D223 Healthcare Policy Analysis and Nurse Roles Notes

Student Name

Western Governors University

D223 Healthcare Policy and Economics

Prof. Name:

Date

A. Analysis of a Federal Public Healthcare Enacted Law

1. What is one federal public healthcare enacted law that affects patient care and healthcare delivery?

One significant federal law impacting healthcare delivery is the Affordable Care Act (ACA) of 2010. The ACA has reshaped the healthcare landscape by expanding insurance coverage, improving healthcare quality, and reducing costs, thereby directly influencing patient care provision across the United States.

2. How does the Affordable Care Act work?

The ACA operates through several mechanisms, including mandatory health insurance coverage requirements, subsidies for low-income populations, and the establishment of health insurance marketplaces. Enforcement is primarily overseen by the Department of Health and Human Services (HHS), along with other federal agencies such as the Centers for Medicare & Medicaid Services (CMS). These bodies administer the policy by ensuring compliance from insurers and healthcare providers and managing enrollment in marketplace plans.

3. What is the legislation’s impact on various populations?

Population Group	Benefit(s)	Negative Impact(s)	Effect on Health Disparities and Equity
Low-income individuals	Increased access to insurance and preventive care	Some faced higher premiums depending on income	Reduced disparities by improving access to care
Elderly	Expanded Medicaid coverage for long-term care	Complexity in navigating plans can cause confusion	Enhanced equity by covering previously uninsured seniors
Small businesses	Access to affordable group insurance plans	Increased regulatory burden and costs for some	Mixed impact depending on business size and location
Uninsured individuals	Significant reduction in uninsured rates	Penalties for non-compliance (individual mandate)	Improved overall health equity through broader coverage

The ACA has notably improved access to healthcare for millions of Americans, particularly marginalized groups. However, it has also created challenges for certain small businesses and individuals regarding cost and compliance.

4. What evidence supports the Affordable Care Act?

Research supports the ACA’s effectiveness in expanding coverage and improving health outcomes. For instance, Sommers et al. (2017) found that the ACA led to a significant increase in insurance coverage and better self-reported health among low-income adults (Sommers, Gunja, Finegold, & Musco, 2017). This evidence highlights the law’s positive impact on healthcare access and equity.

B. Analysis of a State Public Healthcare Enacted Law

1. What is one state public healthcare enacted law affecting patient care and healthcare delivery?

In California, the California End of Life Option Act (EOLOA), enacted in 2016, allows terminally ill patients to request and self-administer aid-in-dying medication. This law influences patient care by offering an option for end-of-life decision-making and autonomy.

2. How does the California End of Life Option Act function?

The law requires strict eligibility criteria and procedural safeguards, including confirmation of terminal illness by multiple physicians and voluntary patient consent. The California Department of Public Health administers the policy, ensuring compliance through data collection and monitoring enforcement. Healthcare providers must adhere to these regulations to legally participate.

3. What is the legislation’s impact on different populations?

Population Group	Benefit(s)	Negative Impact(s)	Effect on Health Disparities and Equity
Terminally ill patients	Greater control over end-of-life decisions	Potential moral or religious objections	Enhances patient autonomy; limited impact on disparities
Healthcare providers	Clear legal framework for aid-in-dying procedures	Ethical dilemmas and professional conflicts	May affect provider-patient relationships
Families	Potential reduction in prolonged suffering of loved ones	Emotional and ethical challenges	Neutral impact on disparities

The EOLOA empowers eligible patients with autonomy but raises ethical debates within communities and healthcare systems.

4. What evidence supports the California End of Life Option Act?

According to Ganzini et al. (2019), patients who utilized aid-in-dying laws reported improved peace of mind and symptom control, with no increase in depression or anxiety among participants (Ganzini, Harvath, Jackson, & Goy, 2019). This supports the law’s role in improving quality of life for terminal patients.

C. The Nurse’s Role in Healthcare Policy at the Organizational Level

1. How do nurses contribute to healthcare policy development, administration, and revision?

Nurses hold a critical position in shaping healthcare policies due to their frontline experience and patient advocacy roles.

Development: Nurses assess healthcare needs, identify gaps in patient care, and propose new policies. They collaborate with interdisciplinary teams and participate in committees to draft policies that improve clinical outcomes.
Administration: Nurses oversee policy implementation, ensuring that standards of care are followed within their organizations. Nurse leaders monitor compliance and address operational challenges to maintain policy effectiveness.
Revision: Nurses review existing policies by evaluating outcomes and gathering feedback from clinical practice. They advocate for changes that enhance patient safety and care quality.

Their unique insights enable them to bridge clinical practice and policy, influencing healthcare delivery at multiple levels.

2. What barriers hinder nurses’ engagement in healthcare policy?

Policy Area	Barriers to Nurse Engagement
Development	Lack of time, insufficient policy education, limited leadership opportunities
Administration	Hierarchical organizational structures, resistance to change, resource constraints
Revision	Limited involvement in decision-making, insufficient feedback mechanisms

Despite these challenges, nurses’ involvement is crucial for relevant, patient-centered policy formulation.

3. How will you engage with healthcare policy in your future nursing practice?

In my future nursing practice, I plan to actively engage in the development of healthcare policy by:

Staying informed on emerging health issues and evidence-based practices.
Participating in interdisciplinary committees and quality improvement projects.
Advocating for patient needs and equity in policy discussions.
Collaborating with policymakers and educating peers on the importance of policy in clinical care.

By adopting these strategies, I aim to contribute meaningfully to policies that enhance patient outcomes and healthcare quality.

References

Ganzini, L., Harvath, T. A., Jackson, A., & Goy, E. R. (2019). Experiences of Oregon nurses and social workers with hospice patients who requested aid in dying. Journal of Pain and Symptom Management, 57(2), 247-254. https://doi.org/10.1016/j.jpainsymman.2018.10.005