How to write an essay on History, Structure and Process of Health-Care Policy and Politics in the United States

How to write an essay on History, Structure and Process of Health-Care Policy and Politics in the United States

History of Health Care Policy and Politics

The evolution of the American healthcare system is due to the political support that led to healthcare financing in the US to enhance healthcare coverage. The earliest reform in the healthcare system dates back to the 20th-century establishment of universal healthcare coverage led by the Republican President Theodore Roosevelt. The proposal of universal healthcare coverage was founded on progressivism ideas. Although successful, the establishment was short-lived in the South (Manchikanti ET AL., 2017). Franklin Roosevelt, a Democrat,  proposed a publicly funded healthcare initiative while making the final copies of the Social Security legislation; this healthcare proposal was eliminated from the final legislation. President Harry Truman later proposed universal healthcare legislation in 1949. However, healthcare coverage in the US increased in 1969 when Medicare and Medicaid Healthcare programs were established due to Lyndon Johnson’s Social security Act the same year. More universal healthcare proposals were received from  President Richard Nixon, Ted Kennedy and President Jimmy Carter, leading to the improvement of universal health care. Hillary Clinton led the policy change for universal healthcare supported by President Bill Clinton in 1993. With significant control of both the houses of Congress by Democrat President Barack Obama, the historical and most comprehensive medical healthcare coverage  was signed into law in March 2010 in the  Affordable Care Act (ACA), also known as “ObamaCare.” ACA has significantly reformed healthcare insurance coverage for more than 20 million Americans, improved healthcare service delivery and aided in healthcare cost expenses.

Structure of Healthcare policy and politics in Nursing in the US

Nurses in the US are registered under the American  Nurses Association (ANA), which advocates for the nursing profession and the nurses’ duties in enhancing healthcare coverage. Nurses are critical in any healthcare system as they contribute massively to each aspect of healthcare service production. America has more than 4 million registered nurses under the ANA, which critically functions to amplify nurses’ voices and influence healthcare politics, policy and service delivery (ANA, 2022). Leadership and management are key components of any organization, and the ANA employs collaborative leadership in which Membership Assembly members coordinate decision-making with the Board of Directors to establish the best nursing policies. Other stakeholders working with ANA include the American Nurses Credentialing Center, American Nurses Foundation, ANA Political Action Committee and the American Academy of Nursing to develop politics securing nurses’ future. The membership assembly governs and presides over the election of the members of the ANA. The members of this organization include leaders from constituent member groups, organizational stakeholders and individuals. The membership assembly discusses national nursing practice policies in open forums, thus influencing healthcare coverage and nursing policies. Besides leadership, the ANA members recommend and appoint competent individuals for the ANA board of committees. The board selects leaders based on recommendations from the Committee of Appointments and track records.

Process of healthcare policy and politics in Nursing in the US

Healthcare cost impacts the country’s economy and citizens’ financial budgets. The ACA provided comprehensive medical care and health insurance coverage. Organizations that influence healthcare policy formation in the US include the  American Association of Retired Persons (AARP), American Medical Association and the AFL-CIO, and health insurance organizations such as  Blue Cross and Kaiser Permanente. On the federal level, selected healthcare leaders draft healthcare policies in collaboration with other healthcare professionals (Disch, 2020). The policy has to pass through the legislature, the executive and the judiciary before being passed into law. Policy formation at the lowest level involves microsystems like clinics and local hospitals by the institution’s administrator and clinical team. These policies often address nursing in the local context and facilitate patient safety. While these policies must adhere to the local and state guidelines, they often guide workplace behavior in specific facilities.


Manchikanti, L., Benyamin, S. H. R. M., & Hirsch, J. A. (2017). Evolution of US health care reform. Pain Physician20(3), 107.

Health policy – american nurses association (ANA). ANA. (n.d.). Retrieved August 22, 2022, from

Disch, J. (2020, January). Nursing leadership in policy formation. In Nursing Forum (Vol. 55, No. 1, pp. 4-10).

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