Introduction to Health Policy and the Policy Process単語カード

policy

consciously chosen course of action (or inaction) adopted by governments and/or other institutions to address a public problem - it can take the form of a law, regulation, rule, procedure, administrative action, incentive, or voluntary practice

Public policy

laws, rules, and regulations enacted to address social issues

Health policy

the subset of public policy dealing with how the health system is organized, financed, and/or delivered

Regulation

the use of governmental authority to control or change some practice in the private sector

Regulatory Policy

Policy that results in government control over individuals and businesses. Examples FDA, restaurant inspections

distributive policy

A type of policy that provides benefits to all Americans- the HRSA Community Health Center program

Redistributive Policy

A type of policy that takes benefits (usually through taxes) from one group of Americans and gives them to another (usually through spending), i.e. Medicaid

Constituent Policy

Policy designed to benefit the public generally or to serve the government (Ex homeland security)

Roles of Health Policy

- Define the functions and powers of health agencies

- Aim to directly promote and protect health

Public health rests on paternalism; what is this?

Authorities restricting individual choice in the name of the public's own well-being

Social Determinants of Health

Education access and quality

Economic stability

Healthcare access and quality

Neighborhood and built environment

Social and community context

Why is health political?

- SDoH tend to be the root cause of good or bad health

- The drivers of SDoH are based on political decisions

- So the causes of health and disease may be driven by politics as much as by anything else

Framing the Issue

- Agenda settings and problem identification

- Identifying populations at risk

- Identifying stakeholders

Building the Response

- Proposing potential solutions

- Message framing and distribution

- Program planning, development, and implementation

Weighing the Impact

- Evaluation

- Economic, political, and social impacts

- Considering alternative solutions

- Anticipating intended and unintended consequences

Health in All Policies (HiAP)

A collaborative approach that systematically factors health, equity, and sustainability considerations into decision-making across all sectors and levels of government - not just health agencies

Health in All Policies matters because it enables us to:

- Respond to "Social Messes": Tackle complex problems no single sector can solve alone

- Innovative: create solutions that advance interdisciplinary, intersectional thinking

- Use Resources Efficiently: Coordinate across agencies instead of duplicating effort

5 Key Elements of HiAP

1. Embed Health Everywhere

2. Make it the Norm

3. Pursue Co-Benefits

4. Engage Stakeholders

5. Institutionalize Change

What is the Policy Process?

1. Problem identification

2. Policy Analysis

3. Strategy & Development

4. Policy Enactment

5. Policy Implementation

6. Evaluation (throughout all steps)

Problem Identification

Frame the issue, gather data on its scope and its impact, and identify gaps in the evidence

Policy Analysis

Identify and weigh options by health impact, cost, and political feasibility

(What will get through the easiest based on cost, current administration, etc.)

Strategy and Development

Plan how the policy will be adopted and operate; engage stakeholders; draft the policy

(Who will push it out to the masses; what media group, what legislator will sponsor policy)

Policy Enactment

Follow internal or external procedures to formally pass or authorize the policy

Policy Implementation/Rollout

Translate policy into practice, build capacity, monitor compliance, and evaluate impact

Who influences policy?

Policy actors are individuals who participate in the development and formulation of policy

Ex: Legislators, institutional and organizational leaders, coalitions, agencies, lobbyists, professional organizations, political parties, media (a key policy gatekeeper)

Legislators

- Introduce bills

- Vote on policies and laws

- Debate different policy ideas

- Discuss policy, come up with plan, and present proposal

-President or governors can veto bill

- People who make the laws; vote to pass the laws, idea is that they are working in the public's interests; representation across the constituents is not always the same, can be influenced by those who donate the most money; try to especially make constituents happy when election year; many legislators have special interests and propose bills in that area; serve on subcommittees and can hinder policies from being on the floor to vote in these subcommittees

- Their staff members draft bills, read evidence, and brunt of work

President

- Constitutional power, executive orders- written directive to manage the operations of the federal gov't.

- Legislative influence: has veto power to reject bill from congress

- Power in military action

- Executive agreement power

- Clamency- pardon people of crime

- Executive order: whenever president issues, it is directed at administrative agency to carry out certain action to enforce laws; sometimes come at a time that we need them for emergencies (COVID mask and vaccine mandates), in times of crises

- Works very closely with administrative agencies to ensure order is being enforced the way they want to

- Can set agenda for legislators (if same party controls house or senate that will greatly influence passing of policies)

Administrative agencies

- Influence and shape public policy by turning broad legislative goals into specific, binding rules, enforcing them and resolving disputes

- What: implement policy by turning laws passed by the government into everyday rules, actions, policy → action (regulation)

- Write the rules, checking

Supreme court

- Cannot create public policies

- Core part of system of checks and balances

- Can affect policies involving individual rights and healthcare

- Determines if things are constitutional

- Once supreme court makes a decision it is called case law

- Precedent for all other rulings regarding this afterwards

- Ex. Brown v Board of Ed- said segregation is unconstitutional

Special Interest Groups

- Very important

- Tasked with talking to legislators to get them to propose a bill, lobby lawmakers

- No bill is passed without a lobbyist hand on it

- Special interest groups hire lobbyists to get whatever the special interest of the group is passed

- Ex. NRA, tobacco lobby, anti-tobacco lobby

-Big part of setting agenda for legislators

Media

- Influence policy by sharing problems leading to more attention on that issue

- If there is no coverage, no one will fight for it or pay attention

- Media sets agenda for public

- Influence what people hear, how often, and when

Political parties

- An organized group of people who share similar political views

- Leadership priorities → who they want in office

- Influence public opinion on policies

- Lobbying and interest groups

- Writing/setting agendas (for what they want and don't want you to see)

- Running campaigns for people, beliefs, and policies they want to see go into action

Public Health Professionals' Roles

- Educate policymakers and opinion leaders

- Help set the legislative agenda

- Speak for those who cannot speak for themselves

- Most non-profit and government employees may NOT: Work on behalf of a candidate or Lobby for or against specific legislation