented investor-driven
public health system should be replaced with a single-payer system. This approach
leverages the government’s financial power to negotiate affordable prices with the
pharmaceutical industry and health care providers. It allows the government to directly
negotiate for lower prices while reducing the costs incurred from engaging middlemen such
as private health insurers. This helps in achieving sustainable cost controls to improve
public health outcomes, and universal coverage to improve accessibility (Sabrin,
2021)Evidenced-Based Change Proposal Essay Discussion Paper.ConclusionThe purpose of
this paper was to explore the faults in the fragmented investor-driven US public health
system, and propose a solution. Based on the analysis, it is clear that the USA pays higher
price per unit of health care services when compared to other developed countries. Despite
paying a higher price, it reports lower health outcomes. The comparison between
performance in USA, UK and Canada reveals that although the USA system spends more on
health care, the UK and Sweden that spend less have better health outcomes. The US system
has commercial, profit driven providers providing care and this sees costs rising. Also, the
system has middlemen who add to the costs. The proposal is to replace the fragmented
investor-driven US public health system with a single-payer system. A single-payer system

4. is preferable because it eliminates middlemen and unnecessary administrative costs, while
leveraging the government’s financial power to negotiate affordable health care costs with
the savings used to improve access. in this respect, the proposal is to apply single-payer
system in order to reduce costs and improve access.AppendixTable 1: Health Care System
Comparative Analysis (source: Organization for Economic Co-operation and Development,
2022) Evidenced-Based Change Proposal Essay Discussion PaperPublic Health Outcomes
United Kingdom Health Care System Sweden Health Care System US Health Care
SystemAverage annual health care expenditure per person $4,400 $5,819
$12,531Mortality from preventable causes (age standardized rate per 100,000
population) 119 93 175Mortality from treatable causes (age standardized rate
per 100,000 population) 69 51 88Infant mortality rate (deaths per 1,000 live
births) 3.9 2.4 5.8Obesity prevalence (percentage of adults) 20.1 13.1
30.9Life expectancy at birth (years) 81.3 82.5 78.6Efficiency (total national
spending on health as % of GDP) 10.43% 10.9% 19.7% ReferencesHeitkamp,
K. L. (Ed.) (2019). Universal Health Care. Greenhaven Publishing LLC.Organization for
Economic Co-operation and Development (2022). OECD Health Statistics 2021.
https://www.oecd.org/els/health-systems/health-data.htmRice, T., Rosenau, P., Unruh, L.
Y., & Barnes, A. J. (2021). Health Systems in Transition: USA (2nd ed.). University of Toronto
Press.Sabrin, M. (2021). Universal Medical Care from Conception to End of Life: The Case for
a Single-Payer System. Page Publishing, Inc.Shi, L., & Singh, D. A. (2022). Delivering Health
Care in America: A Systems Approach (8th ed.). Jones & Bartlett Learning, LLC.Thomas, R. K.
(2021). Health Services Planning (3rd ed.). Springer Evidenced-Based Change Proposal
Essay Discussion Paper.Propose a change to one aspect of your local or regional health care
system or program that would improve outcomes. Then, conduct a comparative analysis of
other, non-U.S. health care systems, focusing on the proposed change. Summarize the
proposed change and your comparative analysis in a 5 page report. Introduction Note:
Complete the assessments in the order in which they are presented. Health care systems
around the world provide useful models for analysis. Familiarity with different models and
approaches to health care enables leaders to identify what works and what does not, as the
basis for proposing a change. As we continue to evaluate the complex and fragmented
system in the United States, it is important for nurse leaders to become familiar with the
programs and systems that provide evidence-based quality care that is affordable and
focused on continual improvement. This assessment provides an opportunity to examine a
local or regional health care issue from a global perspective. Preparation Your organization,
in collaboration with the key stakeholders from the community, is funding an initiative to
investigate potential improvements in the local or regional health care system. As a nurse
leader attuned to the effects of health care policy and finance on the provision of affordable,
high-quality care, you have been asked to join the task force conducting the study. You
know that an examination of other countries' health care systems can provide a solid,
evidence-based foundation for evaluating outcomes and identifying benchmarks.
Consequently, you have decided to undertake an analysis of selected, non-U.S. health care
systems and compare them to each other and to the existing local or regional U.S. system to
help inform decision making as the task force considers proposed changes. In this

5. assessment, you will propose a change to one aspect of your local or regional health care
system or program. Conduct a comparative analysis of different health care systems and
summarize your proposed change and findings from your analysis in a report to executive
leaders. To prepare for your assessment, you are encouraged to begin thinking about the
non-U.S. health care systems you might like to examine. In addition, you may wish to:
Review the assessment requirements and scoring guide to ensure that you understand the
work you will be asked to complete. Review Guiding Questions: Proposing Evidence-Based
Change [DOCX], which includes questions to consider and additional guidance on how to
successfully complete the assessment. Note: Remember that you can submit all or a portion
of your draft report to Smarthinking Tutoring for feedback before you submit the final
version for this assessment. If you plan on using this free service, be mindful of the
turnaround time of 24–48 hours for receiving feedback. MSN PROGRAM JOURNEY The
following is a useful map that will guide you as you continue your MSN program. This map
gives you an overview of all the steps required to prepare for your practicum and to
complete your degree. It also outlines the support that will be available to you along the
way. MSN Program Journey.ORDER YOUR PAPER HERETEMPLATES Use this template for
your summary report. Summary Report Template [DOCX]. Requirements Complete this
assessment in three steps: Propose a change to one aspect of your local or regional health
care system or program that would improve outcomes. Conduct a comparative analysis of
different health care systems, focusing on one aspect of the system you are proposing to
change. Summarize your proposed change and the results of your comparative analysis in a
report to executive leaders. The summary report requirements outlined below, correspond
to the grading criteria in the scoring guide for Proposing Evidence-Based Change, so be sure
to address each point. Read the performance-level descriptions for each criterion to see
how your work will be assessed. The Guiding Questions: Proposing Evidence-Based Change
document provides additional considerations that may be helpful in completing your
assessment. In addition, be sure to note the requirements below for document format and
length and for citing supporting evidence. Identify an aspect of a local or regional health
care system or program that should be a focus for change. Define desirable outcomes,
including who will pay for care and factors limiting the achievement of those outcomes.
Analyze two non-U.S. health care systems or programs that offer insight into a proposed
change for a health care system or program in the United States. Choose one of the following
options for selecting the two systems or programs: Option 1: Select two systems at opposite
ends of the scale in terms of desirable outcomes for the issue reflected in your proposed
change. Option 2: Select two systems that both produce positive outcomes but take unique
or innovative approaches to the problem. Compare the outcomes in each non-U.S. system
with each other and with present outcomes in your local or regional health care system.
Explain why specific changes will lead to improved outcomes. Determine the financial and
health implications associated with the proposed changes. Address the implications of
making the changes. Address the implications of not making the changes. Write clearly and
concisely in a logically coherent and appropriate form and style. Support assertions,
arguments, propositions, and conclusions with relevant and credible evidence. Document
Format and Length Use the Summary Report Template. This APA Style Paper Tutorial

6. [DOCX] can help you in writing and formatting your assessment. If you would like to use a
different worksheet for your community health assessment, obtain prior approval from
faculty. Your summary report should be 5 pages in length, not including the title page and
references page. Be sure to apply correct APA formatting to all source citations and
references. Supporting Evidence Cite 5 credible sources from peer-reviewed journals or
professional industry publications to support your comparative analysis. Additional
Requirements Be sure to delete all directions from the template before submitting your
summary report. In addition, proofread your report to minimize errors that could distract
readers and make it more difficult for them to focus on the substance of your analysis.
Portfolio Prompt: You may choose to save your summary report to your ePortfolio.
Competencies Measured By successfully completing this assessment, you will demonstrate
your proficiency in the following course competencies and assessment criteria: Competency
1: Identify the challenges and opportunities facing health care. Identify an aspect of a local
or regional health care system or program that should be a focus for change. Competency 2:
Compare the effects of different health care finance models and policy frameworks on
resources and patient outcomes. Define desirable outcomes, including who will pay for care
and factors limiting achievement of those outcomes. Analyze two non-U.S. health care
systems or programs that offer insight into a proposed change for a health care system or
program in the United States. Competency 3: Evaluate the positive and negative influences
of leaders on health care processes and outcomes. Determine the financial and health
implications of making—and not making—proposed changes to a health care system or
program. Competency 4: Develop proactive strategies to change the culture of the
organization by incorporating evidence-based practices. Explain why specific changes will
lead to improved outcomes. Competency 5: Communicate effectively with diverse
audiences, in an appropriate form and style consistent with applicable organizational,
professional, and scholarly standards. Write clearly and concisely in a logically coherent and
appropriate form and style. Support assertions, arguments, propositions, and conclusions
with relevant and credible evidence. All of the following must be included: 1. Identifies an
aspect of a local or regional health care system or program that should be a focus for
change. Provides clear expectations for improvements substantiated by credible evidence.
2. Defines desirable outcomes, including who will pay for care and factors limiting
achievement of those outcomes. Provides well-reasoned justification for the definition and
exhibits insight into optimal health care solutions. 3. Explains why specific changes will lead
to improved outcomes. Draws well-substantiated conclusions that are in line with
reasonable expectations. 4. Analyzes two non-U.S. health care systems or programs that
offer insight into a proposed change for a health care system or program in the United
States. Articulates insightful lessons learned from the analysis that have clear implications
for U.S. health care. 5. Determines the financial and health implications of making—and not
making—proposed changes to a health care system or program. Draws insightful, well-
reasoned conclusions based on credible evidence. 6. Writes clearly and concisely in a
logically coherent and appropriate form and style. Main points, ideas, arguments, or
propositions are well-developed and engaging. Adheres to all applicable disciplinary and
scholarly writing standards and conventions. 7. Supports assertions, arguments,

7. propositions, and conclusions with relevant, credible, and convincing evidence. Skillfully
combines error-free source citations with a perceptive and accurate synthesis of the
evidence. Guiding Questions for Assessment 1 Proposing Evidence-Based Change This
document is designed to give you questions to consider and additional guidance to help you
successfully complete the Proposing Evidence-Based Change assignment. You may find it
useful to use this document as a pre-writing exercise, an outlining tool, or as a final check to
ensure that you have sufficiently addressed all the grading criteria for this assignment. This
document is a resource to help you complete the assignment. Do not turn in this document
as your assignment submission. Executive Summary Propose a change to one aspect of your
local or regional health care system or program that would improve outcomes. Then,
conduct a comparative analysis of different health care systems, focusing on the aspect of
the system you are proposing to change, and summarize the results in a summary report.
Identify an aspect of a local or regional health care system or program that should be a focus
for change. • Why did you decide on this particular change? • What improvements do you
expect as a result of the change? • What evidence supports your position? Define desirable
outcomes, including who will pay for care and factors limiting achievement of those
outcomes. • What is your rationale for this definition? • What sources can you cite that
support your definition? Evidenced-Based Change Proposal Essay Discussion Paper• What
are the two limiting factors? Analyze two non-U.S. health care systems or programs that
offer insight into a proposed change for a health care system or program in the United
States. • Select two systems at opposite ends of the scale in terms of desirable outcomes for
the issue reflected in your proposed change or select two systems that both produce
positive outcomes but take unique or innovative approaches to the problem. Then, compare
the outcomes in each non-U.S. system with each other and with present outcomes in your
community. o How do the two health care systems or programs address the issue? o What
lessons are you able to draw from each example that you could apply in your system?
Explain why specific changes will lead to improved outcomes. • What are the expected
improvements in outcomes? • What evidence can you use to justify your conclusions? • Are
your expectations reasonable within the existing health care system? Determine the
financial and health implications associated with the proposed changes. • Address the
implications of making the changes. • Address the implications of not making the changes. o
What are the likely costs and benefits for individuals and the community at large? o What
are the potential short- and long-term effects? o What evidence do you have that supports
your conclusions? Write clearly and concisely in a logically coherent and appropriate form
and style. • Write with a specific purpose and audience in mind. • Adhere to scholarly and
disciplinary writing standards and APA formatting requirements. Support assertions,
arguments, propositions, and conclusions with relevant and credible evidence. • Integrate
relevant and credible evidence from 3–5 peer-reviewed journals or professional industry
publications. • Is your supporting evidence clear and explicit? o How or why does particular
evidence support a claim? o Will your reader see the connection? • Did you summarize,
paraphrase, and quote your sources appropriately? Submission Reminders • Have you
identified an aspect of your local or regional health care system or program as the focus for
change, with supporting evidence? • Have you clearly defined desirable outcomes and

8. provided supporting evidence? • Have you completed your examination of two non-U.S.
health care systems or programs with respect to the issue reflected in your proposed
change? • Have you adequately explained why specific changes will lead to improved
outcomes and provided supporting evidence?Evidenced-Based Change Proposal Essay
Discussion Paper • Have you determined the financial and health implications both of
making and not making your proposed changes and provided supporting evidence? • Is
your report well supported by 5 sources of relevant and credible evidence? • Is your report
5 pages in length, not including the title page and references page? • Did you proofread your
writing and delete all directions from the template? Below is the template for assessment it
must be used: Change Proposal Summary Report Your Full Name (no credentials) School of
Nursing and Health Sciences, Capella University NURS-FPX6218 Leading the Future of
Health Care Proposing Evidence-Based Change Instructor’s Name Month, Year Change
Proposal Summary Report Note: Delete this note and all instructions from the template
before submitting your report. Use headings to organize your text, rather than bullets.
Executive Summary Proposed Change Identify an aspect of a local or regional health care
system or program that should be a focus for change. Desired Outcomes Define each
desirable outcome you wish to examine, including who will pay for care and factors limiting
achievement of those outcomes. Health Care System Comparative Analysis Use Table 1, in
the appendix, for your comparative analysis of the specific outcomes you wish to examine.
Analyze outcomes in two non-U.S. health care systems that offer insight into your proposed
change. • Choose one of the following options for selecting the two systems: o Option 1:
Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue
reflected in your proposed change. o Option 2: Select two systems that both produce
positive outcomes but take unique or innovative approaches to the problem. • Compare the
outcomes in each non-U.S. system with each other and with present outcomes in your local
or regional health care system. Rationale for the Proposed Change Explain why specific
changes will lead to improved outcomes. Financial and Health Implications Determine the
financial and health implications associated with the proposed changes. • Address the
implications of making the changes. • Address the implications of not making the changes.
Conclusion Summarize your analysis and provide your rationale for the proposed change.
Appendix Table 1: Health Care System Comparative Analysis Table directions: 1. Add the
names of the two non-U.S. health care systems and the local or regional U.S. health care
system to the applicable column headings. 2. In the first column, list each outcome. Add
rows to your table, as needed. 3. Add the relevant information pertaining to each outcome
for each health care system in the second, third, and fourth columns. Outcomes [Health Care
System 1] [Health Care System 2] [U.S. Health Care System] List outcome 1 here. List
outcome 2 here. List outcome 3 here. Place in-text citations here, along with any other
information not included in the table itself. References List your APA-formatted references
here. Above is the template for assessment please use it. Evidenced-Based Change Proposal
Essay Discussion Paper