Increasing Access, Increasing Responsibility: Activating the Newly Insured

Discourses of Co-Responsibility and Patient Engagement

Based on the ACA credo of joint responsibility. The health care providers would do their part, but it was ultimately the responsibility of the patients for their own healthcare. This essay looks again at this issue in New Mexico.

• Co-responsibility and Latin American poverty alleviation & patient responsibility in healthcare in the US
• the idea that both the patient and healthcare providers have a responsibility to make sure that goals are met
• patients are required to improve their health through various measures
• providers are required to assist them
• Clients are perceived as active participants in the improvement of their lives rather than recipients of welfare
• Oportunidadas (example)
• program gives funds and workshops to mothers who are to use the training and money to improve the education and health of their children
• thought to break the cycle of poverty through active responsible behavior
• used today in association with ACA (perspective)
• Patient engagement is defined as: "the relationship between patients and health care providers as they work together to promote and support active patient and public involvement in health and healthcare and to strengthen their influence on healthcare decisions at both the individual and collective levels.
• relies on SHARED RESPONSIBILITY and COLLABORATION among patients, providers, health care  administrators and communities
• motivating patients to increase their involvement in their own healthcare
• primary tool for achieving the triple aims:
• reduced cost
• improved patient experiences
• improved health outcomes
• while there is often a recognition of vulnerable populations who lack the ability to participate fully in this process, nothing is done to address the structural inequalities. Instead, modified interventions are suggested to help these vulnerable populations better engage.
• The Affordable Care Act in Action
• Ongoing Barriers to Access
• lack of documentation
• Being just over the income limit for medicaid
• lack of awareness to apply for medicaid
• difficulties with requirements for HMOs
• lack of education about healthcare alternatives
• lack of funding to support patients in getting documentation
• permanent address- homeless
• birth certificate- especially for immigrants

Focus remains on individual patients and their responsibility rather than the structural barriers to access insurance and healthcare