Assignment: The Cost of Health Care
NURS 4105: Advocacy through Healthcare Policy
Name: Maria Pribe
Instructor: Dr. Dorothy Roberts
September 8, 2019
The Cost of Health Care
Cannabis is an illicit drug that is frequently cultivated, trafficked, and abused worldwide. According to the world health organization (WHO), the consumption of cannabis has an annual prevalence rate of 2.5% of the global population (Bridgeman & Abazia, 2017). The legalization of the use of medical marijuana has a significant impact on the cost, access, and quality of health care. A study conducted on conditions that medical marijuana is considered an alternative treatment method showed that states with active cannabis policies had fewer drug prescriptions (Bradford & Bradford, 2016). A reduced number of drug prescriptions cause a decrease in Medicare Part D and enrollee spending. Hence, the use of medical marijuana is cost-effective (Lear-Phillips, 2018). The aim of writing this paper is to analyze the impact of financing and budgetary issues associated with the legalization of medical marijuana in Michigan State.
Funding and Annual Costs of Continuing of the Policy for the Last Year
Health care systems may be financed using government funding, taxation, donations, private insurance, and voluntary aid. The state of Michigan created a marihuana regulation fund in the state treasury to fund the legalization of the use of medical cannabis (Michigan Regulation and Taxation of Marihuana Act, Initiated Law 1, 2018). The initial funding of the policy will be appropriated from a general fund, however, proceeds from the fund would be used to repay any amount allocated. According to Wolfram (2016), the medical marijuana industry generates $44.3 million a year based on the current patient population.
Financial and Budgetary Efforts Developed to Contain Costs.
The state of Michigan passed legislation that allows limited sale and purchase of marijuana by individuals with certified licenses. Michigan’s regulatory agency, the Department of Licensing and Regulatory Affairs, has imposed a 10% excise tax on all marijuana sales, minimum levels of insurance for individuals with licenses, and provide for the levy and collection of fines for violations of the act or rules (Wolfram, 2016). These legislations will create a transparent, licensed, and regulated medical marijuana industry in Michigan causing the collection of revenue to be consistent and businesses to operate under established rules, hence, promoting competition.
Current Cost-Containment Strategies
Public health and safety policies on medical cannabis are modified and changed to adapt to new regulations, restrictions, and penalties (Cornett, 2018). States that have permitted the use of medicinal cannabis have established laws that regulate its sale (Bridgeman & Abazia, 2017). The Michigan Medical Marihuana Act legalized the growth, possession, and use of marijuana to treat debilitating conditions such as neuropathic pain, spasticity in multiple sclerosis, and nausea because of chemotherapy. The law allows Michigan residents to be given permits by the department of licensing and regulatory affairs after a recommendation by a certified doctor. Therefore, a 21 year and older will be allowed to possess 2.5 ounces of marijuana and grow up to 12 plants in an enclosed area (Wolfram, 2016). However, government medical assistance programs and private health insurers do not provide reimbursement of medical cannabis expenses. The schedule 1 classification of cannabis causes hospitals and other care settings that receive Medicare reimbursement or federal grants to consider the potential loss of the funds. The loss of funds may occur if the government penalizes hospitals because of permitting the use of marijuana therapy in their facilities (Bridgeman & Abazia, 2017). In March 2019, Gov. Gretchen Whitmer approved the establishment of the Marijuana Regulatory Agency within the Michigan Department of Licensing and Regulatory Affairs (LARA). The new agency released regulations on the implementation process of the 2018 voter-approved law that legalized marijuana for adults 21 and older (Marijuana Policy Project, 2019). The guidelines outline the role of the agency in promoting the communities’ participation in the cannabis industry. Also, the rules included the provision of licenses that permit the use of cannabis for temporary events. The regulations by LARA provide license renewal fees that are triple-tiered based on the gross weight of products transferred the previous year by the individual, therefore, this will increase the revenue collection (Marijuana Policy Project, 2019). The use of medical marijuana under a strict regulatory framework will allow patients to have increased access to safe medicine. Additionally, the sale and production of the drug through a licensed and accountable system will enhance the growth of the business and promote competition, therefore, impacting the economy of Michigan (Wolfram, 2016).
Health Outcomes of Financing the Policy and the Role of the Nurse in the Workplace
In the United States (US), approximately 3.1 million individuals use marijuana daily (Wilkinson, Yarnell, Radhakrishnan, Ball, & D’Souza, 2016). Thirty states in the US have legalized the use of cannabis for medicinal and recreational purposes. However, the legalization of marijuana for medical use occurs by popular vote and this differs from the approval of medications by the U.S. Food and Drug Administration (FDA) that requires an intensified standard of evidence for both efficacy and safety (Wilkinson et al., 2016). Financing the use of medical marijuana will provide the state the ability to regulate its use causing safer use of cannabis. Consequently, there will be a decline in the prevalence of marijuana use among individuals (Wilkinson et al., 2016). However, the presence of operating medical marijuana dispensaries in certain municipalities may cause an increase in the use of the drug. Shih (2019) noted that young adults living near medical marijuana dispensaries had an increased rate of using the drug and this exposes them to the risk of developing mental and physical health problems.
The use of prescription opioids for patients with chronic pain may lead to an overdose. A research conducted on states having medical cannabis laws established that there was a reduced annual rate of opioid overdose and death by 24.8% (Cornett, 2018). Hence, an increase in the prescription of medical cannabis for health conditions such as cancer and chronic pain may reduce Medicare spending and private insurance costs (Lear-Phillips, 2018).
The role of a health care practitioner is to advocate for the patients’ rights and needs (Lear-Phillips, 2018). Medical marijuana applies to the future roles of nurses because they may encounter a patient with a prescription of the drug. It is the responsibility of the practitioner to ensure a patient acquires quality care in their institution. Therefore, the role of the nurse is critical in the provision of care because a provider may advise them to administer medical marijuana to patients with chronic pain before a therapy session (Lear-Philips, 2018). Additionally, the nurse is required to counsel the patient about safety to avoid developing health outcomes such as addiction to the drug.
Bradford, A. C., & Bradford, W. D. (2016). Medical marijuana laws reduce prescription medication use in Medicare part D. Health Affairs, 35(7), 1230-1236. doi:10.1377/hlthaff.2015.1661
Bridgeman, M. B., & Abazia, D. T. (2017). Medicinal cannabis: History, pharmacology, and implications for the acute care setting. Pharmacy and Therapeutics, 42(3), 180-188. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/
Cornett, L. N. (2018). Legalization of medical cannabis and potential implications for healthcare delivery in the United States. Kentucky Journal of Undergraduate Scholarship, 2(1), Article 2. Retrieved from https://pdfs.semanticscholar.org/d398/14ec2f6c8dca93ca50468c21b78ab2049415.pdf
Lear-Phillips, J. T. (2018). Medical marijuana and the healthcare system. Kentucky Journal of Undergraduate Scholarship, 2(1), Article 4. Retrieved from https://pdfs.semanticscholar.org/d0cd/bb93fa304207554ff46bb4559911d623b807.pdf
Marijuana Policy Project. (2019). Marijuana regulatory agency publishes emergency rules to implement legalization. Retrieved from https://www.mpp.org/states/michigan/
Michigan Regulation and Taxation of Marihuana Act, Initiated Law 1 (2018). Retrieved from https://www.legislature.mi.gov/(S(r03jnxzfjaqkfrcvnkpajhxx))/documents/mcl/pdf/mcl-Initiated-Law-1-of-2018.pdf
Shih, R. A. (2019). Young adults who live near medical marijuana dispensaries use marijuana more often, have more-positive views. Retrieved from https://www.rand.org/news/press/2019/06/17.html
Wilkinson, S. T., Yarnell, S., Radhakrishnan, R., Ball, S. A., & D’Souza, D. C. (2016). Marijuana legalization: Impact on physicians and public health. Annual Review of Medicine, 67(1), 453–466. doi:10.1146/annurev-med-050214-013454
Wolfram, G. (2016). The economic impact of a strong regulatory framework for medical marijuana in Michigan. Retrieved from http://www.mml.org/pdf/resources/Economic%20Report_Gary%20Wolfram.pdf