Health Policy Frameworks, Systems, and Public Health

Comprehensive vocabulary flashcards reviewing the health policy framework, political power theories, international health financing models, public health prevention tools, and the structures of Medicare and Medicaid.

Health Policy

Decisions, plans, laws, regulations, and actions intended to address health problems across clinical care, environmental protections, safety, and disease prevention.

Content (Health Policy Triangle)

The substance of a health policy, including its specific rules, goals, requirements, and measures.

Context (Health Policy Triangle)

The political, economic, social, cultural, and historical circumstances surrounding the creation and implementation of a policy.

Actors (Health Policy Triangle)

The individuals, groups, and organizations that influence, implement, support, or oppose a policy, each possessing varying degrees of power and differing interests.

Process (Health Policy Triangle)

The way a policy is developed, adopted, implemented, and evaluated over time.

Situational Context

Immediate, short-term events or crises—such as a disease outbreak—that influence health policy decisions.

Structural Context

Relatively stable economic, political, and institutional arrangements in a society, such as a country's established health financing system.

Cultural Context

The prevailing social values, traditions, and attitudes that shape public expectations and policy decisions.

International (Exogenous) Context

Influences that originate outside of a country, including international health agreements, treaties, or global economic pressures.

Problem Identification

The initial stage of the policy process where a specific health issue, such as rising rates of smoking-related disease, is recognized.

Agenda Setting

The stage in the policy process where a recognized health problem receives sufficient public or political attention to become an active policy priority.

Policy Formulation

The stage of the policy process during which decision-makers develop and draft potential solutions, legislative proposals, or regulatory actions.

Policy Adoption

The formal phase where the government or authorized body officially selects, authorizes, and enacts a specific policy.

Policy Implementation

The operational stage where administrative agencies enforce regulations, disburse allocated funding, and deliver mandated services.

Policy Evaluation

The stage in which researchers and officials assess whether an implemented policy achieved its intended public health and economic outcomes.

Regulation (Policy Tool)

A formal public health policy mechanism establishing rules that either restrict or require specific behaviors by individuals or corporations.

Fiscal Measures (Policy Tool)

Policy mechanisms using taxes, levies, or financial incentives to alter economic behavior or generate public revenue.

Service Provision (Policy Tool)

A public health tool whereby the government directly finances and provides medical assistance, treatments, or counseling services to the population.

Information Campaigns (Policy Tool)

Educational and mass media initiatives intended to inform the public and encourage voluntary health-promoting behavioral changes.

Pluralism

A theory of political power asserting that influence is distributed among diverse, competing interest groups that actively vie to shape policy.

Elitism

A political power theory holding that a small number of powerful individuals or corporate entities disproportionately dominate public policy choices.

Public Choice Theory

A framework stating that political actors, officials, and agencies pursue their own private interests and incentives rather than acting purely for the public good.

Beveridge Model

A national health system model primarily funded through taxation, where the government operates many hospitals, finances care, and provides services largely free at the point of delivery.

Bismarck Model

A social health insurance framework financed jointly by employers and employees through regulated sickness funds, utilizing predominantly private health care providers.

National Health Insurance Model

A health system model featuring a single principal public insurer covering the entire population, while hospital and physician services remain primarily private.

Mandatory Regulated Insurance Model

A health care model requiring all residents to purchase basic health insurance coverage from regulated private insurance plans, with state subsidies for eligible individuals.

Fragmented Financing System

A multi-payer health financing arrangement—such as that of the United States—combining private employer coverage, individual insurance, Medicare, Medicaid, and out-of-pocket payments.

Denormalization

The public health process of reducing the visibility and social acceptability of a harmful habit, such as smoking, through public bans and educational measures.

Excise Tax

A targeted tax applied to a specific consumer product—such as cigarettes, alcohol, or soda—intended to deter consumption and generate state revenue.

Adverse Selection

An insurance phenomenon occurring when individuals anticipating higher medical expenses enroll in comprehensive coverage at greater rates than healthier individuals, driving up pool costs.

Affordable Care Act (ACA)

A comprehensive $2010$ federal statute designed to expand health insurance access, create marketplaces, regulate insurance practices, prohibit exclusions for preexisting conditions, and expand Medicaid.

Individual Mandate

A provision introduced by the ACA requiring individuals to maintain qualifying health coverage or pay a tax penalty, which was set to $\$0$ beginning in $2019$.

Medicare Part A

The component of federal Medicare funded mainly by the Hospital Insurance Trust Fund that covers inpatient hospital care, skilled nursing facilities, hospice, and certain home health care.

Medicare Part B

The component of federal Medicare covering physician visits, outpatient hospital services, preventive care, and medically necessary services.

Medicare Part C (Medicare Advantage)

Private, Medicare-approved health plans that deliver Part A and Part B benefits, frequently incorporating designated provider networks and extra supplemental coverage.

Medicare Part D

The federal Medicare program component administered by private plans that provides outpatient prescription drug coverage.

Medicaid

A joint federal-state health coverage program that provides medical care and long-term supports to eligible low-income individuals, with state flexibility in benefits and administration.

Black Box (Political Systems Model)

The internal government decision-making process where policymakers evaluate competing demands, negotiate, and formulate final policy outputs.

Outputs (Political Systems Model)

The tangible laws, regulations, funding allocations, and administrative decisions directly produced by government institutions.

Feedback (Political Systems Model)

The reactions, legal challenges, public debates, or compliance responses generated by an enacted policy that return to the political system as new inputs.