Policies Midterm Flashcards
What makes people sick?
Lifestyle
Diet
Economy
Lack of access to care DOES NOT make people sick! Preventative care doesn't prevent you from getting sick cuz what can be done? Other than vacancies what can clinicians do?
Discussion post dont need peer response
Quizzes are on the textbook
HR1-a big law passed in 2025
• It was known as the “Big Beautiful Bill”, but that was not its official name.
• It made the 2017 tax cuts permanent → people keep paying lower taxes.
• It spent more money on border security.
• It cut money for Medicaid and SNAP → fewer benefits for people who need help.
• Added new work requirements for Medicaid → some people could lose their health insurance.
• Removed some clean/green energy tax credits.
• It is expected to increase the national debt by about $3 trillion over 10 years.
• Higher-income people benefit more, while poorer people may lose benefits and have less money.
Hospitals depend on Medicare. Medicare is given to people that don't work or work but dont show paper work for it. but it is being changed by midterm because they dont wanna hurt their voters before they vote for them.
DOGE- Department Of Government Efficiency
The Department of Government Efficiency (DOGE) drove large-scale federal workforce reductions and terminated or scaled back billions in government contracts and grants before concluding its operations on July 4, 2026
Put everyone in the government aka trump, robert whatever the ani vax guy and put what they do there background.
Is health care a right?
What is a health disparity?
Differences in health status between a group and a comparison group
What are Health Inequalities?
The measurable differences in health status, outcomes, or access to healthcare between different population groups that can be avoidable.
Medicare spending accounted for 13% of the federal budget
Medicaid = healthcare for low income
Medicare = healthcare for 65+
Social Security = Retirement → income/money
How does the U.S Pay for wars? ‘
As of WW2 it has been taxing and borrowing money which increases government debt.
Big Pharma- Big pharmaceutical companies
Hated on due to high cost on prescribed drugs
9% of expenditure goes to it
More money actually goes to hospitals but they get no hate
Hospitals are expensive, but people often see them as providing a service directly → doctors, nurses, surgery, emergency care, etc.
Big Pharma is just seen as a company(s) that makes the medications, and people may be more critical of them because of drug prices and large company profits.
Both can be expensive, and hospital bills can be much higher than drug costs.
Why the Hate Summed Up ?
Because people often connect pharmaceutical companies with high drug prices + profits, while hospitals are more associated with actually treating and saving people.
Alternative Health Insurance/Health System Models
Bismark Model
Coverage is universal
Financing comes from employee/employer
Government regulated
Private insurers
Private providers
Used in France, Japan, Germany
Beveridge Model
Universal coverage
Taxation base, government financed
Public payer
Public and private providers
Used in UK, Spain, Italy
National Health Insurance Model
Universal coverage
Taxation based, government financed
Gove regulated and managed
Public payer
Private providers
Used in Canada, South Korea, Taiwan
The U.S. basically used parts of this model but did not make it universal → Medicare is mainly for people 65+
Out of Pocket Mixed Model
Group or individual coverage
Not everyone is covered
People may have group insurance, individual insurance, or no insurance
People pay some healthcare costs themselves
Can have a mix of public and private insurance/providers
Not universal
Used in countries with less organized or mixed healthcare systems
The U.S. has a mixed system → Medicare, Medicaid, private insurance, employer insurance, and out-of-pocket payments.
OSHA- Workplace safty
!!!Federalism is in the midterm!!!!
What is Federalism?
Giving States the power to choose what to do
Governmental power and responsibility sharing
Centralized federal government
Decentralized State government
Advantages of federalism
Ensures diversity of policies and programs across diverse population and regional issues
Minimizes policies conflicts
Produces a healthy dispersal of power
Enhances governmental experimentation and innovation
DOBS Decision overturn Roe Vs. Wade
Roe Vs. Wade gave women the right to access abortion medication so now it is not national, it is given to states to decide.
Levels Of Government
National/Federal
Sate
County
Municipal
Layer Cake Vs. Marble Cake Metaphors
Some federal policies touch the local level
Some state policies transcended national per
Three Branches Of Government
Legislative -> Creates policy
Executive-> Executes Laws
Judicial-> Interprets laws and determines whether they are constitutional
Legislative
100 senators (2 from each state) they serve 6 years
House of Representatives
Has 435 people they serve 2 years (midterms are to re-elect them and a 3rd of the senators)
They represent people residing within their congressional districts within states
Representatives are much closer to the people so they care more and hear us out more
Speaker Of The House
They are a party with a majority of seats
They assign bills to committees and make critical appointments
House Majority and minority leaders
They are elected by their party caucuses and act as strategist and spokespersons for the pirates
Whips
Vice President
Other than being back up present he can flip the scale when senators vote 50/50 on a bill.
The Committees
Standing
Special
Conference
Joint
How Does A Bill Become a Law?
The Congressional Agenda
Member of congress drafts abd submits a pice if legislation
A citizen can draft legislation, but congressperson has to submit it/introduce it
Being on the agenda does not equate to legislative action
Mandated business and other bills compete for attention
A legislation can start in the House or the Senate
A bill needs 51 votes on it to win. (Majority vote) And one presidential signature.
The president can veto it and it means it disappears but congress can deny the veto.
A president can sit on a law to save their face which suck
A pocket veto is when a president knows that congress is gonna veto his vote so he just sits and waits for it to happen.
Filibuster and Cloture
A technique to delay voting on a bill by having the floor indefinitely
A hold is scheduling rule in the sante that allows senators to stall voting on a bill
Now they just bring bills with 50 votes so that there will be no filibuster
What Facilitates Public Policy?
Consent to Be Governed (The Authority)
Gives the government the legal right and power to act.
Builds public trust, making people more likely to follow new laws.
Keeps the political system stable so long-term plans can work.
Public Interest (The Purpose)
Focuses policies on helping the whole community, not just a few people.
Justifies spending taxpayer money on public needs like roads or schools.
Brings different groups together by focusing on a shared goal.
There will forever be conflict in public interest
Policy Actors (The People)
Inside Government: Leaders, lawmakers, and judges who officially write and pass laws.
Outside Government: Citizens, media, and activist groups who push for changes.
Experts: Scientists and researchers who provide data to make sure policies actually work.
Difference between official and unofficial policy actors
Official Policy Actors (Inside Government)
Who they are: Lawmakers (Congress/Parliament), executives (President/Governors), judges, and government bureaucrats.
Their role: They hold formal constitutional power to propose, debate, pass, and enforce public policies.
Key feature: Their decisions are legally binding on citizens.
Unofficial Policy Actors (Outside Government)
Who they are: Individual citizens, interest groups, lobbyists, political parties, the media, and think tanks.
Their role: They push problems onto the government's radar, lobby officials, shape public opinion, and provide research.
Key feature: They have no legal authority to pass laws; they can only persuade or pressure official actors.
What is the agenda?
The lists issues and problems individuals and org are paying attention at any given time
Types of agendas:
Informal agenda and public agenda- The broad list of issues that everyday citizens, the media, and social movements are actively talking about and worrying about.
Formal Agenda: The official list of items that a government body has formally agreed to look at, review, or schedule for a committee.
Governmental Agenda: The specific problems within government that officials feel an urgent, active obligation to prioritize and solve.
Decision Agenda: The final, narrowest list of issues that are up for an immediate, definitive vote or official signing.
What is an Agenda setting?
Is the process by which specific public problems earn the attention of the media, the public, and government officials, deciding which issues will be addressed through public policy and which will be ignored.
The Core Action: It acts as a gatekeeper that transforms a general societal problem (like a postpartum healthcare shortage) into an active political debate.
The Power Dynamic: It determines what people think about, meaning the actors who control the agenda hold immense power over what laws eventually get passed.
The Process: It relies heavily on unofficial actors (like the media or advocates) to stir up public concern until official actors (like lawmakers) feel forced to move the issue onto a government agenda.
Group competition within agenda setting
Limited resources and capacities
Groups fight to earn their issues places in the agenda- or to prepare for the time when an event makes their issue relevant/palpable/appealing
The issue-attention Cycle (Anthony Downs)
Five stages
The pre-problem stage
Alarmed discovery and euphoric enthusiasm
Realizing the cost of significant progress
Gradual decline of intense public interest
The post problem stage
HEALTH CARE VS HEALTH DISPARITY QUESTION ON MIDTERM
health inequities examples on addressing:
Providing access to healthy foods (SNAP) and safe places for physical activity in underserved communities.
Improving housing conditions and environmental quality in communities experiencing higher health risks.
Expanding health education and prevention programs for populations with higher rates of certain diseases.
Addressing social determinants of health such as income, education, transportation, and housing.
(WICK)
(TANF) welfare- money from the government to help low income people that work. Only given for a total of 5 years in your whole life.
healthcare inequities examples on addressing:
Expanding health insurance coverage so more people can afford medical care.
Increasing the availability of clinics and healthcare providers in underserved areas.
Providing language interpretation and culturally appropriate healthcare services.
Reducing barriers such as high costs, lack of transportation, and long wait times.
Expanding access to preventive care, screenings, and vaccinations for underserved populations.
What if anything, different health inequities and healthcare inequities?
Health inequities refer to unfair and avoidable differences in overall physical and mental health outcomes, while healthcare inequities specifically mean unequal access, treatment quality, and resources within the medical care system
An example of a consequence of public policy makers confusing health equity issues for a healthcare equity issue?
EX: Investing heavily in building more clinics or expanding health insurance coverage in a community while ignoring toxic housing, poverty, and food deserts.
What is meant by pluralistic politics, and how can it have positive and negative consequences for health policies addressing health equity?
EX: Pluralistic politics refers to a political system in which many different groups, organizations, and individuals compete to influence government decisions and public policies. In health policy, this means that groups such as healthcare organizations, community groups, businesses, advocacy organizations, and different populations may all have a voice in shaping policies. This can have positive consequences for health equity because it allows underserved communities and advocacy groups to bring attention to health disparities and push for policies that improve access to healthcare and resources. However, it can also have negative consequences because groups with more money, political connections, or resources may have a greater influence on policymakers than disadvantaged communities. As a result, policies may favor powerful groups rather than fully addressing the needs of populations experiencing health inequalities.
Pluralistic politics- a system where multiple diverse groups, interests, and organizations compete and negotiate to influence public policy and power.
How to Identify Vulnerable Populations three key ways
Health needs- socioeconomic, access
Predisposing- genetics, family culture, race, gender
Enabling insurance coverage, social & physical support to get health
The G7
Group of seven advance nations
Members: Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States, plus the European Union.
Benefits: Its small and homogenous membership allows for fast, direct, and consensus-driven discussions among wealthy democratic allies on global economic stability, security, and climate issues.
Drawbacks: Critics note it lacks formal enforcement and excludes major emerging global power
The G20
Group of the largest economies of the world
Members: 19 individual countries, the European Union, and the African Union. It includes all G7 nations plus major emerging economies like China, India, Brazil, and South Africa.
Benefits: It represents around 85% of global economic output and two-thirds of the world's population, making global financial and economic policymaking far more representative and inclusive.
Focus: It serves as the premier global forum for international economic cooperation and financial crisis management
Homeless vs poverty vs ALICE
NIH- National Institutes of Health
What do they do?- Receives grant proposals and directs them to specific Scientific Review Groups (also called Study Sections).
How do they decide whom to give money?-
Once assigned, a Scientific Review Officer (SRO) matches the proposal with at least three expert peer reviewers. These experts:
Evaluate the proposal thoroughly before the meeting based on specific scientific and technical merit criteria.
Write detailed critiques highlighting the strengths and weaknesses of the proposed project.
Assign preliminary scores (typically on a 1-to-9 scale) to determine the application's potential overall impact.
Health Care Evolution
Medical Services in Preindustrial America
Very unsafe
Poor sanitation
No regulation on what to do and who could do it
Medschools started cuz physicians werent paid so they made a school to get money and leave new physicians in debt
Industrial America
Growth and development accrued
Medicine became driven by science and tech, outside of laypeople
There was a bias toward specialization in medical practice and care
AMA (a galvanized the professions and protected the interest of physicians)
AMA organized medicine and organized school for physicians (Thats why its so powerful)
1974 was the year DO were allowed to be with Physicians
Postindustrial America
AMA discouraged employment if physician by hospital and insurance companies
Advanced in medical science necessitated the reform in medical school
Harvard and John Hopkins University opened in 1893
• They made collage degree to enter a requirement
• Medical training became a graduate program
• Recidancy training was added
The Flexner Report 1910
The continued shortage…
At the turn of the 20th century, federal policy promoted education and research in psychiatry.
1960s: concept of community mental health and deinstitutionalization
Shift to community-based mental health services
Wicked problems and unintended consequenced
Health Insurance in not that far from today America
Workers Compensation
The first broad-coverage health insurance in the U.S
Originally designed to make cash payments to workers for wages lost because of job-related injuries and disease
1929: Justin Kimball began a hospital insurance plan for teachers at Baylor University Hospital in Houston Texas. Became the model for Blue Cross plans across the country
During WW2, employees accepted employer-paid health insurance to compensate for the loss of raises
Creation Of Medicare and Medicaid
Several groups were left out/priced out of health care market
Elderly
Disabled
Unemployed
Self-employed
Women/ children
1950 Amendment to Social Security
1960 Enactment Of Kerr-Mills Program
1965 Medicare and Medicaid
• Part A- hospital insurance
• Part B-medical insurance
ACA
Primary focus was to expand health care insurance coverage to near universal levels
*Policy Imagery- refers to the core shorthand way a public policy issue is understood, discussed, and framed by the public and decision-makers.
Positive Framing: Associating a topic with progress, safety, or economic growth.
Negative Framing: Associating a topic with environmental damage, government overreach, or societal risk