If I were selected as the Special Advisor for Nursing/Healthcare issues, the healthcare tagline that I would advise the candidate to adopt for the campaign is “Affordability and Accessibility for All.” The top two priorities that I believe should be the focus of the healthcare platform are lowering prescription drug costs and expanding the primary care/nursing workforce. I would select the first priority because it is one of the areas of healthcare in which the United States lags furthest behind other industrialized nations, with per capita spending on prescription drugs over twice as high as the average for nineteen other industrialized nations (Kesselheim, Avorn, & Srpatwari, 2016). Moreover, prescription drug prices continue to rise, so the problem is only getting worse (Kesselheim et al., 2016). Politically, choosing this policy priority makes sense because it directly impacts a wide range of Americans. Also, there are clear, actionable steps that the government can take to address the problem (Kesselheim et al., 2017), so it would be a campaign promise that the candidate could feasibly keep.
I would choose to make expanding the primary care/nursing workforce the second policy priority because it addresses another imminent problem facing the United States. According to a 2017 study from the Association of American Medical Colleges, there will be a shortage of over a hundred thousand doctors by 2030, a trend that is driven by a combination of population growth, the aging of the Baby Boomer generation, retirements of healthcare providers, and expanded access to coverage as a result of the Affordable Care Act (Mann, 2017). For similar reasons, economists also predict a shortage of nursing care in the coming years (Snavely, 2016). While certain demographic groups, such as those living in rural areas, may be more directly affected by this issue in the short-term, it makes sense highlight this issue in the political conversation because it will start to affect even more Americans in the coming years. Also, from a political standpoint, it makes sense to discuss this issue because it can be tied to both healthcare outcomes and job creation.
I would evaluate the impact of the first priority on the nation’s health by monitoring the prescription drug market. Specifically, I would analyze whether the purchase of prescription drugs for relatively common conditions – such as hypertension, diabetes, and asthma – went up in the aftermath of the implementation of a policy to lower prescription drug prices. I would also monitor statistics on mortality due to medication-manageable conditions. To evaluate the impact of the second policy priority on the nation’s health, I would examine trends in the data on access to primary care services around the country, and I would compare data on the use of primary care services to data on the use of emergency care services. I would also examine the data to see if more Americans were utilizing preventive care services, which can significantly improve healthcare outcomes. Finally, I would watch to see if there is an increase in the diagnosis of chronic conditions that are currently going undiagnosed among Americans who do not have access to primary care.
These priorities can have important effects on the work of nurses, nurse practitioners, and nurse educators. In states where nurse practitioners have prescribing authority, they may have more options when it comes to recommending treatments for patients who face financial barriers. Nurses and nurse practitioners may also be less likely to work with patients whose health conditions have worsened because they could not afford a medication. The second policy priority will increase the demand for both nurses and nurse practitioners. Also, nurse practitioners may be more likely to find positions in primary care settings where they have the opportunity to fully utilize their advanced education. Finally, for nurse educators, the second policy will likely increase the workload, since class sizes will be large as more Americans get the education they need to fill the nursing shortage.
- Kesselheim, A.S., Avorn, J., & Sarpatwari, A. (2016). The high cost of prescription drugs in the United States: Origins and prospects for reform. JAMA, 316(8), 858-71.
- Mann, S. (2017). Research shows shortage of more than 100,000 doctors by 2030. Association of American Medical Colleges. Retrieved from https://news.aamc.org/medical-education/article/new-aamc-research-reaffirms-looming-physician-shor/
- Snavely, T.M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics, 34(2), 98-100.