1. Issel, L. Michele PhD, RN

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As I write this editorial, the 2016 Presidential election campaigning is getting into full swing. The political season has arrived. I last wrote an editorial about politics in 2012, as the Affordable Care Act was being debated during that presidential election campaign. This current election cycle promises to be more entertaining, if not equally angst provoking. This cycle, I focus on why major national political campaigns and elections matter to Health Care Management Review and specifically to the study of health care organizations.

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One reason is uncertainty. Uncertainty creates havoc with financial markets as investors look for safe choices. Similarly, I imagine that executives and administrators of large, complex corporations that are health care organizations also prefer certainty. Is political uncertainty more or less disruptive than other sources of uncertainty to strategic initiatives of health care organizations? Do political uncertainties and preferences have an effect on employee morale or cohesion, such that patient outcomes are affected? These examples highlight the need for research in this area.


The second reason that national elections matter is change. Regardless of an election outcome, some degree of national policy change will occur. As with uncertainty, change is often viewed unfavorably but also leads to interesting research questions. How do health care administrators buffer against change, and how do they know when change will be excessive versus healthy? What are among the most effective organizational approaches to managing change, and what happens when change management is ineffective? What are the pathways between management of externally imposed changes and patient outcomes? Again, these are a few of the many possible questions.


A third reason that politics and elections matter is that they constitute the environment of a health care organization. Everyone agrees that context and organizational environments matter. Beyond the usual market and niche concepts of organizational environments, we could ask about the nature of the political environment for health care organizations. Do they prefer progressive or conservative environments, and does that preference translate into different human resource practices and patient outcomes? What do health care administrators do if the nature of the political environments differs across the geographies of their hospitals and clinics?


Lastly, but not least, is the effect of politics and elections on corporate and local strategy. Strategy development and implementation are essential tools for any health care executive. From a scholarship perspective, research into strategy development and management by health care administrators has not kept up to date with the structural and financing changes in the health care sector. A multitude of questions are possible. One might be: What strategies or strategic approaches do health care executives use in a major election year, and do those approaches differ from approaches used in nonelection years? To what extent are health care organizations active in promoting civic engagement, a factor known to correlate with better health status?


There is no doubt that other characteristics of major political campaigns and elections are relevant to our understanding of the optimal administration and functioning of health care organizations and corporations. This year, consider what we don't know, how research might fill that gap, and the value of that knowledge to the discipline of health care management.


L. Michele Issel, PhD, RN