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. Though there isn’t an agreed upon ethics code like in medicine, 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. For example, we use cost-benefit analysis (utilitarianism) to determine if an intervention is worth implementing based on how much it costs and how beneficial it is. A lot of health policies are centered around defining individual rights, 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. For 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 morally right.
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?
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
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 due 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 study and author papers about 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? 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 bioethics), social/political/economic views (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. For 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). A second example could be 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. The 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 (in cases other than miscarriage, abortion is achieved through either surgical or medicinal means), and public health (illegal abortions can lead to an increase in maternal death rates due to a variety of factors like unsafe tools and fear of imprisonment if it goes wrong).
Why are health policy analyses needed in public health?
Health policy analysis is the process of evaluating various policies to address an issue related to health in order to determine which would be the best solution. This is needed in public health because policy implementation can often be expensive and if we don’t choose a policy that effectively addresses the issue, all of the money spent will have gone to waste. It also helps policymakers ensure that they have thoroughly considered multiple different solutions and are confident that the one they chose is the best fit for that particular problem.
An example of a necessary health policy analysis is a stakeholder analysis. Stakeholder analysis is a tool that helps us understand what resources and influence a stakeholder can bring to a certain policy. Additionally, it helps use generate knowledge about the stakeholders so we can better understand their behaviors, intentions, interests, and interrelations. Stakeholder analyses are extremely beneficial to the success of policies because without stakeholders, we would not be able to create efficient policy plans.
