ch 3 health policy, politics, and reform Flashcards
policy
set of principles that govern an action to achieve a given outcome
health policies
impact on the health of an individual, a family, and a population or community
health in ALL policies is a useful way to think about the extent to which a policy will impact health
advocate for us as nurses and advances our profession
ANA, national league for nursing, American organization for nursing leadership, and American academy of nursing
US spends larger GDP (gross domestic product) than any other nation
the overall life expectancy/infant mortality has not increased with the spending (26%)
Cost-benefit analysis
cost
resources needed to implement an intervention
benefits
reduction of costs incurred as a result of the intervention-including medical costs averted, productivity gains, and the monetized value of health improvements
ULTIMATE outcome
did we keep them living longer or are they dying slowly (more chronic disease)
lives longer with disease or disability
major policy concerns
cost of care
quality of care
access to care (rural locations have a decrease in access)
president t roosevelt campaigns for universal health care
medicare
federal health insurance program for individuals aged 65 and older
medicaid
provides low-income coverage
1997 childrens health insurance program
coverage for children whose parents make too much for Medicaid but do not carry their own policy
2010 Affordable Care Act (coverage increases and cost decreases)
requires people to carry health insurance (fee/penalty for not doing so)
US has NOT developed a universal health care
WHY nurse-informed political involvement
direct caregivers
awareness of patient safety and satisfaction, access to services, clinical outcomes, and health disparities
positioned to see the impact of policy on individuals
nurses policy involvement contributes to
quality outcomes
decrease in cost
expanded access
major differences to the health of the nation
KEY CONCEPTS
health policies are intended to solve problems. In most cases, health policies address the cost, quality, and/or access to healthcare services. It is an intervention to address population health problems, including health disparities related to the SDOH
there is a process to policy change, and it involves people from multiple viewpoints and ideas. Setting new policy and modifying existing policy involves social and professional negotiation and is inherently political. Policy preferences change as a result of the political context
nurses can participate in policy in many ways. Making health policy takes time, effort, and commitment. This process is presented as a dynamic and somewhat cyclical process that includes problem identification, agenda setting, policy formulation, policy legitimation, policy implementation, and policy evaluation
nurses should be aware of the who, what, when, and how of advocacy. Knowing the four R’s of an advocacy plan will guide nurses’ actions when working to influence policy decisions
healthcare services in the US cost more and produce lower quality services when compared with 11 other wealthy nations
health policy often changes incrementally; however, there are several examples of large health policy reforms in the US, including, ACA
nurses participate in policy in many ways including voting in elections, engaging with professional organizations and coalitions, and being an active community members. Nurses have valuable perspectives to share with policymakers and should consider the most effective way to bring that perspective forward.
