Health Policy and Politics

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Nurses may have innovative suggestions for changing a particular health care practice, but if the suggestions are not enacted through policy, they help no one and simply remain good ideas. Fortunately, nurses today frequently are involved in the policy development process due to their increasingly recognized expertise in all aspects of health and health care. These policies may be at the organizational, local, state, national or global levels. The ability of nurses to help establish effective policy allows them to have a broader influence than through practice alone.

This week, you will explore the policy-making process and how issues reach the public agenda. You will also analyze how policies influence health care delivery and population health. In addition, you will consider ethical and value-based frameworks that guide policy development and practice.

Learning Objectives

Students will:

• Analyze the influence of a health care policy on health care delivery and apply Kingdon’s Model to health policy development
• Evaluate key characteristics of an effective women’s preventive health care program

Learning Resources

Required Readings

Milstead, J. A. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones and Bartlett Publishers.

• Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. xvi -13)

This chapter explains public policy and the nurse’s role in directing health care issues to the government and securing a response.

• Chapter 2, “Agenda Setting: What Rises to a Policymaker’s Attention” (pp. 16-34)

This chapter provides examples of the process of moving a problem to the attention of the government so the solution can be considered at the state and federal levels.

• Chapter 3, “Government Response: Legislation” (pp. 36-54)

This chapter explores the multiple factors that influence the development of public policy through the legislative branch of government.

Coalition for Patients’ Rights. (2012). Retrieved from http://www.patientsrightscoalition.org/ 

This website details the initiative of the Coalition for Patients’ Rights, which seeks to ensure that patients everywhere have access to the quality health care providers of their choice.

University of Washington School of Medicine. (n.d.) Ethics in medicine: Managed care. Retrieved from http://depts.washington.edu/bioethx/topics/manag.html 

This article explains the effects and ethical concerns associated with managed care, which integrates payment with the delivery of health care.

Required Media

Laureate Education (Producer). (2012b). Health policy and politics. Baltimore, MD: Author.

Optional Resources

Milstead, J. A. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones and Bartlett Publishers.

• Chapter 5, “Public Policy Design” (pp. 86-97)
• Chapter 6, “Policy Implementation” (pp. 100-112)
• Chapter 7, “Health Policy and Social Program Evaluation” (pp. 114-127)

Discussion: Health Care Policy

In this week’s media presentation, Dr. Trautman, Dr. Wakefield, and Ms. Coyle discuss how public policies initiated at the national or state level ultimately influence what occurs at the institutional and local level of nursing practice and health care delivery. Health care policy usually is developed to address health care cost, quality, or access, or a combination of the three. Due to the nature of their interaction with patients, nurses are well situated to be effective, knowledgeable advocates for their patients.

In this week’s Discussion, you will examine how current policies impact how you as a nurse provide health care. You will then select an issue of interest and determine how you could advocate for policy in that area. 

To prepare:

• Select one public policy that currently is impacting you and your practice. Consider the following:
  • What health care driver was the policy designed to address: cost, quality, access, or a combination?
  • Does the policy appear to be achieving its intended results? On what data are you basing your assumption?
  • What have been the effects (adverse or positive) of this policy on health care cost, quality, and access?
  • How is this policy affecting your nursing practice?
• Next, select a health care issue—something you see or experience on a daily basis—about which you would like to influence a practice change through the policy process.
• Review the Learning Resources, focusing on Kingdon’s Model. How would you utilize this model to guide your policy development?

By Day 3

Post a brief description of a public policy that is having an impact on your practice; summarize your analysis of the policy using the bulleted list above as a guide. Then, summarize the issue you would like to influence though a change in public policy, and outline how you would utilize Kingdon’s Model to guide your policy development.