Week 2: Health Policy and Health Care Reform Unit Objectives
After completing this unit, you should be able to identify health reform efforts that have shaped our health care system describe the health policy process, from need identification to policy implementation and
modification identify and describe major components of the Patient Protection and Affordable Care Act
(ACA) Unit Lecture
The United States spends over 17 percent of its gross domestic product (GDP) on health care
(Kaiser Permanente International, 2011) and spends more money per capita on health care than
any other industrialized nation, yet it is ranked 37 out of 191 nations in terms of health care
system quality (WHO, 2000). Additionally, the United States has an alarming shortage of primary
care providers. This shortage is only going to become more problematic with the implementation
of the Patient Protection and Affordable Care Act (ACA), which is meant to ensure the provision of
health insurance to approximately 30 million previously uninsured people (Bodenheimer & Pham,
2010). Problems in the US health care system can largely be traced to previously implemented
health policies or gaps therein; solutions will have to come from the drafting and administration
of new policies.
Health policy is a subset of public policy, and can be defined as "the decisions, plans, and
actions that are undertaken to achieve specific health care goals within a society" (WHO,
2013). In other words, health policies are those decisions that concern the health of a population
and the provision of health care to that population. Health policies can be used to influence,
or regulate, the actions, behaviors, and decisions of others, such as in requirements that
providers be licensed or that health care facilities be accredited; or they can be used
to allocate resources.
Policies developed to allocate resources can be further broken down into distributive policies (Shi
& Singh, 2012), where the benefits are dispersed throughout society, such as with research
funding or graduate medical training; and redistributive polices (Shi & Singh, 2012), which
reallocate resources for the benefit of a certain group, as occurs with programs such as Medicare
and Medicaid.
Shi & Singh (2012) list several features of US health policy that act or interact with one another
to differentiate our system from those of other industrialized nations. The first differentiating
feature is the subsidiary role the government plays to the private sector, with the majority of
health care financing coming from private sources. The second feature is the adoption of
fragmented reform initiatives meant to serve as temporary "fixes" to isolated segments of the
health care system, as opposed to the activation of long-term solutions meant to impact the
system as a whole.
The third feature is the presence of pluralistic politics, which affects both suppliers and
demanders. Health care in the United States has numerous stakeholders, such as politicians,
lobbyists, and citizens, who have a vested interest in, and who attempt to influence, policy. Finally, the decentralized role of the states, and their ability to develop or tailor policies to meet
the needs of their respective citizens, differentiates our nation's system from those of other
countries. These four features, singularly and collectively, influence the health care policies
adopted and implemented in the United States.
The development of national policies is a complex process that begins with the identification of
an issue or need and then involves the creation of the policy, legislative approval, and, finally,
implementation. It may become necessary at a later date for legislators to change or modify the
policy. For major or contentious policies, there may be only a small window for successful
passage. This was certainly the case with the ACA, the passage of which necessitated alignment
among the Democratic president, the Democratic majority in Congress, and public concern about
the unsustainable growth in health care expenditures and the increasing number of uninsured
citizens.
The ACA is the largest health reform initiative this country has ever attempted. There have been
many reform efforts over the past century—some successful, some not. In fact, virtually every
president since Theodore Roosevelt, who campaigned (unsuccessfully) for a third term in 1912 on
a platform calling for universal health insurance (Henry J. Kaiser Family Foundation, 2009), has
attempted some sort of health reform. The difficulty in passing comprehensive health reform
initiatives tends to reside in the gap between the stated preferences of the population and its
willingness to take an active (i.e., financial) role in supporting the initiatives.
According to the Henry J. Kaiser Family Foundation (2009), opinion polls dating back several
decades typically reflect strong support for guaranteed access to care, comprehensive insurance
for all citizens, and a larger role for the government in health financing. This support quickly
diminishes, however, when people are expected to contribute to the costs of these initiatives.
The passage and implementation of the ACA will dramatically change the dynamics of the US
health care system. One of the more immediate results is the provision of health insurance to
millions of Americans who were previously uninsured. This will have second- and third-order
effects on other aspects of the health care system, such as the availability of primary care
providers, and will likely require the modification of existing policies or the development of new
ones.
The readings and activities of this unit will provide more detail on the principal features of US
health policy and the history of health care reform efforts in the United States. We will explore
some of the major components of the ACA. We will revisit this act in week 8, when we discuss the
future of the US health care system. References
Bodenheimer, T., & Pham, H. H. (2010). Primary care: Current problems and proposed
solutions. Health Affairs, 29(5), 799–805.
Henry J. Kaiser Family Foundation. (2009). National health insurance—A brief history of reform efforts
in the U.S. Retrieved December 17, 2013, from http://www.kff.org/healthreform/7871.cfm
Kaiser Permanente International. (2011). Summary of health care systems in the United States.
Retrieved December 16, 2013, from http://xnet.kp.org/kpinternational/docs/Summary%20of
%20US%20Health%20Care%20System%20Jan%202011.pdf
Shi, L., & Singh, D. A. (2012). Delivering health care in America: A systems approach. Burlington, MA:
Jones & Bartlett Learning. World Health Organization (WHO). (2013). Health policy. Retrieved December 16, 2013, from
http://www.who.int/topics/health_policy/en/
World Health Organization (WHO). (2000). The world health report 2000: Health systems: Improving
performance. Retrieved December 16, 2013, from
http://www.who.int/whr/2000/en/whr00_annex_en.pdf

 

• 1499322653-Week 2.docx

SuperTutor

(15)

Status NEW Posted 06 Jul 2017 06:07 AM My Price 15.00

-----------

Attachments

file 1499322659-Solutions file.docx preview (51 words )

S-----------olu-----------tio-----------ns -----------fil-----------e -----------Hel-----------lo -----------Sir-----------/Ma-----------dam----------- T-----------han-----------k y-----------ou -----------for----------- yo-----------ur -----------int-----------ere-----------st -----------and----------- bu-----------yin-----------g m-----------y p-----------ost-----------ed -----------sol-----------uti-----------on.----------- Pl-----------eas-----------e p-----------ing----------- me----------- on----------- ch-----------at -----------I a-----------m o-----------nli-----------ne -----------or -----------inb-----------ox -----------me -----------a m-----------ess-----------age----------- I -----------wil-----------l b-----------e q-----------uic-----------kly----------- on-----------lin-----------e a-----------nd -----------giv-----------e y-----------ou -----------exa-----------ct -----------fil-----------e a-----------nd -----------the----------- sa-----------me -----------fil-----------e i-----------s a-----------lso----------- se-----------nt -----------to -----------you-----------r e-----------mai-----------l t-----------hat----------- is----------- re-----------gis-----------ter-----------ed -----------onÂ----------- th-----------is -----------web-----------sit-----------e -----------Tha-----------nk -----------you----------- -----------

Not Rated(0)

• Buy Answer