Health Policy
-medicare medicaid
-roe v wade
-affordable care act
Public policy
- Authoritative decisions made in the legislative, executive or judicial branch of government
intended to direct or influence the actions, behaviors or decisions of others.
Policy use
-regulatory tool
● Health policies can be used as regulatory tools
● they may call upon the government to prescribe and control the behavior of a particular
target group by monitoring the group and imposing sanctions if it fails to comply
● State insurance departments regulate health insurance companies in effort to protect
customers excessive premiums, etc
-allocated tool
● may involve the direct provision of income, services, or goods to certain groups of
individuals or institutions
● 2 main types:
-Distributive: spreads benefits throughout the society
-Redistributive: takes resources from one group and gives it to another (Medicaid
taking tax revenue from public to spend it on the poor in form of free health insurance)
forms of policies
-social security
-medical research
-HMOs
-federal antitrust laws
-local ordinance on smoking
principle features
fragmented policies
incremental and piecemeal policies
medicaid (instead of universal healthcare) and CHIP
interest groups
pluralistic suppliers of policy
decentralized role of the states
arguments for enhancing state's role in health policy pg. 518 exhibit 13-2
-americans distrust centralized government
, -federal government has grown too large, intrusive, paternal
-to impersonal, distant, unresponsive
-state and local closer to people in community, more familiar with needs
-national standards reduce flexibility
-states respond to crisis faster than federal gov
Impact of presidential leadership
-franklin Roosevelt and the new deal
-harry Truman and first press to campaign on national healthcare, hill burton act
-Lynden Johnson medicare medicaid great society
-Richard Nixon HMO act
-Ronald Reagan PPS method
bill Clinton universal healthcare platform, passed CHIP
George w. Bush medicare part D drug coverage
Barack Obama affordable care act
Policy cycle
1. issue raising
-create widespread sense that a problem exists and needs to be addressed
2. policy design
-may call on segments of the executive branch
3. public support building
-variety of strategies to make public appeals and increase support from interest groups
4. legislative decision making and policy support building
-interaction with congress, identify issues as bills move through committees
5. legislative decision making and policy implementation
Legislative process
Congress has power to:
1.make all laws
2. power to tax
3. power to spend
-committees and subcommittees (5 committees, 3 house, 2 senate)
- most bills die in committee stages
House committees: all bills involving taxation originate here
Ways and means committee: control over Medicare A, social security, welfare, unemployment,
health care reform
Senate committees