Response 19423339

Peer 1  

Nurses should see themselves as practitioners with the opportunity and obligation to impact current and future delivery systems of health care to be successful. The practice of nursing is based on human health science and caring psychology. This works from a context that holistically respects all people and aims to encourage and advance the health of people throughout their lives and throughout all levels of society (Lesbian, Gay, Bisexual, and Transgender Health, n.d). 

A large number of the leading nursing associations encourage nurses to take part in the formulating of policies actively. For instance, the American Association of Colleges of Nursing underlines the job of nursing in strategy. It distinguishes, in its “Fundamentals” reports, the standard arrangement inclusion that ought to be tended to in instructive projects at the baccalaureate, master’s, and doctoral degrees of expert nursing. The National League for Nursing and the American Nurses Association additionally anticipate that medical caretakers should address the approach as a component of their expert job. Politically, nurses can play a significant role in influencing policies that influences the lives of lesbian, gay, bisexual, and transgender individuals (LGBT) (Burke, 2016). They include individuals from different ethnic and socioeconomic backgrounds, yet society has treated them as lesser beings. Nurses can influence policymaking concerning these groups in the following ways. 

Lobbying political leaders; Through unique knowledge of their constituents ‘ needs, city and county officials have the power to implement policies and programs that protect LGBTQ people, improve community engagement, and open opportunities (Burke, 2016). Nursing leaders can, therefore, lobby political leaders to pass policies that favor LGBT. 

Involvement in campaign groups; Many of these LGBT individuals face discrimination due to current policies in place. Nurses can join in their campaign and together fight for their rights. Sometimes, demonstrations are the only voice that the government hears and responds to. 

Volunteer to engage in conferences or activities related to strategy. Prepare a fact sheet and help prepare a document to educate policymakers. Inform stakeholders regarding events that provide incentives for policymakers to tackle. 

Conclusively, there is a need for changes to be effected on policies relating to LGBT rights to ensure they feel safe in society. As such, nurses should politically intervene with members of LGBT. They have the potential to have a profound global impact on politics. Nevertheless, it is nurses ‘ ethical and professional duty to intervene in policies they deem to be affecting their patients, LGBT notwithstanding. 

Peer 2 

Health policies impact health care and the nursing profession. The involvement of nurses in the development of health policy guarantees the provision of safe, accessible, high-quality and affordable care (Shariff, 2014). Nurses also have a role in patient advocacy. To this effect, they need to routinely consider the health needs of the LGBTQ community to eliminate any disparities in care and to improve the overall health of the general public. 

 

One political action that nurses can take to strengthen their role in policy-making is to take up internship or fellowship positions with nursing organizations that sponsor policy workshops (Aram, Rafii, Cheraghi, & Ghiyasvandian, 2014). During such workshops, nurses may get the opportunity to learn about contemporary health issues such as the needs of the LGBTQ community. With knowledge, nurses would be better placed to develop policy acumen which is the capacity to analyze policies. With policy acumen, nurses can effectively analyze health care services and direct their organizations to respond appropriately to the health needs of LGBTQ people. The development of policy acumen would thus be critical to nurses’ participation in policy-making. 

 

Nurses should also recognize the need for power as a driver for achieving goals in policy-making. Power would enable nurses to influence others inherently. Another plausible political action by nurses, therefore, would be to seek avenues and opportunities for the maximization of power (Aram et al., 2014). This may be achieved by the acquisition of adequate knowledge about health care issues. As such, nurses should engage in collaborative work with members of the LGBTQ community to gain knowledge about salient issues regarding the people. Such knowledge would ensure that nurses speak from a point of authority during policy-making deliberations. 

 

Another aspect of policy influence is advocacy. One of the most important mandates for nurses is to advocate for the rights of their patients. Achieving optimal advocacy would require nurses to take active roles in the political processes of their country. Through such involvement, nurses would be able to execute their advocacy roles more effectively. As patient advocates, nurses should ensure that everything in the healthcare system is centered on the delivery of patient-centered care (Aram et al., 2014). By enhancing their advocacy skills and capacities, nurses may be better placed to push for the perceived gaps in the health care of LGBTQ people. AACN MSN Essentials recognizes the need for a nurse to be able to provide intervention at the system level through policy development and the application of advocacy strategies to impact care (AANC, 2011). This third political action, therefore, would be in line with the requirements of nursing educations. 

Create a relevant response post with a minimum of 150 words that addresses peers’ initial posts regarding the specified discussion topic.  A rule of thumb for all DQ responses is the 3-3 rule; 3 paragraphs minimum, 3 sentences per paragraph minimum. Word document, double space. APA (6ht) 

This the original work if you needed 

Describe three political actions nurses could take to strengthen their role in policymaking as it relates to advocacy for improving LGBTQ health. Correlate your discussion to the AACN MSN Essentials, identify one that most pertains to this topic and elaborate on your selection. 

Attached below is additional information regarding providing adequate care for the LGBTQ community as outlined by Joint Commission and the CDC:  

Joint Commission & LGBTQ Community.pdf  

Lesbian, Gay, Bisexual and Transgender Health: https://www.cdc.gov/lgbthealth/ 

 
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Response 19408761

 
3 postsRe: Topic 1 DQ 2

Servant leadership is a type of leadership in which the main goal of the leader is to serve and place the needs and interests of their followers and organization over their own self-interest and needs (Greenleaf Center for Servant Leadership, 2016). “Servant leadership is a philosophy and set of practices that enriches the lives of individuals, builds better organizations, and ultimately creates a more just and caring world,” states the Greenleaf Institute for Servant Leadership. The phrase “servant leadership” was coined by Robert K. Greenleaf in The Servant as Leader and in his thesis he makes several strong statements including the philosophy that, “caring for persons, the more able and the less able serving each other, is the rock upon which a good society is built” (Greenleaf Center for Servant Leadership, 2016). This type of leadership style is set up to serve each member in the group. In a diverse workplace, this type of leadership would be beneficial in that it allows for personalized management and can help to establish cohesiveness in a team environment (Root, 2007). In other forms of management styles, the needs and visions of the company are often put ahead of the needs of the staff. In the servant leadership setting, all input and opinions are taken into consideration which helps to build loyalty from staff, can improve feelings of teamwork, and increase staff morale (Root, 2007). When employees are satisfied with their jobs and their company, workplace productivity tend to rise.

Transformational leaders work with their employees to implement change. This type of leadership involves creating a vision for followers and guiding changes through inspiration and motivation. This theory was developed by James Burins in the 1970s with the basic assumptions that, “Both leaders and followers have the ability to “raise each other to the highest levels of motivation and morality” (Marquis & Huston, 2017, p. 50).” (Grand Canyon University, 2018). “In Burns’ view, transformational leadership has the potential to motivate followers to satisfy higher-level needs, such as self-esteem and self-actualization. Those influenced by transformational leaders find meaning and value in their work, make significant contributions to the success of their employing organization, and become leaders’ themselves” (Rose O. Sherman, 2019). Transformational leaders use the following four elements when leading others; idealized influence, inspirational motivation, intellectual stimulation, and individual consideration. “Transformational leadership focuses on empowerment, viewing errors as learning opportunities, and valuing innovation which means staff members have a means of continually providing input about how to improve care. As a result, transformational leadership can revitalize healthcare from the point of patient care and more” (Rose O. Sherman, 2019). This can be a very powerful approach, but the visionary, big-picture aspect can distract the leader from the day-to-day tasks. It works best when the leader has a detail-oriented subordinate to keep him things grounded.

Grand Canyon University (Ed). (2018). Nursing leadership & management: Leading and serving. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leading-and-serving/v1.1/

Greenleaf Center for Servant Leadership. (2016). The Servant as a Leader. Retrieved from What is Servant Leadership: https://www.greenleaf.org/what-is-servant-leadership/

Root, G. N. (2007). The Advantages of the Servant Leadership Style. Retrieved from Leadership: https://smallbusiness.chron.com/advantages-servant-leadership-style-11693.html

 
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Response 19406509

 
3 postsRe: Topic 1 DQ 1

A manager is the member of an organization with the responsibility of carrying out the four important functions of management: planning, organizing, leading, and controlling. The managers may react to specific situations and more concerned with short term problem solving. Management is regarded as related to people working in a structured organization and with prescribed roles (R, Lopez. 2014).

A leader doesn’t have to be an authority figure in the organization and a leader can be anyone. The most important aim of a manager is to maximize the organizational output through managerial performance. But leader always seeks new possibilities and understand new possibilities in organization. Most of the workgroups are more loyal to leaders than managers (Essays, UK. 2018).

Leadership and management are interrelated, and they go hand in hand. They have same goals. For example, managing conflicts. At my work setting, if there is a situation or conflict between staff, it goes though the leaders who will work with the individual involved to manage a conflict and if it doesn’t solve than the leader takes to managers and they both work together to solve the issue .

Being a leader once must have a basic leadership skill. I will make sure I am knowledgeable, I am known how to do time management, I have a visionary sight for the benefits of the company and be able to motivate the team for their tasks.

Reference

Essays, UK. (November 2018). Relationship Between Management and Leadership Management Essay. Retrieved from https://www.ukessays.co

 
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Response 19406489

 
1 postsRe: Topic 1 DQ 2

This paper compares and contrasts two leadership theories: transformational and authentic leadership. In addition to this, the paper takes a look at the strengths and weaknesses of each of these two theories in relation to the nursing profession. To begin with, Sfantou et al. (2017) note in their article that the leadership style that is pursued by the leader is highly important, since it determines the nature of the relationship between an individual who is at the top of the organization (or heads the team) and his/her subordinates/followers. When it comes to transformational leaders, they are able to create strong relationships among team members, as well as motivation in the team (in general). Also, transformational leaders are known for improving worker commitment to goal attainment, as well as boosting overall performance on the institutional level (Asif et al., 2019).

What about authentic leaders? They align values with actions and are known for building transparent relationships with their followers (Carvalho et al., 2016). Also, authentic leaders create an environment where everybody feels respected and appreciated for his/her contribution, no matter how small or big (Nelson et al., 2014). If the two leadership styles were compared and the “best” one was chosen for addressing nursing issues, I would point to authentic leadership. Establishing trustful relationships is one of the pillars of a well-functioning nursing team. An authentic leader knows how to do this. Transformational leaders, on the other hand, are really result-oriented. However, in a nursing environment this can actually hinder the working process. For nurses, it is important to be transparent, trustful of their leader, and empathic. In my opinion, authentic leaders help to foster these qualities in their followers to a great extent. While both leadership styles are worthy of consideration, authentic leadership is the “better” version of the two.

References

Sfantou, D., et al. (2017). Importance of leadership style towards quality of care measures in healthcare settings. Retrieved from Healthcare, 5(4).

Asif, M., et al. (2019). Linking transformational leadership with nurse-assessed adverse patient outcomes and the quality of care. Retrieved from International Journal of Environmental Research and Public Health, 16(13).

 
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Response 19406463

 
1 postsRe: Topic 1 DQ 1

Describe the difference in roles between leadership and management.  

Leadership according to Whitney 2018 is the process of influencing people to accomplish a goal. Management on the other hand is the coordination and integrating of resources through planning, organizing coordinating, directing and controlling to accomplish specific institutional goals and objectives (Whitney ,2018). Leadership focus on people while management focus on the system and structure. leadership involves in the innovation whereas management focuses on administer. Managers cope with complexity whereas leadership cope with change. 

Explain how the goals of management and leadership overlap and provide one example.

  1. Exercise broad-perspective decision making.
  2. Communicate with followers.
  3. Motivates followers

As a nurse leader describe how you can facilitate change by taking advantage of this overlap.

 As a nurse leader by exercising broad perspective decision making, I will give opportunities for every sector in my facility to be part of the decision making so that when ideas comes from variety sector health promotion will be improved. Communication is a very big part in life .so as a nurse leader I will encourage every member of my team to be able to come to me and communicate what he or she want to be fixed or what he or she does not fine okay to them. Example if 2 nurses are fighting i want to make it in such a way that they can come to me and communicate it .Me as a nurse leader I will create a lot of incentives for my followers such as best employee of the month, littles words like thank you , having snacks for them ,having a day set aside for nurses to dress up and come to work . with all these motivations just to name a few, it will make my followers to love coming to work and they will practice effective care to their patients by so doing promoting health

 
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Response 2 19490191

Respond to your colleagues post by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.

at least 2 references in each peer responses!   

Registered nurses (RNs) and advanced practice registered nurses (APRNs) play a significant role in policy evaluation. Nurses represent the most substantial portion of the healthcare population (Milstead & Short, 2019). They possess the experience and expertise to positively affect quality improvement and efficiency when they are included as a member of policy and health care teams (Milstead & Short, 2019). RNs and APRNs can become involved in policy review on a local level, state level, or federal level (Milstead & Short, 2019). 

Members of the nursing profession can become involved in policy evaluation on a local level by joining a policy review committee at their place of employment. My current job offers incentives to Nurses that participate in the policy and procedures committees. RNs and APRNs can also become members of the policy board. This will allow them to evaluate policies and advocate for policy changes that improve the quality of care at their facility. Recently at my facility, a surge committee was assembled to redesign the surge policy and protocols. Multiple members of the healthcare team, including RNs and APRNs, participated and provided insight on working during a surge or sudden influx in patient flow. They were able to make suggestions that contributed to the new design for our surge policy at the facility. 

Another way RNs and APRNs can become involved in policy change on a large scale is to join an organization like the American Nurses Association (ANA). According to the ANA (2020), developing effective and useful policy is a core principle. Members of the ANA influence state and federal policymakers. The ANA provides expert information to lawmakers on policies (Milstead & Short, 2019). They assist with data collection and the evaluation of policies (Milstead & Short, 2019). According to Milstead and Short (2019), the process of policy evaluation is similar to the steps of the nursing process, making nurses a valuable asset to redesigning the healthcare system. Joining organizations like the ANA provides the opportunity for RNs and APRNs to lend their expertise to policy analysis. 

The cost will always be a challenge that must be considered when evaluating policy. Sometimes a solution that is recommended during the evaluation of a policy lands outside the budget. This is true on the local, state, and federal levels of policymaking. A cost-benefit analysis (CBA) can be conducted to overcome this challenge. A CBA compares the cost of a program or a policy with its benefits to select the most cost-effective and beneficial solution (Hwang, 2016). Some challenges that may occur when evaluating policy are out of the control of the evaluator, including the pace of policy change, issues with ethics, and political biases (Milstead & Short, 2019). For example, The ANA is known to support democratic candidates (Milstead & Short, 2019). This could decrease the value of the input provided by the ANA amongst policymakers that do not support the democratic agenda. 

References

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

American Nurses Association. (2019) Expert policy analysis. Retrieved https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/expert-policy-analysis/

Hwang, K. (2016). Cost-benefit analysis: its usage and critiques: CBA: its usage and critiques. Journal of Public Affairs (16) p.75-80. Retrieved https://www.researchgate.net/publication/274967779_Cost-benefit_analysis_its_usage_and_critiques_CBA_its_usage_and_critiques

 
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Response 2 19477435

 Respond to at least two of your colleagues* by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

  

Introduction

The demand for healthcare and the shortage of providers to offer this care, especially in geographically and economically challenged populations, has put a strain on healthcare availability. The Creating Opportunities Now for Necessary and Effective Care Technologies for Health (CONNECT) Act of 2019 looks to promote access through increased use of telehealth. 

What It Means

Currently, telehealth is limited by geography, billing and reimbursement, and provider restrictions. The CONNECT bill HR 4932, proposes removal of some or all of these stipulations to expand access to care. Specifically, the bill targets Medicare restrictions and lack of coverage to improve access to the elderly and disabled (Wicklund, 2019). 

The Evidence

The evidence to support telehealth expansion has been proven. As discussed by Totten et al., (2016) numerous studies have shown an increase in positive outcomes regarding patient/provider communication, education, and the management of chronic health conditions. Passing of this bill could provide a multitude of benefits to involved parties. 

First and foremost, it would improve access to care for those limited by age, disability, geography, or finances. Improved access to care promotes health prevention and decreases more costly care due to complications associated with delay of treatment. The expansion of telehealth could also reduce the strain placed on providers by the shortage. The bill looks to permit telehealth use by more providers and remove some of the travel and point of origin restrictions. Greater use of telehealth would also encourage better insurance coverage and reimbursement (H.R. 4932, 2019).

Conclusion

With all the changes in healthcare and the concerns over cost and accessibility, the need for legislation to address these issues cannot be ignored. The promotion of telehealth and removal of current restrictions could solve many of these dilemmas. As healthcare providers, we can continue to conduct the research and provide the evidence needed to advocate for legislative change to improve healthcare. 

 
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Response 2 19434783

I need a response for these 2 peers

Peer 1 

Societal justice and critical reflection are the fundamental concepts underlying community activism. The former refers to the unbiased distribution of resources for a prolific and fulfilling lifestyle (Reichlin et al., 2019). For instance, through campaigns and demonstrations, nurses, practitioners and the general community would be able to advocate the cause of providing adequate medical amenities.  

Critical reflection boosts one’s understanding of the resident community’s issues (such as inadequate staffing) as well as those of others across the globe. Through this approach, the management and staff members would be able to devise long-term resolutions that ensure adequate staffing in the present and future (Reichlin et al., 2019). For example, pursuing suitable programs at academic institutions can steer students in the direction of the healthcare industry.  

Paying attention and keeping up with the trends in the tobacco industry is vital. This effort helps the advanced practice nurses to engage in community activism for preventing the negative health impacts associated with Big Tobacco in their respective societies (Salmond & Echevarria, 2017). As a result, the nurses would be in a position to enlighten the community members on addictiveness and diseases (such as lung cancer) associated with the increased consumption of tobacco products.  

Organizing programs to campaign against smoking is an essential stratagem that would aid nurses in educating the public on why tobacco control policy measures such as higher taxes are needed to ensure reduced consumption. With this tactic, nurses could participate in community activism to curb any further ill effects arising from the use of Big Tobacco (Salmond & Echevarria, 2017). Moreover, holding seminars that counsel smokers and non-smokers, especially the youth, to remain vigilant against industry-instigated efforts would be essential in discouraging the consumption of tobacco products. 

Peer 2 

Through schooling, training, and knowledge learned along the way, Advanced Registered Nurse Practitioners (ARNPs) are equipped with the necessary skillset and tools to assist members of the community have improvement in their health outcomes. As key players in patient, ARNPs play a vital role in community activism to bridge the gap in healthcare disparities across different population groups and to improve the community. Maryland & Gonzalez (2012) asserts that the vast “amount of interactions that nurses have with patients leads to them personally witnessing the positives and negatives of the current healthcare system and consequently enable them to identify the needs of their patients by the care or the lack of it they receive.” Due to their first-hand interaction, nurses can advocate for their patients and their families and convey their experiences to the public and policymakers to bring about change in current health care policies (Maryland & Gonzalez, 2012).  

According to Messias (2019), community activism entails the key concepts of “community, social justice, raising consciousness, critical reflection, praxis, and empowerment of members of the community.” With each key concept comes certain actions on the part of the activist and subsequent delineations of certain orders of events. Nurse Practitioners can embody all the characteristics of community activism Messias asserts to promote the overall health status of the community. According to Messias (2019), community activism starts with an understanding of the community, in which individuals must realize that they are part of a larger group and share common interests in order to catalyze change. Praxis entails the process of ideas and theories being made and actualized, which consequently brings about unification—or division—of members of the community. Praxis affects the practices and customs of members of the community and affect the interaction of these individuals. With social justice, the way individuals perceive justice and what is right or wrong, affects the justice system and what behaviors are viewed as deviant in the community.  

Raising consciousness and empowerment of members of the community are vital to altering the status quo hopefully for the better but negative impacts can ensue. Teaching members of the community that they have rights can empower them to develop or defend them against lawmakers. Shining light on certain issues, such as through protest and petition with local or federal elected officials can bring about necessary changes in the management of certain disease plaguing the community (Mason, Gardner, Outlaw, & O’Grady, 2016). Empowerment is the ultimate goal (Mason et al., 2016) as by doing so individuals in the community will do what is necessary to improve their health on a holistic level.  

Maryland & Gonzalez (2012) argues that nurses can make significant influence in community activism on a multilevel approach. Maryland & Gonzalez (2012) asserts that school nurses can attend school board meetings to voice their personal viewpoint of the ramifications of inadequate staffing to monitor the health of school children. They are only equipped with the knowledge to voice this opinion because of their personal experience with performing their duties of providing basic healthcare to their patients (in this case, school children). My daughter is a third grader at a local elementary school. In a school of more than 800 students, there is only one nurse. Imagine how difficult it is to provide care to these students during the cold and flu season or any ordinary day for that matter. This stresses the importance of community activism by nurses and advanced practice nurses. The level of care they provide to their patient population is affected by factors in the community so who is best to make the issues known and advocate for and against them but nurses? Nurses, through their inimitable experience with their patients, can bring to the forefront issues that affect their patient and the community. Policymakers should hold the voice of nurses in high-esteem prior to making any changes that will affect individuals of a community.  

From a community activism approach, ARNPS can mitigate further negative health impacts from Big Tobacco by bringing social awareness and consciousness to the issue. Letting members of the community become aware or reminded of the ramifications of smoking cigarettes or consuming other tobacco products will greatly decrease the number of individuals in the community that smoke or will smoke. Health fairs broadcasting posters of individuals with lung cancer or tracheostomies from cigarette smoking or oral cancers from chewing tobacco are one of the ways that ARNPS can use community activism to help manage the negative impact of Big Tobacco. On each healthcare visits, ARNPs need to assess if their patients smoke and make them aware of the ramifications in addition to offer smoking cessation counseling and education. Empowerment is necessary to help individuals in the community to stop because many of them have been smoking since childhood. Smoking is also a way that many of these individuals cope and manage stress. Offering them alternative coping measures is crucial to getting them to stop smoking. Educating the community of the long-term risk of smoking, the consumption, and second-hand smoking, is vital to deterring the use of tobacco and promoting the overall health of the community. Mason et al. (2016) states that tobacco usage and exposure is the foremost cause of preventable death in the nation. This statement alone will serve to remind individuals of the negative consequences of smoking and will lead to many of them quitting. 

To conclude, advanced practice nurses play a rather significant role in patient advocacy to improve the health outcomes of their patients. Nurses can employ various teaching methodologies to assist their patients improve their overall health. Tackling issues at the community level can help nurses being awareness to issues that directly and indirectly affect patients. Bringing awareness to certain issues, such as the negative influence of Big Tobacco on the overall health of individuals in a community, are one of the many ways that ARNPS can help ameliorate the health status of the community. The ARNP can collaborate with other members of the interdisciplinary team and elected officials to maximize the impact of decreasing negative health issues in the community. 

Response posts must be minimum 100 words each. Word document, double space. APA (6th) 

This the original work if you needed 

Describe the key concepts underlying community activism and give examples of how each of these concepts applies to a specific context. Examine how advanced practice nurses can engage in community activism to limit further negative health impacts from Big Tobacco in their respective health communities. 

Attached below is an additional resource, an article, that details various ways by which nursing professionals can engage in community activism. 

Patient Advocacy and in the Community and Legislative Arena: http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Advocacy-in-Community-and-Legislative-Arena.html?css=print 

 
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Response 2 19339909

In your responses to your 2 peers, what additional resources can you share that will help you and your fellow classmates be successful? What commonalities do you share with your classmates? What opportunities can you explore for collaboration and peer support?

Please respond to both peers individually.

Both peers reponse is attached below.

 
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Response Dq2

 

 Respond one of your colleagues’ posts by offering a possible resolution to their  questions/concerns with supporting documentation.  

at least 2 references in each peer responses

  

           A cost-benefit analysis is an estimate that analyzes the cost and benefit of a policy or project to evaluate its worth (Hwang, 2016). For lawmakers, the value of a political decision is measured by votes gained compared to votes loss. The fear of being voted out of office definitely played a role in derailing the efforts to repeal and replace the Affordable Care Act (ACA). The pushed to repeal and replace ACA begin to heat up after President Trump was sworn into office as a part of his campaign promise. Many Americans are divided on the issue, with the growing majority against the repeal and replace proposal (Milstead & Short, 2019). The divide creates a challenging decision for politicians hoping to get reelected in the battleground states. The problem arises because no political spin can deny that more people are covered since the passing of ACA, and the repeal of ACA would cause millions of Americans to lose coverage (Grogan, 2017). 

The decision made by legislative leaders are affected by the views of the voters if it poses a threat to the leaders reelection. While having control of both houses in congress republicans were still leary about voting on issues that impacted Medicaid and Medicare (Mistead and Short, 2019). The issue of healthcare is one that exposes all the tricks and tactics that make up politics. The proceed with caution mood looming over political decisions related to healthcare indicate that politicians care more about being reelected than the issue itself (Mistead and Short, 2019). It is a logical strategy. Elected officials have all made the claim that their purpose is to represent the people. Legislative leaders are so worried about the blow back from a decision affect their reelection that it was even suggested that they should repeal ACA symbolically without actually changing anything (Leonard, 2017). 

The cost-benefit analysis was originally a political tactic used to discredit regulatory programs (Sinden, 2019). According to Sinden (2019), the cost of implementing project would be inflated over the value of the benefit to devalue the benefit of the regulation. According to Cole (2012), CBAs are subjective, and the value human lives can easily be manipulated and discounted to promote or denounce regulations. In the case of our legislative leaders, the vote is more valuable than a human life. 

 
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