Public Policy and Politics for Nurses and Other Healthcare Professionals: Advocacy and Action

395 Pages·2010·3.65 MB·English

by  Donna M. Nickitas

POLIC Y POLITICS
AND
for Nurses and Other Health Professionals
Advocacy and Action
Edited by:
Donna M. Nickitas, PhD, RN, CNAA, BC
Professor and Graduate Specialty Coordinator
Dual Degree MS/MPA
Hunter College
Hunter-Bellevue School of Nursing
The City University of New York
Deputy Executive Director, Doctor of Nursing Science Program
Graduate Center, The City University of New York
New York, NY
Editor
Nursing Economic$, The Journal for Health Care Leaders
Pitman, NJ
Donna J. Middaugh, PhD, RN
Associate Dean
Coordinator, Nursing Administration Master’s Specialty
College of Nursing
University of Arkansas for Medical Sciences
Little Rock, AR
Nancy Aries, PhD
Interim University Dean for Undergraduate Education
City University of New York
New York, NY
56598_FMxx_000i_0xvi:56598_Nickitas 3/8/10 12:46 PM Page ii
World Headquarters
Jones and Bartlett Publishers Jones and Bartlett Publishers Canada Jones and Bartlett Publishers International
40 Tall Pine Drive 6339 Ormindale Way Barb House, Barb Mews
Sudbury, MA 01776 Mississauga, Ontario L5V 1J2 London W6 7PA
978-443-5000 Canada United Kingdom
[email protected]
www.jbpub.com
Jones and Bartlett’s books and products are available through most bookstores and online booksellers. To contact Jones and Bartlett Pub-
lishers directly, call 800-832-0034, fax [phone], or visit our website, www.jbpub.com.
Substantial discounts on bulk quantities of Jones and Bartlett’s publications are available to corporations, professional associations,
and other qualified organizations. For details and specific discount information, contact the special sales department at Jones and
Bartlett via the above contact information or send an email to [email protected].
Copyright © 2011 by Jones and Bartlett Publishers, LLC
All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or me-
chanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the
copyright owner.
The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors,
omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and
procedures described. Treatments and side effects described in this book may not be applicable to all people; likewise, some people may
require a dose or experience a side effect that is not described herein. Drugs and medical devices are discussed that may have limited avail-
ability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical prac-
tice, and government regulations often change the accepted standard in this field. When consideration is being given to use of any drug
in the clinical setting, the health care provider or reader is responsible for determining FDA status of the drug, reading the package in-
sert, and reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications, and
determining the appropriate usage for the product. This is especially important in the case of drugs that are new or seldom used.
Production Credits
Publisher: Kevin Sullivan Composition: Auburn Associates, Inc.
Acquisitions Editor: Amy Sibley Cover Design: Timothy Dziewit
Associate Editor: Patricia Donnelly Cover and Title Page Images: left to right, Courtesy of the
Editorial Assistant: Rachel Shuster National Library of Medicine (taken at the American National
Senior Production Editor: Carolyn F. Rogers Red Cross Hospital No. 1 in Paris, France); © Kim Seidl/
Marketing Manager: Rebecca Wasley ShutterStock, Inc.; © Rmarmion/Dreamstime.com
Photo and Permissions Associate: Emily Howard Printing and Binding: Malloy, Inc.
V.P., Manufacturing and Inventory Control: Therese Connell Cover Printing: Malloy, Inc.
Library of Congress Cataloging-in-Publication Data
Policy and politics for nurses and other health professions : advocacy and action / edited by Donna M. Nickitas,
Donna J. Middaugh, Nancy Aries.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-0-7637-5659-8 (pbk.)
ISBN-10: 0-7637-5659-8 (pbk.)
1. Medical policy–United States. 2. Nursing–United States. I. Costello-Nickitas, Donna M. II. Middaugh, Donna J. III. Aries, Nancy.
[DNLM: 1. Health Policy–United States. 2. Health Care Costs–United States. 3. Lobbying–United States. 4. Policy Making–United
States. WA 540 AA1 P766 2011]
RA395.A3P587 2011
362.10973--dc22
2010006367
6048
Printed in the United States of America
14 13 12 11 10 10 9 8 7 6 5 4 3 2 1
56598_FMxx_000i_0xvi:56598_Nickitas 3/1/10 12:16 PM Page iii
Dedication
In memory of my parents, John and Anna Costello: Thank you for encouraging me to follow my
dream and discover my passion of becoming a registered professional nurse. For my husband,
Michael: Thank you for all your patience, love, and guidance on my journey promoting advocacy
and action for my patients, students, and colleagues.
Donna M. Costello-Nickitas
I dedicate this book to my husband Robert and our son Robert Guy, who have awakened my soul
and are my inspiration in everything I do and every choice I make. They have taught me to love
unconditionally, enjoy life and live with purpose. Also, to the memory of my mother, Alpha Duff,
a teacher, who taught me to never stop learning.Ex Deo familia. Ex pertinacia victoria.
Donna J. Middaugh
To the memory of my father, Leon J. Aries, a surgeon, who taught me that caring for one’s patients
was the fundamental job of all health professionals.
Nancy Aries
iii
56598_FMxx_000i_0xvi:56598_Nickitas 3/1/10 12:16 PM Page iv
56598_FMxx_000i_0xvi:56598_Nickitas 3/1/10 12:16 PM Page v
Contents
Foreword ix
Richard H. Carmona, RN, MD, MPH, FACS
Preface xi
Contributors xiii
Section I Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
1 To Engage or Not Engage: The Choice Confronting Nurses and
OtherHealthProfessionals 3
Nancy Aries
2 Health Status and Access to Care 25
Paula Lucey
Section II The Health Labor Force: Understanding
the Distribution of Power and Influence . . . . . . . . . . . . . . . . . . .51
3 Physicians 53
Nancy Aries and Barbara Caress
4 Nurses 75
Donna M. Nickitas
v
56598_FMxx_000i_0xvi:56598_Nickitas 3/1/10 12:16 PM Page vi
vi Contents
5 Allied and Other Health Professionals 103
Donna M. Nickitas
Section III Healthcare Providers: Understanding
How Power, Markets, and Government Impact the
Organization and Delivery of Care . . . . . . . . . . . . . . . . . . . . . .121
6 Hospitals: The Power of Institutional Interests 123
Nancy Aries and Barbara Caress
7 Long-Term Care 143
Emma Kontzamanis and Keville Frederickson
8 Mental and Behavioral Health: Clinical and Policy Impact on
MentalHealthTrends 155
Kunsook Bernstein and Joseph Saladino
9 Public Health Policy: Promotion, Prevention, and Protection 181
Mary Mincer Hansen and Mary Jones
Section IV Healthcare Finance: Understanding the Role
of Markets in Government . . . . . . . . . . . . . . . . . . . . . . . . . . . .209
10 Healthcare Costs: Follow the Money! 211
Jonathan Engel
11 The History of Health Insurance in the United States 237
Leah Curtin and Franklin A. Shaffer
56598_FMxx_000i_0xvi:56598_Nickitas 3/1/10 12:16 PM Page vii
Contents vii
Section V Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261
12 Advancing the Use of Technology in the Organization and
DeliveryofHealthCare 263
Diane J. Skiba and Donna Dulong
13 Healthcare Quality 287
Donna J. Middaugh
14 Health Services Research 309
Donna M. Nickitas, Keville Frederickson, and Jonathan Small
15 Conclusions: A Policy Toolkit for Healthcare Providers and Activists 327
Roby Robertson and Donna J. Middaugh
Appendix A: Web Resources 353
Compiled by Lametria Wafford
Appendix B: Glossary of
ManagedCare Terminology 357
Index 365
Photo Credits 377
56598_FMxx_000i_0xvi:56598_Nickitas 3/1/10 12:16 PM Page viii
56598_FMxx_000i_0xvi:56598_Nickitas 3/1/10 12:16 PM Page ix
Foreword
Ihave been fortunate to have worked in the health field at every professional level through 5 decades.
Being a registered nurse has afforded me a unique vantage point and lens to view through the “ret-
rospectoscope” as well as peer into the future. Nurses by their nature and training view their pa-
tients, community and even the world with great refractive holistic clarity. Being a nurse first has
made me a better physician and surgeon general.
The core values of nursing are with me in all of my endeavors. In fact, I am most proud to al-
ways state, “once a nurse, always a nurse”! I have watched nursing evolve from a subservient role
where we could not write our nursing notes in the progress notes and our observations and con-
structive input were not always welcome. Today we have evolved as health leaders, consummate
patient advocates, and clinical and administrative experts, and public polls often demonstrate that
nurses are among the most trusted professionals.
Our nursing leadership is apparent at all levels of our healthcare systems to include advising on,
constructing, and implementing policy. Policy development and execution is complex and multi-
factorial while being essential to the orderly, efficient, and effective conduct of any organization.
Understanding the process and components of effective policy takes years of training and expe-
rience. Nurses are perfectly positioned to assume a growing role in policy by virtue of their train-
ing, experience, holistic approach, selfless service, and extraordinary public credibility.
We should require our nurses and all health professionals to be knowledgeable about the inter-
section of policy and politics and encourage them to take an active role in the policy arena.
Today more than ever we need well-informed nurses and health professionals to guide our non-
partisan discussions about health reform. As nurses, we serve a special interest group, but our spe-
cial interest group is often the forgotten constituent in the partisan political debate—the patient!
This textbook, Policy and Politics for Nurses and Other Health Professions, is a wonderful guide for
the novice or the professor and it will serve to improve policy health literacy for all.
Richard H. Carmona, RN*, MD, MPH, FACS
17th Surgeon General of the United States
Distinguished Professor, University of Arizona
Vice Chairman, Canyon Ranch
President, Canyon Ranch Institute
*Inactive
ix