CASE A

Politics and economics influence health and health care because they are the governing forces in most countries. The policies that are enacted are approved, implemented, and monitored by government-funded agencies that oversee them.  The mother’s cash grant was initiated by the government and continues to run because the government finds value in the program. If the program were to be discontinued, I would urge the government to review the data that shows benefits and the promise for continued improvement.  The discussion would include objective data to help justify the request to consider keeping the program going.

The benefits of awarding the mother’s cash grants are decreased school dropout rates, improved family health, and personal empowerment. As Devine 2008 suggests, women who receive these feel they have earned it. It erases the stigma of handouts and encourages participation. Although there are many benefits to the program, there are some social biases and social problems that may arise from the program. As Uchimaya (2019) suggests, the program may increase household vulnerability. Uchimaya (2019) explains that households that receive remittance are more likely to become vulnerable during times of negative income shocks. Remittance uncertainty and compensation delays may be the cause, but it is suggested that more research be done in this area specifically to understand better what puts these households at increased risk of vulnerability (Uchimaya, 2019).

It is my opinion that the program is ethically distributed – as much as it can be. The criteria are objective, and this helps to decrease biases – however, it can be argued that any distribution criteria could be biased.  The only recommendation I would have with the program would be to consider increasing responsibility with a household’s longevity with the ultimate goal of full responsibility on the household. I might also suggest a plan that incorporates the children learning and sharing in the duties of the household, so they have the knowledge they need to leave and run their own household without assistance successfully. However, to do this, more resources would need to be made available, and that comes with an expense that may not be affordable. 

I do think a program like this may be beneficial in my community because my community is the poorest county in our state. Offering an incentive to working towards financial stability might help our county prosper. 

CASE B

Political, economic, and ethical issues in developed and developing countries can lead to health disparities. Since politics determines who gets what, it is important for nurses to work within political systems to help create positive changes in health care. Nurses must be knowledgeable of the impact of government, law, and health policy on nursing, health, and communities in which they practice (Stanhope & Lancaster, 2016). Being competent with issues in the community helps us advocate for the people we serve. Advocacy begins with the art of influencing others (politics) to adopt a specific course of action (policy) to solve a societal problem (Stanhope & Lancaster, 2016). Building relationships with and educating policymakers on disparities in the community is the first step in making positive changes in health care within a population.

            Politics and economics enforced by Mexican President Zedillo greatly influenced the health care of families living in poverty in their county. With the development of the program, Progresa, monetary incentives were provided directly to families to help overcome the financial barriers to health services use and schooling and to induce parents to make decisions that would bring their children more education and better health (Levine, 2007). The benefits were given directly to adult female beneficiaries, because studies have shown that mothers are more likely than fathers to spend additional household resources on children’s health and welfare, rather than consumption of goods (Levine, 2007). This is the benefit of awarding the mothers cash grants. This also could create social problems as this could appear as stereotyping of fathers. So, in my opinion, the cash grants were not ethically distributed in that sense. I believe that since Progresa has transformed into Oportunidades, the program has made the necessary changes to benefit all aspects of people living in poverty in Mexico. This change extended to rural and urban communities and the education portion extended to high school students, equally benefiting most all members of the country. If the program were ever discontinued, I, as a nurse, would advocate to maintain funding. With the evidence provided, this program was highly effective in reducing the health care problems of the Mexican population. It resulted in a 12% lower incidence of illness than children not included in the program, 19% fewer days of difficulty with daily activities due to illnesses in adults between age 18 and 50 years old, and 17% fewer days incapacitated in adults over 50 years old (Levine, 2007). I believe a similar program would work in my community and the entire United States. This program is based “co-responsibility” between the government and the recipients, which is a brilliant idea to keep people from “beating the system.” Cash grants are provided to families who exemplify behaviors that result in improved social outcomes. Benefits are only provided if recipients do their part by taking children to clinics for immunizations and sending them to school (Levine, 2007). Capped monthly benefits are in place to avoid unintended incentive among the poor to have more children than they can afford. I honestly believe this is a smarter program than what the United States currently has in place for families living in poverty.

            Political and economic systems have played a significant role in my family’s access to health in the past. After I gave birth to my child, my job could not hold my position. I was desperately struggling to keep my home and feed myself and my new child as a single mother. I also lost my health care insurance coverage. It was a challenge to find another job within my small rural community. I had to temporarily get government assistance through the WIC, SNAP, and Medicaid programs. These programs helped me tremendously until I was able to find an organization to hire me. Had I not been covered by Medicaid, my child may not have been able to get the health care and immunizations that she needed. Having programs as such in place within a community significantly promotes the health of families in need.  Policymakers have argued that providing public health insurance coverage to the uninsured lowers long-run costs by reducing the need for expensive hospitalizations and emergency department visits later in life (Wherry et al., 2015). This is an example of how government intervention can benefit a health care system.

INSTRUCTIONS: THE ABOVE CASES NEEDS FEEDBACK ON THEIR RESPONSE TO THE POST BELOW. 

Post your response to the following prompts:

Explain how politics and economics may influence health and the health care system from your own perspective. Analyze whether the political and/or economic systems play a major role in your or your family’s access to health and explain why. Then, describe how government intervention might benefit a health care system. Be specific and provide examples.

Support your response with references from the professional nursing literature.