Healthcare Policy

Health policy is the decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society. It involves the creation and implementation of laws, rules, and regulations for managing nation’s healthcare system. The World Health Organization in its definition states that, “healthcare policy details a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.” What is key to all this is the understanding that these policies not only affect the cost of care citizens must pay, but also their access to care and the quality of care received, which can influence their overall health.

There are many categories of health policies, including global health policy, public health policy, mental health policy, health care services policy, insurance policy, personal healthcare policy, pharmaceutical policy, and policies related to public health such as vaccination policy, tobacco control policy

Beginning in the mid-20th century the federal government took an increasing role in regulating the healthcare industry in the US. Some major policy legislations enacted included:

  • Social Security Amendments of 1965: which established Medicare and Medicaid
  • Health Maintenance Organization Act of 1973: which promoted prepaid group practice service plans known as health maintenance organizations (HMOs) as an alternative to fee-for-service plans
  • Consolidated Omnibus Budget Reconciliation Act of 1985: which allowed employees to continue healthcare coverage if they would otherwise lose it (due to job loss, medical leave, etc.)
  • Health Insurance Portability and Accountability Act of 1996: required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.
  • Patient Protection and Affordable Care Act of 2010, known as Obamacare: 3 main objectives: (1) to reform the private insurance market—especially for individuals and small-group purchasers, (2) to expand Medicaid to the working poor with income up to 133% of the federal poverty level, and (3) to change the way that medical decisions are made.

 There is one major legislation that has been floated around since the early 1900’s, that is the call for a national health insurance program; however as of 2021 no such measure has been adopted in the United State. And with the partisan divide in congress enactment of any such legislation seems more like an urban myth than a reality.

Photo by Anthony Shkraba on Pexels.com

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