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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.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
• All replies must be constructive and use literature where possible.

POST 1

Advanced Nurse Practitioners and Healthcare Policy As healthcare evolves to meet the growing population demands and provider shortages, more and more advanced nurse practitioners are being utilized to fill these gaps. According to the Patient Protection and Affordable Care Act, our current healthcare system has a critical primary care provider shortage, and an estimated additional 32 million people will require access to primary care providers (Hamric et al., 2013). Advanced nurse practitioners would be a realistic and advantageous solution to the healthcare systems’ needs. The National Academy of Medicine previously recommended in 2011 that APRNs should fulfill their potential as primary care providers and that the restrictions placed on their scope of practice has undermined healthcare reform (Institute of Medicine, 2011). Ten years later, slow legislative action has taken place since to progress APRNs in obtaining full practice privileges. Over the last three decades advance practice nurses have faced many barriers towards advancing the profession. Some of the most common barriers has been opposition from the medical community, legislative and political concerns, and professional unity (Hamric et al., 2013). The medical community has had a tumultuous relationship with the concept of advanced nurse practitioners. Although the need and benefits are apparent and well documented, physicians have struggled with the financial implications of economic competition (Hamric et al., 2013). This has resulted in many lawsuits over the years concerning the legality of advanced practice nurses and their scope of practice. Providing well documented evidence to support high quality care and outcomes as well as beneficial economic collaborative efforts could combat these misconceptions and aid in further physician acceptance. Medical providers have “largely through lobbying, played a central role in creating and perpetuating the states’ contradictory and constraining provisions of APN practice” (Hamric et al., 2013). This has had broad effects and created barriers ranging from difficulty to obtain third party reimbursements, to obtaining prescribing privileges through the drug enforcement administration. Over the decades various organizations have been established in order to represent the growing advanced nursing interest groups. However, one united cohesive voice has not been established and supported, this poses an obstacle in itself for further advancements. It has taken decades for the profession to evolve and define itself as we know it today. Licensure and practice laws for advanced nurse practitioners currently vary state by state. Uniformity amongst the states would help overcome contradictory and constraining legalities helping move momentum forward for the profession (Hain & Fleck, 2014). As of today, only 22 states in America allow nurse practitioners to practice to the full extent of their education and training (CampaignforAction.org, 2021). It has been a very slow political and legislative challenge, one that will require further collaboration from the medical community to continue to gain continued momentum.ReferencesCampaignforAction.org (2021) Improving Access to Care. Retrieved from https://campaignforaction.org/issue/improving-access-to-care/Hain, D., Fleck, L., (2014) “Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign” OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 2, Manuscript 2. Doi: 10.3912/OJIN.Vol19No02Man02Hamric, B. A., Hanson, M. C., & Tracy, F. M., & O’Grady, T. E. (2013). Advanced Practice Nursing: An Integrative Approach (5th ed.). Saunders.Institute of Medicine (2011). The Future of Nursing: Leading Change, Advancing Health. Washington (DC): National Academies Press (US); 2011. 1, Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK209881/ ReplyReply to Comment

POST 2

• Collapse SubdiscussionRojas, YanetWeek 1 DiscussionYanet RojasInfluencing Health PolicyAn important date to remember as the early beginnings of healthcare policy in the U.S. relates to the passing of Titles XVIII and XIX of the Social Security Act on July 30, 1965 (Shamian, 2015). Title XVIII established Medicare, which provided public health coverage to seniors over the age of 65 (Shamian, 2015). There were some amendments made later by Nixon on 1972 which led to the passing of the Health Maintenance Organization Act of 1973 – the law promoted a particular type of health insurance—prepaid group practice service plans, or health maintenance organizations (HMOs), as opposed to the more traditional fee-for-service plans (Shamian, 2015). Another important historical achievement in healthcare policy was the HIPPA Act signed by President Clinton in 1996. HIPPA would ensure the portability of health benefits when workers change or lose their jobs and will protect workers against discrimination by health plans based on their health status. And most recent, the Patient Protection and Affordable Care Act of 2010 signed by President Obama to provide an expansion of health insurance coverage to more Americans through both individual health insurance exchanges as well as through employer-provided plans (Neiman, 2017). Nurses play a crucial role as political advocates in four realms: the workplace, government, professional organizations, and the community. As the most trusted profession, nurses have the unique opportunity, ability, and obligation to influence change and initiate action. Because of our profession, we understand the complexities of today’s healthcare system and therefore play a vital role in health care policy. As Shamian puts it, nurses have a unique perspective and can propose alternate strategies that are less technologically involved, but are just as impactful and innovative for the many health issues faced today (2015).In the workplace, we can help create policies that reflect evidence-based practice; for instance, through a shared governance committee. As a nurse in a Boston hospital that recently went through a strike, we had to write letters to our local legislator asking them for their support. A nurse can be involved in political action through professional organizations, such as being an officer or even member on a committee, such as the American Nurses Association (ANA). Lastly, a nurse can actively be involved in the community through being a healthcare representative on committee boards.The four political spheres of workplace, government, professional organizations, and the community are all interrelated. For instance, my hospital recently went on strike, to fight for more adequate staffing, a promised defined-benefit package, and higher wages. As nurses, we wrote to and lobbied to our local legislators asking them for their support. Local politicians responded to the strike, supporting the nurses. Professional organizations, such as union firefighters, police officers, laborers, and carpenters were at the strike walking with us, supporting the cause of the strike (Neiman, 2017). Lastly, the community was involved, walking with us were friends, family, patients and patient’s families. All four political spheres were interrelated during that time.ReferencesNeiman, P. (2017). Nursing strikes: An ethical perspective on the US healthcare community. Nursing Ethics, 18(4). doi: 10.1177/0969733011408050Shamian, J. (2015). Global Perspectives on Nursing and Its Contribution to Healthcare and Health Policy: Thoughts on an Emerging Policy Model. Nursing Leadership, 27(4). Retrieved from http://web.b.ebscohost.com.proxy.chamberlain.edu:8… ReplyReply to Comment‘