Week 3 lecture and discussion questions

Politics and The Law

The Health Care System

Economics of Health Care

Review the attached PowerPoint presentations.  Once done answer the following questions.

Discuss the power of nursing to influence and change health policy.

Mention and discuss current health policy issues.

Describe and discuss the organization of the public health care system at the federal, state, and local levels.

Analyze the influence of socio-cultural, political, economic, ethical, and religious factors that influence the health and culturally diverse individuals, groups, and communities. 

As stated in the syllabus present your assignment in an APA format word document, APA required font attached to the forum in the discussion tab of the blackboard titled “Week 3 discussion questions” and the SafeAssign exercise in the assignment tab of the blackboard which is a mandatory requirement.  

A minimum of 2 evidence-based references (besides the class textbook) no older than 5 years must be used.  

A minimum of 800 words is required and not exceeding 1,000 words (excluding the first and reference page).  Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.

Economics of Health Care

Chapter 12

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Factors Influencing Health Care Costs

Historical payment systems

Unnecessary use of services

Lack of preventive care

Lifestyle/health behaviors

Societal belief that disease would be eradicated

Technological advances

Aging of society

Utilization of drugs

Shift from nonprofit to for-profit health care

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Public Financing of Health Care: Medicare

Entitlement program to provide health care to the growing population of those 65 years of age or older

Part A

Includes inpatient care in hospitals/skilled nursing facilities, hospice care, some home health care

Must pay a deductible for health services

Does not pay for all health care costs of enrollees; co-payments required after 60 days

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Public Financing of Health Care: Medicare (Cont.)

Entitlement program to provide health care to the growing population of those 65 years of age or older

Part B

Purchased by monthly fee

Not compulsory

Helps pay for out-of-pocket costs for physician services, hospital outpatient care, durable medical equipment, and other services, including some home health care

Enrollees must pay deductibles and coinsurance

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Public Financing of Health Care: Medicare (Cont.)

Entitlement program to provide health care to the growing population of those 65 years of age or older

Part C

Medicare Advantage Plans

Optional “gap” coverage

Provided by private insurance companies approved by, and under contract with, Medicare

May include HMOs and PPOs

May include vision, hearing, dental care, and other services not covered by Medicare Parts A, B, or D

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Public Financing of Health Care: Medicare (Cont.)

Entitlement program to provide health care to the growing population of those 65 years of age or older

Part D

Initiated in 2006 to help defray costs of

prescription drugs

Optional; must enroll in an approved prescription drug plan

Monthly premium, deductibles, and co-payments

Must pay 100% of costs wh

Chapter 11

The Health Care System

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

U.S. Health Care System

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Figure 11-1

U.S. Health Care System (Cont.)

Private health care subsystem

Focus on the individual

Nonprofit and for-profit agencies

Models of services

Solo practice

Single specialty group practice

Multispecialty group practice

Integrated health maintenance model

Community health center

Voluntary or nonofficial agencies

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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U.S. Health Care System (Cont.)

Public health care system

Mandated by the U.S. Constitution

Focus on the population

“promote the general welfare of its citizens.”

Federal policies and practices influence local and state governments

Coordination of services under Department of Health and Human Services

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Public Health

Public health refers to the efforts organized by society to protect, promote, and restore the people’s health.

Concerned with a healthy population

Concerned with a healthy environment

Scope is broad

Encompasses activities that promote good health

Organized into multiple levels (federal, state, local)

Provides services for those unable to obtain health care without assistance

Establishes laws, rules, and regulations to protect the public

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Public Health System

Federal level subsystem

U.S. Department of Health and Human Services

Surgeon General and numerous other agencies

Targets general population, special populations, and international health

IOM Report, HHS in the 21st Century: Charting a New Course for a Healthier America (2008), recommended transformation of system

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Current HHS Strategic Plan

Transform health care

Advance scientific knowledge and innovation

Advance health, safety, and well-being of the American people

Increase efficiency, transparency, and accountability of HHS

Strengthen the nation’s health and human services infrastructure and workforce

Copyright © 2015, 2011, 2007, 2001, 19

Chapter 10

Policy, Politics, Legislation, and Community Health Nursing

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Nurses Who Made a Difference…

Florence Nightingale

Sojourner Truth

Clara Barton

Lavinia Dock

Lillian Wald

Mary Breckenridge

Susie Walking Bear Yellowtail

Florence Wald

Ruth Watson Lubic

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Nurses’ Historical and Current Activity in Health Care Policy

Florence Nightingale

First nurse to exert political pressure on a government

Transformed military health

Knew the value of data in influencing policy

Collected and analyzed data about health services and outcomes, which now is a critical element of public health

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Photo credit:

http://commons.wikimedia.org/wiki/Florence_Nightingale

Nurses’ Historical and Current Activity in Health Care Policy (Cont.)

Sojourner Truth

Advocate for abolishing slavery

Supported women’s rights

Helped transform racist and sexist policies that limited health and well-being of blacks and women

Fought for human rights

Lobbied for funds to educate nurses and physicians

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Photo credit:

http://commons.wikimedia.org/wiki/File:Carte_de_visite.jpg

Nurses’ Historical and Current Activity in Health Care Policy (Cont.)

Clara Barton

Organized relief efforts during U.S. Civil War

Persuaded Congress to ratify the Treaty of Geneva, which allowed the Red Cross to perform humanitarian efforts in times of peace

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Photo credit:

http://commons.wikimedia.org/wiki/File:WcbbustCBarton.jpg

Nurses’ Historical and Current Activity in Health Care Policy (Cont.)

Lavinia Dock

Prolific writer and political activist

Campaigned to allow nurses to control the nursing profession

Advocated for women’s right to vote

Worked closely with Isabel Hampton Robb and Mary Adelaide Nutting to found forerunner to NLN

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Photo credit:

http://commons.wikim