Description
In the past decade, the nation experienced an unusually active period in health policy with the enactment of the Affordable Care Act (ACA). Historically, health policymaking has been a slow yet persistent evolution
DETAILED CONTENTS
Acronyms and Abbreviations…………………………………………………………..xvii
Preface………………………………………………………………………………………xxiii
Acknowledgments ……………………………………………………………………….xxvii
Chapter 1. Health and Health Policy …………………………………………..1
Health Defined ………………………………………………………..2
Defining Health Policy………………………………………………9
Forms of Health Policies………………………………………….13
Categories of Health Policies…………………………………….17
The Impact of Health Policy on Health Determinants
and Health ………………………………………………………..21
Summary ………………………………………………………………33
Case Study: U.S. Hospitals and the Civil Rights Act
of 1964 …………………………………………………………….34
Chapter 2. The Context of Health Policymaking …………………………49
Federal Government………………………………………………..50
State Government …………………………………………………..55
Local Government ………………………………………………….56
Governments at All Three Levels Make Health Policy …..57
The Health Policy Market………………………………………..60
Demanders and Suppliers of Health Policies………………..64
Interplay Among Demanders and Suppliers
in Policy Markets………………………………………………..76
Summary ………………………………………………………………79
Chapter 3. The Process of Health Policymaking ………………………….83
Conceptual Frameworks and Theories of Policymaking …84
A Core Model of the Public Policymaking Process……….85
Formulation Phase ………………………………………………….85
Implementation Phase……………………………………………..90
Modification Phase………………………………………………….94
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Key Features of the Policymaking Process …………………..95
Summary …………………………………………………………….100
Chapter 4. The Role of Courts in Health Policy
and Policymaking………………………………………………….103
The Core Roles of Courts………………………………………104
Structure of the Judicial Branch ………………………………107
Functioning of the Courts………………………………………112
Courts Acting as Referees……………………………………….114
Courts Acting as Meaning Givers…………………………….123
Courts Acting as Rights Enforcers……………………………129
Summary …………………………………………………………….132
Chapter 5. Policy Formulation: Agenda Setting …………………………135
Agenda Setting……………………………………………………..136
Interest Group Involvement in Agenda Setting ………….145
The Influential Role of Chief Executives in
Agenda Setting…………………………………………………158
The Nature of the Health Policy Agenda ………………….159
Summary …………………………………………………………….160
Chapter 6. Policy Formulation: Development of Legislation………..165
The Choreography of Legislation Development …………166
Originating and Drafting Legislative Proposals…………..170
Introducing and Referring Proposed Legislation to
Committees……………………………………………………..177
House or Senate Floor Action on Proposed
Legislation……………………………………………………….183
Conference Committee Actions on Proposed
Legislation……………………………………………………….183
Presidential Action on Proposed Legislation………………184
Legislation Development for the Federal Budget………..184
Legislation Development for State Budgets……………….188
From Formulation to Implementation………………………190
Summary …………………………………………………………….191
Chapter 7. Policy Implementation and Implementing
Organizations……………………………………………………….195
Responsibility for Policy Implementation ………………….197
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CMS as an Exemplar Implementing Agency………………202
Policy Implementation as Policymaking, but with a
Management Aspect ………………………………………….210
Summary …………………………………………………………….215
Chapter 8. Policy Implementation Activities: Designing, Rulemaking,
Operating, and Evaluating………………………………………219
Designing ……………………………………………………………221
Rulemaking………………………………………………………….223
Operating…………………………………………………………….231
Evaluating……………………………………………………………245
Summary …………………………………………………………….254
Chapter 9. Policy Modification ……………………………………………….259
Distinguishing Policy Modification from Policy
Initiation …………………………………………………………262
Medicare: A Long History of Policy Modification
in Practice ……………………………………………………….263
Incrementalism in Policymaking………………………………268
Mechanics of the Modification Phase ……………………….270
Participants in All Three Branches of Government Play
Roles in Modification ………………………………………..270
Modification Occurs Throughout the Policymaking
Process ……………………………………………………………277
Summary …………………………………………………………….287
Chapter 10. Building Policy Competence for Health Professionals….291
Policy Competence Defined ……………………………………292
The Ethics of Influencing Policymaking ……………………293
Policy Competence for Health Professionals: Influencing
Policymaking ……………………………………………………297
Observing to Identify Public Policy Information That Is
Possibly Important to the Professional………………….298
Assessing the Level of Importance of Identified Public
Policy Information for the Professional…………………301
Monitoring the Public Policy Information Identified as
Important………………………………………………………..304
Forecasting the Future Direction of Important Public
Policy Information…………………………………………….305
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Influencing Policymaking……………………………………….307
Using Organizational Relationships to Increase Influence in
Policymaking ……………………………………………………321
The Human Element in Influencing Public Policy
Environments…………………………………………………..330
Summary …………………………………………………………….331
Appendix 1. Overview of the Patient Protection and Affordable
Care Act………………………………………………………………337
Appendix 2. Overview of Medicare ……………………………………………345
Appendix 3. Overview of Medicaid ……………………………………………365
Appendix 4. Briefly Annotated Chronological List of Selected US
Federal Laws Pertaining to Health …………………………..379
Appendix 5. National Institute of Biomedical Imaging and
Bioengineering Establishment Act……………………………439
Appendix 6. Summaries of a Proposed and a Final Rule ………………..445
Appendix 7. News Release: FDA Allows Marketing of First Medical
Device to Prevent Migraine Headaches …………………….455
Appendix 8. Smokefree Laws ……………………………………………………457
Appendix 9. Laws Implemented by the EPA ……………………………….461
Appendix 10. Medicare Revisited—Again and Again………………………465
Appendix 11. The United States Constitution and the Federal
Government…………………………………………………………471
Appendix 12. State Legalization of Recreational Marijuana:
Selected Legal Issues……………………………………………..475
Appendix 13. Finding Better Solutions: CMS Innovation Center
Develops New Payment and Service Delivery Models….477
Appendix 14. Coalition Letter Requesting Changes to Meaningful
Use for Greater Systems Interoperability …………………..479
Appendix 15. Types of Groups Involved in Financing Political
Campaigns …………………………………………………………..483
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Appendix 16. Testimony on Heart Disease Education, Analysis
Research, and Treatment for Women Act (or “HEART
for Women Act”) ………………………………………………….485
Appendix 17. Congressional Conference Committees …………………….489
Appendix 18. The Federal Budget Process……………………………………491
Appendix 19. Michigan’s Budget Process……………………………………..501
Appendix 20. Oversight Plan of the House Committee on Energy
and Commerce, United States House of Representatives,
113th Congress…………………………………………………….507
Appendix 21. MedPAC……………………………………………………………..513
Appendix 22. Improving Access to Mental Health Services for
Veterans, Service Members, and Military Families……….515
Appendix 23. Performance Culture in the Federal Workforce…………..521
Appendix 24. State Experiences with Implementing the ACA ………….523
Appendix 25. Lower Costs, Better Care: Reforming Our Health
Care Delivery System …………………………………………….529
Appendix 26. Observations on the Department of Homeland
Security’s (DHS’s) Efforts to Identify, Prioritize,
Assess, and Inspect Chemical Facilities ……………………..537
Appendix 27. Options for Reducing the Deficit: Increase All Taxes
on Alcoholic Beverages to $16 per Proof Gallon ………..541
Appendix 28. Opening Statement: Hearing on “Where Have All
the Patients Gone? Examining the Psychiatric Bed
Shortage”…………………………………………………………….545
Appendix 29. A Proposed Rule on Revision of Nutrition Labels ………549
Appendix 30. Summary of the FDA’s Ophthalmic Devices
Panel Meeting………………………………………………………551
Index ……………………………………………………………………………………………… 553
About the Author …………………………………………………………………………….. 575
About the Contributor ……………………………………………………………………… 577
