Welcome to HA 415-01Welcome to HA 415-01

Healthcare Policy and Economics

Expectations: CourseExpectations: Course

Complete everything in the unit On Time!

Open the unit and review the reading assignments and lessons each week

To earn full credit, all discussion questions require an initial response (by Saturday) as well as responses to at least two of your classmates.

Expectations: Course Expectations: Course (cont’d)(cont’d)

Please send your question to me via email.

DO NOT LAG BEHIND! Late work will not be accepted unless there are

clear and compelling extenuating circumstances. Documentation will be required to substantiate extenuating circumstances.

Expectations: SeminarExpectations: Seminar

Be on time

Stay the entire time

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Grading RubricsGrading Rubrics

Located in the Syllabus

The rubrics are the bases of how your work is evaluated and graded.

It is very important that your writing is at college-level English and that you fully meet the requirements of each assignment. Make sure that you respond fully to all questions posed by each assignment.

KU Writing CenterKU Writing Center

The Writing Center is a great resource for helping you with your written communications and APA formatting - Just me, but I rely on my “APA Pocket Guide.”

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The Role of Policy and Law in The Role of Policy and Law in Health Care/Public HealthHealth Care/Public Health

Federal and state policy and law shape virtually all aspects of the health care system, from structure and organization, to service delivery, to financing, and to administrative and judicial oversight

Areas include: advertising and marketing of health services and products, health care contracting, employment issues, patents, taxation, health care discrimination and disparities, consumer protection, bioterrorism, health insurance, prescription drug regulation, assisted suicide, biotechnology, human subject research, patient privacy and confidentiality, organ availability and donation, and more.

The Role of Policy and Law in The Role of Policy and Law in Health Care/Public HealthHealth Care/Public Health

Policy and law have also long played a seminal role in everyday public health activities as well as in many historic public health accomplishments

One main focus of policy and law in the realm of public health is identifying the appropriate balance between public regulation of private individuals and corporations Ability of those same parties to exercise rights

without overly intrusive government intervention

Conceptualizing Health PolicyConceptualizing Health Policyand Lawand Law

There are three conceptual frameworks: 1.) The broad topical domains of health policy and law

- Issues of public health- Controversies arising from the field of bioethics

2.) From historical terms, based on the social, political, and economic views that dominate a particular era - Health policy and law have been influenced over time

by three perspectives: professional autonomy, social contract, and free market

Conceptualizing Health PolicyConceptualizing Health Policyand Lawand Law

3.) By conceptualizing health policy and law issues in terms of the stakeholders whose interests are impacted by certain policy choices or by the passage or interpretation of a law

- Patients, health care providers, governments, the public, managed care and traditional insurance companies, employers, the pharmaceutical industry, the medical device industry, the research community, interest groups, and others all may have a strong interest in various policies or laws under debate.

Defining PolicyDefining Policy

Who makes policy? Private actors Government (federal, state, local) Authoritative decision makers

Public policy problems These lie beyond individual patient concerns

Structuring policy options Mandatory/voluntary Take action/refrain from acting

Federal Policymaking Federal Policymaking StructureStructure

Legislative branch House of Representatives Senate

Executive branch White House Administrative agencies

Judicial branch

Federal Legislative Federal Legislative BranchBranch

Congress is the lawmaking body of the federal government

Congress consists of Senate and House Senate

Statewide 2 senators from each state

House Elected by district Proportional to population At least one representative per state

Legislative BranchLegislative Branch

Committees Examples of key health committees:

Senate Finance, subcommittee on health care Senate Health, Education, Labor and Pension House Ways and Means House Appropriations committee, subcommittee

on Labor, Health and Human Services, Education, and Related Agencies

Legislative BranchLegislative Branch

Constituents Voters in state or district Voters in nation Political party President

Federal Executive Federal Executive Branch (cont’d)Branch (cont’d)

White House President Executive offices

Assist and advise president

15 cabinet departments Interpret and implement laws passed by

Congress

Federal Executive Federal Executive Branch (cont’d)Branch (cont’d)

Presidential powers/duties Sets the agenda Budget proposals Persuasion (Bully Pulpit) Sign/veto bills Executive Orders

Federal Executive Federal Executive Branch (cont’d)Branch (cont’d)

Presidential Constituents Nation (all voters) Public who voted for president Political party Other nations International organizations

Administrative Agencies Duties/powers: implement statutes through

rulemaking

Federal Health Federal Health BureaucracyBureaucracy

Key agencies Department of Health and Human Services

(HHS) Department of Veterans Affairs (VA) Department of Defense (DOD)

Federal Health Bureaucracy - Federal Health Bureaucracy - HHSHHS

Key agencies Administration for Children and Families Administration on Aging Agency for Healthcare Research and Quality Agency for Toxic Substances and Disease

Registry Centers for Disease Control and Prevention Center for Medicare and Medicaid Services Food and Drug Administration Health Resources Services Administration Indian Health Services National Institutes of Health Substance Abuse and Mental Health Services

Admin.

Federal Health Bureaucracy – Federal Health Bureaucracy –

VA & DODVA & DOD

VA Provides comprehensive care to veterans who

were not dishonorably discharged

DOD TriCare provides health insurance to current and

retired military personnel and their families

State and Local Policymaking State and Local Policymaking and Health Bureaucracyand Health Bureaucracy

State-level policymaking is important Key decisions are made on the state level There is variation among states in how

policymaking process is structured

State/local health bureaucracy State level agencies (ex: Medicaid, public

health) Local public health agencies

The Role of LawThe Role of Law

The law’s importance in U.S. stems from its primary purpose: to function as the main tool by which we organize ourselves as an advanced, democratic society

A society as sprawling and complex as ours needs formal, enforceable rules of law to provide a measure of control

The Role of LawThe Role of Law

The main way the law governs the many kinds of relationships in society is to recognize and establish enforceable legal rights and to create the institutions necessary to define and enforce them

A legal right denotes a power or privilege that has been guaranteed to an individual under the law, not merely something that is claimed as an interest or something that is a matter of governmental discretion

Sources of LawSources of Law

Regardless of how “law” is defined, at the core of the legal system lies a body of enforceable written rules:

- Constitutions (Federal and State)

- Statutes

- Regulations

- Common law (aka case law), meaning that interpretation of law is based and binding on legal precedent

Key Features of the Legal Key Features of the Legal System: Separation of System: Separation of

PowersPowers The legal doctrine that supports the arrangement

of shared governance

To guard against a concentration of political power, governmental powers and responsibilities are divided among three separate, co-equal branches

Includes concept of “checks and balances”

Key Features of the Legal Key Features of the Legal System: FederalismSystem: Federalism

Refers to the allocation of Federal and State legal authority

Under the Constitution, the federal government is one of limited powers, while the states more or less retain all powers not expressly left exclusively to the federal government.

Key Features of the Legal Key Features of the Legal System: The Special Role of System: The Special Role of

CourtsCourts

Courts have responsibility to determine what the Constitution means, permits, and prohibits.

Courts protect and enforce individual legal rights, determine whether the political branches of government have violated the Constitution, and maintain stability in the law through the application of legal precedent

End