NURS 8100 Week 8: Federal Role in Health Care Policy

Sample Answer for NURS 8100 Week 8: Federal Role in Health Care Policy Included After Question

How does the organization and structure of government, including the existence of multiple levels (federal, state, local), promote or hamper effective policy making and implementation? What role does the federal government, in particular, play in the development of policies that affect nursing practice in today’s health care organizations? This week, you will examine how federalism has influenced the current health care system. You will consider the positive, or negative, implications of redundancy in health policy resulting from different levels of government.

Learning Objectives

Students will:

• Assess the implications of federalism in health care policy making
• Analyze the politics and issues surrounding a current health care policy

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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.

Required Readings

Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.

• Chapter 15, “Health Care Reform and National Health Insurance”Chapter 15 discusses the history of legislating national health care insurance in the United States. The chapter focuses on the different methods of financing a national health care reform, from a single-payer government fund to employer and individual mandates.
• Chapter 16, “Conflict and Change in America’s Health Care System”Chapter 16 highlights the historical relationships between health care purchasers, insurers, providers, and suppliers. Over the decades, these stakeholders have battled for control of the U. S. health care system, as health care costs increase and more people remain uninsured.

France, C. (2008). The form and context of federalism: Meaning for health care financing. Journal of Health Politics, Policy & Law, 33(4), 649–705. doi: 10.1215/03616878-2008-012

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

 

The author argues that the United States’ unique form of federalism works negatively within a fragmented societal context to create an equally fragmented and dispersed health care system. The article highlights the United States health care system by comparing it with systems in Canada, Germany, and Australia.

Frankel, M. S. (2009). Commentary: Public outreach by the FDA: Evaluating oversight of human drugs and medical devices. Journal of Law, Medicine & Ethics, 37(4), 625–628.

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

Kennedy, E. M. (2005). The role of the federal government in eliminating health disparities. Health Affairs, 24(2), 425–428.

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

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In this article, the late Senator Kennedy discusses health care disparities among marginalized groups in the United States. He proposes the expansion of Medicaid and State Children’s Health Insurance Program (SCHIP), increased cultural competency among health care providers, health care research related to marginalized groups, and an increased public health investment by the United States. He includes a brief history of government involvement in reducing health care disparities.

Discussion: Federalism’s Impact on Policy

The fragmentation of the U.S. health care system, with its differing modes of financing and service delivery, is a reflection of a dispersed government structure. Policy making is shared and distributed across various branches and levels of government. As a result, policy making processes can be slow to respond, manipulated towards personal interests, and often redundant. Consider, for example, the public entitlement programs such as Medicaid, Medicare, the State Children’s Health Insurance Program (SCHIPS), and the PPACA of 2010. Where is there overlap between these policies? How do they demonstrate a dispersed government structure?

This week, you will analyze the role of the federal government in health care policy making.

To prepare:

• Review this week’s Learning Resources focusing on the France article and the textbook readings.
• Identify two nursing or health care policies that address similar needs, one passed at the federal level and the other at another level of government (state or local).

By Day 3

Post a cohesive response that addresses the following:

• Provide an example of two policies that address similar needs, passed at two levels of government (i.e., federal, state, or local).
• What are the advantages and/or disadvantages of this duplication? How does this example reflect the implications of federalism? Provide support from the literature for your position.
• To what degree should the federal government get involved in health care policy making? Provide concrete examples to support your position.

Read a selection of your colleagues’ postings.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

• Ask a probing question, substantiated with additional background information, evidence or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

  

Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

This week, you assessed the implications of federalism in health care policy making and analyzed the politics and issues surrounding a current health care policy.

Next week, you will focus on the role of state and local government in policy making, with particular attention to the function of state boards of nursing in the regulation of practice.

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A Sample Answer For the Assignment: NURS 8100 Week 8: Federal Role in Health Care Policy

Title: NURS 8100 Week 8: Federal Role in Health Care Policy

Federalism’s Impact on Policy 

Federalism challenges and stabilizes public policy by introducing innovation that would otherwise not have been introduced. Understanding it is critical in understanding the current healthcare policy-making entangled in a complex maze of shared and competing powerstructures. In the United States, the impact of federalism is vital, particularly in the healthcare sector, where policies passed at the Federal level have overlapping enactments at the State or local level. Medicare, Medicaid, SCHIPS, and PPACA are all health insurance programs. They are designed to subsidize healthcare for Americans, but their operationalization is based on different factors. For instance, Medicare is a federal health insurance program based on age, while Medicaid is open to needy Americans without age restriction. On the other hand, PPACA introduces rights and protection designed to ensure fairness in health coverage. At the same time, SCHIPS is intended to offer a range to children, and each state administers it under different names. 

These policies address the same population’s health needs, but they are differentiated using different names and eligibility criteria. State Health Insurance Assistance Program (SHIP) and Medicare are examples of overlapping healthcare policies because the State and Federal governments offer them. This overlap arises because SHIP gets funding from the Federal government to provide people with Medicare-free coverage at the state level. On one side, it creates better service delivery, mainly because the states better understand the population’s needs (Frankel, 2019). Nevertheless, it results in underexploited economies of scale that impede innovation for better service delivery (France, 2018). Again, given that the beneficiaries of SHIP are already covered under Medicare, it raises questions about why more money is channeled to the States via SHIP. Yet, it could be used to help vulnerable populations without any coverage. 

According to Bodenheimer & Grumbach (2020), federalism has sparked controversies in the American healthcare policies’ political contentiousness and divergent interests from the public and private sectors. This creates conflicts that reduce efficiencies in the delivery of services. To streamline these challenges, the stakeholders involved ought to work in harmony so that they can benefit the consumers through efficient service delivery to avoid service duplication (Kennedy, 2017). The policy overlaps between the Federal and State levels are proof of the bureaucracy at both levels of governance. France (2018) notes that the Federal government championed policy initiatives during the liberal period, which changed in the conservative era after power was devolved to the States. Therefore, initiatives by the state can be argued as the best for delivering services to the people. 

References 

Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (7thed.). New York, NY: McGraw-Hill Medical. 

France, C. (2018). The form and context of federalism: Meaning for health care financing. Journal of Health Politics, Policy & Law, 33(4), 649-705. doi: 10.1215/03616878-2008-012 

Frankel, M. S. (2019). Commentary: Public outreach by the FDA: Evaluating oversight of human drugs and medical devices. Journal of Law, Medicine & Ethics, 37(4), 625-62

NURS 8100 Week 8: Federal Role in Health Care Policy Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

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