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    Health Care Policy And Politics

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    Interest group-people who share the same interest directly with political processesFactions-special interests, pressure groups, or organized interests• Development of interest groupso James Madison’s The Federalist No. 10 (1787)? Republic? “The best wisdom is to control the effects of interest groups”? Interest group roots fall back on the constitution and the birth of the American version of democracyo Alexis de Tocqueville, French philosopher and politician• Functions and methods of influenceo Lobbying- “direct influence of public officials and ultimately an influence on their decisions or legislation”o Grass Roots Mobilization- “indirectly influencing officials through constituency contract”o Electoral Influence-“can be considered the primary prevention of policymaking because it is important activity that precedes policy work. ”o Shaping public opinion- overlaps with electoral influence and grassroots mobilization; it involves issue advocacy and public percuasion, similar to campaigning for an issue• Landscape of contemporary health care interest groupso American Nurses Association represented since 1974 represents as (ANA) goal- “improvement of the healthcare system in the United States”o ANA members endorsed decisions that are formulated from ANA policy focuses and not on a candidate’s party. • Assessing value and considering involvemento Through involvement within interest groups nurses have capabilities of networking, engaging learning opportunities, and to improve patient careo Advocating to the highest level for all patientso Building on previous experiences and working as a team• Framework for assessing Interest groupsEight Factors to consider when looking into an interest groupo Efficiency-How does the group support, advocate and protect members?o Effectiveness-What are the accomplishments and outcomes the interest group focuses within?o Values- What is important to you as well as the group? Is there a connection between your passions as well beliefs within the group?o Tactics- What methods and tools are used within the group?o Visibility and responsiveness- How does social engagement and interaction affect members?o Perception- What influences of other individuals affect members? What concerns do members have to be aware of?o Costs-What are the financial contingencies members need to be aware of?o Benefits-How can members grow, succeed and make a difference among communities?• Summaryo Interest groups provide numerous networking opportunitieso Health care policy decision topics discussionso Benefits from interest groups discuss current topics/ issues, challenges and solutionso I challenge each of you to get involved within a nursing organization82 Current Issues in Nursing AssociationsAssociations- “groups of people who have joined together to pursue a common purpose or goal”Registered Nurses achieve support from associations with important discussions related to compensation, hours of employment in relation to the force of labor laws, prescriptive authority, safe environments, and patient staffing ratios.

    “Many of these organizations advocate for nurses and nursing in a particular area of interest. Most also advocate for patients. ”• Nursing’s professional organizationso Membership? Nursing associations bring benefits to public policy• “Although public policy is already expensive and time consuming for organizations, much more effort is needed in helping nurses understand how this improves practice and income. ”? Why do nurses not join associations?• “Nobody asked me”? Reasons why nurses join associations• Two primary reasons: networking & information to build upon? Membership retention issue among nursing organizations• Economic expenses such as membership dues are not always covered by employers and then come back to nurses directlyo Advocacy? Nursing organizations advocate for nurses by funding from nursing dues or contributions to be active in congress and state legislation decision making• Specifically, political action at federal and state agencieso Examples code of ethics, credentialing, working with groups with similar concernso Leadership? Leadership brings a commitment as well as purpose to an organization as opportunities provide privileges to grow and make a difference? “Volunteers are the life-blood of organizations and provide countless hours in advancing the mission”? Future in addition to present leadership numbers are a concern for many organizations due to commitments of families, personal life, work and financial constraints. • Summaryo83 Professional Nursing Associations: Meeting needs of Nurses and the profession• Evolution of Nursing Organizationso First Nursing Organization? “late nineteenth and early twentieth centuries”? “Royal British Nursing Association”? Came about from “alumnae associations, nursing schools and alumnae groups”• Nursing organizations and today’s nurseso Over 120 specialty nursing associations in the United Stateso Discuss current and future health concerns? An example of The Code of Ethics for Nurses (ANA)• “The professional of nursing, as represented by associations and their members, is responsible for articulating nursing values form maintaining the integrity of the profession and its, practice and for the shaping social policy.

    (p. 24)• The relationship of associations and their members“Nursing associations need members, and nurses need associations”With health care always changing it is important to have support from an association as well as continue to support one another within the nursing profession. o Member benefits: Gain knowledge, education, information, friendships, networking, volunteer prospects, project opportunities, professional engagement as well as advancement. o Educational resources: Achieving new knowledge to enriching nursing skills/practice and direct patient care. o Career advancement: Volunteering as well as joining as a member provides resume building, leadership, and mentor professional development. o Antidote to compassion stress and fatigue: “Nurses who participate in association conference or who use association-sponsored networking tools report feeling professionally supported and invigorated as an outcome of these collegial interactions (Sadovich, 2005)”o Professional satisfaction: Building relationships as well as friendships within a profession organization allows personal professional achievements through continually growing as an individual.

    o Leadership development: Imperative for nurses to build knowledge among each other, allows for experience in communication, skills and teamwork. • Where and When To Volunteero Choosing Which Organization To Join? Giving back throughout communities brings personal satisfaction and positive gratititudeo When To Join and How To Volunteer? Personal choice based on professional goals and interest• Organizational Structure-What makes the organization what iti is? Understand the Mission. Does the organization support my values and beliefs?• Bylaws- “rule book” Keep in mind bylaws “outline the purpose of the organization”• Governance Policies- Provide possibly for appropriate and not appropriate changes based on organization valueso Getting Where You Want To Be In An Association? Personal Satisfaction? Professional Growth? Networking? Paying it Forward• Summary84 TAKING ACTION The Center to Campion Nursing in America: Mobilizing Consumers andOther Stake holders“The mission of the Center of Campion Nursing is to assure ever American has access to a highly skilled nurse when and where they need one- Center of Champion Nursing in America”• The Center To Champion Nursing In America As A Consumer-Driven Force for Changeo The Center of Champion Nursing in America (CNNA) established in 2007. ? Focus on consumer representation to support challenges among nurses (“eg. , the nurse and nurse faculty shortage, and health care delivery). ”o Goals: Increase nursing enrollment as well as education demands to meet the patient needs of “twenty first century”• Evolving Strategic Prioritieso Prepare more RN’s within the nations education systemo Diversity within RN workforceso Improve access to for consumers to healthcareo Leadership growth to increase nursing advancement• Lessons Learnedo Trust is imperative for all patientso Nursing communities earn respect and trust among patient supporto Health care is always changing85 TAKING ACTION The Raise the Voice Campaign: Nurse Led Innovations Changing Public Policy“Innovation distinguishes between a leader and a follower –Steve Jobs”Focus: Patients getting the health care the deserve and nurses making a drive to improve patient care.

    • Innovations and policyo Addressing Social Determinants Of Health: Chicago Parent Program? Deborah Gross, PhD, RN, FAAN• Target: Child abuse reflecting on parents uneducated by positive approaches to child behaviors, turning to personal cultural beliefs and norms. • What did she do: 12 week program using videotaped scenarios focused on parenting challenges and how to effectively deal with situations. • Conclusion: Those who completed the program had improved positive tactics to handling their child’s behavior challenges. o Keeping People In Their Communities: Living Independently For Elders? Pennsylvania Nursing School aims improvement targeted to keep elderly patients within their homes rather than institutionalized care environments due to lower costs.

    ? Living Independently for Elders (LIFE) formed by Medicare and Medicaid? Benefits: decrease in declining elderly adults related to “falls, unnecessary medications, emergency room use, hospitalizations, and nursing home placement”? Expense: less than institutionalized care as a result of success from LIFE programo Raise the Voice? Nurses are constantly pushing for groundbreaking improvements within health care. To bring positive change throughout communities presently and continue to move forward into the future!86 Coalitions: A Powerful Political Strategy• Birth And Life Cycle Of Coalitionso Coalition: group of people who have a mutual interest that work toward a goal together. • Building And Maintaining A Coalition: The Primero Essential four Ingredients:? 1. Leadership? 2. Membership? 3. Resources? 4.

    Serendipityo Coalition Structure? Procedures• Group processo “Norming and Storming creating group behavioral norms and settling disagreements”o Decision-Making? Among a coalition is difficult with members having different perspectives and community targets? Trust is not always present during this phase. o Coalition Meetings? Purpose• Complete work-exchange knowledge/information• Social engagement? Meeting Focuses• Decision making• Problem solveo Promoting The Coalition? Communication is essential• Catchy title to the audience for engagement? How to people hear about coalitions?• Social media, advertisement and target audienceso Funding a Coalition? Members choose how they will come up with expenses? Assign people to make contacts informing the groups mission requesting for support? Funding sources• Pitfalls and Challengeso Failure to Get Right People To Participateo Culture And Language Differences Among Coalition Memberso Persistent Distrust Among Coalition Memberso Control Freaks And Protecting Turfo Poor Handling Of Different Perspectiveso Failure To Acto Losing Balance• Political Work Of Coalitionso Reasons Not to Advocate? Coalitions lose finical support due to loss of representationo Reasons To Advocate? Change in laws? New policies? Goals met in addition to accomplishmentso How To Advocate With Grace? “proceed with care”? Members should understand appropriate methods that won’t endanger members or funders• Evaluating Coalition Effectivenesso Table 86-1 PG 631 ADD!87 TAKING ACTION A Rough Road in Texas: Advanced Practice Nurses Build a Strong Coalition• Coalition for nurses in Advanced Practice (CNAP)o Objectives? Increase perspective authority? Ensure clinical privileging with due process? Expand third-party reimbursento Vision: improve the future for advanced practice nurses as well as patientso Today: CNAP provides government expertise and focusses power for all APN groups88 TAKING ACTION The National Coalition for Lesbian, Gay, Bisexual, and Transgender Health• Lesbian, Gay, Bisexual, and Transgender Health (LGBT)o Equal healthcare access among all people regardless of sexual orientation, gender, gender identity, gender expression, or character of sex differentiation/intersexo Healthcare service access and payment coverage must include full reproductive services (including family planning and pregnancy termination). No matter if a patient is able to pay for services or not.o Every patient is treated equally maintaining dignity, confidentiality and hipaa standardso Military personal with any sexuality background are also included within equal health care as well as medical treatment and “not fear risking discharge from the military services”89 Taking Action The Virginia Nursing Kitchen Cabineto Kitchen Cabinet Mission? Founded by: Legislative Coalition of Virginia Nurses Association? Promote awareness to candidates regarding nursing profession shortage, advise resolutions, effect political campaigns and transform public policy?90 The Politics of Pharmaceutical Industry• Medications Demands on patientso Values Conflict? Increase profits• New medications• Demands for current medicationso Detailing-“combines education-like activity with traditional advertising”? It was estimated in 2005, “6.8 billion dollars or 22% of promotion spending” departed toward detailing• Along with, “18.4 billion or 58% of promotion spending went to free drug samples”• Public concernso “The public wants treatment to be based solely on a clinical assessment of the patient’s best interests, not on personal or monetary considerations tied to specific medications, but industry promotion is designed to sell particular drugs in service of the company’s primary goal of profitability”Discussion QuestionsWhat is one of your biggest concerns as you further your education in regards to advanced practice roles as an educator or as a nurse practitioner in relation to policy and politics?How has or will a nursing organization you have joined or are considering to join influenced your current nursing practice? What do you hope to get out of the nursing organization experience?Where do you see Pharmaceutical Industry in 5, 10 and 20 years from today? What do you hope comes in the future? How will the patient experience be influenced?

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    Health Care Policy And Politics. (2019, May 02). Retrieved from

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