Introduction
Health care is a policy that the public sector cannot afford to shy away from at all circumstances. Any country that is mindful of development needs a healthy population to achieve its vision. Healthy individuals translate into a healthy nation.
If a nation were to be likened to a machine, then people would be the different parts that make up the machine. Therefore, if one of the components making the machine is faulty, then the entire machine becomes faulty.
The same way, if people in a nation are ailing, the nation cannot function optimally and this insight underscores the need to have a health public policy. The health care sector is divided into two broad categories, which include the one intended at keeping people healthy and the other intended at restoring health or cure.
All activities concerning people behavioral health is part of public health or the other category. Behavioral health may include activities like smoking, eating, or alcohol whereby, if people would make the right choices they would be healthier.
Public health involves general cleanliness and sanitation as well as environmental conservation. On the other hand, when people fall ill, the medical care division is responsible to deliver services to restore health (Kovner, Knickman, & Jonas, 2008, p.4).
Definition of Public Policy
Public policy in line with government action refers to principles that guide the administrative branch of government in taking action concerning various issues in a manner that follows the laid down procedures according to the law of the land and institutional customs.
The fundamental thing is the constitutional law and its implementation. Other substrates are the judicial system and the legislative regulations (Cutler, 1996, p.1). “Public policy is the broad framework of ideas and values within which decisions are taken and action, or inaction, is pursued by governments in relation to some issue or problem” (Brooks, 1989, p.16). In short, when the government makes a choice or decision that lays down the foundation or guidelines for future actions in similar situations, it amounts to public policy.
The Health Care Policy Problem
Though the public sector has been involved extensively in health care, many issues are yet to be addressed. According to Cutler (1996), the cost of medical care is still rising at a high rate (p.1). The question that lingers is whether the government should reduce its expenses on medical care.
People are no longer assured of receiving medical services; hence, they are living at a risk. The health care system is made up of many uninsured people. Gold (1999) rues that, “It is a system that continues to be built around the concept of pluralism, a substantial private sector role, and the continued presence of a large uninsured population.”
There are many older people today than there were a few years ago and the elderly require more medical care. Such demographics culminate into an aging population, which has led to increased medical costs.
Health costs have also risen due to the increase in per capita income. Rich people need more medical care as compared to poor people and it is normal that medical expenses would rise proportionally with income. In the present world, people are better insured and as a result, they are demanding more medical care.
This trend implies that medical expenses will continue to rise due to the spread in insurance coverage. Medical services are labor-intensive requiring them to have high productivity. Generally, services have slow productivity, which has resulted to an increase in the price levels of medical services.
Also involved are administrative costs, which translate to high service prices. Medical expenses are not planned and are usually required in an emergency. The need for medical services may be so urgent that the patient cannot look for the most efficient service provider hence doctors can add additional costs and as Cutler pints out, this has led to increased spending because the ability to do this has grown over time (1996, p.15).
Among the many inputs to health, lifestyle is one of them. People are responsible for the goods they consume. Personal health is affected when people smoke, drink alcohol, and/or fail to exercise. Although some of these goods directly affect utility, they contribute to lower health. Today, factors like air, water and sanitary conditions are less important than they were some years ago even though they contribute directly to the public health.
Evaluation of health care policy and the actors involved
The healthcare system is characterized by various features, which make it unique from other sectors. Institutions like hospitals, community health centers, practicing physicians and nursing homes deliver both medical care and public health services.
These institutions operate independent of each other although sometimes they offer similar services. Moreover, these institutions cannot operate without professionals; therefore, administrators, nurses, physicians, technological, and pharmaceutical developers play a major role in running institutions involved in health care.
In advancement of technology, medical technology has not been left behind. Electronic communication and new drugs have gone further to fuel changes in the health care sector. New pharmaceuticals and surgical procedures have helped improve service delivery.
However, these have increased the cost of health care hence making it unaffordable to a larger percentage of the population. Another issue that comes into perspective is the need to strike a balance between health care being a business that is profit oriented and it being a ‘social good’ or nonprofit making especially in the current world (Kovner, Knickman, & Jonas, 2008, p.6).
Evaluation of the Health Care Policy
A good public policy must fulfill some factors to be deemed sound. It has to be in the interest of the public, which means that there is balance and no one is overlooked, effective, efficient on resources utilization, consistent, politically viable and technically correct (Smith, 2003, p.14). The foundation of public policy is formed by values of individuals, groups and the entire society.
Technological advancement has led to improvement in the quality of services delivered but consequently led to an increase in medical spending. However, this has led some patients to benefit from this advanced technology largely. It is now possible to treat diseases that were previously hard to treat like heart attack.
The innovation has led to cure for diseases that were previously known to be incurable. Technological advancement is therefore on net valuable worthwhile since some patients are bound to benefit from any one of them. Researches have been undertaken and all of them have a common conclusion that marginal value of medical care is low meaning that the care is provided to the point that it brings little health benefits (Cutler, 1996, p.25).
The approaches to Health Care Policy
The challenges and the evaluation of a good health policy system as presented above require a new approach. “…to increase the choice that people have over different insurance policies, particularly policies that will limit the amount of care provided, and to increase the financial returns from choosing less expensive health insurances” (Cutler, 1996, p.27).
The more insured people there are, the less the burden of medical care will be. Several policies are suggested including encouraging small insurance companies to pool together or into large groups so that they can be able to offer a variety of insurance policies.
The small firms do not have the ability to offer a variety of insurance policy because of expensive administrative costs (Enthoven, 1993, p. 44). Employer-provided health insurance attracts tax exclusion, which is limited because they reduce the amount of after tax savings on less expensive health insurance plans.
Considering public health, it will be important to intervene in people’s personal behaviors if looked from the angle that one person’s behavior affects others. When a person smokes, it affects not only his/her health, but also the health of those around him/her.
Not all smoking or drinking is bad and individuals choose to engage in such behaviors based on their evaluation of the monetary and health costs. The public sector is responsible of providing information to people so that they can make informed decisions on their lifestyles.
Children are especially vulnerable to misinformation through advertisements hence the public sector should intervene to ensure the right information on the effects of smoking or alcohol drinking is delivered and understood in its entirety. The lifestyle choices of people like smoking affect the entire society. These choices cause health problems and they need to bear the burden of health care provision due to their long time effects on public health. This can be done by raising the tax levies on some of these products like cigarettes and alcohol (Grossman, Sindelar, Mullahy, & Anderson, 1993, p.12).
The choice of health insurance markets affects the choice of labor markets. Largely, insurance is received through the employer, by sharing the premium on a 70 and 30 percent between the employer and employee respectively.
Employment is preferred because it is a form of group coverage, which is not distorted. According to Cutler (1996), the employer relationship is strained due to high costs of health insurance (p.2). This form of health care provision causes workers to be locked in their jobs thus lower labor market turnover. It is not every worker that is willing to accept this form of health insurance where his/her wages are reduced to cater for increased health insurance costs especially the low wage earners.
Government involvement
Government is involved in health care largely. The involvement of the government in health care sector cannot be compared to its involvement in any other sector. The government has several roles in which it is involved in as pertaining health care, which includes regulation, informational or monitoring role (Cutler, 1996, p.1).
Seldom does the government dictate the amounts of a product to buy or from whom to buy. It is unheard of for the government to provide the product on its own. However, government is extensively involved in health care unlike in other markets. The main role of the government is providing health insurance.
The government offers insurance to the less fortunate in the society, the old and those with disabilities through public hospitals and clinics and as Cutler posits, “Governments pay for nearly half of health care services and supplies consumed in the United States” (1996, p.1).
In addition, the government is charged with the responsibility of direct health care provision, which is done, to many people veterans and defense personnel who receive care at public hospitals; therefore, instead of contracting private insurers, the government reimburse to providers.
The government finances biomedical research in a bid to improve the quality of medicine availed to the public. The government is also involved with the other area of personal health. To this effect, the government is involved in the health care sector through the tax policy where high taxes are levied on products like cigarettes and alcohol unlike other goods to contribute to behavior change in the behavior of people by making the right choices thus contributing to public health.
Finally, the government is responsible for health care regulation and this implies that, any new medical drugs and tools must be authorized by the responsible regulatory body, for example the Food and Drug Administration. Stringent measures are put in place to manage the health care system as a whole, which serves to show the sensitivity of the sector.
Suggested Health Care Policy Direction
Research has been carried out to come up with plausible policies and their implementation strategies. Research carried out on public health can help to save lives or even avoid diseases. The policy is fully inclusive and looks at the good of the less privileged in the society through provision of health care insurance that is affordable by all workers. The policy looks at the interest of the society as a whole through addressing public health where sanitation is highly emphasized.
The health care policy has proved to be effective and has achieved its goals. The public policy on health care has prospected to change for the better and this can be attributed to technological advancement that has contributed to great opportunities. For instance, diseases that hitherto passed for ‘untreatable’, they are now treatable in the wake of technological and research improvement.
Conclusion
The health care policy presented in this paper looks at health care as a public policy that is pertinent to a country’s achievement of its vision. The policy presented here digs out the problem of the current health care policy, evaluates the policy itself, and gives suggestions on how these can be implemented.
In conclusion, for a good health care policy to work and the results be seen, it is important to note that it will take the effort not only of the public sector through implementing laws, but also the general public will have to take responsibility through checking their behaviors and lifestyles.
A healthy nation boils down to personal responsibility because the government, through its strategic and plausible policies cannot force individuals to practice healthy living. Policies can only inform people on what to do but the decision to live healthily lies with an individual.
Therefore, as the government strives to adopt and implement health policies, individuals have to work in line with the formulated strategies. This way the health care policy will be able to attain its preconceived goals and objectives.
References
Brooks, S. (1998). Public policy in Canada: an introduction. Oxford: Oxford University Press.
Cutler, D. M. (1996). Public Policy for Health Care. Cambridge: National Bureau of Economic Research Enthoven, A. (1993). Why Managed Care Has Failed to Contain Health Costs, Health Affairs. Health Affairs, 12 (3), 27-43.
Gold, M. (1999). The Changing US Health Care System: Challenges for Responsible Public Policy. Milbank Quarterly, 77, 3-37.
Grossman, M., et al. (1993). Policy Watch: Alcohol and Cigarette Taxes. Journal of Economic Perspectives, 7(4), 211-222.
Kovner, A., Knickman, J., & Jonas, S. (2008). Health Care Delivery in the United States. New York: Springer Publishing Company.
Smith, L. (2003). Public Policy and Public Participation Engaging Citizens and Community in the development of Public Policy. Population and Public Health Branch. BL Smith Group Inc.