The policy issue that will be addressed in this final project paper is health care policy. Health care policy relates to how to preserve and advance the health status of the public. The significant goal of health care policy is to develop the health and wellbeing of the citizens in a particular country. Scholars have learned that it is health care, not health, which has focused national attention and stirred national discourse for the past several years. As the cost of health care continues to increase, consequently, the greater part of the public are left with no health insurance. This implies that the policy makers at federal, state and local government should come up with ways of dealing with these issues the country is confronted with in the 21st century.
The project also details that in the United States, healthcare quality and provision measures play an important role in ensuring that the citizens have access to the health services. The major players in the healthcare policy will be discussed in this paper. Also, the paper enlists that the available measures of healthcare provision have not been efficient enough to increase affordable access. The need for healthcare reforms cannot be ignored in order to meet the country’s demand for healthcare. In this context, the paper addresses major opponents and proponents of healthcare policy. Unlike other types of public health, the healthcare reforms should be long term, because they require a commitment in the face of increasing prices of medical services. At the same time, many health care insurance providers such as Medicaid and Medicare in the United States have reached the stage where they are expensive and competitive in the market; hence without subsidization they will not be affordable.
The paper also focuses on the possibility of alternative policy to address the issue of healthcare. Since the current healthcare policy is as a result of prior policy action undertaken in an effort to obtain the country’s long standing goal of enhancing the country’s provision of affordable medical services. The country’s ability to meet affordable health care needs from both public and private sources has been one of the main irritants in the United States healthcare policy.
The governor of the State of Louisiana is concerned with the health care reform package. The governor is undecided on how to address the serious health care issues facing the state of Louisiana, particularly, poverty-stricken and uninsured children. The governor wants to know the important issues pertaining to eligibility and enrollment, which the healthcare policy seeks to address. In this context, the governor assigned me to write a policy memorandum on a healthcare policy and explore an alternative policy with the goal of streamlining the process in order to make it more efficient, user friendly and cost-effective.
The Public Policy Problem
Healthcare policy is a governmental policy that shapes health and health care in national, state and local arenas. Health policy involves promoting and protecting health, preventing disease and preserving life through policies that ensure the determinants of health for all segments of the population. It covers a broad range, including economic, housing, environmental, budgetary and health services policy. Essentially, the public, politicians, press and professionals see health policy to include mainly those that finance and organize the delivery of personal health services. Lundy & Janes (2009) say that health is fundamentally related to income and other measures of socioeconomic status such as educational opportunities and community support.
Healthcare policy includes all those factors and forces that affect the health of the public. Barr (2011), in his book, notes that healthcare policy overlaps with health economics, but broadens its scope in order to include social and political processes, which are affecting healthcare. Almgren (2007), in his studies, notes that health care policy even at the introductory level requires a richer dialog that frames the evaluation of the health care system by what is known about the prevalence of disparities in health and health care.
Studies indicate that the United States has the best medical care system in the world and at the same time, the country has one of the worst health care systems among the developed countries of the world. Barr (2011) says that there are two broad forces that contribute to the relatively poor state of health in the United States. Firstly, the socioeconomic factors such as education, poverty and lifestyle and secondly, the qualities of the United States health care system. Health care costs continue to rise and more people are left without health insurance.
Why the Problem is Important?
Health care is important, because the nation continues to face a plethora of health policy problems. The most persistent one is getting worse for many rather then better is access to care. Weissert & Carol (2012) mention that in the recent decades, the access to care has become worse at faster rates as more and more employers reduce the scope of their health care coverage or give it up altogether, leaving much of workforce uninsured.
Health care policy is important since they influence the pursuit of health. Andersen, Rice & Kominsk (2007) say that health care policy is important of the nature of its financing characteristics, which are described by an array of contextual measures that suggest resources potentially available to pay for health services. Andersen, Rice & Kominsk (2007) also indicate that there are incentives to purchase or provide services such as rate of health insurance coverage, relative price of medical care and other goods and services and methods of compensating providers.
Most health care in the United States is delivered by the private sector, but as public policy pays for and regulates so much of it, health care policy is very essential. Weissert & Carol (2012) indicate that private payers for health care tend to mimic the payment approaches of public policy, so the public policy reach extends even further into the private portion of health care policy. For these reasons, and since so much of health care is subcontracted and develops the income stream of private segment providers, producers of health care products and others, claim processors, private interest groups that have enormous stake in public policy and discover it as a good bargain to apply rather lavishly on lobbying and other strategies aimed at influencing public health care policy (Weissert & Carol, 2012).
For the private health care delivery, it has been noted that public health has a few dollars to fund its advocacy. Weissert & Carol (2012) say that public health policy spending by the federal government for health education to battle sexually transmitted and other infectious diseases, reduce smoking, prevent cancer and perform surveillance and mitigate environmental hazards have been dropping. For example, the research shows that in 2009, the federal governments spend $17,60 per person for disease prevention. At the same time Weissert & Carol (2012) indicate that health insurance premiums for an individual in 2009 cost more than $8,000, suggesting a huge disparity in spending for health care versus preventive efforts through public health.
Healthcare policy in the United States involves a complex web of decisions made by various institutions and political actors across a broad spectrum of public and private sectors. Patel & Rushefsky (2006), in their work, note that the institutions and actors include federal, state, and local governments in the public sector. In the private sector, they involve providers such as hospitals and nursing homes, health care professionals and health care purchasers such as insurance companies, industries and consumers. Patel & Rushefsky (2006) indicate that a wide variety of interest groups influence and shape health care politics and policymaking.
These institutions and players are involved throughout the health care policy cycle. The policy cycle includes getting problems to the government and agenda setting, policy formulation and legitimating, budgeting, implementation, additionally, evaluation and decisions about policy continuation (Peckham & Meerabeau, 2007).
The Public Policy Alternatives for Addressing the Problem
The alternative of health care policy is to come up with a social policy that has public health structure (Weissert & Carol, 2012). For example, Social Security Retirement Income has been the single most important policy to reduce poverty in the United States, especially among elders, thereby contributing to the healthful living standards for millions of people. The social policy can prevent several million children from preventive and infectious diseases. Weissert & Carol (2012) further say that the availability of social policy as an alternative to healthcare policy will help in promoting public health and preventing diseases. An effectively implemented policy will enable the public to make healthy choices equitably to all groups of people regardless of where they live, work, and study. The public through the social policy will be able to obtain needed services and information and take part in public life in state, therefore, creating supportive and sustainable environments. According to Reisman (2006), it is important to consider household spending on health related inputs.
In addition, Morone, Litman & Robins (2006) say that the biggest health care payer in the United States is the government, which pays for 44% of all American health care spending. The government spending mostly comes from two programs, which include Medicare and Medicaid.
Medicare is mainly for people over 65 and pays 19% of the country’s total health care bill. On the other hand, Medicaid was established as an alternative for low income people and it pays 18% and all other federal, state and local programs add another 7% (Morone, Litman & Robins, 2006). Politics run into every nook and cranny of American health care. The raising costs in health care are a serious problem in the United States. Reisman (2006), in his article, notes that through the social policy, private sector health care will be valued at the market price billed according to the agencies. In addition, public sector health care will be valued at the historic cost of the factor inputs.
The Stakeholders who would be Proponents and Opponents
The proponents include the public who are the health consumers such as patients, families and consumer organizations such as the American Association of Retired Persons. Hospitals will also oppose the change of the health care policy (Lundy & Janes, 2009). Providers such as physicians, dentists, nurses, nurse practitioners, physician assistants, pharmacists and allied health professionals are expected to oppose the policy change (Lundy & Janes, 2009). The proponents of social policy indicate that this type of policy program is a major aspect of the lives of citizens, taxpayers and workers (Beland, 2010). For that reason, Beland (2010) also says that using social policy to address the issue of health care will help to address economic problems associated with health care and inequality in health care access.
The public health enterprise is expected to be the opponents of the policy. Other allied groups ranging from local health centers and nationals voluntary organizations like the American Health Association are expected to oppose the social policy (Lundy & Janes, 2009). Insurance industry, long term care and mental health are the major proponents of the health care policy, because of the massive benefits they obtain from health care policy. Lundy & Janes (2009) indicate that voluntary facilities and agencies such as HIV/AIDS support groups, addiction support groups, and public education and lobbying groups are the main stakeholders in the health care policy. The other type of opponents of the social policy as an alternative include health professions, education and training institutions, which include schools of public health, medicine, nursing, allied health and pharmacy.
The opponents of social policy also include professional associations such as national, state and regional organizations that are representing health care professions or institutions such as American Nurses Association, the American Medical Association, the American Public Health Association and the American Hospital Association act as stakeholders in the health care policy (Lundy & Janes, 2009). Research communities such as educational institutions, government agencies and non-profit foundations and charitable trusts such as The Robert Wood Johnson Foundation and the Bill and Melinda Gates Foundation are expected to support the social policy.
Social Justice and/or Ethical Issues for the Recommended Policy Alternative Raises
In social policy, Barusch (2011) says that social justice process aids the government and the groups involved to allocate the costs of healthcare and benefits equitably to all the people. Social justice exists to the extent that community esteem for individual who need health care is not based on a hierarchy. Barusch (2011) says that social policy affects the degree of health care inequality in the country.
The ethical issue attached to social policy is that mainstream health care for most Americans will be delivered by managed care organization. Even Medicare beneficiaries who have shunned managed care have begun to embrace it. Peckham & Meerabeau (2007) indicate that through the social justice health care the focus will be on public health issues, tackling inequalities and key health problems such as mental health and sexual health.
Since no one in the United States can be sure that the care he or she receives will be free of errors, omissions or excesses, the quality of care delivered in the country has come under great scrutiny for high rates of medical errors, inappropriate and ineffective treatments. The role of social justice cannot be overlooked in such instances of the lack of systematic mechanisms for defining, monitoring, reporting and working to correct patterns of inadequate care (Weissert & Carol, 2012). Social justice will play a major role in health care by engaging states to accept responsibility for basic health and safety laws, innovating in everything including control of prescription drug costs and paying nearly half of Medicaid costs.
Additional Potential Ramifications of Adoption of This Policy Alternative
The social policy requires partnership between the federal and state governments when it comes time to implement the major reform programs such as the Patient Protection and Affordable Care Act. The social policy will help in implementing expansion of the Medicaid program to millions of Americans, brought into Medicaid eligibility by the law and implementing the health insurance industry reforms mandated by law (Weissert & Carol, 2012). In addition, Walsh & Stephens (2002) say that the funding of health and social care provision was an important issue for the government in the 21st century.
Social policy should however address the fast access to private health insurance and be open to all, but then again the use of private provision is unevenly distributed across social classes. Walsh & Stephens (2002) further say that healthcare provided through the social policy will have an incentive to be more efficient as they would be seeking to maximize profit. It should be noted that the discipline of social policy is no longer only concerned with what the state itself provides in terms of welfare (Peckham & Meerabeau, 2007). Instead, according to Peckham & Meerabeau (2007), it is concerned with the whole structure of social entitlement and social responsibility in society which forms the basis of citizenship.