Discussion: Federalism’s Impact on Policy NURS 8100
Discussion: Federalism’s Impact on Policy NURS 8100
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.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 8 Discussion
Assignment 1: Issues in Health Care
Reform (Interview)
Continue to work on this Assignment, assigned in Week 2 and due in Week 9.
By Day 7 of Week 9
Submit this Assignment.
Assignment 3: Policy Analysis Paper
[Major Assessment 2]
Continue to work on this Assignment, assigned in Week 4 and due in Week 11. Analyze
the politics and issues surrounding your selected health care policy. This information
should be included in Part 1 of your analysis paper.
By Day 7 of Week 11
Submit this Assignment.
Week in Review
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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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.
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.