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Health Policy Flashcards

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1
Q

policy

A

settled course of action to be followed by gov, business, institute to obtain a desired effect

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2
Q

Examples of policies

A

laws, regulations, voluntary practice

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3
Q

Who makes policies?

A

Fam, hc company, community

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4
Q

public policies

A

all gov activities that influence the lives of citizens with settles courses of action

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5
Q

Health policy

A

set course of action to obtain a desired health outcome for an ind, fam, group, comm, society

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6
Q

Law

A

rules that govern relx of ind and org to other ind and to gov
- result from legislative, judicial, constitutional decisions, admin actions

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7
Q

Laws can be policies but…

A

not all policies are laws

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8
Q

Politics

A

art of influencing others to accept a specific course of action (the policy)
- plays role in dev of policies
- found in fam, prof, employing agents, gov

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9
Q

Goals for public health policy dev

A
  • prioritize and address health needs
  • plan and dev policies to address priority needs
  • advocate for resources to address needs
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10
Q

Elements of policy dev

A
  • communicate effectively to inform ppl about health and how to improve it
  • strengthen, support, and mobilize comm and partnerships to improve health
  • create and implement policies, plans, and laws that impact health
  • utilize legal and regulatory actions designed to improve and protect the public’s health
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11
Q

Private health system

A

outside of government control
- influenced by business management
- economics is CENTRAL fx in decision-making
- decisions are swift and protective
- needs determine by consumerism and market trends

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12
Q

Cost shifting

A
  • private health system idea where pts are charged based on ability to pay
  • when some ppl pay, allows others to get “charity care” if they can’t pay
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13
Q

Public health

A

Authority vested in the states
- focus on populations
- econ is a fx in decision-making (not full decider)
- decisions are slow and deliberate, infl by political enviro at the moment
- needs determined by voting shifts, electoral realignment, term limits

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14
Q

Sub categories of public health

A

Federal, state, and local programs

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15
Q

Subcategories of pricate health sys

A

profit and nonprofit

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16
Q

What does the executive branch do

A

Sign/veto laws, pardon ppl, appoint federal judges, elect pres
- suggest, admin, and regulate policy

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17
Q

Subdivisions of executive branch

A
  • federal: president
  • state: governor
  • local: mayor
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18
Q

Legislative fxn

A

make laws, approve pres appts
- ID probs, propose, debate, pass, modify laws to address those probs

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19
Q

Subdivisions of legislative branch

A
  • federal: Congress (house of reps based on pop and senate (2/state))
  • state: legislature (house of reps and senate)
  • local: council members and county commissioners
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20
Q

Judicial branch

A

Decide if laws are constitutional, appointed by pres, 9 justices, can overturn rulings by other judges in lower level courts
- interpret laws and meaning

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21
Q

Subdivisions of judicial branch

A

federal, state, and local courts

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22
Q

Process of passing a bill

A

State and federal level
- bill made by legislators and brought to house or senate
- bill assigned to committee of reps in the House
- committee passes, goes back to house for full vote
- H.R. passes, goes to Senate
- Senate gives to committee to review
- committee passes, goes to Senate for full vote
- Senate votes and approve, to pres
- pres signs into law or vetoes

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23
Q

What happens if pres vetoes

A

Bill goes back to most recent legislative body (Senate or H.R.) who can override with 2/3 majority

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24
Q

Social security act

A

1935
- assist older adults and unemployed ppl
- survivor insurance for widows and kids
- child welfare, health dept grants, maternal and child projects

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25
Public health act
1944 Consolidated all existing PH legislation, health services for migratory workers, fam planning services, health research facilities, NIH, nurse training acts, prevention and primary care services, rural health
26
When was the public health service created
1798
27
When was the NIH made
1948
28
when was medicare and medicaid made
1965 - made by congress, implemented by exec branch
29
What happened in 1997
state child health improvement act made
30
what happened in 2002
PH security and bioterrorism preparedness and response act
31
What happened in 2010
ACA made
32
What happened in 1906
pure food and drug act
33
what happened in 1912
Children's bureau act
34
When was OSHA made
1970
35
What happened in 1988
Family support act
36
What happened in 1996
Welfare reform act
37
KNA legislative priorities for 2023
- workplace violence prevention - workforce supps (nursing shortage) - discrim of nurses (non purposeful like med errors)
38
How can nurses help health policy
- vote - join professional orgs - KNA legislative priorities - join a coalition - become member of political action - committee (PAC) - campaign for candidates - become a lobbyist - run office
39
Advocacy
- act or process of supporting a course or proposal - garner attn and focus on particular topic in common
40
lobbying
- promote or secure passage of legislation by influencing public officials - targeted efforts aimed at those in positions of power like legislators or public officials to influence public policy or dev legislation
41
All lobbying is advocacy...
not all advocacy is lobbying
42
factors influencing decision makers
- constituent needs - scientific evidence - potential health impact - personal interest
43
U.S spending on hc
- spends more money, accesses care less frequently and has worse health outcomes - ranks last r/t quality, access, efficiency, equity - 5% spent on pop, 95% on ind care - US has lower life expectancy, higher suicide rates, highest chronic disease burden, highest obesity, high premature death rate - low numbers of dr visits and practicing drs
44
1800s hc
- health issues r/t social issues like poor water and sanitation - 1850 - accident insurance was available for railroad and steamboat travel
45
Why wasn;t there hc in the 1800s
- fam/friends did most hc in the home - hospitals were crowded and unsanitary - health expenses were low
46
hc in the 1900s
- industrial revolution made worse working conditions from inc factories - rapid medical advances and inc trust in the med establishment
47
What did the food, drug, and cosmetic act do
Rx drug regulation - old timey FDA
48
When was the first insurance plan for employees
1929 - insurance for teachers and later extended - early modern insurance and monthly payment plan
49
hc in the great depression
Hospital followed the model of hc for employees - gave steady income to hospitals and drs and provided hc to ppl
50
McCarran-Ferguson act
1945 - entrusted states with the authority and responsibility of regulation of business and insurance d/t lack of oversight
51
Hill-Burton act
1946 - National direct support for community hospitals and give money and standards for planning of hospitals and establishing community service obligations
52
Goal of hospital beds to population ratio
4.5 beds for every 1000 people in pop
53
how did hc change in the 40s and 50s
unions form, esp in post-ww2 - employees offer insurance to get ppl to work for them
54
Medicare
65+ people and disabilities - no income requirement
55
Medicaid
health insurance program for ppl with low income and limited resources - state-based and there ARE income requirements
56
What happened in hc in the 1970s
- hc costs rose from the recession
57
Medicare dx related group (DRG) sys
1985 - created to control costs - allows same payment for procedures/tx across the board - private hospitals could not shift income to support charity causes - causes lots of pt dumping cases
58
COBRA
1985 act by Regan - consolidated omnibus budget recon acts - allows some employees to keep hc after employment - temporary and varies by state, some ppl may have to pay for full premium for coverage incl coverage previously paid for by employer - expensive
59
EMTALA
1986 - emergency medical tx and active labor act - EDs must screen all pt who go to hospitals - EDs start to be primary care for some pts - changes wait times and staffing
60
Health security act "Hillarycare"
1993 Clinton bill - universal coverage and basic benefits for health coverage with restructure and competition that gave consumers options, would restructure, allow competition - did not pass
61
SCHIP
1993 state children's health insurance plan - kids from low income got state-insured health insurance
62
Medicare modernization act (2003)
- most signif law in 40y for senior health - provides seniors and ppl with disabilities w/ some rx drug benefits (Medicare Part D) - more benefits and coverage
63
2006 MA health reform
- led by mitt romney - provided health insurance to almost all MA residents - share responsibility employers and gov - ACA precursor - cost containment still an issue - dropped uninsurance rates considerably
64
Mental health parity act and addiction equity act
2008 - insures most compensate comparably for addiction and MD services and physical health

Public Health (9 decks)

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