CPH Exam: Health Policy and
Management
Infectious disease control (before 1850) - ANS*public health efforts were extremely limited and
medical practice played a very small role in society before 1850.
*acute illnesses and injuries were common; treatments were not typically effective.
*over time, large cities established boards of health in response to local events.
*these early public health efforts focused primarily on protecting the public from infectious
diseases introduced by travelers.
Marine Hospital System (MHS) - ANScreated in 1798 to deal with the spread of diseases from
city to city.
*later became the U.S. Public Health Services.
*MHS was a compulsory insurance system for merchant seaman that funded a network of
locally controlled marine hospitals along the coastal and inland waterways.
Building infrastructure (after 1850) - ANS**by the mid-19th century, advances in medical science
expanded the ability of public health efforts to control the spread of infectious disease through
public health efforts.
*widespread immunization
*FDA created in 1906
Several factors contributed to the limited role of medical services before the 20th century -
ANS*medical practice was dominated by individuals with little formal training and professional
standards did not exist
*medical care was based on primitive medical practices.
*medical practice lacked an institutional setting.
*families and communities still provided the majority of care, and most people did not see the
need for medical care.
*medical education was substandard.
Flexnor report - ANS*evaluated medical education system.
*recommendations included requiring a curriculum based on science that was at least 4 years
long as well as higher admission standards.
Medicare - ANS*federal health program for the elderly and people with disabilities.
*funded through payroll taxes, general revenue and premiums.
*to be eligible, an individual and his/her spouse has to contribute to Medicare for 10 years or
pay monthly premiums to buy-in to the program.
, *must be 65 or older, disabled and entitled to social security benefits, or have End Stage Renal
Disease.
Medicare Part A - ANS*hospital insurance
*covers inpatient care, skilled nursing, and hospice.
*financed through mandatory payroll taxes levied on the employer and employee.
Medicare Part B - ANS*supplemental medical insurance (SMI)
*covers outpatient services including physician care.
*voluntary program financed through premiums and general tax revenue.
Medicare Part C - ANS*Medicare Advantage
*provides several alternatives to traditional medicare.
*can choose from a number of HMOs, PPOs, or private fee-for-service plans.
*financed by payments from Medicare and may require an additional premium.
Medicare Part D - ANS*prescription drug coverage.
*voluntary program and enrollees can choose between a stand-alone plan for prescriptions or a
Medicare Advantage plan that provides prescription drug benefits.
*premiums are subsidized for low-income beneficiaries.
Medicaid - ANS*joint federal-state program that provides health care for low income people.
State Children's Health Insurance Program (SCHIP) - ANS*provides broad federal guidelines
while giving states flexibility in designing their eligibility requirements and policies.
State governments' authority over public health comes from: - ANS*their police powers and the
expectation that the state would care for the needy.
Local public health agencies (LPHA) - ANS*responsible to the state government for effective
execution of public health functions.
*an administrative and service unit of local government employing at least one full-time person
responsible for health within a jurisdiction smaller than a state.
6 basic functions of local public health authorities - ANS*tracking vital statistics about births
*deaths and diseases controlling communicable diseases
*sanitation
*laboratory services
*maternal and child health services
*health education
Health Policy - ANS*the aggregate of decisions by governments and other stakeholders that
determine the allocation of resources and services that affect the health of the population.
Management
Infectious disease control (before 1850) - ANS*public health efforts were extremely limited and
medical practice played a very small role in society before 1850.
*acute illnesses and injuries were common; treatments were not typically effective.
*over time, large cities established boards of health in response to local events.
*these early public health efforts focused primarily on protecting the public from infectious
diseases introduced by travelers.
Marine Hospital System (MHS) - ANScreated in 1798 to deal with the spread of diseases from
city to city.
*later became the U.S. Public Health Services.
*MHS was a compulsory insurance system for merchant seaman that funded a network of
locally controlled marine hospitals along the coastal and inland waterways.
Building infrastructure (after 1850) - ANS**by the mid-19th century, advances in medical science
expanded the ability of public health efforts to control the spread of infectious disease through
public health efforts.
*widespread immunization
*FDA created in 1906
Several factors contributed to the limited role of medical services before the 20th century -
ANS*medical practice was dominated by individuals with little formal training and professional
standards did not exist
*medical care was based on primitive medical practices.
*medical practice lacked an institutional setting.
*families and communities still provided the majority of care, and most people did not see the
need for medical care.
*medical education was substandard.
Flexnor report - ANS*evaluated medical education system.
*recommendations included requiring a curriculum based on science that was at least 4 years
long as well as higher admission standards.
Medicare - ANS*federal health program for the elderly and people with disabilities.
*funded through payroll taxes, general revenue and premiums.
*to be eligible, an individual and his/her spouse has to contribute to Medicare for 10 years or
pay monthly premiums to buy-in to the program.
, *must be 65 or older, disabled and entitled to social security benefits, or have End Stage Renal
Disease.
Medicare Part A - ANS*hospital insurance
*covers inpatient care, skilled nursing, and hospice.
*financed through mandatory payroll taxes levied on the employer and employee.
Medicare Part B - ANS*supplemental medical insurance (SMI)
*covers outpatient services including physician care.
*voluntary program financed through premiums and general tax revenue.
Medicare Part C - ANS*Medicare Advantage
*provides several alternatives to traditional medicare.
*can choose from a number of HMOs, PPOs, or private fee-for-service plans.
*financed by payments from Medicare and may require an additional premium.
Medicare Part D - ANS*prescription drug coverage.
*voluntary program and enrollees can choose between a stand-alone plan for prescriptions or a
Medicare Advantage plan that provides prescription drug benefits.
*premiums are subsidized for low-income beneficiaries.
Medicaid - ANS*joint federal-state program that provides health care for low income people.
State Children's Health Insurance Program (SCHIP) - ANS*provides broad federal guidelines
while giving states flexibility in designing their eligibility requirements and policies.
State governments' authority over public health comes from: - ANS*their police powers and the
expectation that the state would care for the needy.
Local public health agencies (LPHA) - ANS*responsible to the state government for effective
execution of public health functions.
*an administrative and service unit of local government employing at least one full-time person
responsible for health within a jurisdiction smaller than a state.
6 basic functions of local public health authorities - ANS*tracking vital statistics about births
*deaths and diseases controlling communicable diseases
*sanitation
*laboratory services
*maternal and child health services
*health education
Health Policy - ANS*the aggregate of decisions by governments and other stakeholders that
determine the allocation of resources and services that affect the health of the population.
