Healthcare Policy Case Study

Claudette D. JohnsonGrand Canyon University

NUR-508May 30, 2012

_________ _____ ____Affordable Health Care

Act

Objectives

Present the background of a policymaker and explain advocacy for a cause

An outline of governmental efforts to address healthcare issues from a local level

Review of efforts- past, present and future health reform direction

Explain struggles and barrier in policy making

Meet Senator Carole Pankau (R)23rd District Minority Caucus

Whip

BackgroundService

Experience

Du Page County Board

member

Republican Committeem

an

Republican Committeem

an

Community

ExperienceChambers of Commerce

Illinois Federation of Republican

Women

Republican women’s

Club

National Order of Women

Legislators

Senate Experien

ce

Public Health Minority

Spokesperson

Appropriations III

Environment & Energy

Labor & Revenue

(Carol Pankau, 2008-2012)

Policy Maker SkillsAbility to listen & truly understandKeep open mind, hear without judgmentDeal with ambiguity & complex issuesBelieve that sharing challenges and asking for input

is more important than personally providing solutions

Be clear on goals, directing without orderingBe a servant, helper, & teacher first, leader secondThink before reactingChoose words not to damage those being ledAbility to use foresight & intuitionSeeing things whole and sensing relationships and

connections (Marquis & Huston, 2008)

Impact in Politics

Illinois State Senator

Illinois State Representati

ve

Senate Committee of the

Whole; Public Health (Minority Spokesperson);

Appropriations III; Environment

and Energy; Labor; Revenue

(Carol Pankau, 2008-2012)

Medicaid

Eligibility & Benefits

Cost Sharing & Waivers

Long-Term Services & Supports

Outreach & Enrollment

Quality of Care

Health Policy Story

Reforming state’s Medicaid system

Establishment of various benchmarks for quality, care and finances as required by providers to meet reimbursement requirement

Requiring applicants to meet residency standards.

Create a newer system of income for Medicaid eligibility

Medicaid

Expand Coverage

Hold Insurance Companie

s Accounta

ble

Lower Healthcar

e cost

Guarantee more

choices

Enhance the

quality of care for

all American

s

The Affordable Care Act

(United States Department of Health & Human Services, 2012)

Recent Efforts

• Encourage Integrating Health systems

• January 2012

Improving quality &

lowering costs

• Help identify & reduce disparities

• March 2012

Understanding & Fighting

Health Disparities

• Defining eligibility & enrollment policies

• March 2012

Framework for Affordable care Act

(United States Department of Health & Human Services, 2012)

2013 Future Efforts

Increasing Medicaid

payments for primary care

doctors

Expanded Authority to

Bundle Payments

Additional Funding for

(CHIP)

(United States Department of Health & Human Services, 2012)

2014 Future EffortsNo

Discrimination Due to Pre-

Existing Conditions or

GenderEliminating

Annual Limits on Insurance

Coverage

Increasing Small Business

Health Insurance Tax

Credit

Ensuring Coverage for Individuals

Participating in Clinical Trials

Paying Physicians

Based on Value Not Volume

Increasing Small Business

Health Insurance Tax

Credit

Ensuring Free Choice

Promoting Individual

Responsibility

Increasing Access to Medicaid

(United States Department of Health & Human Services, 2012)

2015 Future efforts

Paying Physicians Based on Value Not Volume

(United States Department of Health & Human Services, 2012)

Theories

The Interest-Group

Theory of Government

Overcoming behavior for public good-

trade-offs

impact of regulation

and government

on the allocation of

resources

to make trade-offs among a variety of interests

social costs of rent

seeking - lobbying

Challenges/Obstacles in Policymaking

Trying to align different

ideas with the goal of the

policy

Culture and change colliding

Conflict between

morals, ideals and

( Carole Pankau, May 1, 2012)

Policy MakingIs a negotiating process

http://www.cartoonstock.com/directory/m/mentor.asp

We seek not to lead but to serve first and find that in serving, our greatest

influence is leading.

Benjamin Lichtenwalner

Conclusion

References

Abood, S. (2007, January). Influencing healthcare in the legislative arena. OJIN: The Online Journal of Issues in Nursing.

12(1). doi: 10.3912/OJIN.Vol12No01Man12. Retrieved from

http://www.nursingworld.org/ManMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Tableof

contents/Volume122007/No1IJAN07/tpc32_216091.aspx

Carol Pankau (2008-2012). Carol Pankau, State Senator 23rd District. Terrain Tribune Inc. Retrieved from

http://www.pankau.senategop.org/

Centers for Medicare & Medicaid Services. (2012). Keeping America Healthy. Medicaid.gov. Retrieved from

http://www.medicaid.gov/AffordableCareAct/Provisions/Eligibility.htm

Hakala, D. (2008, March 19). The top 10 leadership qualities. HR World. Retrieved from

http://www.hrworld.com/features/top-10-leadership- qualities-031908/

Illinois General Assembly. (2012). Carole Pankau. Retrieved from http://www.ilga.gov/senate/Senator.asp?MemberID=1299

Jooste, K. (2004). Leadership: a new perspective. Journal of Nursing Management, 12(3), 217-223. Retrieved from

http://angel02.gcu.edu/section/default.asp?id=704017

References

Lichtenwalner, B. (2010, November). The modern servant leader: Servant leadership manifesto. Leadership and

Technology. Retrieved from http://modernservantleader.com/servant-leadership/servant-leadership-manifesto/

Marquis, B. L. & Huston, C. J. (2009). Leadership roles and management functions in nursing: Theory and application (6th

ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.

Tollison, R. D. (1991). Regulation and Interest Groups. The Locke Institute Journal. Retrieved from

http://www.thelockeinstitute.org/journals/luminary_v1_n1_p4.html

United States Department of Health & Human Services. (2012, May). Take health care into your own hands. Retrieved from

http://www.healthcare.gov/law/timeline/index.html