Week 2: Intro to health policy and health systems Flashcards
(57 cards)
Health policy
- Many definitions
- Not always written down or codified
- Policy as a process in time and place
- Inevitably political
- What is and what could b
What is health policy?
Who: political actors, public sectors (government), private sector (industry)
What: decisions, plans, actions
non-decisions , no plans , inaction
Within the power of policy actors
Where: within society
Healthcare system, institutions, organizations, services, funders
External to health care system (food, transportation, tobacco
Why: achieve health and health care goals
(Non)Decisions Political actors Public and/or Private Sector Goals
Remember: health policy is always political – is always a question of values
Health systems
Set of institutions and rules to regulate, finance and pay for personal services called health care
Health policies vs Health systems
- Often aimed at particular gestures of health systems
- Health policy efforts need to be informed by the specifics of health systems
vs. - Make some health policy issues more relevant/visible
- Make some health policy efforts more possible
Policy objectives
- Trade-offs: often more than one objective
- Objective are not always compatible
Security: Minimum human needs (food, shelter, etc)
Liberty: Freedom to do what you want, without harming others
Equity: “treating likes alike”
Efficiency: Getting most for money spe
How can we accomplish our objectives
- Policy instruments
- Tools available to achieve selected policy goals
Do nothing
Status quo
Extortion
Encourages activities without forcing it
Using symbolic gestures like
Expenditure
Spending money
Promote something good that will benefit others
Taxation
Tax policy to encourage/discourage activities
Reducing the amount of tax an individual is required to pay
Regulation
Rules to encourage or penalize activities
Public ownership
Government-run activities
Lalone Report (1947)
Human biology: Biological causes of disease, genetic inheritance
Environment: Physical and social, not under individual control
Lifestyle: Personal decisions
Health care organizations: Availability and quality of clinical services, healthcare services are kept separate, environment and lifestyle services are not a concern in healthcare systems
Social determinant of health
Non-medical factors that affect a person’s health and well-being
Population health
- Stresses the importance of improving health for the entire population
- Acts on “broad range of factors and conditions that have a strong influence on health”
What is health care?
Relationship in which a group of individuals (“carers” or “providers” offer personal services to an “individual “patient”
- “personal” implies emphasis on due process rather than outcome
- relies on trust
Principle - agent relationship
patient = principle
health care provider (HCP) = agent
We (patient) must delegate decisions to agent (HCP)
Asymmetry of Information
Recipients of care cannot judge the effectiveness of care
Types of Services (the ‘silos’)
Levels of care
Minimal integration (coordination)
Primary, Secondary and Tertiary
Systems with good primary care are more…
Cost-effective, equitable, and deliver high quality care
Primary care
First point of entry in the health care system
Critical to ensure health system, sustainability and performance
Primary care does not just include clinical care
May include health promotion, disease prevention and rehabilitation
Primary care focuses on services..
to diagnose, treat and manage disease
Primary care focuses on…
Relationships
- not about “cheaper” providers, but those who “specialize in relationships” with patients, other parts of the healthcare system, broader population
