Health care policies week 1

Chapter 2

Policy and the Policymaking

Process

Chapter Overview

• Chapter 2 provides a basic overview of policy

and the policymaking process

• Chapter 2 focuses on:

– Defining policy

– Public policymaking structure

– Federal and State health bureaucracy

– Interest groups

Defining Policy

• Who makes policy?

– Private actors

– Government (federal, state, local)

– Authoritative decision makers

• Public policy problems

– Beyond individual concerns

• 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

Federal Legislative Branch

• Congress is lawmaking body of federal government

• Congress consists of Senate and House

– Senate is statewide, and there are two senators from each state

– House is elected by district, proportional to population, and at least on representative per state

Legislative Branch: Committees

• Workhouse of Congress

• 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 Branch

• Constituents

– Voters in state or district

– Voters in nation if have leadership role or national

aspirations

– Political party

– President

Federal Executive Branch

• White House

– President

– Executive offices assist and advise president

• 15 cabinet departments

– Interpret and implement laws passed by Congress

Federal Executive Branch

• Presidential powers/duties

– Sets the agenda

– Budget proposals

– Persuasion

– Sign/veto bills

– Executive Orders

Federal Executive Branch

• Presidential Constituents

– Nation (all voters)

– Public who voted for president

– Political party

– Other nations

– International organizations

Federal Executive Branch

• Administrative Agencies

– Duties/powers: implement statutes through

rulemaking

– Constituents

• President

• Congress

• Individuals and entities regulated by agency

• No one?

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

• 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

• 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 –

VA & 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 made on state level

– Variation among states in how policymaking

process is structured

• State/local health bureaucracy

– State level agencies (ex: Medicaid, public health)

– Local public health agencies

Interest Groups

• Interest group is the general term used to

describe a variety of organizations that focus

on a particular issue or issues and have the

goal of influencing and educating

policymakers and the general public

• Interest groups do not make policy