Nursing Policies Assignment Essay

Nursing Policies Assignment Essay

Nursing Policies Assignment Essay


The US has one of the highest healthcare spending in developed nations, and healthcare costs have increased dramatically in the past decades. One significant challenge to containing health care costs is administrative inefficiency related to the various components of the payer/provider/patient interface (Nunn et al., 2020). The administrative costs occur in various forms, including prior authorization and eligibility determinations, claims processing and payment, and quality measurement. High administrative costs are particularly important contributors to high healthcare expenditures, which show the need for reforms to decrease costs in the US (Nunn et al., 2020). The high US administrative healthcare costs reflect the inefficiencies of the current healthcare system.


Administrative costs cannot be eliminated, even in a public healthcare system, but they can be reduced through technology, policies, and practices. Policymakers across the US envision using technology to reduce administrative overhead and processes before and after care (Cutler, 2020). The policymakers argue that healthcare technology can be implemented to facilitate the scheduling of patients’ appointments, manage patient communications, bill patients, and collect payments, which will lower administrative costs. For instance, they are pushing for policies for all facilities to have electronic medical records since they streamline patient care processes.

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I agree with the policymakers that policies are needed requiring facilities to have certain technologies that streamline healthcare delivery. While healthcare organizations currently budget more than a quarter of their spending toward administrative tasks, technology has a great opportunity to simplify a patient’s care and reduce administrative costs. Hospitals should put a greater emphasis on healthcare technology that increases patients’ choice and access to care (Cutler, 2020). The focus of the technology should be to remove barriers to healthcare appointments and provide direct, transparent pricing for every patient care aspect.


Cutler, D. M. (2020). Reducing administrative costs in US health care. The Hamilton Project Policy Proposal, 9, 3-25.

Nunn, R., Parsons, J., & Shambaugh, J. (2020). A dozen facts about the economics of the US healthcare system. Economic Facts. Washington, DC: The Hamilton Project.


The Affordable Care Act (ACA) is one of the most important healthcare policies enacted in the US since Medicare and Medicaid. The policy was designed to expand health coverage to millions of uninsured Americans. It expanded Medicaid eligibility, created a Health Insurance Marketplace, banned insurance companies from denying coverage due to pre-existing conditions, and required all health insurance plans to cover a list of essential health benefits (McIntyre & Song, 2019). In addition, it allowed children to remain on their parent’s insurance plan until 26 years. As a result of the ACA, lower-income families qualified for subsidies for health insurance purchased through the Marketplace.

            However, the ACA created tension between individual rights and the collective good. The ACA came with an individual mandate requiring Americans to purchase health insurance or risk a tax penalty. Individuals with no employer-sponsored insurance coverage had no choice but to purchase the higher-cost plans through the health insurance exchanges (Fiedler, 2020). A majority of young adults who could not afford the premium opted to take the tax penalty. Although the policy aimed at expanding access to healthcare, some policymakers felt that it infringed on Americans’ economic rights. Republicans argued that failure to purchase health insurance is not illegal, and no American should be forced to have health insurance (Fiedler, 2020). The penalty for failing to purchase health insurance was less than the cost of paying for actual insurance, and there were no criminal sanctions attached.

            The ACA aimed at increasing healthcare coverage and ensuring all Americans access essential health care services, which promotes the overall good. The policy promoted social justice by including premium tax credits and cost-sharing reductions to lower expenses for lower-income individuals and families. Furthermore, it aimed to promote better health outcomes in the population by requiring insurance plans, including those sold on the Marketplace, to cover at no cost various preventive services, including checkups, counseling, immunizations, and health screenings (McIntyre & Song, 2019). However, the ACA was legally controversial due to the individual mandates, which led to numerous court challenges before its enactment. 


Fiedler, M. (2020). The ACA’s Individual Mandate In Retrospect: What Did It Do, And Where Do We Go From Here? A review of recent research on the insurance coverage effects of the Affordable Care Act’s individual mandate. Health Affairs, 39(3), 429-435.

McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2), e1002752.


The policy proposal selected from the IOM Future of Nursing Practice Report Brief is: “Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.”  The IOM got it right because the dynamic US healthcare system will need equally profound changes in nurses’ education before and after licensing and certification. Therefore, an enhanced education system for nurses is crucial to ensure that the current and future generations of nurses can provide safe, quality, patient-centered care across all patient care settings, including primary care, community health, and public health (Sullivan, 2018).

The education system should equip nursing students with the tools necessary to evaluate and improve the standards of patient care and the quality and safety of care. It should also emphasize preserving the fundamental principles of nursing education, like ethics and integrity and holistic, compassionate approaches to care (Sullivan, 2018). Furthermore, the education system should equip nurses with skills that enhance their adaptability and flexibility in regard to changes in science, technology, and population demographics that influence healthcare delivery.

The American Association of Colleges of Nursing (AACN) is a professional nursing organization that deals with this recommendation. The AACN is considered the national voice for academic nursing. It strives to create quality standards for nursing education and helps schools implement these standards (AACN, n.d.).The AACN has supported the recommendation by developing nursing curriculum standards like the competency expectations for graduates of BSN, master’s, and DNP programs. In addition, the AACN engages in health Policy advocacy and works to advance public policy on nursing education, practice, and research (AACN, n.d.). It is a leader in obtaining sustained federal support for nursing education and research and influencing legislative and regulatory policies affecting nursing schools.


Sullivan, T. (2018). Institute of Medicine Report, The future of nursing: leading change, advancing health. Policy and Medicine.

The American Association of Colleges of Nursing (AACN). (n.d.). About AACN.


The New York Essential Plan (NY State policy) and the Affordable Care Act (Federal policy) are examples of two policies that address similar needs but passed at two levels of government. The Essential Plan is a NY health insurance program for state residents that do not qualify for Medicaid or the Child Health Plus Program. NY State established this program to fill the health insurance coverage gap that many residents and families have since they do not qualify for Medicaid but cannot afford full premium coverage (Gottfried, 2018). On the other hand, the Affordable Care Act (ACA) extended healthcare coverage to millions of uninsured Americans. The act required that all Americans obtain health insurance and barred insurance companies from denying coverage or charging extra to individuals with pre-existing conditions (McIntyre & Song, 2019).

The duplication of the two policies has the advantage of increasing the number of NY residents who have health insurance coverage. Besides, the duplication has made healthcare more accessible to low-income families. The NY State of Health Essential Plan also features the same ten health essentials as the ACA, and this duplication has ensured that NY residents have access to essential health care (Gottfried, 2018). The duplication of the two health policies reflects the implication of federalism since it promotes the political participation of policymakers at the state level (Gluck & Huberfeld, 2018). State policymakers established that the low- or no-cost Essential Plan would help overcome barriers to purchasing health insurance.

The Federal government should deeply be involved in healthcare policymaking by creating policies that ensure equal access to healthcare and high-quality health care across all states. Policymakers at the federal level should develop healthcare policies with input from other professionals, which will ensure all Americans across the country have equal access to healthcare regardless of their socioeconomic status (Gluck & Huberfeld, 2018). Besides, the federal government should be involved in coordinating and overseeing all healthcare policies enacted at the local and state levels. For instance, the Federal government enacted the ACA, which ensured that all Americans have access to essential healthcare services and increased the number of insured Americans in all states.


Gluck, A. R., & Huberfeld, N. (2018). What is federalism in healthcare for. Stan. L. Rev., 70, 1689.

Gottfried, R. N. (2018). Single-Payer Plan for New York Could Lead the Country. American journal of public health, 108(4), 452–453.

McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2), e1002752.


One of the recent regulations promulgated by the Arizona State Board of Nursing (AZBN) is the Full practice authority for nurse practitioners (NPs). The AZBN removed the requirement that NPs be supervised by, or collaborate with, a physician. As a result, NPs in Arizona can practice independently. Although NPs in AZ can practice without physician supervision, the regulations require NP to refer patients outside the NP’s knowledge and experience to a physician or another healthcare professional (AZBN, 2021). Alternatively, the NP can consult with another healthcare provider about the patient’s condition. Furthermore, the AZBN specifies that NPs should only practice in their certification area and should never practice outside their advanced practice specialty area (AZBN, 2021). NPs should only offer health care services, including diagnosing and prescribing within their population focus and role for which they are educationally prepared.

            The state regulations are supported in my current workplace, with NPs being allowed to practice within their scope of practice. NPs working in the facility can assess patients, diagnose, order, interpret diagnostic results, and initiate treatment plans. Besides, NPs are considered primary care providers in their areas of specialty. However, the organization is strict about NPs practicing only in their areas of specialization. Thus, a PMHNP can only provide care to patients with psychiatric and mental health conditions.  

            States across the US have a different scope of practice for NPs, including Full, Reduced, and Restricted practice. NPs in states with Full practice like AZ are allowed to practice within their full scope of training. States with Reduced practice like Illinois require NPs to have a collaborative agreement with a physician to participate in the elements of NP practice (Kandrack et al., 2021). However, states with Restricted practice like Texas mandate NP supervision and delegation in their practice. Restricted practice adversely impacts the professional nurse since the NP is limited from practicing to their full scope of training, unlike NPs with Full practice (Kandrack et al., 2021).


Arizona State Board of Nursing. (2021, July). SCOPE OF PRACTICE: Nurse Practitioners.

  Kandrack, R., Barnes, H., & Martsolf, G. R. (2021). Nurse Practitioner Scope of Practice Regulations and Nurse Practitioner Supply. Medical Care Research and Review, 78(3), 208–217.


The US and Canada have their Medicare programs launched more than 50 years ago to provide health insurance to thousands of citizens. Although the structures of the two programs are different, they have some similarities. The US Medicare act is a federal legislation that provides insurance coverage to seniors and individuals with specific, adverse health conditions (Himmelstein et al., 2020). Individuals are responsible for paying premiums for other parts of the Medicare program.

On the other hand, the Canada Medicare act is a Federal legislation for publicly funded health care insurance. It outlines the primary objective of the Canadian health care policy which is to protect, promote and restore the physical and mental well-being of Canadian citizens and to promote reasonable access to health services devoid of financial or other barriers (Himmelstein et al., 2020). The government does not cover all medical costs, which results in higher out-of-pocket costs. For instance, services like vision care, dental visits, and prescription drugs are not covered.

Comparing the two policies, I learned that both Medicare acts cover similar services, although prices and treatment are different. I also discovered that Canada is the only country globally with universal health care with no universal drug coverage. The Canadian government established a national prescription drug insurance plan called Pharmacare to help its citizens with medication costs (Himmelstein et al., 2020). Pharmacare offers individuals access to prescription medication based on their need rather than their ability to pay.

International organizations have a role in developing policy by providing policy recommendations and pushing governments to enact them. International organizations influence government to enact a policy through persuasion (Copelovitch & Pevehouse, 2019). For example, an international organization can recommend a policy that increases access to healthcare for citizens in a particular country and persuade the policymakers in the country to enact it to promote better population health outcomes.


Copelovitch, M., & Pevehouse, J. C. (2019). International organizations in a new era of populist nationalism. The Review of International Organizations, 14(2), 169-186.

Himmelstein, D. U., Campbell, T., & Woolhandler, S. (2020). Health care administrative costs in the United States and Canada, 2017. Annals of internal medicine, 172(2), 134-142.



Write a cohesive response that addresses the following:
• Briefly summarize a significant challenge to containing health care costs.
• How do policy makers envision technology could be utilized to address this challenge (above)? Provide at least one example to support your response.
• Do you agree or disagree with the policy makers? Describe why you agree or disagree and include one or more insights from this analysis that relate to the question of how information technology could, or could not, help contain costs while supporting health care reform initiatives.

Write a cohesive response that addresses the following:
• In the first line of your posting, identify a health care policy.
• Explain the tension between individual rights and the collective good.
• Analyze the ethical and legal considerations of the policy.

write in your small group thread a cohesive response that addresses the following:
• Briefly summarize the policy proposal you selected from the IOM Future of Nursing Practice Report Brief (Application 2). Based on your analysis of the policy proposal, did the IOM get it right?
• Identify any professional organizations dealing with the issue/recommendation and provide at least two specific ways in which the professional organizations have supported or could support the policy proposal/recommendation.
Document of the iom is attached or email

Page four/wk8

write 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.

Page five /wk 9
Write a cohesive response that addresses the following:
To writer- you can chosen Arizona for practice stated, Advanced practice nurse can practice independently in this stated without supervising physician- you can chose any topic you want.
Instructions to the writer- You can chose any topic your like and related to your work it can be an imagination but it should be realistic-

• What are the most recent regulations promulgated through your state board of nursing for advanced practice?
• How are the state regulations supported within your place of employment?
• How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States?

Page 6/wk 10
To writer- chose any topic and country u like

Post a cohesive response that addresses the following:
• Post information on the nursing or health-related policies you located including a reference to the source.
• Indicate the country you are comparing to the U.S.
• Compare and contrast the two policies. What insights did you gain as a result of this comparison?
• What is the role of international organizations in developing policy? Provide a specific example.

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