NURS 6050 Policy and Advocacy for Improving Population Health Care 2

Respond to Two students’ Discussion for Week 3

NURS 6050 Policy and Advocacy for Improving Population Health Care 2 Learning Objectives

Students will:

1. Analyze how cost-benefit analysis affects legislative efforts
2. Analyze legislative intent of bills
3. Identify proponents and opponents of bills
4. Analyze legislative process of bills
5. Advocate policy position for bills

Discussion: Politics and the Patient Protection and Affordable Care Act

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society. NURS 6050 Policy and Advocacy for Improving Population Health Care 2

Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.

To Prepare:

• Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).
• Consider who benefits the most when policy is developed and in the context of policy implementation.

NURS 6050 Policy and Advocacy for Improving Population Health Care 2 By Day 3 of Week 3

Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.

By Day 6 of Week 3

Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

*Note: Throughout this program, your fellow students are referred to as colleagues.

NURS 6050 Policy and Advocacy for Improving Population Health Care 2 Submission and Grading Information

Grading Criteria

To access your rubric:

Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 3

To participate in this Discussion:

NURS 6050 Policy and Advocacy for Improving Population Health Care 2 Sample Papers

Do RESPOND TO TWO Colleagues By Day X of Week 3

Respond to at least two of your colleagues* on X different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

Student 1 (A,A)

Cost/benefit analysis plays a critical role in assisting leaders in government in making improved decisions on distributing limited tax dollars. This technique has not been used greatly at the federal level for a consecutive amount of years. Certain states have utilized this technique to help with individual programs, for example, evaluating whether an economic development incentive is cost-effective in creating jobs (Urahn, S.K., 2012). I personally feel it all depends on the legislator running for office and their personal views on the healthcare system in general. If the candidate feels that the money being used for the ACA could be used “better” somewhere else, then this could impact their idea to repeal/replace the ACA.

29.8 million people would lose their health insurance across the nation, if the Affordable Care Act (ACA) was repealed. This would double the number of individuals without health insurance; also resulting in 1.2 million jobs being lost across the board. I feel that legislators, once again, have their own minds set on policies and the healthcare system. NURS 6050 Policy and Advocacy for Improving Population Health Care 2

The ideal way of handling this situation, would be to look at the statistics of how many individuals in the nation are being supported with the ACA. Also, reviewing the statistics/data which is stated above, can help guide the candidate to making decisions.  The voice of the people is fairly strong and needs to be taken account of in the decision making of legislators.

Seeing that the “number one job of a legislator is to be re-elected”, it is ideal that the candidate proves the words which they speak of. We have seen too much of “speaking with no action” in our history. Candidates need to understand that in order to be re-elected, the people want to see positive change that will impact all citizens in a positive way.

Typically elected officials want to make good policy. As they think about how they can make a difference, they ask themselves “What is the smart course of action to take?” During this process, unbiased, independent research is very important in helping them make decisions. Legislators must consider the “Triangle Test”, which consists of “Do my constitutes care about this issue?”, “Is this good policy for the Nation and does this make sense?”, and “Is this press worthy?” (National Council for the Social Studies, n.d.)

NURS 6050 Policy and Advocacy for Improving Population Health Care 2 References

1. Economic Policy Institute. (n.d.). How would repealing the Affordable Care Act affect health care and jobs in your state? Retrieved from https://www.epi.org/aca-obamacare-repeal-impact/
2. National Council for the Social Studies. (n.d.). How Legislators Make Decisions. Retrieved from https://www.socialstudies.org/advocacy/how-legislators-make-decisions
3. Urahn, S.K. (2012). The Cost Benefit Imperative. Retrieved from https://www.governing.com/columns/mgmt-insights/col-cost-benefit-outcomes-states-results-first.html

Student 2 (S,J) NURS 6050 Policy and Advocacy for Improving Population Health Care 2

Professor I disagree with they idea that the number one job of a legislator is to be reelected. Legislators are members of the legislative branch of government and should be tasked with serving the people by proposing bills having votes and passing laws that are in the interest of the people and the democracy. The reality of this scenario however, is not what actually occurs in Congress. There are a number of interest groups and private and cooporate entities and individuals that influence these legislators and influence the laws that they propose. Unfortunately, the topic of health care falls is treated similarly by legislators.

Health care is a polarizing topic in America, while most may agree that health care should b e universally accessible determining how to fund it is where the quagmire  begins. Additionally, presidential elections and local elections are often seen by legislators as mandates by the people to get their agenda completed. This however is not often the case. Under President Obama there was the passage of the Affordable Care Act, “which permits young adults up to age 26 to enroll as dependents on a parent’s private health care insurance and additionally made insurance companies have to cover individuals with existing underlying conditions”(Cantor, Monheit, DeLia Lloyd, 2012).

Under the current administration there is a similar belief that they also have a mandate by the people to repeal the Affordable Care Act, their efforts to do so have been tied up in the courts and has put them out of touch with reality also because they are still trying to repeal the law during a pandemic when there are millions of people who desperately need health care due to preexisting conditions and also the threat of the virus. NURS 6050 Policy and Advocacy for Improving Population Health Care 2

Additionally, it should be noted that it was documented that an “estimated 30 million Americans are expected to gain health insurance through the
Affordable Care Act (ACA), and a healthy and sizable workforce will be needed to meet the increased demand”(Anderson, 2014) It should be noted that when policy works the way it was intended to the people and the country benefit as can be seen in the aforementioned statistics. However when self interest groups have control over politicians , these groups and their political interest alone benefit

NURS 6050 Policy and Advocacy for Improving Population Health Care 2 Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

NURS 6050 Policy and Advocacy for Improving Population Health Care 2 Required Readings

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 3, “Government Response: Legislation” (pp. 37–56)

Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 180–183 only)

Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003

Note: You will access this article from the Walden Library databases.

United States House of Representatives. (n.d.). Retrieved September 20, 2018, from https://www.house.gov/

United States Senate. (n.d.). Retrieved September 20, 2018, from https://www.senate.gov/

United States Senate. (n.d.). Senate organization chart for the 115th Congress. Retrieved September 20, 2018, from https://www.senate.gov/reference/org_chart.htm

Videos Provided by the University NURS 6050 Policy and Advocacy for Improving Population Health Care 2

Laureate Education (Producer). (2018). Working with Legislators [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Contemporary Issues in Public Health Policy with Joel Teitelbaum [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Peter Beilenson: Population Health [Video file]. Baltimore, MD: Author.

Discussion Grading Rubric

Excellent Good Fair Poor NURS 6050 Policy and Advocacy for Improving Population Health Care 2

Main Posting 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources. NURS 6050 Policy and Advocacy for Improving Population Health Care 2

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Main Post: Timeliness 10 (10%) – 10 (10%NURS 6050 Policy and Advocacy for Improving Population Health Care 2)

Posts main post by day 3.

NURS 6050 Policy and Advocacy for Improving Population Health Care 2