Posted: August 16th, 2024

Module 1 Discussion: Nursing & Health-Care-Policy

Module 1 Discussion
Nursing & Health-Care-Policy
Analyze the history, structure, and process of health-care-policy and politics in nursing and the health care delivery systems in the United States.
Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
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Module 2 Discussion: Advocacy
What examples of advocacy do you see in your own nursing practice? List and discuss 2 examples.
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

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Module 1 Discussion: Nursing & Health-Care Policy

The Evolution and Dynamics of U.S. Healthcare Policy

Healthcare policy in the United States has undergone significant transformations since the early 20th century, shaping the current landscape of nursing practice and healthcare delivery. This complex system, influenced by various political, economic, and social factors, continues to evolve in response to changing national needs and priorities.

Historical Development

The foundations of modern U.S. healthcare policy can be traced back to the early 1900s. During this period, progressive reformers advocated for improved public health measures and workplace safety regulations (Kovner et al., 2018). However, it wasn’t until the mid-20th century that major federal healthcare initiatives began to take shape.

A pivotal moment came in 1965 with the establishment of Medicare and Medicaid under the Social Security Act. These programs dramatically expanded access to healthcare for elderly and low-income populations, respectively. The introduction of these government-sponsored health insurance programs marked a significant shift in the role of federal policy in healthcare delivery (Altman & Frist, 2015).

Subsequent decades saw further policy developments, including the creation of the Children’s Health Insurance Program (CHIP) in 1997 and the passage of the Patient Protection and Affordable Care Act (ACA) in 2010. The ACA, in particular, represented a comprehensive attempt to reform the U.S. healthcare system, aiming to increase insurance coverage, improve quality of care, and control rising healthcare costs.

Structural Components

The structure of U.S. healthcare policy is characterized by its complexity and multi-layered nature. At the federal level, key stakeholders include Congress, which enacts healthcare legislation, and executive branch agencies such as the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), which implement and oversee healthcare programs.

State governments also play a crucial role in healthcare policy, with responsibilities ranging from regulating insurance markets to administering Medicaid programs. This federal-state dynamic creates a diverse patchwork of policies and practices across the country (Béland et al., 2016).

Private sector entities, including insurance companies, healthcare providers, and pharmaceutical firms, exert significant influence on policy formation through lobbying efforts and market behaviors. Professional organizations, such as the American Nurses Association, advocate for policies that support nursing practice and patient care.

Policy Process

Healthcare policy development in the U.S. follows a complex and often contentious process. Typically, it begins with problem identification, followed by agenda setting, where issues gain attention from policymakers and the public. Policy formulation involves drafting potential solutions, which may be influenced by various interest groups and stakeholders.

Legislation must then navigate the political process, including committee hearings, floor debates, and voting in both houses of Congress. If passed, policies move to the implementation phase, where regulatory agencies develop specific rules and procedures for enacting the law (Weissert & Weissert, 2019).

Throughout this process, nursing professionals play an increasingly important role. Nurses often serve as expert witnesses in legislative hearings, provide input on proposed regulations, and participate in policy implementation at the institutional level. Their frontline experience in healthcare delivery makes them valuable contributors to policy discussions.

Impact on Nursing and Healthcare Delivery

Healthcare policies have profound effects on nursing practice and the broader healthcare system. For instance, the ACA’s emphasis on preventive care and population health has expanded the role of nurses in primary care settings and community health initiatives. Policy changes related to reimbursement models, such as the shift towards value-based care, have altered how healthcare organizations operate and how nurses document and deliver care.

Moreover, policies addressing workforce issues, such as the Nurse Reinvestment Act of 2002, have aimed to address nursing shortages and improve nursing education. These initiatives have implications for nurse recruitment, retention, and professional development (Spetz, 2016).

Conclusion

The history, structure, and process of healthcare policy in the United States reflect the nation’s complex and evolving approach to healthcare delivery. As key stakeholders in the healthcare system, nurses must understand these policy dynamics to effectively advocate for their profession and their patients. Ongoing challenges, such as healthcare disparities and rising costs, ensure that healthcare policy will remain a critical area of focus in the years to come.

References

Altman, D., & Frist, W. H. (2015). Medicare and Medicaid at 50 years: Perspectives of beneficiaries, health care professionals and institutions, and policy makers. JAMA, 314(4), 384-395.

Béland, D., Rocco, P., & Waddan, A. (2016). Reassessing policy drift: Social policy change in the United States. Social Policy & Administration, 50(2), 201-218.

Kovner, A. R., Knickman, J. R., & Jonas, S. (2018). Jonas and Kovner’s health care delivery in the United States. Springer Publishing Company.

Spetz, J. (2016). The nursing profession, diversity, and wages. Health Services Research, 51(2), 505-510.

Weissert, C. S., & Weissert, W. G. (2019). Governing health: The politics of health policy. Johns Hopkins University Press.

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Tags: healthcare delivery, healthcare policy, Nursing Practice, policy process