Chat with us, powered by LiveChat Which part of the module did you think was the least beneficial to your learning? Explain your answer. Which part of the module did you think was the most beneficial to your learning? Ex | Wridemy

Which part of the module did you think was the least beneficial to your learning? Explain your answer. Which part of the module did you think was the most beneficial to your learning? Ex

Which part of the module did you think was the least beneficial to your learning? Explain your answer.

Which part of the module did you think was the most beneficial to your learning? Explain your answer.

Dynamic Influences on Health Care Policy

Dr. Carla Nye


Quality and Safety

1999 – when to err is human came out – errors 5th leading cause of death

2011 – errors 3rd leading cause of death


ACA and Value Based Care

Looking at each of these dimensions

Improving the patient experience of care (including quality and satisfaction);

Improving the health of populations; and

Reducing the per capita cost of health care.

For every action there is an equal and opposite reaction


Quadruple Aim

Create value

Coordinate care

Payment reform

Improve access to coverage

Aca has rules –

Community benefit – hospitals must do community health assessment, make a plan and partner with communities

Hospitals penalized for readmissions, but paid for developing transition to care programs.






Self pay, barter Pre-Industrial

Insurance policies early 1900’s

Social Security 1935

Medicare and Medicaid 1965

Children’s Health Insurance program 1997

Affordable Care Act 2010

Government as a subsidiary to private sector – in most developed countries – health care is seen as a right and the government is fully involved to ensure citizens have access to HC. Not the case in the US. Private sector is dominant. Right to health care has led to ACA. Citizen distrust of govt, Government intrusion on personal liberty is foundational to Declaration of independence. Govt has traditionally filled gaps where private sector cannot or wont address.

Insurance policies for workers

Social security for those with retirement savings wiped out due to depression

Medicare and Medicaid – insurance only there for working middle class and wealthy – poor left to own devices, charity

Children's health insurance – States are given flexibility in designing their CHIP eligibility requirements and policies within broad federal guidelines.



Fragmented policies

Incremental and piecemeal policies

Pluralistic Suppliers of Policy

Decentralized roles of the states

Impact of presidential leadership

Politics of the ACA

Fragmented policies – fragmented policies between federal, state, and local governments – came from checks and balances. Multiple combinations of public and private management of HC, and different in every state.

Incremental and piecemeal policies – Multiple compromises over the years between parties have led to smaller, incremental changes – nothing full bore until ACA. Within programs, changes are made incrementally – no big overhaul.

Interest groups as demanders of policies – each group fights hard to protect its interests – end result some type of compromise, where no one is truly happy. AMA, AARP, AHA, PharmA, labor unions, insurers.

Pluralistic Suppliers of Policy – executive, legislative and judicial branches can influence policy at fed, state, and local levels

Decentralized roles of the states – State is the primary controller of regulating managed care, care of disabled, oversight of professions. Very hard to coordinate a national strategy.

Impact of presidential leadership – and unintended consequences – Truman passed the Hill Burton act in 1946 that gave grants for building adequate hospital rooms for population. 1965 Johnson passed Medicare and Medicare. By 1980 – reached the level of hospital beds set out in Hill Burton and at same time Medicare and Medicaid reached gigantic expansion and expense. Ronald Reagan authorized PPS method of payment to reduce hospital utilization, which created a downward trend in inpatient stay and a glut of hospital beds.

Politics of the ACA – Democrats had control of house (Nancy Pelosi) and senate (Harry Reid). Obama had huge support from populace as well as party. Details of the ACA were largely kept secret from the public. (compared to when Clinton introduced his plan in 1993, which was very public). ACA passed with little contributions from the republicans, little input from the public. It won through the stakeholders with pledges to the stakeholders that they would get many new insured people – particularly the young healthy population.



Key Health Care Concerns of Selected Interest Groups
Federal and State Governments Cost Containment Access to Care Quality of care
Employers Cost Containment Workplace health and safety Minimum regulation
Consumers Access to care Quality of care Lower out-Characteristics of US Health Policy of-pocket costs
Insurers Administrative simplification Elimination of cost shifting
Practitioners Income Maintenance Professional autonomy Malpractice reforms
Provider Organizations Profitability Administrative simplification Bad debt reduction
Technology Producers Tax Treatment Regulatory environment Research funding


Political Climate

Politics is the use of relationships and power to gain ascendency among competing stakeholders to influence policy and the allocation of resources

Politics is a noun/a process/a system

Wide range of political philosophies – answer the question of the state and its moral and ethical responsibilities to the people and to those outside of the state.

The idea behind the state is people cannot rule on their own – that there needs to be an organizing structure to maintain balance, control, moral and ethical duties and obligations.

Early Liberalism – (Hobbes, Locke, Mill) – individuals participate in political decision making and express their views freely: intellectual freedom, limited government in economic activities and personal life, govt protections against abuse of power,

Current Liberalism – Support expanded government, holding onto the status quo (medicare and Medicaid), government makes the regulations that control

Early Conservatism – stability and structure, government had the power and duty to protect the weak

Current conservatism – oppose rapid change, decrease in federal responsibility for health and social issues to state governments, a reduced tax burden so citizens can have $$ to control the economy, decreased federal involvement in life – individual freedom to choose

Socialism (marx) equality of all, classless society, economy that contributes to the welfare of all, , lack of individual ownership, lack of privatization of property – property is owned by central government that controls economy.

Communism –revolution to achieve socialism (soviet block)

Social Democrats – willing to work within system to achieve fairness (Scandinavian countries) , welfare state – lawyer and barista making similar salaries, shorter work hours.







Orville Season 1 Episode 7 Majority Rules

Social Libertarian (left): Jefferson (Democratic-Republican). Favoring a socialist democratic republic with limited power.

Social Liberal (left): Johnson (Democrat) and Lincoln (Republican). Favoring authoritative Democracy for the benefit of the collective.

Conservative Libertarian (right): Reagan (Republican). Favoring authoritative conservatism for individual liberty.

Liberal Conservative (right): Hamilton (Federalist). Favoring authoritative conservatism for the collective.


US (Canada, and Australia) are also liberal welfare states




Social Determinants of Health


Crises ??

Opioid crisis – USA death rates

The U.S. falls between #36, Qatar, and #38, Poland, in this analysis, below lower-income nations like South Korea (#12), Malta (#16), Chile (#18), and Slovenia (#29). (Washington Post)

Gallup’s November 2017 poll on health care costs found that about one-third of Americans put off medical treatment due to costs, and more women (37%) than men (22%) do. This may be due to the fact that  women’s healthcare costs are typically higher than men’s. What’s most somber about this statistic is that nearly two-thirds of people who forego care due to cost say they have a serious condition. Self-rationing of care due to cost can lead to earlier, avoidable, disability and death.


Estimates of Death rates above normal




Now what?






















Framing the Discourse


Clinical Professor

Virginia Commonwealth University School of Nursing

We are going to

talk about politics!!!

Politics are all around us

It is imperative for you to read, analyze, examine your frame, and to discuss and advocate

Politics – definition: the activities associated with the governance of a country or other organization, especially the debate or conflict among individuals or parties having or hoping to achieve power.

Politics are controversial!!!

We need to talk about politics, but we also need to be respectful.



Introduce the field of sociolinguistics and explain its relevance to Health Policy, Leadership and Advocacy;

Discuss the concept of political discourse;

Explore your political leanings, and reflect on the impact of how you grew up, what you have experienced, and pivotal events in your life that shaped who you are and what you believe.


Conflict exists whenever incompatible activities occur (Deutsch, 1973)












Sociolinguistics: (micro sociolinguistics) The study of the relationship between language and society, of language variation, and of attitudes about language.

Sociology of Language: (macro sociolinguistics) The study of the relationships between language and society with the goal of understanding the structure of society. Often concerned with large-scale socio-political issues.


Think Piaget – assimilating repative consisten behaviors.


14% at the extremes and the remaining 86% are in the Exhausted Minority





You are a product of your environment – nature and nurture


Simple Framing

Every word evokes a frame;

Words defined within a frame evoke the frame;

Negating a frame evokes the frame;

Evoking a frame reinforces the frame;

According to Lackoff:

Republicans frame

Democrats explain


Liberal Conservative
Freedom to choose Right to life
Right to life Making the streets safer
Planned EOL discussions Death Panel
Healthcare for all Freedom to choose
Gun Control Gun Safety
Open borders Controlled immigration
Undocumented immigrants Illegal aliens



Productive Conflict Resolution

Development of conditions that allow reformulation of the problem

Availability of diverse ideas that can flexibly combined into novel patterns

Detachment from original viewpoint to see conflict from new perspective

The goal should never be to change a fellow member’s mind on an issue or candidate, but to elevate their thinking and discussions on political topics.

Assuming that someone with different political beliefs is somehow intellectually or morally deficient ends the conversation before it begins.


Etiquette for Effective Structured Controversies

Be respectful of each other.

Disagree with another person's position and ideas but don't be critical of the person.

Don't take criticism of your ideas as a personal attack.

Listen to everyone's ideas, especially if you don't agree with them.

Change your mind when the evidence supports this.

Try to understand both sides of the controversy.

Understand the position differences before trying to reach consensus.

Focus on reaching the best outcome, not on winning.

Encourage one to consider previously unexamined ideas

Stimulates interest and sparks curiosity

Improve advocacy skills

Enables higher level of decision making and problem solving

Moves us out of the win-lose solutions















Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Ask A Question and we will direct you to our Order Page at WriteDemy. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.

Fill in all the assignment paper details that are required in the order form with the standard information being the page count, deadline, academic level and type of paper. It is advisable to have this information at hand so that you can quickly fill in the necessary information needed in the form for the essay writer to be immediately assigned to your writing project. Make payment for the custom essay order to enable us to assign a suitable writer to your order. Payments are made through Paypal on a secured billing page. Finally, sit back and relax.

Do you need an answer to this or any other questions?

About Wridemy

We are a professional paper writing website. If you have searched a question and bumped into our website just know you are in the right place to get help in your coursework. We offer HIGH QUALITY & PLAGIARISM FREE Papers.

How It Works

To make an Order you only need to click on “Order Now” and we will direct you to our Order Page. Fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.

Are there Discounts?

All new clients are eligible for 20% off in their first Order. Our payment method is safe and secure.

Hire a tutor today CLICK HERE to make your first order

Related Tags

Academic APA Writing College Course Discussion Management English Finance General Graduate History Information Justify Literature MLA