Global Perspective on Health Policy Essay
A macro perspective on health policy issues can be helpful to identify how problems become policy issues and how these issues result in the creation of health care policy. The neglected epidemic of Chronic Disease also known as non- communicable diseases are a controversial issue that needs to be addressed in the world. In this paper, the writer will provide an explanation of how this issue has resulted from a policy’s creation. Identify the steps in the state and federal policy development process. Furthermore, differentiate between policy development and implementation. Also, explain how stakeholders become involved in the process and why their voices often become a driver for change in health policy.
What is Chronic Disease?
Non-communicable diseases (NCDs), also known as chronic diseases are not transferred from person to person. They are slowly progressed over time. The four main kinds of non-communicable diseases are cardiovascular diseases such as strokes or heart attacks, any type cancer, chronic respiratory diseases like chronic obstructed pulmonary disease and diabetes. Other Chronic Diseases that affect many Americans are, Obesity and Overweight, Asthma, Epilepsy, Food Allergies, Glaucoma, Alzheimer’s, and Heart Disease (Non-communicable diseases. 2014). A Chronic Disease is a long-term illness that can be controlled, but not healed. The worldwide population is affected by chronic diseases. In the United States, chronic disease is the leading cause of disability and death that accounts for 70% of all deaths.
Out of these premature deaths, 90% effect low- income and middle-class population. The World Health Organization shows that chronic illnesses are also the main reason for untimely deaths everywhere, even in places where communicable ailments are widespread (What is Chronic Disease?. 2011). According to the article, chronic disease is the most preventable and can be successfully controlled, and they are also very costly health issues and the most common. With the proper care and treatment, these long-term diseases can be controlled (What is Chronic Disease?. 2011).
The Epidemic of Chronic Disease
In today’s society, Chronic Disease is responsible for an enormous percentage of diseases in people. Non-communicable diseases affect all regions of the world and age groups. People before the age of 60 attribute to 9 million of the deaths associated with chronic disease. Even though Chronic Disease are a huge problem in low-income areas, these diseases and risk are not exclusive to more wealthy Americans (Horton, R. 2005). The most vulnerable to the risk factors that contribute to chronic diseases are adults, elderly and children. Studies prove that it comes from unhealthy diets, exposure and use of tobacco products, not regularly exercising and harmfully using alcohol. Non-communicable disease are driven by aging and the globalization of unhealthiness in our lives (Non-communicable diseases. 2014). The globalization of unhealthiness like eating unhealthy can result in high blood pressure, overweight and obesity, high blood glucose levels, and higher blood lipids. Many of these risk factors can be lead to cardiovascular disease, which is a common NCD (Non-communicable diseases. 2014).
The Center for Managing Chronic Disease (CMCD) aims help in the effectiveness with management and prevention in chronic disease. The main goal of CMCD is to help people at risk, or that are most vulnerable. Conducting advanced research and publicizing the results to aid in policy change and practices (What is Chronic Disease? 2011). On September 2011, a meeting with the UN High Level on Non-Communicable Diseases was an exceptional chance to produce a sustained global drive contrary to preventable disease and disability, premature death for chronic diseases, like stroke, cancer, heart disease and respiratory disease and diabetes. This is an increasing global threat in NCDs that is a barrier to developmental goals. These development goals include health equity, poverty reduction, human security and economic stability (The Lancet. 2011). Policy Making Process. In healthcare, Chronic Disease epidemics cause many threats to the world. In response to the crisis, The Lancet NCD Action Group and the NCD Alliance has proposed five priority actions.
Which are: “Leadership, prevention, treatment, international cooperation, and monitoring and accountability—and the delivery of five priority interventions—tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies (The Lancet. 2011).” The import involvements were chosen for their health paraphernalia, cost-value, small costs of implementation, and political and financial achievability. Tobacco control is the most urgent and immediate priority. They have propose a goal for 2040 that in essence the world would be free from tobacco where fewer than 5% of people engaged in tobacco use (The Lancet. 2011). Policy problems are identified by many factors that include methods that include getting issues on the political agendas and removing them. The first step in the Policymaking Process is agenda setting. Agenda setting is all about decision-making in the first phase of the policymaking process. To be considered on the agenda, difficulties must arise to policymakers’ attention.
Healthcare problems are highly visible, because the affect the nation, whereas major problems no relating to health are considered invisible to make the agenda (The Lancet. 2011). The Policymaking process discusses the precise decisions and procedures that are required for a policy to be considered, proposed and implemented. This process is an interactive progression with various points of access that provides opportunities to impact the many decisions (Politics and the Policymaking Process. n.d.).Policymaking process is an interactive process with several points of entree that provides chances to influence the decision-making processes involved in each of the stages. Furthermore, there are three phases of policymaking: the implementation phase, the formulation phase, and formulation phase (Politics and the Policymaking Process. n.d.). Policy development and implementation. During Policy Development, policies may be developed and applied at several stages and may vary from formal regulations and legislation to the informal procedures by which governments function (Policy Development. n.d.).
An example of policy development would be in government policy that is related to youth, children and health developed at national and federal; territorial and provincial; community, local and district; or international levels by elected executives transversely with a quantity sectors that includes education, health, social services, finance, recreation and labor. Additionally, policy development time frame is determined by various factors that include government agendas and media attention. (Policy Development. n.d.). On the contrary, Policy implementation involves putting implemented policies into play. Success from implementation is depends on three essential elements.
First element is the state or president and government officials locally, must pass down polices to the proper agency with the government bureaucracy (Policy Implementation – Boundless Open Textbook. n.d.). The second element that is essential to policy implementation is strong interpretation. Meaning that legislative intent need be deciphered into functioning guidelines and agendas. The concluding element necessary in operative policy implementation is also challenging to achieve. Dedication of assets to implement policy beneath the primarily element must be combined with organization of the policy with enduring processes (Policy Implementation – Boundless Open Textbook. n.d.).
Stakeholders in Healthcare. A Stakeholder involvement in planning, management policymaking has be brought on by new general development models. These models seek a different role for each state based on consensus, pluralistic structures and political legitimacy. Stakeholder contribution can be categorized into three forms: cooperative, instructive and consultative (Involving Stakeholders in Aquaculture Policy-making, Planning and Management. n.d.). In Cooperative involvement primary stakeholder act as companions with government in the decision processing. Consultative involvement is where government makes the primary decisions and stakeholders still have influence in the outcome and processes. Last, in Instructive involvement the government makes the choices but apparatuses occur during information interchange (Involving Stakeholders in Aquaculture Policy-making, Planning and Management. n.d.).
The macro perspective on health policy issues can be helpful to identify how problems become policy issues and how these issues result in the creation of health care policy. Chronic diseases impact the healthcare industry in many ways. This controversial issue impacts all age groups. The Center for Managing Chronic Disease (CMCD) helps with management and prevention in chronic disease. This paper, provided an explanation of how the epidemic of Chronic Disease has resulted from a policy’s creation. Moreover, identified the steps in the policy development process. Furthermore, differentiated between policy development and implementation. Also, explained how stakeholders become involved in the process and why their voices often become a driver for change in health policy.
What is Chronic Disease?. (2011). The Center for Managing Chronic Disease. Retrieved October 13, 2014, from http://cmcd.sph.umich.edu/what-is-chronic-disease.html Horton, R. (2005). The Lancet. The neglected epidemic of chronic disease : The Lancet. Retrieved October 13, 2014, from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2967454-5/fulltext#bib4 Non-communicable diseases. (2014). WHO. Retrieved October 13, 2014, from http://www.who.int/mediacentre/factsheets/fs355/en/ The Lancet. (2011). Priority actions for the non-communicable disease crisis: The Lancet. Retrieved October 14, 2014, from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960393-0/abstract Policy Development. (n.d.). A Brief Guide to Understanding Policy Development. Retrieved October 10, 2014, from http://www.ruralnovascotia.ca/documents/policy/understanding%20policy.pd Politics and the Policymaking Process. (n.d.). The Policymaking Process. Retrieved October 12, 2014, from http://www.pearsonhighered.com/assets/hip/us/hip_us_pearsonhighered/samplechapter/0205011616.pdf Policy Implementation – Boundless Open Textbook. (n.d.). Boundless. Retrieved October 15, 2014, from https://www.boundless.com/political-science/textbooks/boundless-political-science-textbook/domestic-policy-15/policy-making-process-95/policy-implementation-516-6175/ Involving Stakeholders in Aquaculture Policy-making, Planning and Management. (n.d.). Involving Stakeholders in Aquaculture Policy-making, Planning and Management. Retrieved October 15, 2014, from http://www.fao.org/docrep/003/AB412E/ab412e32.htm
Global Perspective on Health Policy Essay
The controversial issue of healthcare coverage for all individuals is an ethical and moral issue that Americans struggle with and as socially proactive as they are on there are many issues arising of it. Healthcare is not only about health and coverage but the major issue is about funding, what can be funded and what cannot be funded and how is going to be funded. Universal healthcare in other countries offers insight into some of the biggest issues and best alternatives for providing healthcare to all and to resolve the health care rising cost. The ethical issue of health care has led to the Accountable Care Act or Obama Care policy development and legislation. More time, data and research has to be done before the definite results of this legislation can be proven.
A controversial issue
Considering the opposing views about Accountable Care Act legislation, it’s reasonable to understand why universal health care has elicit such a heated political controversy among political parties as well as throughout American people. Unlike other Western industrialized nations, the U.S. has not established a universal health care system. Since health care is a fundamental defining policy of the modern state, and since Obama’s health care reform can be seen as an expansion of the role of government, it can be analyzed in a global context (Ha, 2012). The issue of health care reform brings important ethical issues of justice to the forefront, as individuals, communities, and the legislature struggle with how to provide quality health care for the many without sacrificing the basic rights of even the few (Sorrel, 2012).
The divide on health care coverage, cost and sustainability for all Americans and the increased cost of health care in United States led to legislations being brought to seek out a solution to the issue. The American Recovery and Reinvestment Act was the first of these laws, this act signed into law in 2009 by President Obama. The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act was also signed into law. Also enacted and accompanied by the Health Care and Education Reconciliation Act. Another legislation that became a law in 2010 is the Patient Protection and Affordable Care Act (Patel, 2013).
Provisions in the act are designed to expand insurance coverage, control costs, and target prevention (Gable, 2011). One of the primary targets is adults aged 19-64, since their access to health care and use of health services deteriorated between 2000 and 2010, particularly among those who were uninsured (Kenney, McMorrow, Zuckerman, & Goin, 2012). The PPACA includes reforms such as prohibiting insurers from denying coverage for pre-existing conditions, expanding Medicaid eligibility, subsidizing insurance premiums, and providing incentives for businesses to provide health care benefits. Insurance companies will no longer be able to drop clients when they become ill. The act has the potential to improve health outcomes across all income and age groups at a reduced cost (Sorrel, 2012).
Steps in the state and federal policy development process. The steps of the development process focus in the four “pillars” of health reform: improving the quality of care, making health insurance affordable, supporting personal responsibility, and developing a sustainable approach to health care financing. This platform will help focus the initiative to tackle the growing costs of health care while preserving the highest quality of care for all Americans and avoiding cost-shifting wherever possible (Bipartisan Policy Center, 2013).
Many ACA provisions went into effect immediately or soon after the health reform law was enacted in 2010; others are being phased in over time. Several major reforms, including the Medicaid expansion, insurance exchanges, and minimum coverage provision (“individual mandate”) will go into effect in 2014, and still others will go into effect later. APHA recommends several great resources for tracking state progress on creating health insurance exchanges, funding states have received through various ACA provisions, and states’ intentions regarding the Medicaid expansion, and other topics (APHA, 2010).
Policy development vs implementation.
Policy development starts with knowing what the problem is and how the policy will improve the issue. So the importance of analyzing the data about the problem needing fixed. When writing the policy provide the opportunity for the input of the policy makers to suggest changes which provides different viewpoints. To present the policy to the committees for approval or changes as needed. Policy Implementation is ready to start with a timetable of how the implementing of the policy and briefing the States. Implementation of the Affordable Care Act is an enormous administrative challenge, and many details of its implementation are still developed by the Department of Health and Human Services (Wann, 2013). Policy development starts from the moment the public, the legislature think there is an issue and a solution is needed. The ACA development started many years ago back in the 90s when the Clinton administration specifically Hillary Clinton supported the creation of a Universal Health Care system, that laid the foundation on which ACA started to gather the issues and started to research possible solutions.
The issues was brought by the public to the press, to the meetings and hearings during the elections campaign and started to gather strength and support on President Obama challenge not only the American people, but the entire Congress to bring out to the negotiations idea on how to increase access to care while reducing cost. The ACA legislation development follows several tenets as the building block in which the legislation was written and develop on, Quality affordable health care for all Americans, the role of public programs, Improving the quality and efficiency of health care, prevention of chronic disease and improving public health, Health care workforce, Transparency and program integrity, Improving access to innovative medical therapies, Community living assistance services and supports and Revenue provisions (Democrat Senate, 2004).
The implementation process of the legislation follows the same tenet but there is not planning and changing is the plan drafted and written how each steps will be attained and when and lastly the evaluation of the development and the implementation and sitting back in the drafting table to fix any encountered issues. The development and implementation phases of the legislation cannot be seen as two different path but rather as a process of two collaboration between the two parts using the same foundation to build. To summarize the differences between development and implementation would be that the developments of the policy consist of the idea to the final written policy. The implementation of the policy is the start of putting the policy in action.
The stakeholders became involved with the affordable care act because even though this was controversial many believed that the needs were far greater than the issue and some changes were needed. Stakeholders for this legislation is the entire country of United States as the affected party, the health care providers, the legislators, the President of United States. In health care, the overarching goal for providers, as well as for every other stakeholder, must be improving value for patients, where value is defined as the health outcomes achieved that matter to patients relative to the cost of achieving those outcomes. Improving value requires either improving one or more outcomes without raising costs or lowering costs without compromising outcomes, or both. Failure to improve value means, well, failure (Porter, Lee, 2013).
Stakeholders are heard during the elections periods where the issues to be discussed should and have to be of interest to the public to be added to the political platform. The press plays an important role on serving as the echo or the microphone to put the issues that are important for the American people. The Health care providers were a major force on the legislation development as their input from a business standpoint played major role on discussing areas that were part of the problem as well as area that needed to stay the same and it also serve as another voice of the public on such a controversial issue.
Congress as a stake holder not only play a vital role on policy development and drafting but was the starting point of bringing the issue to the front and placed it in the agenda to be discussed and heard and last the President and its executive branch as the approval seal to the developed policy. In summary the Affordable Care Act has pique the interest not only as a national issue but a global one. Like any policy development the issues have to discuss by the stakeholders representing health care and each and every one has a specific interest in the issue to be solve.
American Public Health Association, (2014), ACA Implementation. Retrieved
August 4, 2014 from http://www.apha.org/advocacy/Health+Reform/implementation/ Bipartisan Policy Center, (2013). Managing Costs, Preserving Care: Health Care Cost Containment Report Release. Retrieved on August 4th, 2014 from http://bipartisanpolicy.org/projects/health-care-cost-containment-initiative Patel, K. Parker, R. Villaruel, A.Wong,W (2013). Amplifying the Voice of the Underserved in the Implementation of the Affordable Care Act. Retrieved on August 4th, 2014 from http://www.iom.edu/Global/Perspectives/2013/AmplifyingTheVoice Ha, J. (2012). Health Care Reform vs ObamaCare: Partisan framing of FOX, MSNBC, NYT snd WSJ. Retrieved on August 4th, 2014 from http://gnovisjournal.org/2012/11/30/health-care-reform-vs-obamacare-partisan-framing-of-fox-msnbc-yt-and-wsj/ Porter, M. E. (2013), The Strategy that will fix health care. Harvard Business Review, Retrieved On August 4th, 2014 from http://hbr.org/2013/10/the-strategy-that-will-fix-health-care Sorell, M. J. (2012), Patient Protection and Affordable Care Act: Ethical Perspectives. Retrieved on August 4th, 2014 from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Ethics/Patient-Protection-and-Affordable-Care-Act-Ethical-Perspectives.html