Categories of Health Policy. Health

¶ … categories of health policy.

Health policies are a form of the broader field of public policy. What constitutes public policy is difficult to define but it is generally assumed to include any activity by government that affects the lives of ordinary citizens (p.5) in the text public policy was defined "as authoritative decisions made in the legislative, executive, or judicial branches of government that are intended to direct or influence the actions, behaviors, or decisions of others (p.5).

Health policies in the United States are established through the public policy making process (p.6). Some of the health policies are determined through the public policy making process while others are determined through the private sector. Regardless of where the policy is formulated there are essentially two basic types of policies. The first type is regulatory that influences the actions, behaviors, and decision of others (p.8).

The second type of health policy is identified as allocative (p.13). These policies are essentially subsidies that are intended to influence or alter the demand for or supply of particular health care products and/or services so that such products and services are guaranteed access to them. Two of the most obvious public allocative policies are the U.S. Government's practice of subsidizing medical education and the construction of hospitals in an effort to ensure that the supply of physicians is guaranteed and that hospitals will be available in areas that otherwise would not be served.

As to regulatory policies, the presumption is that the private market place should determine most issues but that some measure of regulation is necessary to ensure that markets do not fail (p.12). In order to forestall this from happening, some form of government intervention is necessary and regulatory policies are the mechanism through which this is insured.

2) Discuss the connection between health policies, health determinants, & health.

The essential purpose of all health policies, regardless of type, is to support the general public in their quest to seek good health (p.16). These policies are applied to specific situations through a set of variables known as health determinants (p.16). These health determinants as affected by health policy, in turn, directly affect health. The health determinants include the physical environments where people live and work; behavioral choices and biology; social factors; and, availability of and access to health services.

It is the role of health policies to dictate how these individual health determinants ultimately affect the public's health (p.16). Through the application of health policies the public is hopefully provided with protection against the various health determinants that affect health. Over the years, for instance, health policies have made it possible for additional protections to be provided against potentially hazardous situations such as smog, asbestos, lead-based paints, and tobacco-based products. The application of health policy has affected how the health care industry has addressed these health determinants and, in the end, how the health of the general public is also affected. The ultimate concern is health. Toward this end, health policies must be formulated that address the various variables that have the potential to affect health. As these variables are changeable, health policies must be adaptive as well. On occasion, health policies fail to properly and adequately address the health needs of society as the present controversy over the recent enactment of the Affordable Care Act clearly demonstrates. During such time there is a period of time when the health determinants are out of balance and new health policies must be formulated (p.21).

3) Describe the nature of problems that drive policy formulation.

In the process of developing health care policy it are the problems that are viewed most urgent that receive the most attention (p.61). It is rare event when the legislature anticipates the needs of the industry and formulates policies in advance of when they are needed. Instead, health care policies are generally formulated after a near crisis has developed (p.62). Again, taking the present problem of health care and health insurance in the United States, the problem is not a new one. The problem has been around for several decades and it is only now when there are over forty million uninsured Americans and health costs have seemingly spiraled out of control that the U.S. Congress has decided to address the problem.

On occasion, health policy changes also occur in response to an attempt to address other, closely linked, problems (p.64). Again, this has been recently evidenced by the recent battles in Congress over the federal budget. Although the budget deficit did not directly involve health care policy, the result was a compromise on the budget that required a corresponding change in the health care policy as to Medicare. This is not an unusual situation in the area of health care policy. Often, budgetary concerns must be addressed which in long-term have an impact on the formation of health care policy.

The formation of health care policy does not occur in a vacuum and there is a constant struggle between interests. Too often the concerns of the majority are afforded too much consideration and the interests of smaller and seemingly less important segments of society are overlooked. This is a serious problem for policy makers and one that reoccurs frequently but a problem that is inherent to the process that policy is developed in a democratic society (p.68).

4) Discuss the concept of incrementalism in public policymaking.

One of the phenomena of policy making is the concept of incrementalism. In some isolated situations, public policies might undergo wholesale changes but in most cases public policy changes in stages which is described as incrementalism (p.150). The enactment of the Medicare program and the recent enactment of the Affordable Care Act are both examples of wholesale change but such enactments are the exception. The general governmental approach to policy change is to do so by building upon existing programs and modify them in response to what are seen as current needs. Wholesale changes are viewed as being disruptive and tending to upset the equilibrium that governments tend to prefer.

The process of incrementalism is believed to more predictable and the result is greater stability. It is only in the direst of circumstances that wholesale changes are considered; when an immediate or radical change is viewed as necessary. Because most policy changes demand that compromise be made between the parties, incrementalism makes such compromise more palatable for those concerned. Because the proposed changes are minimal, there is less chance for there to be major disagreement on the issues (p.150). In situations demanding wholesale change, there is less room for compromise as the parties are not confident how such changes will impact society. When the changes are minimal, the parties are more prone to experiment with new ideas because there is less to lose if the new ideas are not successful. With wholesale change there is a greater chance that the program will fail and picking up the pieces of such failure will be more difficult and expensive (p.151).