Health policy broadly describes the actions taken by governments—national, state, and local—to advance the public’s health. It is not a single action but requires a range of legislative and regulatory efforts ranging from ensuring air and water quality to supporting cancer research. Health care policy is that piece of health policy that deals with the organization, financing and delivery of health care services. This includes training of health professionals, overseeing the safety of drugs and medical devices, administering public programs like Medicare and regulating private health insurance. The obligation of governments to promote and protect the public’s health is grounded in the U.S. Constitution.
Health care policy targets the organization, financing and delivery of health care services. For example, health care may be delivered through a managed care provider or a preferred provider network. It may be financed through employer-sponsored health insurance or an individual policy or Medicare. And the care you get may be pegged to federally-funded research that has identified the most effective treatment.
Connected to all of this is a myriad of details concerning the licensing of health professionals and facilities, health information privacy protections, measures of health care quality and mistakes, malpractice, electronic medical records and efforts to control health care costs.
Many federal agencies have health care policy responsibilities. The Department of Veteran’s Affairs oversees a system of hospitals and clinics. The U.S. Department of Health and Human Services consists of multiple agencies that tackle various aspects of health care policy. The Centers for Medicare and Medicaid Services sets policy for these two major programs. The Food and Drug Administration is responsible for ensuring the safety of drugs. The National Institutes of Health oversees health care research ranging from mental health to AIDS to alternative medicine. The Centers for Disease Control and Prevention monitors collects data on health and investigates outbreaks of illness.
Concerns about the growing numbers of uninsured, the high costs of health care, and reports by the Institute of Medicine, among others, on health care quality, led to passage in 2010 of Patient Protection and Affordable Care Act, or PPACA. The PPACA is designed to reconfigure health care policy to improve access to health insurance, to rein in health care costs and to improve health care quality.
States are involved with health care policy many ways. Jointly with the federal government, states administer Medicaid and the Children’s Health Insurance Program. They regulate private health insurance and license medical professionals and facilities. Some directly operate public hospitals and mental health facilities. They administer public health departments that, among other things, operate public health clinics and provide vaccinations.
Local governments’ involvement with health care policy varies with the size of the local governments. Larger jurisdictions may operate public hospitals with emergency departments and tertiary care centers for complicated cases. They also have public health departments that operate clinics, operate school-based clinics and provide ambulance and emergency medical response services.
National, state and local governments coordinate their efforts in emergencies. The Federal Emergency Management Administration coordinates responses to natural and man-made disasters, which include ensuring the readiness of state and local health care providers.