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Healthcare policy and politics in nursing and the U.S. healthcare delivery system have a rich history, complex structure, and intricate processes determining healthcare services and the nursing profession’s participation. Nurses and healthcare professionals must understand these changes to navigate healthcare policy and fight for policies that improve patient outcomes (Anders, 2020). These components can show how nursing has shaped healthcare policy and how nurses can continue improving healthcare in the U.S. This discussion examines the history, structure, and process of nursing healthcare policy and politics, focusing on significant milestones, players, and policy-making phases.
History
Key events and milestones characterize the history of healthcare policy and politics in nursing in the United States. Lavinia Dock, a nurse and women’s rights activist in the early twentieth century, significantly impacted nursing policy. Dock and other nursing pioneers created the American Nurses Association (ANA) in 1911. Medicare and Medicaid’s 1965 creation increased federal healthcare policy involvement, ensuring low-income and elderly persons received aid from these initiatives (Fulmer et al., 2021). The programs were implemented and delivered by nurses. In the 21st century, healthcare policy debates have focused on access, results, inequities, and prices. The 2010 Affordable Treatment Act (ACA) expanded insurance coverage, regulated insurance practices, and promoted preventive treatment (Crowley & Bornstein, 2019). Nurses advocated for ACA provisions that emphasized nursing practice and patient-centered care.
Structure
Nursing and healthcare policy and politics involve various stakeholders at various levels. HHS and other departments, such as CMS, develop and implement national healthcare policies. The CMS handles Medicare and Medicaid and establishes nursing and healthcare reimbursement policies. State governments oversee healthcare licenses, scope of practice, and funding (Leslie et al., 2021). State nursing boards govern nursing practice. The ANA, NLN, and specialty nursing organizations impact policy, advocate for nurses and patients, and promote their interests. Healthcare experts, insurers, consumer advocacy groups, and providers influence the policy. These stakeholders collaborate to develop policies that fulfill patient needs, improve healthcare quality, and address workforce challenges.
Process
Nursing healthcare policy and politics include agenda setting, policy development, policy execution, and policy evaluation (Hajizadeh et al., 2021). Setting the agenda involves prioritizing healthcare policy issues. Evidence, research, and stakeholder involvement are required to improve awareness of healthcare issues. Policy formulation develops solutions to healthcare challenges. This stage includes hearings, forums, and debates with policymakers, experts, advocacy groups, and stakeholders. Nurse organizations provide advice, research and lobby for evidence-based policies promoting nurse practice and patient care.
Policy development is followed by policy implementation. This stage entails developing guidelines, providing resources, and monitoring and enforcing compliance. Nurses create policies, enforce regulations, and assure patient safety and great care. Policy evaluation comprises monitoring outcomes, collecting data, and analyzing results to determine whether or not goals have been reached. Nursing scholars assess policies by examining their effects on nursing practice, patient outcomes, and healthcare systems. In recent years, healthcare policy debates have centered on access and affordability, private insurance versus government-funded programs, quality and patient safety, workforce problems, and technology in healthcare delivery. Nurses have led these discussions, advocating for policies that improve access to care, promote health equity, and strengthen the nursing profession.
In conclusion, nursing policy, politics, and U.S. healthcare delivery systems have changed. Nurses and nursing organizations have shaped policies that support high-quality care, the nursing profession, and changing healthcare requirements.
References
Anders, R. L. (2020). Engaging nurses in health policy in the era of COVID?19. Nursing Forum, 56(1), 89–94.
https://doi.org/10.1111/nuf.12514
Crowley, R. A., & Bornstein, S. S. (2019). Improving the patient protection and affordable care act’s insurance coverage provisions: a position paper from the American College of Physicians. Annals of Internal Medicine, 170(9), 651. https://doi.org/10.7326/m18-3401
Fulmer, T., Reuben, D. B., Auerbach, J., Fick, D. M., Galambos, C., & Johnson, K. S. (2021). Actualizing better health and health care for older adults. Health Affairs, 40(2), 10.1377/staff.
https://doi.org/10.1377/hlthaff.2020.01470
Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: A systematic review. BMC Nursing, 20(1).
https://doi.org/10.1186/s12912-021-00648-6
Leslie, K., Moore, J., Robertson, C., Bilton, D., Hirschkorn, K., Langelier, M. H., & Bourgeault, I. L. (2021). Regulating health professional scopes of practice: comparing institutional arrangements and approaches in the US, Canada, Australia and the U.K. Human Resources for Health, 19(1).
https://doi.org/10.1186/s12960-020-00550-3
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