Health policy formulation is a multi-stage process that requires policymakers taking decisive steps toward the improvement of healthcare systems according to the requirements of time and communities. It must address all the aspects and manifestations of the health care sector as a system. That is why it must be grounded on the appropriate legislation that regulates the staffing, working process organization, and financing. Also, the primary aim of health policy is assuring and promoting health improvement of the communities and separate individuals. However, the particular health policies applied in different states (for example, in Florida) tend to violate the priorities omitting some crucially essential steps. Thus, it is important to evaluate the current Florida health policy utilizing rational decision-making approach and stage sequential model for underlying its favorable and adverse features.
The roots of any problem in healthcare should be found in the policy formulation. The current health policy employed within the framework of Medicare in Florida prohibits advanced practice nurses from independent practice. According to the Florida Association of Nurse Practitioners (n.d.), there is a significant understaffing of primary care physicians division. At the same time, the number of insured patients eligible to obtain primary care services under the Medicare is rapidly increasing. The outcomes of such an inconsistency between the number of patients and specialists are aggravated by the restriction of nurse practitioner licensure (Florida Association of Nurse Practitioners, n.d.). Florida faces such a problem while many other states covered by the Affordable Care Act refused from such a restriction.
It is appropriate to utilize rational policy formulation approach to address this policy. Rational decision-making approach implies that the process of policy-making “combines influence from interest groups, data, political negotiations, and ideology” (Mason, Leavitt, & Chaffee, 2014, p. 52). Thus, it is essential to include all the influential factors when formulating the health policy. However, the healthcare sector crisis Florida is currently experiencing is a result of the omission of the staffing factor. Moreover, there is no step taken to address this omission and solve the problem of practitioner understaffing with the help of allowing nurse practitioners to perform independently.
The prohibition of nurse practitioners to perform as physicians is irrelevant in the current situation. According to the stage sequential model described by Ripley, there are four stages of policy formulation which include “agenda setting, policy formulation, program implementation, and policy evaluation” (as cited in Mason et al., 2014, p. 52). When applied to current Florida health policy, it reveals the poor execution of the final stage. The disadvantage of the discussed policy is in its failure to meet the new requirements after its evaluation. The strict prohibition of the independent practice of advanced nurse practitioners is irrational because it increases the problem of understaffing. The anticipated advantage of Florida policy is financial savings and higher quality of services carried out by physicians in comparison to nurses. However, the latest study confirms that “patients with a nurse practitioner as a primary care provider are less costly to Medicare than patients with a physician primary care provider” (Florida Association of Nurse Practitioners. n.d.). Thus, stopping the nurse practitioner licensure restriction would eliminate the crises and improve the policy,
Concluding the report, the current Florida health policy needs correction at the stage of evaluation to be able to address the urgent needs in the sector which include understaffing and consequent losses in the quality of performance. The relevant studies verify the high quality of nurse practitioners’ performance. The introduction of such specialists into primary care at the positions of physicians is rational under the circumstances of the overall understaffing in the sector.
Mason, D.J., Leavitt, J.K., & Chaffee, M.W. (Eds.). (2014). Policy & Politics in Nursing and Health Care (6th ed.). St. Louis, MO: Elsevier Health Sciences.