: Presidential Agendas

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?To Prepare:Review the Resources and reflect on the importance of agenda setting.Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.BELOW IS THE QUESTION———————-Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?BELOW IS THE REQUIRED READING————————-Learning ResourcesRequired ReadingsMilstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. 11-13 only)Chapter 2, “Agenda Setting: What Rises to a Policymaker’s Attention?” (pp. 17-36)Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 171-180)Chapter 12, “An Insider’s Guide to Engaging in Policy Activities””Creating a Fact Sheet” (pp. 217-221)DeMarco, R., & Tufts, K. A. (2014). The mechanics of writing a policy brief. Nursing Outlook, 62(3), 219-224. doi:10.1016/j.outlook.2014.04.002Kingdon, J.W. (2001). A model of agenda-setting with applications. Law Review M.S.U.-D.C.L., 2(331)Lamb, G., Newhouse, R., Beverly, C., Toney, D. A., Cropley, S., Weaver, C. A., Kurtzman, E., … Peterson, C. (2015). Policy agenda for nurse-led care coordination. Nursing Outlook, 63(4), 521-530. doi:10.1016/j.outlook.2015.06.003.O’Rourke, N. C., Crawford, S. L., Morris, N. S., & Pulcini, J. (2017). Political efficacy and participation of nurse practitioners. Policy, Politics, and Nursing Practice, 18(3), 135-148. doi:10.1177/1527154417728514Institute of Medicine (US) Committee on Enhancing Environmental Health Content in Nursing Practice, Pope, A. M., Snyder, M. A., & Mood, L. H. (Eds.). (n.d.). Nursing health, & environment: Strengthening the relationship to improve the public’s health. CORE SKILL: comparing how DIFFERENT ADMINISTRATIONS treated the SAME health issue — which reveals that agenda-setting is driven by politics and framing, not only by the objective severity of the problem.
THE ANALYTICAL FRAMEWORK — use KINGDON’S MULTIPLE STREAMS MODEL and the paper transforms: three independent streams flow through the system — the PROBLEM stream (conditions get defined as problems, often via a focusing event, a crisis, or a striking indicator), the POLICY stream (a “primeval soup” of solutions floating among experts, waiting for a problem to attach to), and the POLITICS stream (national mood, election results, interest-group pressure, administration turnover). When the three CONVERGE, a POLICY WINDOW opens, and a POLICY ENTREPRENEUR couples a solution to a problem and pushes it through. Windows close quickly. THIS EXPLAINS THE CENTRAL PUZZLE OF THE ASSIGNMENT: why some issues get attention while equally serious ones do not. The answer is rarely “because they were more serious.”
STRUCTURE OF THE GRID: select ONE health issue (opioid crisis, mental health parity, maternal mortality, gun violence as a public health issue, rural hospital closures, prescription drug pricing, health disparities) and compare TWO OR THREE administrations across: how the issue was DEFINED and FRAMED (this is where the action is — framing the opioid crisis as a CRIMINAL JUSTICE problem versus a PUBLIC HEALTH problem produces entirely different policies from identical facts, and that observation is the strongest thing you can say); the specific policy or legislative response; the funding committed; the outcome and its measurement; and the role nurses and nursing organizations played.
BE EVENHANDED. This is graded partly on political neutrality — describe positions accurately and fairly rather than advocating. Assess policies on their evidence and their outcomes, not on party. A paper that reads as partisan will lose marks even where the facts are right.
KEY CONCEPTS TO DEPLOY: agenda-setting; problem definition and framing; focusing events (a crisis that concentrates attention — a mass-casualty event, a high-profile death, a pandemic); INCREMENTALISM (Lindblom — policy usually changes in small steps from the status quo, because comprehensive rational analysis is impossible and coalitions are hard; this explains why sweeping reform is rare and why the ACA looks the way it does); PATH DEPENDENCY (past choices constrain present options — the US employer-based insurance system is an accident of WWII wage controls, and it now shapes everything); interest groups and iron triangles; and the difference between the AGENDA (what gets discussed) and the ALTERNATIVES (what gets considered).
THE FACT SHEET / ADVOCACY component: one page, scannable, with a clear position and a specific ask. Lead with the problem stated in human terms, support with data, name the policy solution, and make the ask concrete.
NURSING’S ROLE: nurses are consistently the most trusted profession in public polling (Gallup, for over two decades) — which is an ADVOCACY ASSET that the profession systematically underuses. That is worth stating as a call to action, and it is a genuine strategic insight rather than a platitude.