Opinion Essay: The Effects of Political Forces on the US Healthcare System and ACA

Just like any other sector of the US economy, the healthcare industry is undergoing dramatic and unprecedented changes (Martin, 2013). According to Martin (2013), it is the Affordable Care Act (ACA) that is responsible for the sweeping changes in the nation's healthcare system. Healthcare is affected by social, demographic, political, technological and information, ecological, global, economic, and anthro-cultural forces from every dimension. This paper examines the aspects of the ACA driven or affected by political forces of change and the effects that this force can have on healthcare. It also discusses the role that nurses play in effecting this change in the healthcare system.

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To begin with, being a creation of a political process and bipartisan politics, various aspects of the ACA and healthcare in general such as costs, affordability, access, and quality are affected and determined by politics and political factors. Moreover, political decisions do affect these aspects in different ways. For instance, according to Blendon and SteelFisher (2009), aspects of healthcare such as universality are affected by the interaction of various economic, political, and social factors. Given that it is political players who double up as decision and policy makers in the area of healthcare, aspects of the ACA such as costs are often used by politicians to shore up public support and approval. The kind of decisions that legislators make touching on healthcare often have ripple effects on the public's access to healthcare and hence this indicates the impacts of political forces on both ACA and healthcare as a whole.

Additionally, politics impacts healthcare and the ACA in general by influencing and shaping public's opinion and perception of the effectiveness of this legislation on healthcare quality, access, and costs. According to Bambra, Fox, and Scott-Samuel (2005), healthcare in itself is political in nature and hence affected by political forces because it is considered a political right, its social determinants are subject to political interventions and actions, and like other resources, health is not equitably distributed in the society and hence a political issue. Also, as Blendon and SteelFisher (2009) observe, underlying politics and political decisions usually influence healthcare policymaker decisions.

Thus, in a sense, it is the political decision and policymakers who determine whether citizens will have universal access to affordable and quality healthcare. Additionally, as Borrell, Espelt, Rodriguez-Sanz, and Navarro (2007) point out, politics and political decisions or policies on healthcare have important effects on socioeconomic health inequalities or disparities. Thus, there is a close connection between health care outcomes and politics since the labor market and welfare state policies on healthcare made by politicians do directly affect social inequalities regarding access to quality and cost-effective or affordable healthcare in the US.

Amid these changes in the US healthcare system, nurses have an important role to play to effect such change. According to Hassmiller (2010), under the Healthcare Reform Act, nurses are given a unique opportunity to play an integral and central role in leading the healthcare reform. One responsibility of a nurse in effecting and leading change in healthcare is using nurse-led innovations in improving the quality of care, expanding access to healthcare, and lowering the costs of care (Hassmiller, 2010). Examples of such innovations include home visitation programs and nurse-managed health clinics. Nurses should also play the roles of engaging in research and generating evidence, redesign in nursing education, embracing technology, developing and providing leadership, and engaging in health promotion campaigns (Hassmiller, 2010). Furthermore, as Salmond and Echevarria (2017) note, the role of nurses in leading the transformations in healthcare is to focus emphasize on promoting quality improvement, healthcare outcomes, data analytics, care coordination, and patient-centered care to ensure quality, affordable, and seamless care.

In summary, the aspects of ACA that are driven by force include costs, quality, affordability, sustainability, access, and effectiveness. The effect of political forces on the changing healthcare is that it influences healthcare policy and decision-making process on various issues that affect and determine quality and cost of care. The role of the nurse in effecting this change is to engage in health promotion aimed at improving quality, lowering costs, and enhancing access to care.

References

Bambra, C., Fox, D., & Scott-Samuel, A. (2005). Towards a politics of health. Health Promotion International, 20 (1), 187-193

Blendon, R.J., & SteelFisher, G.K. (2009). Commentary: Understanding the underlying politicsof health care policy decision making. Health Services Research, 44(4), 1137-1143

Borrell, C., Espelt, A., RodriguezSanz, M., & Navarro, V. (2007). Politics and health. Journalof Epidemiology & Community Health, 61(8), 658-659

Hassmiller, S. (2010). Nursing's role in healthcare reform. American Nurse Today, 5(9). Retrieved April 25, 2018, from https://www.americannursetoday.com/nursings-role-in-healthcare-reform/

Martin, M. (2013). Nursing during an era of change: A challenge and opportunity. Journal of Nursing Education and Practice, 4(1), 189-198

Salmond, S.W., & Echevarria, M. (2017). Healthcare transformation and changing roles fornursing. Orthopedic Nursing, 36(1), 12-25