The impact of different constituents on legislation became a burning issue of the contemporary health care system as nursing professionals can influence the policy-making process with regard to their knowledge of the advantages and disadvantages of different models and strategies.
In this respect, it is necessary to talk about the issues important for modern people in terms of nursing and health care system including specific legislation decisions that are aimed at advancing the role of nursing professionals and making the patient care more adequate and affordable. Every patient has a right to be treated in accordance with his/her needs regardless of the financial side of the issue. Consequently, the patient care should be performed in the way requiring adequate treatment, post operational care, and all other issues that help the patients to recover earlier.
The public policy that should be addressed is the Women’s Health and Cancer Rights Act passed in 1998 that was aimed at bringing more women to breast reconstruction though this problem remains unsolved even due to the legislation act passed on this issue. As breast reconstruction is a must for women who have underwent mastectomy, it is important to make sure that all candidates for breast reconstruction know about the advantages and disadvantages of this procedure and realize the possibility of complication.
As reported in the study by Morrow and Pusic (2011), “a substantial proportion of women undergoing surgical treatment for breast cancer are candidates for unilateral or bilateral breast reconstruction. Survey research suggests that patient knowledge of reconstructive options statistically increases willingness to consider mastectomy” (pp. 5-6). However, financial side of the problem prevails in discussion because of the following problems related to breast reconstruction: high percentage of uninsured population, “many physicians are reluctant to accept this third party payer [Medicaid] due to poor reimbursement” (Alderman et al., 2009, p. 2).
The policy was designed to address access and cost of the breast reconstruction interventions with regard to affordability of this procedure primarily to those patients who have large insurance coverage or can pay directly to the physician and nursing staff without using the insurance. The policy seems to fail its intended results as reported in the study by Alderman et al. (2009) and the situation remained the same as before introduction of the act. If the act was currently effective, there would be no need to discuss this legislative document.
The effect of the policy did not affect neither cost nor access nor quality of the services provided as the quality remained as high as it was before which also led to the high costs while access to the breast reconstruction was open though limited with the help of cost barriers. My nursing practice includes working with patients who need breast reconstruction and those in the pre-operational stage right after the procedure of mastectomy. When patients cannot afford the breast reconstruction or the reimbursement level is too low, this affects my desire to perform altruistic actions that I can perform for adequate payment.
I would like to affect the policies in the way described in the book by Milstead (2007) who analyzes the way nurses can affect legislation. The ethical decision-making is an important part of the legislation development. As claimed in the report by University of Washington School of Medicine (n. d.), the ethical issues contradict the efficiency of the services provided in terms of minimization of resources. It is necessary to take into account the salaries of physicians and expected payment for every procedure of breast reconstruction with regard to the resources needed before, during, and after the surgery.
Reference List
Alderman, A. K., et al. (2009). Financial impact of breast reconstruction an academic surgical practice. Plastic Reconstruction Surgery, 123(5), 1408–1413. Web.
Milstead, J. (2007). Health policy and politics: A nurse’s guide (3rd ed.). Sudbury, MA: Jones & Bartlett Publishers.
Morrow, M., & Pusic, A. L. (2011). Time for a new era in outcomes reporting for breast reconstruction. JNCI, 103(1), 5-7. Web.
University of Washington School of Medicine. (n. d.) Ethics in medicine: Managed care. Web.