5 Features of US Health Policy

GPPPS

1. Government as Subsidiary to the Private Sector
2. Fragmented, Incremental, and Piecemeal Reform
3. Pluralistic and Interest Group Politics
4. Impact of Presidential Leadership
5. Decentralized Role of the States

Describe the Public Policymaking Model

Describe the different forms of Health Policy

(How does each branch affect policy?)

Regulatory Policy

call on government to prescribe and control the behavior of a particular target group by monitoring the groups and imposing sanctions if it fails to comply.

Allocative Policy

the direct provision of income, services, or goods to certain groups of individuals or institutions

Destributive or REDestributive

3 components of the

Policy Making Model

1. formulation
2. implementation
3. modification

What are the 4 Critical Policy Issues?

Where are the (5) main Access Concerns?

MERLA

–Access and the Minorities

–Access and the Elderly

–Access in Rural Areas

–Access and Low Income

–Access and Persons with AIDS

What are the 3 branches of Government?

Executive (President)

Legislative (Congress)

Judicial (Supreme Court)

How did the ACA pass?

–        Kept details from public to avoid criticism

–        Democratic congress

–        Insurance Buy-In

–        Economic Downturn

What 2 states set precedents for

the ACA to pass in 2010?

Oregon and Massahusets

Define Health Policy

Authoritative decision made

within government regarding healthcare

What authority does the legislative branch have?

Enacts laws

Creates and funds health policy

Balances health policy with other policy demands

What authority does Executive branch have?

Implement Laws

Approve/Veto legislation

Propose legislation

Judicial Branch health policy authority

Interprets laws

Creates body of case law

Preserves rights of citizens

Resolves disputes

3 Precedants of Reform

from Oregon's Health Policy

SEE

State coverage for pre-existing conditions

Employer Mandate

Expansion of Medicaid

4 Precedents of Reform

from Massachusett's Health Policy

EPIC

Employer Mandate

Premium Subsidies for poor

Individual Mandate

Central Exchange for health insurance

3 Dilemmas of Healthcare Reform

UPC

Universal Coverage (requires single payer)

Pre-existing conditions (underwriting w/o risk rating)

Cost (reform is unstable w/o cost control)

Explain

    Health policy as a by-product of social policy

Insurance tied to employers as a result of wage-freezes during WWII and a Supreme Court ruling that employee benefits, including health insurance, could be legitimately included in the collective bargaining process

Jurisdictional fragmentation

Distribution of congressional committee hearings on health-related issues divided among more committees than hearings in any other policy domain

31 committees and sub-committees deal with healthcare

Why did the Clinton Healthcare plan fail?

–        More transparent and caused more opponents. 

–        Insurance did not support. 

–        Missed window of opportunity