Health Policy Making
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In Microsoft Word, complete essay questions 1-5. For each question, write a thorough and well-reasoned response. 1. Discuss the roles of federal and state governments in health policy. 2. Compare and contrast the operation of traditional economic markets with that of policy markets. 3. Who are demanders and suppliers of health policies? What motivates each in the policy marketplace? 4. Compare and contrast the pluralist and elitist perspectives on interest groups in policy markets. 5. Define power and influence. What are the sources of power in policy markets? Textbook: Health Policy making in the United States 6th edition by Beaufort B. Longest, JR. Use the attached from last week as a template.
Module Activity One 16
Jennifer L. Callahan
Dr. Frank Fan
September 2, 2018
Module 1 Activity
Defining Health and Identifying Human Health Determinates
The definition of Health can and has been controversial. Some definitions are much looser in clarity than others. Most individuals define Health simply by stating that Health is the sum of injury or illness in one’s life. While this is a factor in overall Health, there is a much clear and reputable definition of what Health truly is. The World Health Organization defines Health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 1946).
Because health is multifaceted, it is necessary to define and identify what the human health determinates are. Health determinants are a range of personal, social, economic, and environmental factors that influence health (HHS 2014a). Decades of research, studies, and evaluations have evolved our basic understanding of determinants from four major influences to a much more comprehensive list. The original four influences included: environment, lifestyle, heredity, and medical care. Healthy People 2020 (www.healthypeople.gov), the national agenda for improving health, provides six major influences today which include: biology, behaviors, social environment, physical environment, public and private-sector programs and interventions, and quality health services.
Defining Public and Health Policy
There are two sectors in which health policy applies. Those sectors include the public (government) sector and the private sector. Policies exist to carry out behaviors, actions, and decisions. Policies guide an organization and its employee’s in how to behave, conduct business, and to achieve organizational goals. Executive staff, and those appointed by them, carry the authority to establish or modify policies as needed to ensure the organization is fulfilling the expectations and functioning within laws and regulations.
Public Policy is generally defined as the sum of government activities, whether acting directly or through agents, as those activities have an influence on the lives of citizens (Peters, 2013). Health Policy is a specific version of public policy. The difference between private and public health policy is the primary focus. Policy that specifically focus on health or influences action aimed at health are referred to as health policy rather than public policy.
Forms of Health Policy
Health policies are categorized into four different forms which include: law, rules or regulations, other implementation decision, and judicial decisions. Policy laws are enacted at all levels of government. Laws typically drive extensive activity and effort from entities across the board and seek long-term implementation. In February 2017, Senate introduced the Childhood Cancer STAR act (S.292). This bill was an amendment to the Public Health Service Act and authorizes the National Institutes of Health (NIH) to provide support in collecting medical specimen’s and information of children and young adults whom have cancers with the least effective treatments. The amendment aims at better understanding these forms of cancers and the effects of their treatment. Further, this amendment establishes grants and registries through 2022 with the Centers for Disease Control (CDC), establishes support programs and task forces through The Department of Health and Human Services (HHS) and mandates Psychosocial care for Pediatric Cancer Survivors, and requires the Government Accountability Office make recommendations regarding financial barriers cancer survivors encounter (www.congress.gov, 2018).
Law implementing administrative agencies are taxed with policy development known as rules or regulations. Administrative agencies are deeply empowered with producing, facilitating, and distributing rules and regulations they are authorized to handle and those of which are deemed necessary. Administrative agencies are official government bodies and can also be categorized into a multitude of bodies including: boards, commissions, agencies, divisions, corporations, and departments. July 30, 2018, the Office of the Assistant Secretary of Defense for Health Affairs, DOD published an information collection notice in relation to the Paperwork Reduction Act of 1995. The DOD and the Office of the Secretary are seeking to collect information from the public regarding the necessity of information collected and how it relates to the proper performance of the agency’s primary function’s. The feedback solicited includes topics such as enhancement opportunities, clarification of information collection, and reduction of burden in the information collection process (www.federalregister.gov, 2018). Currently, this rule is still in process but is set to be heard after public feedback collection closes on September 28, 2018. A rule or regulation will be implemented following review of the publics input.
Implementation decisions are policy and are frequently instituted by executive branch organizations and agencies that are tasked with carrying out the implementation of laws and rules or regulations. This form of health policy receives laws and rules or regulations and works to implement them nationwide. The process of implementation often requires evaluation and decision making regarding the best approach to ensure successful implementation. This process results in the implementation decision form of health policy. In October 2017, The Food and Drug Administration implemented a Generic Drug User Fee Amendment. This implementation began October 1, 2017 and spans through September 30, 2022. The amendment creates consistent access to high quality and safe generic drugs and drug products and details an implementation plan (www.fda.gov, 2018).
Judicial decision health policy comes from the court system. Inevitably, an issue will arise between healthcare providers, their organizations, the government, and any multitude of agencies in between. When an issue arises that is related to a law, rule or regulation, or implementation decision, a court action or suit can be filed. Judicial decisions make decision impacting the standing of an afore mentioned healthy policy to permanently resolve the concern presented. Judicial decisions can take place within any level of the judicial system. In 2011, Congress allowed a transfer of patent challenges and the forum in which they are heard. This ruling moved patent challenging from litigation in court to a board of appeals internally with the U.S. Patent and Trademark Office. This resulted in alleged unfair overturns. A supreme court case was filed where the plaintiff argued that the patent review process was unjust and did not serve its purpose. The pharmaceutical industry agreed with he plaintiff and onboarded their support arguing that the patent review process allowed brand name drug makers to abuse the patent system in maintaining their high prices. The Obama administration defended that they were within their authority legally when they modified the review process to allow more broaden interpretation of patents. Subsequently, the supreme court ruled that the inter partes review process will remain with the U.S. Patent and Trademark Office and not with the Circuit Court although if one prefers, a case with the circuit courts can still be filed (www.supremecourt.gov).
Compare and Contrast Health Policy Forms
Health policies take two categoric forms: allocative policies and regulatory policies. Allocative policies provide benefit to a distinct class of group of people or organization, usually at the cost of others, and aims at achieving public objectives. Allocative policies cater in the form of a subsidy, come with federal funding, and most often benefit poverty-stricken families, or those with a high identified financial need. Essentially, allocative policies help bridge the gap in care for those who cannot afford their needs independently. Examples include Medicaid, food stamps, WIC, and government housing. Regulatory policies exist as means to drive influence and often triggers behavior, actions, and decisions as directed through policy. Each level of government carries the authority to establish regulatory policy and aim at achieving public objective. Regulatory policy can be categorized five ways: market-entry restriction, health services quality control, social regulation, controls to preserve market, and health service provider rate and price controls. Regulatory policy can often overlap with allocative policy and ultimately directs the involved entities, agencies, etc. into fulfilling the needs of the public and to meet objects set forth by the government.
115th Congress. 2018. “Childhood Cancer Survivorship, Treatment, Access, and Research Act of
2018.” Accessed September 2, 2018 at https://www.congress.gov/bill/115th-congress/senate-bill/292?q=%7B%22search%22%3A%5B%22health+care%22%5D%7D&r=1
Peters, B. G. 2013. American Public Policy: Promise and Performance, ninth edition. Thousand Oaks, CA: CQ Press.