Nursing & Health-Care-Policy

Sample Answer

Okay, let's break down the history, structure, and process of healthcare policy and politics within nursing and the broader US healthcare delivery system.

1. History of Healthcare Policy and Politics in the US

The history is marked by evolving responses to societal needs, economic pressures, and political ideologies, often with nursing playing a significant, though sometimes under-recognized, role.

• Early 20th Century: Professionalization & Public Health:
  • Nursing emerged as a formal profession. Early nurses like Lillian Wald (Henry Street Settlement) and Lavinia Dock were deeply involved in public health, social reform, and advocating for the poor and vulnerable. They lobbied for sanitation, child labor laws, and better working conditions – foundational public health policy issues.
  • The focus was on hospital-based care and public health initiatives, often funded through philanthropy and local government.
• Mid-20th Century: Rise of Hospital Care & Early Insurance:
  • The Great Depression highlighted the lack of access to care. Efforts like the Sheppard-Towner Act (1921, later repealed) and early Blue Cross/Blue Shield plans began to address financial barriers.
  • World War II wage controls led employers to offer health insurance as a benefit, shifting the financing model.
  • Nursing focused on improving hospital standards, nurse education (e.g., ANA formation in 1896, state boards), and beginning to organize for better working conditions and salaries.
• 1960s: Major Legislative Milestones (Medicare & Medicaid):
  • After decades of debate and political maneuvering (including significant nursing involvement, particularly concerning hospital needs and nurse staffing), Medicare and Medicaid were enacted in 1965. This fundamentally reshaped the US healthcare system, creating a major payer source and significantly increasing access for the elderly and low-income populations.Okay, let's break down the history, structure, and process of healthcare policy and politics within nursing and the broader US healthcare delivery system.