The report explains that the economic impact in poor countries is seen in the form of grants and loans that the World Bank grants. The report explains that credit worthy countries that are extremely poor can qualify for long-term interest free credit. These credits are given under the International Development Assistance program. Although some countries qualify for these interest free credit, they often resort to borrowing funds because IDA funds are limited and based on a first come first serve basis. Countries that have both IDA and loans for the purpose of healthcare for citizens are under what is referred to as an IDA blend. It is referred to in this manner because the terms under which the funds are borrowed is a mixture of the ID and those of the International Bank for Reconstruction and Development (IBRD) program. The author explains that the IBRD program carries an interest rate but is well below the rate that a private financial institution would carry. The author further explains that IBRD loans

"are available to creditworthy countries with a per capita income below $5,225.

When countries reach this threshold, the process of "graduating" from the IBRD

scheme is triggered. In its IBRD loans, the Bank borrows at preferential interest rates and then on-lends to the borrowing country at a rate that is somewhere between the rate the Bank borrows at and the market rate. International Development Assistance credits are financed in part through the income earned on IBRD loans, and in part through contributions from bank members (Wagstaff,

2001)."

Although borrowing money for health services solves one problem, it also creates a problem which is that of debt.. Debt is particularly problematic as it relates to poor countries and healthcare because it effects the ability of the country to get additional loans as the loans are based on creditworthiness. Having to pay back loans also impedes on the ability of the country to provide its citizens with other services. The overall economies of these countries are also affected by the debt because it prevents the government from invest in revenue creating Although there has been some effort to provide these countries with debt relief so that they can move forward and create economic opportunity for the country.

Obviously the economic condition of an entire country along with the economic conditions of the individual family unit affect access to healthcare. In addition, the cost of delivering healthcare to the masses is a real expense. Debates concerning whether or not healthcare should be free or consists of user fees. The research suggests that free healthcare is problematic because the quality of the care isn't as good as fee-based care. In addition, free care often leads to extended waiting periods that can cost people time. On the other hand, fee-based systems are costly for poor people and in many cases the cost associated with fee-based care places the burden on people in society that can least afford it. As such, economic issues affect the development and implementation of health policies.

In addition to the political and economic forces that govern health policy, social forces also exists. Health policy is a social issue because healthcare is a necessity for every human being. There is a time in every persons life when healthcare is needed. As a result of this need health policy is related to the society as it pertains to quality of life issues.

According to many scholars providing healthcare is an ethical issue. Many governments believe that being able to provide healthcare for everyone is necessary for social equity. Social equity guarantees that the resources that are available to some people are available to all people. This includes services such as education, and healthcare. When a society does not provide healthcare for the entire populous in a manner that is affordable and efficient, certain ethical questions arise. The main question that arises is whether or not healthcare is a right as opposed to a privilege. For many, access to healthcare is a privilege because they don't have access to affordable insurance and as such they can not receive the care that they need.

According to Navarro (2009), health policies are also affected by class alliances. Navarro asserts that there is "an alliance between the dominant classes of developed and developing countries -- a class alliance responsible for the promotion of its ideology, neoliberalism. This is the cause of the enormous health inequalities in...

Instead, the author argues, there has been a significant change in the nature and character of the interventions that are offered to citizens. These changes are a result of changes in class (and race and gender) relations in each nation (Navarro,2009).
Public Health and Health Policy

Public health suffers greatly when health policies do not address the needs of the entire populace. That is, when a society helps those who can not help themselves, the entire society is made better for everyone. For instance, when emergency rooms close because so many uninsured people use emergency rooms to gain access to healthcare everyone in the community suffers. That is, the closing of the emergency affects everyone who lives in the community. Because this the case everyone should be concerned with the health policies of a nation.

Public health is also at stake as it pertains to communicable diseases. Even though many communicable diseases have vaccines, people that don't have access to healthcare can not get such vaccines. This means that the entire society is at greater risk for acquiring certain communicable diseases. In addition, in some countries, diseases such as AIDS are often left untreated because people can not afford the medication needed to prolong their lives. This results in an increase in premature death and it leaves many children without parents. A large number of orphans in a society leads to cycles of poverty and lack of education. These cycles prevent countries from moving forward into better economic positions.

Conclusion

The discussion began by defining health policy. The research found that health policy is composed of three primary determinants. These determinants include political, economic, social, and cultural determinants, lifestyle determinants, and socializing and empowering determinants. The purpose of this discussion was to define the relationship between the political, economic and social forces that affect health policy. The research found that all of the aforementioned factors have stakeholders. These stakeholders are affected by healthcare policy and such they have a hand in shaping policy. In the context of politics healthcare policy is shaped by legislation. Politics has the power to influence the type of health policy that is implemented. The investigation also found that economic conditions also have a profound impact on the delivery of healthcare services. The research explains that both grants and loans are made available to some poor countries so that the government can provide healthcare for its citizens. Additionally, poor people are adversely effected form a lack of healthcare access. The research also suggest that health policies that include free healthcare are not always efficient because they include extended waiting periods. In addition the quality of the free care is usually inferior to that of fee-based care. These waiting periods cause people to seek out fee-based healthcare, even if the seeker is poor. Finally, the investigation revealed that there are social forces that affect health policy. The most apparent social forces involve social equity and human rights. Social equity guarantees that all people living in a society have access to healthcare. The research also suggests that access to healthcare should be considered a human right.

Works Cited

Bambra, C., Debbie Fox, Alex Scott-Samuel. (2003) Towards a New Politics of Health. Retrieved on December 11, 2009 from: http: / / eres.welch.jhmi.edu / eres / docs/4464 / bambra_2003_1.pdf

Banerji D. (2006) Serious Crisis in the Practice of International Health by the World Health Organization: The Commission on Social Determinants of Health. International Journal of Health Services, Volume 36 (4), 637 -- 650,

Muntaner, C., Salazar, R.M.G.,Benach, J., Armada F. Venezuela's Barrio Adentro. (2006) An Alternative to Neoliberalism in Health Care. International Journal of Health Services, Volume 36 (4). 803 -- 811,

Navarro, V. (2007) What is a National Health Policy. International Journal of Health Services, 37 (1) 1 -- 14

Navarro, V. (2009) What we mean by social determinants of health. Global Health Promotion. 16(5) 423-441

Wagstaff A.(2001) Economics, health and development: some ethical dilemmas facing the World Bank and the international community. Journal of Medical Ethics. 27:262 -- 267