Midterm Flashcards
What are ethics in health policymaking? Why do we need to know them? How can they promote health and health equity?
Broadly, ethics are moral principles that a person holds and uses to guide their decision making
Ethics in health policymaking can be examined using three frameworks: utilitarianism (analyzing policies in terms of consequences), liberalism (major emphasis on the rights of individuals), and communitarianism (virtues needed to maintain an appropriate social order in a community)
Policymaking uses aspects of each framework.
Examples: legislators use cost-benefit analysis (utilitarianism) to determine if an intervention is worth implementing based on how much it costs and how beneficial it is and a lot of health policies are centered around defining individual rights (liberalism), like the right to an abortion.
Ethics are needed in policymaking because if we don’t have these principles, policymakers may create policies that have dire consequences while in pursuit of health equity
Example: if a policy was created to prevent the reproduction of genetic deformities in a population, this may be seen as eugenics because the rights of disabled people to exist were not considered
Though the policy may have had good intentions, it directly questions whether disabled people should be allowed to reproduce, which goes against what is considered ethically right
Also calls into question the ethics of forcing someone to terminate their pregnancy because the fetus has a genetic disorder
Ethics can help promote health and health equity in policymaking because it provides justification for why we give certain groups benefits and not others
Example: Medicaid is governmental healthcare that is used by low-income populations because they can’t afford private insurance
This was created because the President and government at the time decided that it was unethical for someone to live or die simply because they couldn’t afford medical treatment
Medicaid promotes health in low-income families because it is reducing costs of services they wouldn’t be able to afford otherwise, like medications and medically necessary surgeries
Also promotes health equity by partially or fully removing income as a health disparity so that all people have access to the same quality of medical treatment
How can international health organizations impact U.S. public health policy?
The World Health Organization is an international organization with several roles, including policy development, data collection and standardization, and coordination of services. One of their most important contributions to public health is vaccine development. Their development of vaccines could influence U.S. public health policy through the creation of a new vaccine that could be added to the standard immunizations children/adults receive. For example, if the WHO developed a vaccine that provided long-lasting protection against the flu, this vaccine would be added to immunization requirements due to its extremely infectious nature and prominence in the U.S.
Define allocative and regulatory policies. What are their similarities and differences? Give 2 examples of each kind of policy.
Allocative: deliver net benefits to a specific group of individuals or organizations at the expense of others to achieve public goals
Examples: federal aid to medical schools and allocating funds for healthcare programs in low-income communities
Regulatory: establish rules or standards that individuals, organizations, or governments must follow to protect public health
Examples: regulations on food safety and mandatory vaccinations
What is a stakeholder?
Stakeholder: individuals or groups that have an interest in or are affected by a policy that may be put into place; they offer different perspectives and try to influence policymakers to create policies that lean in a direction that benefits them
What is healthcare policy? Give 3 examples of them.
Healthcare policy: authoritative decisions made within government intended to direct or influence the actions, behaviors, or decisions of others pertaining to health and its determinants
Examples: the Affordable Care Act, the Roe v. Wade Supreme Court decision, and Oregon’s Death with Dignity Act
What is health equity? How does it affect the development of health policies? Why do we need it?
Health equity: a situation in which everyone has the opportunity to attain their full health potential and no one is disadvantaged because of social conditions
Achieving health equity is the main goal of health policy
Because we want everyone to be able to access good, equitable healthcare, we ask researchers and academics to research various health disparities that affect someone’s ability to reach their full health potential
Health equity is necessary because it provides us with a healthcare goal
If we have an idea of the kind of result we want from this policy (for example, cheaper healthcare costs to help alleviate pressure for low-income families), we will spend more time ironing out the details of the policy and trying to convince others who may not agree with us to vote in favor of the policy
What is the role of stakeholders in health policy? Why is it important to keep stakeholders engaged? (8) What are examples of health policies affected by stakeholders?
In health policy, stakeholders can provide a variety of benefits (funding, strategic direction, support, etc.) for policymakers in order to influence the direction of the policy.
It’s important to keep stakeholders engaged because they can:
1. Advance policy changes at the State level
2. Increase support for quality improvement (QI) initiatives from key decision makers
3. Ensures that QI efforts represent a variety of perspectives
4. Increase public awareness
5. Improve coordination of QI efforts
6. Expand capacity for current and future QI efforts
7. Increase transparency of QI efforts
8. Empower community members to be involved in QI activities
Examples of health policies affected by stakeholder:
Immunization requirements are affected by physicians and researchers who know when children are healthy enough to have them
Tobacco policies can be influenced by interest groups or lobbyists who provide money to politicians
What are the steps in the policymaking process?
There are two major camps regarding the policymaking process: the government and 3 conceptual frameworks.
The Legislative branch (made up of the House of Representatives and the Senate) proposes laws and debates on their effectiveness based on factors like ethics and funding
Once the law passes through both chambers, the President either signs the law or vetoes it, but the veto can be overridden if the law passes through Congress again
The Executive branch also consists of 15 Cabinets, which help interpret and implement laws passed by Congress
If a law is questioned, both sides argue in front of the Judicial Branch (Supreme Court), who will then decide if the law will remain the way it is or if it needs to be altered because it violates the Constitution.
The 3 conceptual frameworks are: policy and law concerns (health care, issues arising in the public health field, and controversies in bioethics), prevailing historical factors (professional autonomy, free market, and social contract), and stakeholders (individuals/entities impacted by a certain policy or legal determination)
These frameworks are also heavily involved in the governmental portion of policymaking.
Example: stakeholders almost always provide their input when the creation of a policy in the Legislative branch affects them (like when physicians are consulted about the appropriate time for vaccinations so a vaccine policy can be created for schools)
Example: when Roe v. Wade was overturned and the Judicial Branch ruled that the question of abortion rights needed to be turned back over to the states
Issue of abortion can be considered a bioethical one (going back to the first conceptual framework) because it deals with various aspects like morality (religious groups believe that it’s “murdering” the unborn), medicine (abortion is considered a standard in reproductive healthcare), and public health (illegal abortions can lead to an increase in maternal death rates).
Why are health policy analyses needed in public health? What is an example of one? How can they improve health outcomes?
Health policy analysis: multi-disciplinary approach to public policy that aims to explain the interaction between institutions, interests, and ideas in the policy process
Needed in public health because it can help legislators understand past policy failures/successes and plan future policy implementation
Example: a necessary health policy analysis is a stakeholder analysis
Stakeholder analysis: helps us understand what resources and influence a stakeholder can bring to a certain policy
Generates knowledge about the stakeholders so we can better understand their behaviors, intentions, interests, and interrelations
Benefits: increases the policy’s chance of success through factors like implementation, design and preparedness, etc. and can help policymakers envision a future or expansion of this policy
Health policy analyses can help improve health outcomes because they can create a roadmap of why certain policies have failed while others are still thriving or how to update a policy to improve health outcomes
Example: Medicaid was originally created as part of the Social Security Act in the 1960s
At the time of its passage, it may have sufficiently addressed the health needs of the American population and there was no need to alter it
However, as time passed, disparities affected human health more and more and it was eventually recognized that Medicaid needed to be expanded upon
This is where health policy analysis comes in
Legislators examined data and understood what the original policy did successfully and what it failed to address
Eventually, the Affordable Care Act was created and passed, which significantly expanded what who was able to use Medicaid
Helped improve health outcomes because more people were able to afford healthcare and have access to medical necessities like medication and specialized visits
