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Brennan 

YesterdayDec 13 at 12:54am

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Initial Post

 

Voter’s Choice

As a legislator, your position and continued position as such, depends on the votes of the American people. A legislator must please the people when creating policies in order to be considered for re-election. These decisions consist of but not limited to, “creating laws, making decisions on war, and taking control of taxes” (Branches of Government | House.gov, n.d.). When the president proposes a new law, the legislators must consider the votes of the American people. Even if the legislator personally agrees with the proposed law, how the American people feel outweighs the personal feelings of the legislator. For example, Donald Trump attempted to amend the Affordable Care Act (ACA) in many ways, including “reducing outreach and opportunities for enrollment in the ACA’s insurance exchanges, and discouraging legal aliens from enrolling in Medicaid” (Thompson, 2020). While there could be benefits to this, the legislators agreed that the risks outweighed the benefits, and that the new policy by Trump was a bad decision. Due to the bad decision, legislators couldn’t afford to not be re-elected.

The Customer is Always Right

It seems as if the majority of the colleagues in this course are from Alabama, and everyone knows football is a big deal in Alabama. So, think of it from a sports analogy. The football players are part of the team, but so is the head coach. If the quarterback (president) is constructing plays (policies) that are costing the team a victory (cost efficient lifestyle) and jeopardizing the support from the fans (American people), then the coach (legislators) must decide—do we reject these plays (policies) or do we allow these plays to pass and risk not being re-elected (fired as the coach). Many people were against the idea to replace the ACA due to “premium costs, and it being non-beneficial to individuals with pre-existing conditions” (Center on Budget and Policy Priorities, 2021).

So due to these factors, the legislators will listen to the American people, abide by the votes of the people, and either reject or pass policies based on the votes of the American people. If the American people are happy, they will continue to vote for the legislators to be re-elected.

 

References

 

ACA survives legal challenge, protecting coverage for tens of millions. (2021). Center on Budget and Policy Priorities. https://www.cbpp.org/research/health/suit-challenging-aca-legally-suspect-but-threatens-loss-of-coverage-for-millionsLinks to an external site.

 

 

Branches of Government | House.gov. (n.d.). https://www.house.gov/the-house-explained/branches-of-government#:~:text=The%20legislative%20branch%20is%20made,controls%20taxing%20and%20spending%20policiesLinks to an external site..

 

 

Thomson, F. (2022, March 9). Six ways Trump has sabotaged the Affordable Care Act | Brookings.. Brookings. https://www.brookings.edu/articles/six-ways-trump-has-sabotaged-the-affordable-care-act/Links to an external site.

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ReplyReply to Week 3: Discussion

  • Collapse SubdiscussionHillary St JamesHillary St JamesMondayDec 11 at 7:18pmManage Discussion EntryInitial PostHow does the cost-benefit analysis in terms of Legislator being re-elected affect efforts to repeal/replace the ACAIt is a common assumption that a politician’s role is to promote and uphold the public good through representing the people, however, that is not always what happens. In fact, the good of the country is secondary to a politician’s main goal, which is re-election or to stay in power (Feldstein, 2006). With the knowledge that a legislator is functioning under the constant question of re-election it is no wonder that their actions are not always aligned with what is best for society at large. Instead, legislators are frequently pandering to different interest groups in the hope of garnering support for their re-election efforts, whether in terms of endorsement or financial backing. I like how it is said in the book, Health Policy and Politics, “In a world where re-election is a key consideration and media are a relentless presence, [the cost-benefit analysis] means the best solution may not ultimately be the path chosen” (Milstead & Short, 2019, p51). It is arguable whether most politicians care about what is best for this country or their constituents but regardless of what they want politicians must consider what is best for their re-election. In most cases what is best for re-election is public opinion and financing to go towards improving public opinion. As a result, politicians must consider the desires of their campaign contributors.In relation to the Affordable Care Act the cost-benefit analysis of the legislators has changed over time. It has been widely speculated that the initial overwhelming push back on the affordable care act by republican legislators had more to do with opposing democrats and specifically President Obama then any real distain for the bill itself. However, in the years immediately following the ACA being passed a combination of factors lead to republican legislators presenting as anti-ACA. These factors include public opinion on the affordable care act, lobbyists spending or withholding funds and the encroachment of other political topics on the public radar. In the first few years after the affordable care act was passed the Koch brothers spent over $400 Million dollars in television advertisements attacking the bill (Benen, 2013). According to a study done on the opposition of the affordable care act in 2015, these advertisements had a major impact on Americans views of the ACA and with more than “60% of Americans stating that most of what they know about the ACA came from TV” it’s not hard to see why it would have such an effect (Dalen, Waterbrook & Alpert, 2015). With the Affordable Care act incredibly unpopular with the American people during the elections following its enactment it was in the Republican legislator’s best interest to also oppose the act. However, over the last decade public opinion has changed and a recent KFF poll showed that over 60% of the American public now has favorable feelings about the affordable care act (KFF, 2023). Public opinion was greatly influenced by the advertising campaigns paid for by lobbyist groups like the National Federation of independent Businesses and those of the Koch brothers; Americans for Prosperity and Freedom Partners. These groups also donate to legislators whose actions align with the group’s goals. In 2012, the National Federation of independent Businesses sued against the Affordable Care Act citing a violation of the constitution (McFadden, 2021). Powerful groups took an anti-ACA stance and legislators did not want to risk opposing said groups, which might have resulted in loss of funding. As the first suit against the affordable care act and then the second was struck down by the supreme court the pressure changed from repeal to replace. However, this too came with another cost-benefit analysis road bump for Republican legislators as the Koch brothers’ groups, Americans for Prosperity and Freedom Partners also opposed the Republican backed Americans Health Care Act going as far as to offer money to republican legislators who would go against their party on the vote (McFadden, 2021). This was a contributing factor to why the American Health Care Act was not passed. But the ultimate blow came from Sen. John McCain who cast the deciding vote against the bill. Sen. McCain had a history of supporting healthcare reform that ran in contrary to his fellow republicans, although he strongly disagreed with the ACA, in the end he voted with his convictions against the AHCA (Huetteman, 2018). Many have questioned his actions and I wonder in the context of cost-benefit analysis if he found the cost to compromise his morals and the standards to which he held his party too high. That in combination with the fact that he was not running for re-election may have had a significant influence on his cost-benefit analysis for his vote.How does voter analysis affect legislators recommending national policyVoter analysis can take on a couple different meanings. The media most frequently uses polls and surveys that look at who people are most likely to vote for in an upcoming election. Other ways to conduct voter analysis consist of surveys or polls on topics or on demographics. Polling is an expansive industry and not all polls are created equal, with barriers to polling practically nonexistent due to access to technology and the ability for anyone to publish polls with enough money, it is increasingly important to identify polls that consider representation, sample size, methods, and approaches (Kennedy, 2020). One type of voter analysis that affects legislators recommending national policy is the analysis of topics or issues, such as the KFF poll in relation to the public opinion of the Affordable Care Act, mentioned above. Another type of voter analysis that might affect legislators recommending national policy is the analysis of who votes in each district by demographic because legislators will be concerned with pleasing their constituents, not the country at large. Lovett (2022) identifies three main motivations for voters; group identity, issues, and expected performance of each candidate. Knowing these factors for the population in each voting district can affect how legislators vote as they strive to remain in office. Votes are contingency shapes behaviors for the general public and the legislators, however, only the legislators’ votes are public and have direct consequences on their jobs (Scibak, 2023). It is the role of the legislators to have influence in the government, make good public policy and get re-elected to accomplish these tasks they must be attuned to the voters, this can be accomplished in part through voter analysis.ReferencesBenen, S. (2013). Explaining healthcare to the Koch brothers. NBC News. Explaining health care to the Koch brothers (nbcnews.com)Links to an external site.Dalen, J. E., Waterbrook, K., & Alpert, J. S. (2015). Why do so many Americans oppose the Affordable Care Act?. The American journal of medicine, 128(8), 807–810. https://doi.org/10.1016/j.amjmed.2015.01.032Links to an external site.Feldstein, P. (2006). The politics of health legislation: An economic perspective (3rd ed.) Chicago, Il: Health Administration Press.Huetteman, E. (2018, August 26). McCain’s complicated health care legacy: He hated the ACA he also saved it. PBS News Hour. https://www.pbs.org/newshour/health/mccains-complicated-health-care-legacy-he-hated-the-aca-he-also-saved-itKennedy, C. (2020, August 5). Key things to know about election polling in the United States. Pew Research Center. https://www.pewresearch.org/short-reads/2020/08/05/key-things-to-know-about-election-polling-in-the-united-states/KFF. (2023). KFF Health tracking poll: The public’s views on the ACA. KFF. KFF Health Tracking Poll: The Public’s Views on the ACA | KFFLinks to an external site.Lovett, A. (2022, March 28). Voter motivation. Journal of Ethics & Social Philosophy. Vol 22 No 3 (2022): Volume XXI, issue 3. https://jesp.org/index.php/jesp/article/view/1255Links to an external site.McFadden, A. (2021, June 23). The long, costly battle over Obamacare might be over. OpenSecrets. https://www.opensecrets.org/news/2021/06/costly-battle-obamacare-over/Links to an external site.Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed., pp51). Jones & Bartlett Learning.Scibal, J.W. (2023, November 20). An Analysis of voting and legislative behavior. Behavioral Analysis in Practice. https://doi.org/10.1007/s40617-023-00875-0

legislation grid

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LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

RESOURCES

 

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

To Prepare:

·       Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)

Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.

Part 1: Legislation Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:

·       Determine the legislative intent of the bill you have reviewed.

·       Identify the proponents/opponents of the bill.

·       Identify the target populations addressed by the bill.

·       Where in the process is the bill currently? Is it in hearings or committees?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

·       Advocate a position for the bill you selected and write testimony in support of your position.

·       Explain how the social determinants of income, age, education, or gender affect this legislation.

·       Describe how you would address the opponent to your position. Be specific and provide examples.

·       At least 2 outside resources and 2-3 course specific resources are used.

BY DAY 7 OF WEEK 4

Submit your completed legislation grid and testimony/advocacy statement.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area. 

  1. To submit your completed assignment, save your Assignment as WK4Assgn+LastName+Firstinitial
  2. Then, click on Start Assignment near the top of the page.
  3. Next, click on Upload File and select Submit Assignment for review.

 

Rubric

NURS_6050_Module02_Week04_Assignment_Rubric

NURS_6050_Module02_Week04_Assignment_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeFederal and State LegislationPart 1: Legislation GridBased on the health- related bill you selected, complete the Legislation Grid Template. Be sure to address the following:• Determine the legislative intent of the bill you have reviewed.• Identify the proponents/opponents of the bill.• Identify the target populations addressed by the bill.• Where in the process is the bill currently? Is it in hearings or committees?

35 to >31.0 pts

Excellent

The response clearly and accurately summarizes in detail the legislative intent of the health- related bill. …The response accurately identifies in detail the proponents and opponents of the health-related bill. …The response accurately identifies in detail the populations targeted by the health-related bill. …The response clearly and thoroughly describes in detail the current status of the health- related bill.

31 to >27.0 pts

Good

The response accurately summarizes the legislative intent of the health-related bill. …The response accurately identifies the proponents and opponents of the health-related bill. …The response accurately identifies the populations targeted by the health-related bill. …The response accurately describes the current status of the health-related bill.

27 to >24.0 pts

Fair

The response vaguely or inaccurately summarizes the legislative intent of the health-related bill. …The response vaguely or inaccurately identifies the proponents and opponents of the health-related bill. …The response vaguely or inaccurately identifies the populations targeted by the health-related bill. …The response vaguely or inaccurately describes the current status of the health-related bill.

24 to >0 pts

Poor

Summary of the legislative intent of the health-related bill is vague and inaccurate or is missing. …Identification of the proponents and opponents of the health-related bill are vague and inaccurate or is missing. …Identification of the populations targeted by the health-related bill is vague and inaccurate or is missing. …The description of the current status of the health- related bill is vague and inaccurate or is missing.

35 pts

This criterion is linked to a Learning OutcomePart 2: Legislation Testimony/Advocacy Statement• Advocate a position for the bill you selected and write testimony in support of your position.• Explain how the social determinants of income, age, education, or gender affect this legislation.• Describe how you would address the opponent to your position. Be specific and provide examples.

40 to >35.0 pts

Excellent

Testimony clearly, accurately, and thoroughly provides statements that fully justifies a position for a health-related bill…. Response provides a detailed, thorough, and logical explanation of the social determinant affecting the topic, and how to address opponents to the position for the health-related bill and includes one or more clear and accurate supporting examples.

35 to >31.0 pts

Good

Testimony clearly and accurately provides statements that somewhat justifies a position for a health-related bill. …Response provides an accurate explanation of the social determinant affecting the topic, and how to address opponents to the position for the health-related bill and may include at least one supporting example.

31 to >27.0 pts

Fair

Testimony used to justify a position for a health-related bill is vague or inaccurate. …Explanation of how to address the opponents and social determinant for the position for the health-related bill is vague or inaccurate, lacks logic, and/or the supporting examples are vague or inaccurate.

27 to >0 pts

Poor

Testimony used to justify a position for a health-related bill is vague and inaccurate, incomplete, or is missing. …Explanation of how to address the opponents and social determinant for the position for the health-related bill is vague and inaccurate or is missing.

40 pts

This criterion is linked to a Learning OutcomeReferences

10 to >8.0 pts

Excellent

Response includes 3 or more course resources and 2 or more outside sources.

8 to >7.0 pts

Good

Response includes 2-3 course resources and 2 outside sources.

7 to >6.0 pts

Fair

Response includes fewer than 2 course resources and/or fewer than 2 outside resources.

6 to >0 pts

Poor

Response includes 2 or fewer resources.

10 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and OrganizationParagraphs make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas.Sentences are carefully focused– neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. …Purpose, introduction, and conclusion of the assignment is incomplete or missing.

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting: English Writing StandardsCorrect grammar, mechanics, and proper punctuation.

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1-2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3-4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The paper follows correct APA format for title page, font, spacing, indentations, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1-2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3-4) APA format errors.

2 to >0 pts

Poor

Contains many (≥5) APA format errors.

 

Required Readings

·       Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.

o   Chapter 3, “Government Response: Legislation” (pp. 37–56)

o   Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 180–183 only)

·       Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

·       Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350Links to an external site..

·       United States House of RepresentativesLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.house.gov/

·       United States SenateLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.senate.gov/

·       United States Senate. (n.d.). Senate organization chart for the 117th CongressLinks to an external site..  https://www.senate.gov/reference/org_chart.htm

·       

·       Document: Legislation Grid Template (Word document)

Library

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USING THE WALDEN LIBRARY

Where can you find evidence to inform your thoughts and scholarly writing? Throughout your degree program, you will use research literature to explore ideas, guide your thinking, and gain new insights. As you search the research literature, it is important to use resources that are peer-reviewed and from scholarly journals. You may already have some favorite online resources and databases that you use or have found useful in the past. For this Discussion, you explore databases available through the Walden Library.

Note: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are required to participate in the Discussion on at least three different days (a different day for main post and each response). It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner.

 

RESOURCES

 

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

To Prepare:

·       Review the information presented in the Learning Resources for using the Walden Library, searching the databases, and evaluating online resources.

·       Begin searching for a peer-reviewed article that pertains to your practice area and interests you.

BY DAY 3 OF WEEK 4

Post the following:

Using proper APA formatting, cite the peer-reviewed article you selected that pertains to your practice area and is of particular interest to you and identify the database that you used to search for the article. Explain any difficulties you experienced while searching for this article. Would this database be useful to your colleagues? Explain why or why not. Would you recommend this database? Explain why or why not.

BY DAY 6 OF WEEK 4

Respond to at least two of your colleagues’ posts by offering suggestions/strategies for working with this database from your own experience, or offering ideas for using alternative resources.

LEARNING RESOURCES

Required Readings

·       Al-Jundi, A., & Sakka, S. (2017).Critical appraisal of clinical researchLinks to an external site.. Journal of Clinical and Diagnostic Research: JCDR, 11(5), JE01–JE05. https://doi.org/10.7860/JCDR/2017/26047.9942

·       Shellenbarger, T. (2016). Simplifying synthesisLinks to an external site.. Nurse Author & Editor, 26(3). Retrieved from http://naepub.com/reporting-research/2016-26-3-3/ 

·       Walden University Library. (n.d.). Databases A-Z: NursingLinks to an external site.. Retrieved October 4, 2019 from https://academicguides.waldenu.edu/az.php?s=19981

·       Walden University Library. (n.d.). Evaluating resources: JournalsLinks to an external site.. Retrieved October 4, 2019, from https://academicguides.waldenu.edu/library/evaluating/resource-types/journals

·       Walden University Library. (n.d.). Instructional media: Fundamentals of library researchLinks to an external site.. Retrieved October 4, 2019 from https://academicguides.waldenu.edu/library/instructionalmedia/researchfundamentals

·       Walden University Writing Center.Links to an external site. (n.d.). Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/home

·       Walden University Writing Center. (n.d.). Common assignments: Synthesizing your sourcesLinks to an external site.. https://academicguides.waldenu.edu/writingcenter/assignments/literaturereview/synthesizing

·       Walden University Writing Center. (n.d.). Scholarly writing: OverviewLinks to an external site.. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/scholarly

·       Walden University Writing Center. (n.d.). Webinars: Technical informationLinks to an external site.. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter/webinars/technical

·       Document:Academic Success and Professional Development Plan TemplateDownload Academic Success and Professional Development Plan Template(Word document)

·       Document:Introduction to Scholarly Writing: Tips for successDownload Introduction to Scholarly Writing: Tips for success(PDF)