What factors might explain why the Obama plan succeeded? What events may have caused the Clinton
plan to fail? - Answers 1. With regard to the Obama plan, skyrocketing healthcare spending and the
number of uninsured Americans reflect both the magnitude and the severity of the problems in the US
healthcare system. These issues triggered renewed interests in and heated debate of healthcare among
all kinds of stakeholders. Healthcare reform has been thefocus in presidential campaigns in both parties.
Furthermore, the example of healthcare reform in Massachusetts serves as a potential solution for the
problem.
2. As for the Clinton plan, the ambitious administration significantly "underestimated the opposition and
overestimated the support" (Oberlander 2007). The Clinton administration failed to gain support from
any major stakeholders, Congress, hospitals, providers, pharmaceutical companies, and the public. The
insurance industry even created an advertisement, "Harry and Louise," and successfully rallied public
opposition to the plan.
3. One major difference between the strategies is the speed with which this process was handled. While
Clinton took time to build a consensus (which never happened), Obama rushed through the process to
seize the window of opportunity.
Measures of health - Answers Physical health-life expectancy, mortality, disability
Mental Health-mental conditions, behaviors, perceptions, satisfaction, services rendered
Social health-education level, income, occupation, quality of life, living environment
Public Health - Answers Art of preventing disease, prolonging life and promoting physical healht
2. How do you think the failure of the Clinton healthcare reform effort influenced the outcome of the
congressional election that followed? - Answers A. The failure weakened the Clinton administration and
the Democratic Party and therefore emboldened Republicans, which contributed to their win in the
Congressional election that followed.
. Why does health reform continue to be controversial despite widespread opinion in favor of change? -
Answers The healthcare system is resistant to change, and the consequences associated with the failure
to reform are enormous.
A. Although the problems within the healthcare system are severe and widespread, divisions within the
US political system and adherence to the status quo are significant challenges to health reform. "No
,matter how much momentum it seems to have, no matter how many signs point to change, there is
nothing inevitable about health care reform in the United States" (Oberlander 2007).
B. Furthermore, a variety of stakeholders with contradictory and conflicting interests pose further
barriers to reform efforts. Interests may be divided even within an interest group.
C. Moreover, a wide range of resources will need to be invested to implement reform, threatening its
feasibility.
D. Finally, policymakers are deeply concerned by the problems within the system, but the political will to
change is undermined by vigorous opposition from all forces. At the same time, if reform fails, they are
worried that there will be no political will to do anything about the uninsured for a long time.
1. How is health defined? - Answers A. WHO (1946) defines health as "not merely the absence of disease
or infirmity but a state of complete physical, mental and social well-being." Health is also the result of
personal characteristics and choices.
2. What are the major determinants of health? How do they interact? - Answers A. environment,
B. health status,
C. medical care, and
D. individual characteristics.
3. What is health policy, and what are its determinants? - Answers A. Health policy is legislation on
individuals, organizations, or society aimed at improving health for the population or subpopulations.
B. Broad determinants include the nature of the health problem, the sociocultural norms that influence
the perception of the problem, and the political system within which policy is formulated.
C. Narrower determinants include potential solutions to the identified health problem, views and efforts
of the stakeholders, demonstrated leadership of the policymakers, and the availability of resources
needed to implement the policy.
4. Who are the stakeholders of health policy? What kinds of concerns does each stakeholder have about
the current US healthcare system? - Answers 1. Consumers and patients: They are typically the intended
beneficiaries of health policy because they bear the consequences of a health problem than could be the
target of health policy.
, 3. Healthcare providers: They value autonomy and the prestige and expertise associated with their
careers.
4. Healthcare organizations: They are concerned with how to better serve their customers and deliver
high-quality care while maintaining the financial well-being and competitiveness of their institutions.
5. Payers and insurers: For private insurers, the main concern is maintaining their share of the health
insurance market. For public insurers, the main interest is ensuring coverage for vulnerable populations
at reasonable costs.
6. Regulators: They regulate the healthcare system to ensure the availability of basic services and the
quality of the services and to control overall costs.
7. Medical device and pharmaceutical manufacturers: Their main concerns are the sale of their products,
profits, and their competitiveness and market share.
A. Educational and research institutions: Health policy affects the type and quantity of healthcare
providers to be trained and the types of research to be conducted.
B. Businesses and corporations: These stakeholders seek to minimize the costs they incur for providing
health insurance as a benefit to their employees.
. What are the major types of health policies? Cite an example of each type. - Answers A. Examples of
regulatory policies include prohibition of smoking in public places, licensure requirements for medical
professions, and processes related to the approval of new drugs.
B. Allocative health policies can be distributive policies and redistributive policies.
C. Examples of distributive policies are the funding of medical research through the National Institutes of
Health, provision of public health and health promotion services, training of medical personnel, and
construction of healthcare facilities.
D. Examples of redistributive policies include means-tested social insurance programs, such as Medicaid,
the welfare program, and public housing.
Why is it important to study health policy? - Answers A. Understanding the development of health policy
is the first step toward influencing policy.
B. The study of health policy enables one to engage in efforts to improve it.