Lecture 11/Chapter 13 Flashcards
1
Q
Learning Objectives
A
- Definition, scope, and role of the US health policy
- principal features of US health policy
- describe the legislative health policy process
- identify critical health policy issues in the US
- passage, implementation, and repeal of the ACA from a political perspective
2
Q
health policy introduction
A
- government involvement in social welfare -> traced to almshouse and pesthouses
- social programs created under the social security legislation in the 1940s
- government has had success bringing about social change through health policy
3
Q
public policies
A
- decision made in the legislative, executive, or judicial branches of government
- direct actions, behaviors, or decisions of others
4
Q
health policy
A
- aggregate of principles, stated or unstated
- characterize distribution of resources, services, and political influences impacting the population
- plan to promote better health
- made by legislative, executive, and judicial branches
- laws
- affect how businesses function
5
Q
uses of policy
A
- regulatory tools- laws and regulations, procedures, people need to conform to these laws
- allocative tools- how do we distribute resources and money
- affect stakeholders
6
Q
different forms of health policies
A
- affect groups or classes of individuals
- physicians, the poor, the elderly, and children
7
Q
principal features of US health policy
A
- government as subsidiary to the private sector
- fragmented policies
- incremental and piecemeal policies
- interest groups as demanders of policy
- pluralistic suppliers of policy
- decentralized role of the states- a lot of health care is managed at a state level
- impact of presidential leadership
8
Q
politics of the ACA
A
- obama stated everyone would have health insurance
- ACA become reality following a unique set of political circumstances
- speed with which the reform was pushed through the legislative process
- general public was confused and not supportive about the legislation
9
Q
aspects of the US government and populace
A
- relationship of the government to the private sector
- distribution of authority and responsibility within a federal system of government
- relationship between policy formulation and implementation
- a pluralistic ideology as the basis of politics
- incrementalism as the strategy for reform
10
Q
comprising five components of policy cycle
A
- issue raising
- policy design
- public support building
- legislative decision making and policy support building
- legislative decision making and policy implementation
11
Q
congress has 3 important powers
A
- power to enact laws
- power to tax
- power to spend (allocate resources)
12
Q
most influential house committees
A
- ways and means committee
- commerce committee
- committee on appropriations
13
Q
most influential senate committees
A
- committee on labor and human resources
- committee on finance
14
Q
legislative process
A
- a bill is introduced in the house of representatives
- if approved it is forwarded to the senate
- sent to president after passing the house and senate
- if signed it becomes a law
15
Q
policy implementation
A
- new law is forwarded to the appropriate agency of the executive branch -> multiple level interpret and implement legislation
- proposed regulation published in the federal register -> hearing on how law is to be implemented
- parties may adjourn to the courts
16
Q
implementation of the ACA
A
- 12 states had decided to create state based health insurance exchanges
- 5 states opted for a state based marketplace through the federal platform
- 6 selected state partnership marketplaces
- 28 states health insurance exchanges were created by the federal government
17
Q
critical policy issues
A
- most health initiative focused on access, cost, and quality of care
- access to care:
- providers
- integrated access
- access and minorities
- access in rural areas
- access and low income
- access and persons with HIV/AIDS
18
Q
critical policy issues: cost of care
A
- increasing drug prices have drawn public attention
- no government action taken to prevent price hiking
- prices of prescription drugs may continue to rise
19
Q
critical policy issues: quality of care
A
- research on quality
- malpractice reform
- 6 areas of quality improvement:
- safety
- effectiveness
- patient centeredness
- timeliness
- efficiency
- equity
20
Q
critical policy issues: role of research in policy development
A
- documentation
- analysis
- prescription
21
Q
critical policy issues: future considerations in health policy
A
- domestic health policy- initiative to expand and evaluate primary care delivery models
- international health policy- government spending on global health initiative is stable
22
Q
summary
A
- health policies are developed to serve the publics interests
- interest group politics have an influence on policy
- presidential leadership and party politics played a major role in the ACA passage
- critical policy issues pertaining to access, cost, and quality remain unresolved
23
Q
social security act
A
provided pensions (money from federal government) for people to live on
- 1965- amendment to social security act -> medicare and medicaid
- people didnt have insurance because people werent working -> medicare and medicaid changes that
24
Q
khbj
A
25
regulatory tools
- health policies may be used as regulatory tools
- they call on government to prescribe and control the behavior of a particular target group by monitoring the group and imposing sanction if it fails to comply
26
allocative tools
- health policies may be used as allocative tools
- they involve the direct provision of income, services, or good to certain groups of individuals or institutions
- distributive policies include:
- funding of medical research through the national institute of health
- the development of medical personnel
- the construction of facilities
- initiation of new institutions
- redistributive policies:
- creates visible beneficiaries and payers
- take money or power form one group and gives it to another
27
private sector dominant role
- private sector dominant role
- government spending on health care fills the private sector gaps
- intervention includes:
- environmental protection
- preventative services
- communicable disease control
- care of special groups
- institutional care of mentally and chronically ill
- medical care to the indigent
- support for research and training
28
pluralistic and interest group politics
- US health policy outcomes result from compromises to satisfy demands
- the first two communities supply policies demanded by the third
- legislative and executive respond to demands of the private interest groups
- the policy community has included:
- legislative committees
- executive branch
- private interest group
29
interest groups demand power
- well organized interest groups are the most effective demanders of policies
- ex. american medical association, american association of retired persons, american hospital association, pharmaceutical research and manufacturers of america
- to overcome pluralistic interests and maximize policy outcomes, diverse interest groups form alliances with legislators
30
impact of presidential leadership
- Lyndon B Johnson passed Medicare and Medicaid
- harry Truman passed the hill-burton hospital construction act
- Richard Nixon passes the federal support of health maintenance organizations in 1973 (HMO) and the enactment of the national health planning and resources development act of 1974 (CON)
- Barack Obama- ACA of 2010
31
incrementalism
- there are multiple phases to the policy
| - first phase might collect taxes for the next phase
