Health Care Policies
Helpm31990
9781284151619_SLID_CH02.ppt
Chapter 2
Policy and the Policymaking Process
Chapter Overview
- Provides a basic overview of policy and the policymaking process
- Focuses on:
- Defining policy
- Public policymaking structure and process
- Federal, state, and local health bureaucracy
- Interest groups
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Defining Policy
- Who makes policy?
- Private actors
- Government (federal, state, local)
- Authoritative decision makers
- Public policy problems
- Beyond individual concerns
- Determine if a “decision” represents a “policy”
- Structuring policy options
- Mandatory/voluntary
- Take action/refrain from acting
Federal Policymaking Structure
- Legislative branch
- House
- Senate
- Executive branch
- White House
- Administrative agencies
- Judicial branch (discussed in chapter 3)
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Federal Legislative Branch
- Congress is lawmaking body of federal government.
- Congress consists of Senate and House.
- Senate: statewide; two senators from each state
- House: by district; proportional to population, at least one representative per state
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Legislative Branch: Committees
- Workhorse of Congress
- Examples of key health committees
- Senate Finance, subcommittee on health care
- Senate Health, Education, Labor, and Pensions
- House Ways and Means
- House Appropriations, subcommittee on Labor, Health and Human Services, Education, and Related Agencies
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Legislative Branch
- Constituents
- Voters in state or district
- Voters in nation if have leadership role or national aspirations
- Political party
- President
Federal Executive Branch
(1 of 4)
- White House
- President
- Executive offices assist and advise president
- 15 cabinet departments
- Interpret and implement laws passed by Congress
Federal Executive Branch
(2 of 4)
- Presidential powers/duties
- Chief of State—symbol of the country and its citizens
- Chief Executive Officer—manages cabinet and executive branch
- Commander in Chief of the Armed Forces—top ranking military official in the country
- Other powers: agenda setting, budget proposals, persuasion, sign or veto bills, executive orders
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Federal Executive Branch
(3 of 4)
- Presidential constituents
- Nation (all voters)
- Public who voted for president
- Political party
- Other nations
- International organizations
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Federal Executive Branch
(4 of 4)
- Administrative agencies
- Duties/powers: implement statutes through rulemaking
- Constituents
- President
- Congress
- Individuals and entities regulated by agency
- No one?
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Federal Health Bureaucracy
- Key agencies
- Department of Health and Human Services (HHS)
- Department of Veterans Affairs (VA)
- Department of Defense (DOD)
Federal Health Bureaucracy—HHS: Key Agencies
(1 of 2)
- 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
Federal Health Bureaucracy—HHS: Key Agencies
(2 of 2)
- Centers for Medicare and Medicaid Services
- Food and Drug Administration
- Health Resources and Services Administration
- Indian Health Service
- National Institutes of Health
- Substance Abuse and Mental Health Services Administration
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Federal Health Bureaucracy—
VA and 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 and Health Bureaucracy
- State-level policymaking is important.
- Key decisions are made on state level.
- The Constitution gives states primary responsibility for protecting the public’s health.
- There is variation among states in how policymaking process is structured.
- State and local health bureaucracy
- State-level agencies (e.g., Medicaid, public health)
- Local public health agencies
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Interest Groups
- Interest group: general term for a variety of organizations that focus on an issue or issues and have the goal of influencing and educating policymakers and the general public
- Interest groups do not make policy
- Types of interest groups: trade associations, think tanks, advocacy groups, lobbying firms
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