Health Policy Brief

HLSC 4040 Health Policy

Assignment Write-up: Health Policy Brief

Instructions:

Students are required to select a topic from the list of topics provided below and write or develop a POLICY BRIEF on one of the topics of their choice (needs to be approved beforehand if selecting this option). A policy brief is a relatively short write-up commonly used as a tool for advocacy and policymaking. It is used to communicate information to policymakers, advocates or other persons in leadership positions as guidance for a certain course of action. Basically, it describes a problem, provides alternative solutions (with advantages and disadvantages) for addressing the problem, and then offers a specific policy action from among the alternatives that offers the best chance for addressing the problem.

You can address your policy briefs to any of the following: Directors of health programs, health agency leaders, local and state legislators, and activists, state Governors or even Presidents of any country. An example of this assignment is provided below.

IMPORTANT: All Policy Briefs must be the original work of the student. The Professor is aware that there are many examples of policy briefs on the internet and students MUST NOT simply adopt those policy briefs as their own or cut-and-paste from them to make it appear as if it is their work. Such an act will be considered as plagiarism and for which the student will receive a zero for this assignment.

Below is the required outline of the policy brief that students MUST follow. Students who fail to follow this outline will receive a grade of zero (0) for this assignment.

Policy Brief Outline: All papers must follow this outline

1. Statement of the problem or issue: brief description of, and justification for the need to address the health problem or topic;

2. Policy options (describe other policy options that must be considered in addressing this problem. You must state the advantages and disadvantages of each of the options that you provide);

3. Policy recommendation (after carefully considering each option, state the specific policy recommendation that you suggest or recommend to the person/authority to whom you are writing);

4. References/Bibliography (provides the original and complete sources of information that you have used to develop the policy brief).

Grading of the policy brief

The Policy Brief is worth 10 points and distributed as follows: statement & description of the problem/issue = 3 points; description of policy options (content, quality of writing & depth are important) = 3; policy recommendations) = 2 points; documentation of sources = 2 points.

Length of Policy Brief : The policy brief must be 2 pages long, excluding the reference pages.

Papers/briefs must be typed or word-processed utilizing Times New Roman, 12-point font, 1-inch margins, and single-spacing. Papers must include the title/topic page of the assignment that contains your name and date. Papers must be submitted through eLEARN by the due date.

Acceptable sources

Use at least 5 different sources to research your health policy issue. This may include texts, scientific papers, journal articles and interviews. If you use interviews, make sure to interview appropriate personnel for the health policy issue you select to gain additional perspective. Interviews can be conducted by e-mail, phone, correspondence, or in-person with appropriate personnel at local, state, and federal levels of public and/or private organizations.

Style & Notation

Use the American Psychological Association (APA) format for citations and bibliography. When citing sources, the original sources must be used, instead of simply referencing the Internet link from the World Wide Web. References for interviews must include the name or title of the person interviewed and the date of the interview. Please access this link to help you with proper APA citation http://owl.english.purdue.edu/owl/resource/560/01/.

Library Resources

The TSU Library is available to all students who are enrolled in the course. The library has facilities including, but not limited to electronic journals, interlibrary loans, databases, and library support .

Topics for the Policy Brief Assignment (Select one topic from this list)

1. The use of face covering (mask) during the COVID-19 Pandemic in Tennessee

2. Mandatory testing for COVID-19 for first responders (e.g. healthcare workers, fire fighters, police etc.) in Tennessee

3. Preventing the abuse of opioids in the state of Tennessee

4. HIV prevention among Hispanics in the United States of America.

5. The “Obama Care” & the insurance coverage of the uninsured in the USA

6. Addressing dental care in the United States of America

7. Mental health among military veterans in the United States

8. Illegal immigration into the State of Tennessee

9. HIV prevention among African Americans in the USA

10. Violence among prison inmates in the Tennessee correctional system

11. Providing Universal Health coverage in America

12. Teenage smoking in the state of Tennessee

13. Federal immunization policies in the United States

14. The threat of terrorism to the United States

15. Gun control policies and violence in the United States

16. Post traumatic disorders (PTSD) among war veterans in the USA

17. Hate crimes and its consequences on health in the United States

18. Handling of flood OR fire emergencies in the United States by the Federal Emergency Management Agency (FEMA)

19. Preventing West Nile infection in the United States of America

20. Protecting & preserving the health of the elderly through the Medicare Program in the United States.

Sample of Policy Brief

To:  Mr. Bob Alex, Hon Minister of Health From:  Mr. John Doe Date:  August 18, 2017 Re:  Federal Mandate for Infertility Treatment Coverage by Insurance Providers

Statement of Issue :  6 million Americans currently suffer from a medical disorder resulting in infertility.   Because only 14%-17% of insurance companies provide coverage for fertility services, including assisted reproductive technologies, access to treatment is restricted to the affluent who pay high out-of-pocket expenses.   Without insurance coverage, costs are spread across a small fraction of the population, increasing per capita rates for treatment and encouraging physicians to favor quicker and cheaper practices that compromise quality of care and raise health care costs.

· Reproduction is a “major life activity” according to the Supreme Court. By denying access to effective treatment for most socioeconomic groups, current policy violates the Americans with Disabilities Act.

· Costs of infertility treatments without insurance coverage are a significant barrier to access.  An infertile couple will pay an average of $59,484 in medical expenses per live delivery with assisted reproductive technologies.

· Premium increases to provide insurance coverage for infertility treatments are low.  The monthly cost of providing infertility treatment in Massachusetts, which mandates coverage, is approximately $0.26 per person.

· Exclusion of infertility coverage increases multiple gestations, the main cause of neonatal morbidity in IVF patients.   With financial and time pressure from patients with limited funds, doctors have incentives to maximize pregnancy outcomes that may negatively affect maternal and neonatal health and increase hospital costs.

  Policy Options

· A federal mandate for annualized case rate packages would require all insurance companies to provide infertility treatment.  Local provider communities would decide on specific treatment algorithms and base their one-year case rates of unlimited services on these algorithms.  Patients would receive treatment at designated centers. Supported by infertility interest groups such as RESOLVE and many women’s groups.

· Advantages :  Provides coverage to all patients, reducing per capita costs and allowing insurance companies to negotiate discounts for services.  Resolves ethical issue of discrimination under ADA.  Eliminates incentives for couples to seek premature ART, reducing the risk of multiple gestations and limiting related health care costs.  Eliminates discrepancies between states.

· Disadvantages :  Increases premiums for all payers, most without infertility problems. Encourages more people to seek treatment, increasing costs.  Reluctance to increase premiums and payments from providers, who argue that infertility, is not a life-threatening disease. Mixed support from reproductive specialists, who will either benefit or lose business through designation of treatment centers.

· A restricted federal mandate, like the above option in structure, would limit coverage only to those with higher probability of success, such as younger women with no male-factor infertility.  Limits could also be placed on the number of treatment cycles performed.

· Advantages :  Less costly than a full federal mandate.  Provides coverage for couples with best chances of success, limiting costs.  May encourage couples with little hope of conceiving to consider adoption.  Insurance company support more likely for limited mandate.

· Disadvantages :  Limits on treatment will encourage overuse of ART and incidence of multiple gestations.  Would not fully resolve discrimination issue, because clear restrictions are difficult to set.  Consumer savings from reduced benefits would be small relative to total premiums.

· Optional state mandates, already successful in areas such as Illinois and Massachusetts, would leave discretion to state legislatures.  As already reflected in current legislation, the scope and restrictions of the initiatives would vary considerably, and the federal government would make no requirement stipulating mandatory coverage.

· Advantages :  Doctors, providers, and patients could be encouraged to limit costs without government intervention.  More individualized policies depending on state demographics.  Less opposition from national insurance providers.

· Disadvantages :  Many current state policies have significant restrictions on coverage.  Variety in state policies could not address problem of multiple gestation and overuse of ART as effectively.  Insurance companies who provide coverage in states without mandate will pay disproportionately high costs as more people enroll in their plans.

Policy Recommendation :  With rising usage rates of infertility treatment, along with rising rates of multiple gestations, quick reform is necessary to ensure patients have access to cost-effective, quality care.  Although state reform has worked in some areas, the time needed for broad implementation in states without current initiatives hurts the health of patients.  A federal mandate without significant restrictions, streamlining care and providing consistency between states, will increase access to many people in a short amount of time.  While this option costs money, individual burden will be very minimal.  Additionally, the costs of infertility treatments and ART have been steadily falling with rising use, suggesting that infertility treatments will be more affordable as the market grows through expanded insurance coverage.

Sources: Faber, Kenneth.  “IVF in the US: multiple gestations, economic competition, and the necessity of excess.”

Gleicher, Norbert.  “Strategies to improve insurance coverage for infertility services.”  Fertility and Sterility.  Vol. 70, No. 6, December 1998. Griffen, Martha and William F. Panak.  “The economic cost of infertility-related services: an examination of the Massachusetts infertility insurance mandate.”  Fertility and Sterility.  Vol. 70, No. 1, July 1998.

Neumann, Peter.  “Should Health Insurance Cover IVF?” Journal of Health Politics, Policy and Law.  Vol. 22, No. 5, October 1997.

“RESOLVE: Inform Congress about Infertility.”  http://www.resolve.org/advltr1.htm.  Netscape Navigator, Feb. 6, 2000.