Politics and the Law

Government Authority: Protection of the Public’s Health n Neither the U.S. Constitution nor state constitutions guarantee access to health care n State power concerning health care is termed “police power” n The state can use its power to protect health, welfare, and safety of citizens

Power, Authority, and the Health of the Public: Concepts of Power n Coercive n Reward n Expert n Legitimate n Referent n Information n Connection

Freedom Versus Equality n In the U.S., we equate freedom with “liberty” (freedom “of”) n Socialist societies equate freedom with “equality” (freedom “from”) n The more liberty that exists in a society, the less equality

Evolution of the U.S. Government’s Role in Health Care n Marine Hospital Service n St. Elizabeth Hospital n Veterans Administration n Hill-Burton Act n Medicare n Medicaid

Federal Government n Executive Branch n Department of Health and Human Services (DHHS) n U.S. Public Health Service n Department of Education n Department of Labor n Legislative Branch n Judicial Branch

Department of Health and Human Services n Medical and social science research n Communicable disease prevention n Financial assistance for low-income families n Child abuse and domestic violence prevention n Medicare and Medicaid

Department of Health and Human Sciences n Child support enforcement n Food and drug safety n Maternal and infant health improvement n Services for older adults n Substance abuse treatment and prevention

U.S. Public Health Service n Agency for Health Care Policy and Research n Food and Drug Administration n Agency for Toxic Substances and Disease Registry n Health Resources and Services Administration

U.S. Public Health Service n Substance Abuse and Mental Health Services Administration n National Institutes of Health n Centers for Disease Control and Prevention n Indian Health Service

State Government n Executive Branch n State Agencies n Legislative Branch n Judicial Branch

Local Government Services include: n public health n public education n drinking water n sewage disposal n police protection n solid waste management

Different Types of Law n Constitutional n Statutory n Judicial or Common

How an Idea Becomes a Law n A bill introduced by member of legislature n The bill is considered by a committee n If passes committee, the bill goes to the floor of House or Senate for a vote n If a bill passes through these processes in identical form, it is called an “act” n The next step is to sign the act into law

How Nurses Can Get Involved n Be an informed voter n Get to know legislators and make your views known to them n To have an idea introduced as a bill, you must find sponsor in House and Senate n Be aware of media coverage and strategically plan your moves

Lobbying n Lobbyist is a person who is employed for the primary purpose of lobbying n Most states require lobbyists to be registered n State rules and regulations vary n Should back up position with data

Political Action Committees (PACs) n Primary purpose of a PAC is to endorse and support candidates for public office who support the legislative agenda of the group making the endorsement n Nursing PACs exist at federal and state levels, most often through ANA

Regulation and Licensing of Nursing Practice n Nursing practice in each state is governed by a nurse practice act n Nurse practice act includes laws and regulations that control: –requirements for entry into practice –standards for acceptable practice –standards for continuing competence –disciplinary actions for misconduct

Regulation and Licensing of Nursing Practice n States administer NCLEX n Nurse must be licensed in a state to work n Licensure protects the public because: –it protects the title of RN –it delineates scope of nursing practice n Nurse Multistate Licensure Mutual Recognition Model

Nursing Practice and the Law To be found guilty of malpractice: n A duty was owed to the client n There was a breach of the duty owed to the client n Harm was caused to the client n The harm was foreseeable n The action or inaction of the nurse caused the harm