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2 main categories of federal agencies: ANSW ✔✔ 1- Executive department
agencies are under direct control of the president and include the 15 cabinet-
level departments
2- Independent agencies' heads are appointed by the president, confirmed by
the Senate, and must have a legitimate reason to be fired
2 types of policies and laws that address the competing interest in public
health ANSW ✔✔ ▪Ones that define the functions and powers of public health
agencies
▪Ones that aim to directly protect and promote health
3 commonly found healthcare systems around the world: ANSW ✔✔
▪National health insurance system which is publicly financed but care is by
private practitioners (Canada)
▪National Health system which is publicly financed and where care is provided
by government employees or contractors (Great Britain)
▪Socialized insurance system that is financed through mandatory contributions
by employers and employees and care is delivered by private practitioners
(Germany)
5 Principles of Ethical Codes in Medicine ANSW ✔✔ Principle of
Nonmaleficance
Principle of Beneficence
Principle of Utility
Principle of Distributive Justice
Principle of Autonomy
,A public policy problem: affects? ANSW ✔✔ Affects more than an individual
and expands its focus upon the greater community
-Ex: An individual might decide to take advantage of employer-sponsored
health insurance vs. public policy question is whether all employers should be
required to offer health insurance to employers
ACA's provisions to address workforce issues: ANSW ✔✔ ▪Increase funding
from community health centers
▪Increase funding fro the National Health Service Corps (provides scholarships
and loan repayments to students who agree to become primary care providers
and work in medically undeserved communities)
▪Increase funding for PA and nurse practitioner training
▪Provide new funding to establish nurse-practitioner led clinics
▪Provide new funding for state to plan/implement innovative strategies to
boost primary care workforce
▪Establish a National Health Care Workforce Commission to coordinate federal
workforce efforts and boost data collection/analysis
▪Establish teaching health centers
▪Provide payments for primary care residencies in community-based
ambulatory care centers
▪Increase the number of Graduate Medical Education slots available to primary
providers by redistributing unused slots
▪Promote residency training in outpatient setting
▪Provide grants to training institutions to promote careers in the healthcare
sector
▪Increase reimbursement for primary care providers under Medicare and
Medicaid
,Adjudicatory/enforcement power ANSW ✔✔ -Claims of public rights (claims
involving private persons as one party and the government as the other party-
not criminal)
-This power can be granted to administrative agencies
▪Congress may create a court (administrative court) within an agency to judge
the claims
▪The courts have no juries, little to no witnesses, and the evidence is mostly
based on written reports
▪Congresses uses the power to specify which agencies have authority to
enforce certain statues and substantive areas of law
Administrative Agencies ANSW ✔✔ Work out of the public's eye to
implement the laws passed by Congress and the executive orders signed by the
president
Administrative Regulations ANSW ✔✔ ▪Specific regulations are written to
assist with the implementation of statutory directives and to promote statutes'
underlying policy goals
▪The administrative agencies of the executive branch of government are
organized to deal with specific policy subject matters
▪These agencies have more time and knowledge of the subject than Congress
or state legislatures to enforce statues and make public the regulations, rules,
and orders that are needed to carry out statutory regulations
▪Regulations have the full force of law
After president submits budget proposal to Congress by the first Monday in
February: ANSW ✔✔ ▪Each chamber then passes a budget resolution which
identifies how the chamber would spend federal money categorized by
different categories
▪Members for each chamber then meet to develop a single conference report
reflecting an agreement on the overall budget
, ▪Congress then passes a concurrent budget resolution which is binding upon
the House and Senate as a framework for revenue collection and spending
▪Following the passage of the concurrent budget resolution, the House and
Senate budget committees hold hearings to discuss the budget and the
Congressional Budget office provides the budget committees with its budget
and appropriations committees with its analysis of the president's proposal
▪In March, the House and Senate budget committees each craft a budget plan
during "mark-ups" which are public meetings
▪When the markups are finished, each committee sends a budget resolution
containing budget total, spending breakdown, reconciliation instructions,
budget enforcement mechanisms, and statements of budget policy to its
respective chamber
Agencies must follow the requirements created in the Administrative
Procedure Act (APA) which: ANSW ✔✔ -Contains detailed requirements
causing agencies to issue a notice of their intent to issue a new rule or change
an existing rule as well as provide for/respond to public comments on the
proposed issue
-The APA only creates procedural standards for an agency to follow when
promulgating regulations but it does not create standards for the content of
the regulations
Agency Powers ANSW ✔✔ -Statues are usually written broadly due to lack of
time for further development by Congress
-The executive branch agency fills in the details through policy statements,
developing rules, and promulgating regulations
-Declaring regulations is the most important and powerful role of agencies
-Agency regulations have the force of law
-The issue being regulated must be within the power of the agency to regulate