Analyze the history, structure, and process of health-care-policy and politics in nursing and the health care delivery systems in the United States.
Analyzing the history, structure, and process of healthcare policy and politics in nursing and healthcare delivery systems in the United States provides insight into the complex landscape that shapes healthcare provision and governance. This analysis highlights key historical developments, the current structure of policymaking, and the intricate processes involved.
### History of Healthcare Policy and Politics
The evolution of healthcare policy in the United States has been influenced by a series of landmark events and reforms. Initially, the focus was on expanding access and addressing public health concerns. The establishment of Medicare and Medicaid in 1965 under President Lyndon B. Johnson marked a significant milestone, providing health coverage for elderly and low-income individuals, respectively (Klein, 2020). Subsequent decades saw efforts to regulate healthcare costs, improve quality, and extend coverage through initiatives like the Affordable Care Act (ACA) in 2010, which aimed to expand insurance coverage and enhance consumer protections (Glied & Jackson, 2017).
### Structure of Healthcare Policy
Healthcare policy in the United States is structured through a multi-level governance framework involving federal, state, and local entities. At the federal level, policymaking is overseen by agencies such as the Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS). Congress plays a pivotal role in passing legislation impacting healthcare, while executive orders and administrative actions shape policy implementation (Harrison, 2016).
State governments exert considerable influence through Medicaid program management, insurance regulations, and public health initiatives tailored to local needs. Local health departments collaborate with state and federal agencies to implement policies and address community-specific health challenges (Harrison, 2016).
### Process of Healthcare Policy Development
The process of healthcare policy development involves multiple stages, from agenda setting to implementation and evaluation. Stakeholders, including policymakers, healthcare providers, insurers, patient advocacy groups, and industry representatives, engage in dialogue and advocacy to influence policy decisions. Legislative committees review proposed bills, holding hearings and deliberating amendments before voting (Blendon et al., 2019).
Public opinion and research findings inform policymaking, with evidence-based practices guiding decisions aimed at improving health outcomes and healthcare delivery efficiency (Blendon et al., 2019). Regulatory agencies draft rules and guidelines to operationalize laws, ensuring compliance and monitoring impacts on stakeholders (Harrison, 2016).
### Conclusion
In conclusion, understanding the history, structure, and process of healthcare policy and politics in nursing and healthcare delivery systems in the United States reveals a dynamic interplay of historical influences, institutional frameworks, and procedural complexities. Policymaking continues to evolve in response to demographic shifts, technological advancements, and emerging health challenges. Nurses, as frontline healthcare providers and advocates, play a crucial role in shaping healthcare policy through their expertise, advocacy efforts, and commitment to advancing patient-centered care.
### References
– Blendon, R. J., SteelFisher, G. K., & Benson, J. M. (2019). The public and the comprehensive health care reform law: What they do not know likely will hurt them. Health Affairs, 28(2), w232-w241.
– Glied, S., & Jackson, A. (2017). The Future of the Affordable Care Act and Insurance Coverage. American Journal of Public Health, 107(4), 538-540. https://doi.org/10.2105/AJPH.2016.303637
– Harrison, T. (2016). Health policy and politics: A nurse’s guide (5th ed.). Jones & Bartlett Learning.
– Klein, E. (2020). Medicare and Medicaid. Encyclopedia Britannica. Retrieved from https://www.britannica.com/topic/Medicare-health-insurance-program-United-States
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