Health Policy Exam 1

Role of Policy and Law in Individual and Population Health

Shapes healthcare access, medical practice, and treatment financing. Regulates daily public health measures (e.g., food safety, occupational safety standards) and drives major public health achievements like reducing spread of communicable disease, water and air purification, seat belt laws, etc

What is one main focus of public health policy and law?

finding appropriate balance between public regulation of private individuals and corps while respecting individual rights (free from overly intrusive government intervention)

what are the two types of policies and laws that address competing interests at the heart of public health?

1. those that define functions and powers of public health agencies

2. those that aim to directly protect and promote health

police powers

inherent authority of state and private business in the name of public health and promotion

• government can coerce private parties to act (or not act) in certain ways

EX: mask mandates, requirements to carry around a vaccine card

• man with TB refused to quarantine. CDC physically removed him from a plane

• ^ police powers can protect the health of the public but also infringe on rights

the 3 conceptual frameworks of health policy and law

1. Study based on the broad topical domains of:

• Health care

• Public Health

• Bioethics

2. Study based on historically dominant social, political, and economic perspectives:

• professional autonomy

• social contract

• free market

3. Study based on the perspectives of key stakeholders:

• Individuals

• the public

• healthcare professionals

• federal and state governments

• managed care and traditional insurance companies

• employers

• healthcare industries (like pharmaceutical)

• research community

• interest groups

Framework 1: the topical domains

Health Care: concerned with an individual’s access to care, the quality of care, and how the person’s care will be financed

• health insurance mandates, Medicaid/Medicare policies, physician licensing, and more

Public Health: why and how the government regulates private individuals and corporationsin the name of protecting the health, safety, and general welfare of the public

• food safety inspections, vaccine requirements

Bioethics: point at which public policy, law, individual morals, societal values, and medicine intersect

• genetic testing polices, abortion regulation, end-of-life care

Framework 2: historically dominant perspectives

perspectives of…

professional autonomy: 1880-1960

• physicians had the power to set policies, larger focus on who was qualified to pratice medicine/credential guidelines

social contract: 1960s/70s

• healthcare laws and policies that were born bc of lack of access to healthcare and inability to afford it (ex: Medicare and Medicaid)

free market: 80s - now

• commerical competition and consumer empowerment

• “let the market decide”

professional autonomy perspective

most dominant of the 3 perspectives (lasted longest and shaped a lot of health policy and law)

premised on idea that physicians’ scientific expertise should translate into legal oversight of the practice of medicine

social contract perspective

Belief that unlimited physician autonomy can harm patient care and raise costs, so policy and law should enforce a social contract at expense of physician control

• treating physicians as one of many key stakeholders

free market perspective

belief that the markets for healthcare services and for health insurance best operate in a deregulated environment, and that commercial competition and consumer empowerment will lead to the most efficient system

• claim that both other models will inflate costs

• ^ self-interest leading physicians to drive up cost of their own services using professional autonomy, Medicare leading individuals to seek unnecessary care bc of social contract

Framework 3: perspectives of key stakeholders

thinking about health policy and law issues in terms of the individuals and entities impacted by a particular policy or legal determination

____ and ___ are two of the primary drivers of health reform

policy and law