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Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Chapter 19 Edwards, Wattenberg, and Lineberry Government in America: People, Politics,

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Presentation on theme: "Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Chapter 19 Edwards, Wattenberg, and Lineberry Government in America: People, Politics,"— Presentation transcript:

1 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Chapter 19 Edwards, Wattenberg, and Lineberry Government in America: People, Politics, and Policy Fourteenth Edition Policymaking for Health Care and the Environment

2 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Roots of Health Care Policy  Governments have long advocated for public health.  National health insurance was considered in 1930s.  Failed due to lobbying of American Medical Association.  Government’s role has expanded over time.  No universal coverage exists.

3 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Health Care Programs Today  Government provides care for veterans and Indians.  Sponsors research at National Institutes of Health.  Most people use single-payer private healthcare system.  Costs are rapidly increasing.  Government funds Medicare and Medicaid.  Also plays a major role in public health management.

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8 Source: Organisation for Economic Co-operation and Development (2010), "OECD Health Data", OECD Health Statistics (database). doi: 10.1787/data-00350-en (Accessed on 14 February 2011). Notes: Data from Australia and Japan are 2007 data. Figures for Belgium, Canada, Netherlands, Norway and Switzerland, are OECD estimates.

9 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Global$899 1United States of America$7,164 2Luxembourg$5,996 3Monaco$5,750 4Norway$5,207 5Switzerland$4,815 6Netherlands$4,233 7Malta$4,197 8Austria$4,150 9Belgium$4,096 10Germany$3,922 11Canada$3,867 12France$3,851 13Denmark$3,814 14Ireland$3,796 15San Marino$3,690 16Sweden$3,622 17Iceland$3,583 18Australia$3,365 19Finland$3,299 20United Kingdom$3,222

10 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Health Care Policy The Health of Americans Americans generally lag behind other countries Lower life expectancy and higher infant mortality rate The Cost of Health Care Americans spend more than any other country—$2.3 trillion and one-seventh of GDP. Reasons for high costs: High-tech medicine Insurance pays for health care. Malpractice lawsuits leads to defensive medicine, which drives up costs.

11 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Uneven Coverage, Uneven Care Health Insurance facts 46 million have no insurance. Most common reason for no insurance is losing or changing a job. Health insurance closely tied to income — Higher income = more insurance

12 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Managed Care Health Maintenance Organization (HMO): organization contracted by individuals or insurance companies to provide health care for a yearly fee. Designed to reduce costs through oversight and limiting patient choices. Limits choice of health care providers

13 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. 1 Monaco 89.7 2011 est. 2 Macau 84.4 2011 est. 3 San Marino 83 2011 est. 4 Andorra 82.4 2011 est. 5 Japan 82.3 2011 est. 6 Guernsey 82.2 2011 est. 7 Singapore 82.1 2011 est. 8 Hong Kong 82 2011 est. 9 Australia 81.8 2011 est. 10 Italy 81.8 2011 est. 11 Jersey 81.4 2011 est. 12 Canada 81.4 2011 est. 13 France 81.2 2011 est. 14 Spain 81.2 2011 est. 15 Switzerland 81.1 2011 est. 16 Sweden 81.1 2011 est. 17 Israel 81 2011 est. 18 Iceland 80.9 2011 est. 19 Anguilla 80.9 2011 est. 20 Bermuda 80.7 2011 est. 49 Portugal 78.5 2011 est. 50 United States 78.4 2011 est. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

14 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. RankCountry or territory Infant mortality rate (deaths/1,000 live births) -World42.09 1 Singapore2.31 2 Bermuda2.46 3 Sweden2.75 4 Japan2.79 5 Hong Kong2.92 6 Macau3.22 7 Iceland3.23 8 France3.33 9 Finland3.47 10 Anguilla3.52 11 Norway3.58 12 Malta3.75 13 Andorra3.76 14 Czech Republic3.79 15 Germany3.99 16 Switzerland4.18 17 Spain4.21 18 Israel4.22 19 Slovenia4.25 20 Liechtenstein4.25 21 South Korea4.26 22 Denmark4.34 43 5.72 44 Cuba5.82 45 Guam6.05 46 United States6.26 European Union

15 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. The Role of Government in Health Care Government in the United States plays smaller role than governments in other countries National Health Insurance: a compulsory insurance program for all American that would have the government finance citizens’ medical care. Current plan (“Obamacare”)- Private insurance or Gov’t Insurance. Phased in 2010-2018. Medicare: provides hospitalization insurance for elderly and optional coverage for other medical expenses Medicaid: public assistance program to provide health care for the poor, which is funded by both national and state governments

16 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Policymaking for Health Care Interest groups play a major role in health care policy making, leading to uneven government and private health care policies. – Elderly – Businesses / Labor groups – Insurance companies – Health providers

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19 http://ucatlas.ucsc.edu/spend.php

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21 Two Presidents, Two Health Care Plans Clinton Guarantee health care coverage for all Paid for by employers who pay a premium into a public fund and tax increases on cigarettes Interest groups lobbied hard against this bureaucratic and complicated plan which died in Congress. Bush Health savings accounts Drug benefits for elderly through Medicare

22 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. The Health Policy Issues Ahead Nothing suggests health care will become cheaper. Health Policy Controversies – Stem cell research Limits on federal funding and research, but states spending more – Is medical rationing the solution to high health care costs?

23 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. U.S.A. Ranked 37 th by W.H.O. Health (50%) : disability-adjusted life expectancy (homicides, obesity*) Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities Fair financial contribution 25% (lack of insurance, 37%+ by choice*) * John Stossel criticisms

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25 Chapter 19 Environmental Policy

26 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. 3 reasons why environmental policy is controversial… Policy creates winners and losers Scientific uncertainty Entrepreneurial politics

27 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. ENTREPRENEURIAL POLITICS BENEFITS TO MANY COSTS TO ONLY A FEW

28 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Environmental policy in America More adversarial than most European nations. What is done depends heavily on the states. –Federalism causes conflict Different Levels of Government –Separation of powers causes complications The 3 Branches of Government

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30 Environmental Policies in America Environmental Protection Agency: A federal agency created in 1970 and charged with administering all the government’s environmental legislation Administers policies dealing with toxic wastes The largest independent regulatory agency

31 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. MAIN GOVERNMENT AGENCY

32 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Environmental Policies in America Clean Air Clean Air Act of 1970 Charged the Department of Transportation with responsibility to reduce automobile emissions. 1990 amendments allowed emissions trading

33 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Las Vegas

34 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. THE GROWTH OF BALTIMORE (Urban Sprawl)

35 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. U.S.A. Car Fatalities 1972 = 52, 389 2003 = 42, 884 2004 = 42, 636 2006 = 41, 354 2008 = 31,110 (Jan–Oct)

36 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. TYPES OF ACCIDENTAL DEATHS, USA 2002 PERCENT (1) Motor vehicle (MVA)44.30% (2) Falls17.80% (3) Poison,liq/solid13.00% (4) Drowning3.90% (5) Fires, Burns,Smoke3.40% (6) Medical/Surgical Complication3.10% (7) Other land transport1.50% (8) Firearms0.80% (9) Other (nontransport)17.80%

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39 West Jordan, Utah Population 19502,107 19603,009 19704,221 198027,192 199042,892 200068,336 2009104,915

40 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Dayton, Ohio Population 18302,950— 18406,067105.70% 185010,97780.90% 186020,08182.90% 187030,47351.80% 188038,67826.90% 189061,22058.30% 190085,33339.40% 1910116,57736.60% 1920152,55930.90% 1930200,98231.70% 1940210,7184.80% 1950243,87215.70% 1960262,3327.60% 1970243,601−7.1% 1980193,536−20.6% 1990182,044−5.9% 2000166,179−8.7% 2009153,843−7.4%

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42 Environmental Policies in America Clean Water Water Pollution Control Act of 1972 Intended to clean up the nation’s rivers and lakes requiring the use of pollution control technology. Has helped reclaim numerous rivers and lakes since its passage But misses “runoff” pollution from city streets and other areas.

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48 Grand Lake Ohio 2010-11

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50 Retention Ponds Prevent flooding Storm / Displaced water storage

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53 Environmental Policies in America Wilderness Preservation The U.S. is a world leader. National parks / national forests restrict use to keep them for future generations. George W. Bush proposed letting states decide on roads in wilderness areas. Endangered Species Endangered Species Act: federal government must protect actively endangered species—regardless of economic impact

54 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Environmental Policies in America Toxic Wastes Superfund: created by Congress in 1980 to clean up hazardous waste sites; money comes from taxing chemical products Has virtually eliminated haphazard dumping of toxic waste, but less successful in cleaning up existing waste Nuclear waste presents a serious challenge Yucca Flats, Nevada as home for nuclear waste

55 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. SUPERFUND CLEANUP SITES Green=Cleaned Yellow=Proposed Red=Identified

56 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Energy Sources and Energy Politics 87% of the nation’s energy comes from coal, oil, and natural gas. Coal is the most abundant fuel—90 percent of nation’s energy resources—but also the dirtiest. Oil accounts for 40% of our energy, but creates a dependence on foreign (especially Middle East) sources. The most controversial energy source is nuclear.

57 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Energy Policy

58 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Energy Policy

59 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. The Global Warming Gridlock Earth is expected to warm between two and six degrees by 2100 due to carbon dioxide. Total costs could be $5 trillion. United States is leading producer of carbon dioxide, but has not ratified Kyoto treaty Kyoto requires reduction in greenhouse gas. States, like California, are reducing emissions.

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61 Groups, Energy, and the Environment Environmental clean up is political since it puts “public” goods against other private concerns. Explosion of groups formed to protect the environment in 1960s and 1970s. Opposition to strict environmental laws, claiming it may hurt economy. Policies will be controversial and expensive.

62 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Democracy, Health Care, and Environmental Policy The issues involve all levels of governments. High-tech issues limit citizens’ participation. Relies heavily on group participation Groups, not individuals, have resources needed to afford the research into the science and policy of the issues.

63 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. The Scope of Government and Health Care and Environmental Policy As citizens want more health care reform, government will grow. Increased environmental protection will also increase the size of government. With party divisions, incremental, not fundamental change is most likely.

64 Copyright © 2009 Pearson Education, Inc. Publishing as Longman. Summary Technology is important to health and environmental policies. –Advances have improved health care but also increased its cost. –Advances have improved quality of life, but reliance on coal and oil as sources of energy have contributed to environmental degradation. Government will continue to grow to address these policy issues.


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