Policy & Politics in Nursing and Health Care Seventh Edition Diana J. Mason, PhD, RN, FAAN Rudin Professor of Nursing Co-Director of the Center for Health, Media, and Policy School of Nursing Hunter College City University of New York New York, New York Deborah B. Gardner, PhD, RN, FAAN, FNAP Health Policy and Leadership Consultant, LLC Honolulu, Hawaii Freida Hopkins Outlaw, PhD, RN, FAAN Adjunct Professor Peabody College of Education Vanderbilt University Nashville, Tennessee Eileen T. O'Grady, PhD, NP, RN Nurse Practitioner and Wellness Coach McLean, Virginia 2 Table of Contents Cover image Title page Copyright About the Editors Contributors Reviewers Foreword Preface What's New in the Seventh Edition? Using the Seventh Edition Acknowledgments Unit 1 Introduction to Policy and Politics in Nursing and Health Care Chapter 1 Frameworks for Action in Policy and Politics Upstream Factors Nursing and Health Policy Reforming Health Care Nurses as Leaders in Health Care Reform Policy and the Policy Process Forces That Shape Health Policy The Framework for Action Spheres of Influence Health Health and Social Policy Health Systems and Social Determinants of Health Nursing Essentials Policy and Political Competence 3 Discussion Questions References Online Resources Chapter 2 An Historical Perspective on Policy, Politics, and Nursing “Not Enough to be a Messenger” Bringing Together the Past for the Present: What We Learned From History Conclusion Discussion Questions References Online Resources Chapter 3 Advocacy in Nursing and Health Care The Definition of Advocacy The Nurse as Patient Advocate Consumerism, Feminism, and Professionalization of Nursing: the Emergence of Patients' Rights Advocacy Philosophical Models of Nursing Advocacy Advocacy Outside the Clinical Setting Barriers to Successful Advocacy Summary Discussion Questions References Online Resources Chapter 4 Learning the Ropes of Policy and Politics Political Consciousness-Raising and Awareness: the “Aha” Moment Getting Started The Role of Mentoring Educational Opportunities Applying Your Political, Policy, Advocacy, and Activism Skills Political Competencies Changing Policy at the Workplace Through Shared Governance Discussion Questions References Online Resources Chapter 5 Taking Action: How I Learned the Ropes of Policy and Politics Mentors, Passion, and Curiosity Chapter 6 A Primer on Political Philosophy Political Philosophy The State 4 Gender and Race in Political Philosophy The Welfare State Political Philosophy and the Welfare State: Implications for Nurses Discussion Questions References Online Resources Chapter 7 The Policy Process Health Policy and Politics Unique Aspects of U.S. Policymaking Conceptual Basis for Policymaking Bringing Nursing Competence Into the Policymaking Process Conclusion Discussion Questions References Online Resources Chapter 8 Health Policy Brief: Improving Care Transitions Improving Care Transitions: Better Coordination of Patient Transfers among Care Sites and the Community Could Save Money and Improve the Quality of Care1 References Online Resources Chapter 9 Political Analysis and Strategies What is Political Analysis? Political Strategies Discussion Questions References Online Resources Chapter 10 Communication and Conflict Management in Health Policy Understanding Conflict The Process of Conversations Listening, Asserting, and Inquiring Skills Conclusion Discussion Questions References Online Resources Chapter 11 Research as a Political and Policy Tool So What is Policy? What is Research When It Comes to Policy? The Chemistry between Research and Policymaking 5 Using Research to Create, Inform, and Shape Policy Research and Political Will Research: Not Just for Journals Discussion Questions References Online Resources Chapter 12 Health Services Research: Translating Research into Policy Defining Health Services Research HSR Methods Quantitative Methods and Data Sets Qualitative Methods Professional Training in Health Services Research Competencies Fellowships and Training Grants Loan Repayment Programs Dissemination and Translation of Research Into Policy Discussion Questions References Online Resources Chapter 13 Using Research to Advance Health and Social Policies for Children Research on Early Brain Development Research on Social Determinants of Health and Health Disparities Advancing Children's Mental Health Using Research to Inform Policy Research on Child Well-Being Indicators Research on “Framing the Problem” Gaps in Linking Research and Social Policies for Children Nursing Advocacy Discussion Questions References Online Resources Chapter 14 Using the Power of Media to Influence Health Policy and Politics Seismic Shift in Media: One-to-Many and Many-to-Many The Power of Media Who Controls the Media? Getting on the Public's Agenda Media as a Health Promotion Tool Focus on Reporting Effective Use of Media Analyzing Media 6 Responding to the Media Conclusion Discussion Questions References Online Resources Chapter 15 Health Policy, Politics, and Professional Ethics The Ethics of Influencing Policy Reflective Practice: Pants on Fire Discussion Questions Professional Ethics Reflective Practice: Foundational Nursing Documents Personal Questions Reflective Practice: Negotiating Conflicts between Personal Integrity and Professional Responsibilities Personal Question U.S. Health Care Reform Reflective Practice: Accepting the Challenge Personal Question Reflective Practice: the Medicaid 5% Commitment—an Appeal to Professionalism Discussion Question Reflective Practice: Your State Turned Down Medicaid Expansion Personal Question Reflective Practice: Barriers to the Treatment of Mental Illness Personal Question Ethics and Work Environment Policies Mandatory Flu Vaccination: the Good of the Patient Versus Personal Choice Conclusion Discussion Questions References Online Resources Unit 2 Health Care Delivery and Financing Chapter 16 The Changing United States Health Care System Overview of the U.S. Health Care System Public Health Transforming Health Care Through Technology Health Status and Trends Challenges for the U.S. Health Care System Health Care Reform Opportunities and Challenges for Nursing Discussion Questions References 7 Online Resources Chapter 17 A Primer on Health Economics of Nursing and Health Policy Cost-Effectiveness of Nursing Services Impact of Health Reform on Nursing Economics Discussion Questions References Chapter 18 Financing Health Care in the United States Historical Perspectives on Health Care Financing Government Programs The Private Health Insurance and Delivery Systems The Problem of Continually Rising Health Care Costs The ACA and Health Care Costs Discussion Questions References Online Resources Chapter 19 The Affordable Care Act: Historical Context and an Introduction to the State of Health Care in the United States Historical, Political, and Legal Context Content of the Affordable Care Act Impact on Nursing Profession: Direct and Indirect Overall Cost of the Aca Political and Implementation Challenges Conclusion Discussion Questions References Online Resources Chapter 20 Health Insurance Exchanges: Expanding Access to Health Care What is a Health Insurance Exchange? Exchange Purchasers Other Health Insurance Options Federal or State Exchanges State-Based EXCHANGES Development of the Exchanges Establishing State Exchanges The Federal Exchange Rollout: ACA Setback New York's Success Story The Oregon Story Exchange Features 8 Marketplace Insurance Categories Role of Medicaid Nurses' Roles with Exchanges Consumer Education State Requirements Include Aprns in Exchange Plans Assessing the Impact of the Exchanges and Future Projections Conclusion Discussion Questions References Online Resources Chapter 21 Patient Engagement and Public Policy: Emerging New Paradigms and Roles Patient Engagement Within Nursing Patient Engagement and Federal Initiatives The VA System: an Exemplar of Patient-Centered Care From Patient Engagement to Citizen Health Conclusion Discussion Questions References Online Resources Chapter 22 The Marinated Mind: Why Overuse Is an Epidemic and How to Reduce It Commonly Overused Interventions Reasons for Overuse Financial Incentives as the Major Cause of Overuse The Marinated Mind Physician and Nurse Acknowledgment of Overuse Public Reporting to Reduce Overuse Journalists Advocate for More Transparency About Overuse Discussion Questions References Online Resources Chapter 23 Policy Approaches to Address Health Disparities Health Equity and Access Policy Approaches to Address Health Disparities Evaluating Patient-Centered Care Summary Discussion Questions References Online Resources 9 Chapter 24 Achieving Mental Health Parity Historical Struggle to Achieve Mental Health Parity Implications for Nursing: Mental Health Related Issues and Strategies Discussion Questions References Online Resources Chapter 25 Breaking the Social Security Glass Ceiling: A Proposal to Modernize Women's Benefits1 Benefits for Women Strengthening the Program Changes We Oppose Strengthening Financing Discussion Questions References Online Resources Chapter 26 The Politics of the Pharmaceutical Industry Globalization Concerns Values Conflict Direct to Consumer Marketing Conflict of Interest Education Gifts Samples Conclusion Discussion Questions References Online Resources Chapter 27 Women's Reproductive Health Policy When Women's Reproductive Health Needs are Not Met Why Do We Need Policy Specifically Directed at Women? Women's Health and U.S. Policy Discussion Questions References Online Resources Chapter 28 Public Health: Promoting the Health of Populations and Communities The State of Public Health and the Public's Health Impact of Social Determinants and Disparities on Health Major Threats to Public Health Challenges Faced by Governmental Public Health 10