The Changing United States Health Care System”
The Changing United States Health Care System” in your course textbook, using either the story of Wald’s efforts to improve the health status of impoverished immigrant communities or the story of how advanced practice registered nurses have struggled with their legitimacy within the health care delivery system, compare your own experience in nursing.
Have there been challenges you have faced? If so, what strategies did you employ to overcome these challenges?
How do you envision your career moving forward in advocating for your patients? Your community? Yourself?
Topic 2
From your daily briefs, Kaiser Health News Morning Briefing or POLITICO Pulse.
List the interest groups that are mentioned in the brief and what their interest is in the piece.
Categorize the issues in the brief according to the following—politics and politicians, access to health care, health care insurance, health care legislation, money, drugs, or other.
NSG4068 Trends in Healthcare Policy
Week 2 Discussion
Social Determinants of Health
Topic 1
Increasingly, health policymakers are becoming aware of the social determinants of health and the role they play in prevention disease and promoting health and wellness.
In the “Frameworks for Action in Policy and Politics” chapter, examine Box 1-1 (Political Aspects of the Social Determinants of Health) and Figure 1-6 (The Who, What, Where, When, and Why of Nursing’s Policy Influence). Compare these with the story about Lilian Wald’s work in New York City.
Reflect on the “what” of Wald’s strategies. In your opinion, which did she use effectively?
Looking further at the “what” in Figure 1-6, answer any one of the following questions:
Discuss at least three competencies/strategies that you have used effectively.
Identify three competencies/strategies that you don’t currently use and discuss how you might incorporate them into your advocacy toolbox.
Topic 2
Review the four recommendations in the IOM report The Future of Nursing: Leading Change, Advancing Health and find your state’s action coalition.
Discuss your state’s action coalition’s work as it aligns with these four recommendations.
Is each recommendation being addressed?
Based on your analysis of the website, how would you describe your state’s progress toward meeting the IOM recommendations?
NSG4068 Trends in Healthcare Policy
Week 3 Discussion
The ACA or the AHCA: Imperfect Solutions to Increasing Access to Health Care?
This week’s discussion focuses on the federal government’s role in protecting the public’s health using the ACA and current efforts to “repeal and replace” the ACA. Please note that the government’s role in protecting the public’s health did not begin with the ACA. In the late 1800s, Lilian Wald brought health care to the community. And in 1965, Congress passed bills authorizing Medicare and Medicaid. Since 1965, Congress has expanded government-sponsored health care to pregnant women and children.
Topic 1
Compare the current provisions in the ACA with those in the failed first version of the AHCA.
Share your opinions about why the AHCA failed in the first attempt at passage.
Topic 2
In addition, subscribe to the “HealthCetera” podcast and listen to the podcast weekly. This is a production of WBAI, free speech radio of Pacifica Foundation Radio in New York City. Diana Mason and Barbara Glickstein are founders and codirectors of the Center for Health Media Policy (CHMP). Both are recognized as experts in media, nursing, health, and health policy. They have a longstanding relationship as producers and moderators of HealthCetera, a live, award-winning radio program on public radio and iTunes. They are bloggers for Disruptive Women in Health Care and for the American Journal of Nursing (AJN). The CHMP is an interdisciplinary initiative for advancing the health of the public and healthy public policies through media, research, education, and public forums.
Listen to a podcast related to the ACA or AHCA.
Describe how you identified advocacy for the topic in the podcast, include examples.
NSG4068 Trends in Healthcare Policy
Week 4 Discussion
Advance Care Planning and Analysis Read the section titled “Reflective Practice: Pants on Fire” from the chapter “Health Policy, Politics, and Professional Ethics” and address the questions below.
How do you judge Palin’s quote below, as an effective strategy to oppose Democrats’ plans for health care reform or unethical scaremongering?
“And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s death panel so his bureaucrats can decide, based on a subjective judgment of their level of productivity in society, whether they are worthy of health care. Such a system is downright evil.”
Reflect on what informs your judgment: commitment to advance care planning, analysis of facts, and/or political party loyalties?
Is it right for nurses to endorse health reform legislation even if the legislation is not perfect?
Does this apply to the recently failed American Health Care Act?
NSG4068 Trends in Healthcare Policy
Week 5 Discussion
Nurses as Change Agents in the Community
In the chapter, “How Community-Based Organizations Are Addressing Nursing’s Role in Transforming Health Care,” the authors describe the community as the focus of advocacy action for change. They list a series of questions that help community teams develop organizing principles to guide their interventions, and the aim is to attack social determinants of health to make community change. Suppose a community team identifies lack of access to exercise modalities as a public health issue. If the team were to determine that pedestrian walkways need to be constructed:
Discuss at least two factors that would facilitate the development of the walkways.
Discuss at least two factors that would hinder the development of the walkways.
Include in your discussions ways that the team might work to overcome those hindrances.
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