1. Government Influences on Health Care
Chapter 2
Government Influences on Health Care
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Key Terms
accreditation
care plan
Federal Register
health maintenance organization (HMO)
homeopathy
informed consent
managed-care organizations (MCOs)
Medicare
Medicaid
Nursing Licensure Compact (NLC)
nurse practice acts
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3. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Key Terms (cont.)
Occupational Health and Safety Act (OSHA)
political action committees (PACs)
preferred provider organization (PPO)
scope of practice
standards of practice
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

4. The Importance of Understanding the Role of Government in Health Care
The government plays a key role in promoting the health and well-being of Americans
This knowledge lets consumers and health-care workers to have an understanding of and an informed say in developing new legislation
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

5. Health Care Legislation
Three levels of government
Federal
State
Local
Laws concerning health care were developed based on the fundamental principles of health-care leaders
Standards of practice were the foundations of laws related to consumer protection
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

6. Hospitals and Nursing Schools
Bellevue Hospital School of Nursing
American Red Cross
Mayo brothers in Minnesota
American Medical Association
Rockefeller Foundation
Carnegie Foundation
American Society of Superintendents of Nurse Training Schools
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7. Hospitals and Nursing Schools (cont.)
National League for Nursing (NLN)
American Nurses Association (ANA)
Columbia University in New York
Hill-Burton Hospital Construction Act of 1946
Army Cadet
Nursing Corps
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8. The Multidisciplinary Health-Care Team
Among others, the multidisciplinary health-care team includes:
Doctors
Nurses
Laboratory technicians
X-ray technicians
Social workers
Plan of care
Standards of care
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9. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Nurse Practice Acts
Define the scope of practice for nurses within each state
Scope of practice is the identification of and legal limitations to the usual and customary skills practiced by a professional
Nursing Licensure Compact
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

10. Consumer Bill of Rights
Stressed the importance of the relationship between the health-care provider and the patient
Stipulated that the health-care system:
Is fair and meets patients’ needs
Gives patients a way to address problems
Encourages patients to take active roles in health care
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

11. Consumer Bill of Rights (cont.)
Rights of the consumer to:
Have choice of providers
Have access to emergency services
Take part in treatment decisions
Receive respect and nondiscrimination
Maintain confidentiality of health-care information
Have resources for complaint and appeal
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

12. Patient’s Bill of Rights
Minnesota was the first state to establish a Bill of Rights for Patients as a state law in 1973
American Hospital Association (AHA): The Patient Care Partnership: Understanding Expectations, Rights, and Responsibilities in 2003
Informed consent is one of the most important rights of patients
See Box 2-1.
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

13. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Accreditation
The process by which an institution is recognized as meeting specific predetermined standards of care
A hospital that is not accredited may not be eligible to receive state or federal funding assistance
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

14. AHA Criteria for Hospitals in Pursuit of Excellence
Care coordination
Efficiency
Health-care–acquired infections
Health-care equity
Health information technology
Medication management
Payment models
Patient input
Workforce and culture
See Box 2-2.
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

15. The Government’s Role in Health Care
To provide for the general welfare of the people and provide spending power to do so
The Children's Bureau
Woman, Infants, and Children program (WIC)
Sheppard-Towner Act of 1921
President Roosevelt's New Deal
National Insurance Plan
Social Security Act of 1935
Unemployment Compensation and Old Age Benefit laws
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16. United States Department of Health and Human Services
Established in 1939 as the Federal Security Agency
Renamed in 1980
Healthy People
Under the guidance of this department, local, state, and federal governments provide direct services, financing, information, and setting of policy
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Direct Services
Include providing health care to:
Native Americans
Military personnel and their families
Prisoners
Managing screening clinics for diseases
Managing immunization clinics for children
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Financing
The government funds health education programs and finances health care through:
Medicare
Medicaid
Social Security
The government also provides grants for medical and nursing research and education
See Box 2-3.
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19. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Information
National Institutes of Health (NIH)
Centers for Disease Control and Prevention (CDC)
Health, United States
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20. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Policy Setting
USDHHS
Public Health Service sector
Bureau of Professions
Division of Nursing
Division of Dentistry
Division of Medicine
Federal legislation concerning health care is recorded and published in the Federal Register
See Table 2-1.
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21. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Policy Setting (cont.)
Federal law can mandate quarantine, and state laws can mandate specific health-related actions
Occupational health is regulated by the federal Occupational Safety and Health Act (OSHA)
Selective Service
Social Security benefits
Divorce, abortion, and custody laws
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

22. The Rising Costs of Health Care
The cost of health care in the United States has steadily increased in recent history and continues to rise.
Public health benefits (Medicare and Medicaid) were introduced, but increasing costs threaten their survival.
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

23. Health Care Delivery Systems
Managed care organizations (MCOs)
Health maintenance organizations (HMOs)
Preferred provider organizations (PPOs)
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

24. Private Health Insurance
Increasing health-care costs have led to higher premiums for membership in private health-care insurance plans
Prevention and early intervention seem to be the keys to reducing health-care costs and are the core of Healthy People 2020
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25. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Health-Care Reform 
Any effort to reform health care must involve:
Managing costs
Promoting access
Identifying payers
Two major worries include rationing care and limiting coverage for specific problems
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26. Resurgence of Self Care
Focus on illness prevention, early detection, and early intervention
Self care
Midwives
Lay practitioners
Hydrotherapy
Homeopathy
Dorothy Orem
Martha Rogers
Jean Watson
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27. Resurgence of Self Care (cont.)
Complementary and alternative medicine (CAM)
Outreach programs
Nursing education programs
Culturally competent care of a diverse population
Occupational health programs
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Global Health
United Nations (UN) was formed in 1945
Common goals, including:
Human rights
Peace
Economic and social advancement of all people
Meets annually with the World Health Organization (WHO)
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Future of Health Care
Federal legislation and funding
Political action committees (PACs)
Nurses
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.