NURS – 6050N Discussion Paper

We use APA 7th edition Presidential Agendas Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items. Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently? To Prepare: • Review the Resources and reflect on the importance of agenda setting. • Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities. By Day 3 of Week 1 Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently? Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning. • Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. 11–13 only) • Chapter 2, “Agenda Setting: What Rises to a Policymaker’s Attention?” (pp. 17–36) • Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 171–180) • Chapter 12, “An Insider’s Guide to Engaging in Policy Activities” o “Creating a Fact Sheet” (pp. 217-221)NURS – 6050N Discussion Paper

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Nurses comprise the majority of healthcare providers in the US health workforce. They spend most of their time working with individuals and families in clinical, or community settings. As highlighted by Milstead & Short (2019), since nurses have a better understanding of the issues that affect the health and wellbeing of individuals, families, and communities they can apply this knowledge to influence population health through health policy. Having worked as an emergency nurse at some point during my nursing career, an important health issue addressed by different stakeholders at the presidential level is the Opioid Crisis, which caused resulted in thousands of opioid-related deaths due to the abuse and misuse of prescription opioids. Nurses play a huge role in addressing the opioid crisis through prevention, health education, management, and health policy (Milstead & Short, 2019).  They educate, prescribe, and dispense drugs as well as give physical and mental support and care to individuals diagnosed with opioid use disorders and related consequences.NURS – 6050N Discussion Paper

President Trump

In the year 2017, President Trump declared the opioid epidemic an emergency.  He acknowledged the occurrence of close to 64,000 drug-related deaths in the year 2016, the highest in American history, and more than three quarters were related to opioid use (McCarty, Priest & Korthuis, 2018). He oversaw the formation of the Commission on Combating Drug Addiction and the Opioid Crisis under the leadership of Christ Christie, governor of New Jersey. This commission promoted the formation of the Support Act to restrict providers’ ability to write narcotic prescriptions (Christie et al., 2017).

Today, relevant stakeholders monitor narcotic prescriptions electronically and this limits the patient’s ability to obtain multiple prescriptions from different healthcare providers. Besides, Trump signed the INTERDICT (International Narcotics Trafficking Emergency Response by Detecting Incoming Contraband with Technology) which ensures tight control and prevents the transportation of illegal drugs. The author feels that President Trump’s approach to addressing the Opioid crisis was the best since it focused on a five-point strategic approach namely: prevention, treatment, recovery, research, and advanced practice. However, it would be important to implement stricter measures that would promote adherence to the Support Act.

President Obama

President Obama focused more on improving population access to care to ensure that individuals, families, and communities could access healthcare services easily trough the Affordable Care Act popularly known as Obamacare (Meinhofer & Witman, 2018). In the year 2010, he also signed the FSA (Fair Sentencing Act) into law to ensure that people who committed crimes with different drugs received different sentences. In the year 2016, he signed the CARA (Comprehensive Addiction and Recovery Act) in 2016 into law to promote the availability of naloxone in addressing the opioid crisis. However, the author feels that President Obama’s health Agenda failed to address the Opioid crisis more effectively.

Although promoting universal health coverage for both resource-rich and resource-limited settings was a good effort, he could focus more on both primary, secondary and tertiary health prevention resources to reduce opioid use and abuse (Meinhofer & Witman, 2018). In his position, the author would primarily focus on implementing rehabilitative services and increasing the effectiveness of PDMPs (Prescription Drug Monitoring Programs) to promote reliable PDMP profiles, real-time availability of data, and easily identify patients who falsify information or lie to the prescriber.NURS – 6050N Discussion Paper

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President George Bush

The opioid crisis began during the administration of President Bush and he used a more proactive than active approach to address the crisis. President Bush used more of a legal approach to punishing drug-related crimes at a period when the illegal drug market in the US flourished. In collaboration with the relevant stakeholders, President Bush focused more on developing budgets for law enforcement, allocating resources and funds to law enforcement agencies and officers, and enrolling drug offenders for either imprisonment or rehabilitation since addiction was perceived to be more of a  punishable crime rather than a public health issue. In his position, the author would have focused on both legal and health approaches. As suggested by McCarty, Priest & Korthuis (2018), the health approach would include strategies to manage, rehabilitate, and monitor the use of prescription opioids. NURS – 6050N Discussion Paper

References

Christie, C., Baker, C., Cooper, R., Kennedy, P. J., Madras, B., & Bondi, P. (2017). The president’s commission on combating drug addiction and the opioid crisis. Washington, DC, US Government Printing Office, Nov 1.

McCarty, D., Priest, K. C., & Korthuis, P. T. (2018). Treatment and prevention of opioid use disorder: challenges and opportunities. Annual review of public health, 39, 525-541.

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

Meinhofer, A., & Witman, A. E. (2018). The role of health insurance on treatment for opioid use disorders: Evidence from the Affordable Care Act Medicaid expansion. Journal of health economics, 60, 177-197. NURS – 6050N Discussion Paper