ATI: Economic Influences

Definition of Policy: The CDC defines policy as "a law, regulation, procedure, administrative action, incentive, or voluntary practice of governments and other institutions."
- Public health policy refers specifically to regulations, laws, actions, and decisions affecting health within a community.
Influence of Public Health Policy: Public health policy significantly impacts citizens' health and wellness by fostering the understanding and attainment of health goals.
Health Policy: A subset of policy specifically focused on health outcomes for individuals, families, or communities. The landscape of health policy in the U.S. is characterized by ideological and political debate, which evolves over time.
Role of Nurses: Nurses advocate for clients by identifying and implementing public health regulations and policies.
- Essential for public health nurses to understand health policy intricacies and political influences to promote and protect public health effectively.
Understanding Current Issues: Healthy People 2030 outlines public health needs and is updated every decade, helping nurses identify pressing health care topics and engage in policymaking.

Policies can be categorized by both the components of healthcare (e.g., public health, mental health) and their functions (e.g., allocative, regulatory).
Social Policies: These address societal problems and come from governmental actions.
Private Policies: Constructed by entities like insurance companies and healthcare providers.

Defined as an authoritative decision at the legislative, executive, or judicial levels of government, aimed to influence behaviors or decisions.
Established at federal, state, and local levels, with health laws made by the legislative branch and enforced by the executive.

Quality, Access, Cost: Policies are generally grouped by these categories to facilitate modification and research.
Allocative vs. Regulatory Policies:
- Allocative Policies: Provide benefits to a specific group, often funded by taxation (e.g., Medicare).
- Regulatory Policies: Influence actions and behaviors to meet public objectives (e.g., HIPAA).

Public policy is a shared governmental responsibility across federal, state, and local levels, impacting community health.
Tools for policymakers include creating laws, raising funds through taxation, and establishing agreements with private entities.

Medicare: A federal health insurance program for individuals aged 65 or older and those with disabilities, funded by payroll taxes.
- Contains four parts: hospital care, medical expenses, prescription drugs, and supplemental insurance plans.
Medicaid: Federal and state program for low-income individuals, covering essential health services such as inpatient/outpatient care and preventive services.
- Unique state delivery can lead to varied health care policies across the U.S.

Focus on community-specific health needs, managing issues like water safety and communicable diseases.
Decision-making at local levels has significant impacts on healthcare access and public health outcomes.

Nurses engaging in political advocacy can influence public health policies through interaction with elected officials.
The collaboration among the healthcare workforce, including nurses, physicians, and other disciplines, is crucial for quality patient care delivery.

Public Sector: Includes Medicaid, Medicare, Veterans Health Administration, etc., governed by taxpayer funding.
Private Sector: Comprises healthcare services outside government control, including for-profit and nonprofit entities.

Major private sector insurance companies include United Health Group, Anthem Health, Aetna, Cigna, and Kaiser.
Nonprofit healthcare entities often include hospitals and care facilities.

The U.S. spends approximately 17% of its GDP on public health care, impacting accessibility.
Challenges include limited funding, bureaucratic inefficiencies, and the need for manageable care delivery processes.

Medicare & Medicaid Funding: Funded through taxes, with Medicare costing taxpayers approximately $799.4 billion in 2019.
CHIP: Provides insurance for children in families too high-income for Medicaid but too low for private insurance.
ACA: Enacted in 2010, aimed to expand coverage and eliminate discrimination based on preexisting conditions.

Ethical dilemmas arise from limited resources, requiring prioritization in funding allocation to benefit the maximum number of people.
Utilitarianism can serve as a guiding principle for decision-making in resource distribution.

Understanding health policy is essential for nurses to advocate effectively and guide public health initiatives.
The blend of public and private health services has both strengths and weaknesses, leading to ongoing debates about healthcare access and funding equity.