Health policy and the private sector: New vistas for nursing

Joyce Pulcini, Diana J. Mason, Sally Cohen, Christine Kovner, Judith K. Leavitt

Research output: Contribution to journalArticle

Abstract

During the past two decades, the drive to rein in rising health care costs has shifted some of the power in health care policy making from professional groups, government agencies, and not-for-profit health care organizations to large for-profit corporations (1-4). This has been a worldwide phenomenon, as the provision and financing of health care services is shifted from governments to private health care organizations (5,6). In the United States, the shift in power is manifested in profound ways. Market competition and bottom-line economics have permeated the health care system, creating powerful new incentives for mergers, other corporate restructuring, and the shift to for-profit status by formerly not-for-profit insurance companies and providers. Private sector health care is now increasingly influenced by for-profit organizations (3). Moreover, the health insurance industry has been transformed as traditional indemnity insurance is replaced by versions of managed care. The role of government, or the public sector, in setting parameters for health care financing and standards for the delivery of health care services is increasingly outpaced in cost cutting by organizations that directly face the bottom line. In addition, private foundations, many of which are under the auspices of managed care organizations, now fund a large proportion of health care research and demonstration projects, a task once largely within the realm of the government. Through education and experience, nurses have developed political sophistication and understanding of policy making in the public sector (7). The challenge now is to educate nurses to adapt their political and policy strategies to the new health care milieu. This challenge is particularly crucial for advanced practice nurses, who must survive in a managed care environment.

Original languageEnglish (US)
Pages (from-to)22-28
Number of pages7
JournalNursing and Health Care Perspectives
Volume21
Issue number1
StatePublished - Jan 2000

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Private Sector
Health Policy
health policy
private sector
Nursing
nursing
health care
Delivery of Health Care
profit
Organizations
Managed Care Programs
Insurance
managed care
nurse
Public Sector
Policy Making
Nurses
health care services
Health Services
public sector

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Health policy and the private sector : New vistas for nursing. / Pulcini, Joyce; Mason, Diana J.; Cohen, Sally; Kovner, Christine; Leavitt, Judith K.

In: Nursing and Health Care Perspectives, Vol. 21, No. 1, 01.2000, p. 22-28.

Research output: Contribution to journalArticle

Pulcini, Joyce ; Mason, Diana J. ; Cohen, Sally ; Kovner, Christine ; Leavitt, Judith K. / Health policy and the private sector : New vistas for nursing. In: Nursing and Health Care Perspectives. 2000 ; Vol. 21, No. 1. pp. 22-28.
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