Health Care Policy An Overview Andrew Holtz
Scary Points Voracious Beast ($60-thousand/second) More complex than tax code Abandon common sense
Compelling Points Everybody wants health care Everybodys paying for it (payroll deductions, premiums, taxes, out-of-pocket) Health Care policy isnt for wonks. It connects with our basic desires and our pocketbooks.
Whos in charge?
Federal Health and Human Services Centers for Medicare & Medicaid Services (CMS) Paying for care Food & Drug Administration (FDA) Regulating Drugs & Devices National Institutes of Health (NIH) Research Centers for Disease Control & Prevention (CDC) Public Health Defense – CHAMPUS, VAMCs
Federal Laws of Note EMTALA Emergency Medical Treatment & Labor Act - Right to emergency treatment PRWORA Personal Responsibility & Work Opportunity Reconciliation Act -Medicaid & SCHIP: 5-year waiting period ERISA Employee Retirement Income Security Act MMA Medicare Modernization Act
States Medicaid Administer and share costs with Feds Regulate doctors and hospitals Individual insurance State budgets have three main pieces: public safety, schools, health care The rest is small potatoes.
Local Cities and Counties may be the safety net providers. Non-Governmental Charities & social service organizations (some church-affiliated) also provide services.
TIP Take a deep breath… Dont try to memorize it all Its a lot… and it keeps changing Find a friend or two Public agency/elected official staff Foundations, universities Hospital/clinic administrator
Insurance Employers Public Individual None Consumer Directed - HSAs
Insurance isnt enough Geography Culture/Language
Medicine isnt Everything Dont confuse Heath Care with HEALTH Social, Political, Economic forces Physical Environment
Stay Focused Dont get lost in the complexity Whats important to your audience Know where to turn for help