1. Welcome to HA 415-01 Healthcare Policy and Economics

2. Expectations: Course  Complete everything in the unit On Time!  Open the unit and review the reading assignments and lessons each week  To earn full credit, all discussion questions require an initial response (by Saturday) as well as responses to at least two of your classmates.

3. Expectations: Course (cont’d)  Please send your question to me via email.  DO NOT LAG BEHIND!  Late work will not be accepted unless there are clear and compelling extenuating circumstances. Documentation will be required to substantiate extenuating circumstances.

4. Expectations: Seminar  Be on time  Stay the entire time  By all means, let me know if you have a question!  Contact Kaplan Tech Support if you keep getting “dropped.”

5. Grading Rubrics  Located in the Syllabus  The rubrics are the bases of how your work is evaluated and graded.  It is very important that your writing is at college- level English and that you fully meet the requirements of each assignment. Make sure that you respond fully to all questions posed by each assignment.

6. KU Writing Center  The Writing Center is a great resource for helping you with your written communications and APA formatting - Just me, but I rely on my “APA Pocket Guide.” However, I am also here to help!

7. The Role of Policy and Law in Health Care/Public Health  Federal and state policy and law shape virtually all aspects of the health care system, from structure and organization, to service delivery, to financing, and to administrative and judicial oversight  Areas include: advertising and marketing of health services and products, health care contracting, employment issues, patents, taxation, health care discrimination and disparities, consumer protection, bioterrorism, health insurance, prescription drug regulation, assisted suicide, biotechnology, human subject research, patient privacy and confidentiality, organ availability and donation, and more.

8. The Role of Policy and Law in Health Care/Public Health  Policy and law have also long played a seminal role in everyday public health activities as well as in many historic public health accomplishments  One main focus of policy and law in the realm of public health is identifying the appropriate balance between public regulation of private individuals and corporations  Ability of those same parties to exercise rights without overly intrusive government intervention

9. Conceptualizing Health Policy and Law  There are three conceptual frameworks: 1.) The broad topical domains of health policy and law -Issues of public health -Controversies arising from the field of bioethics 2.) From historical terms, based on the social, political, and economic views that dominate a particular era - Health policy and law have been influenced over time by three perspectives: professional autonomy, social contract, and free market

10. Conceptualizing Health Policy and Law 3.) By conceptualizing health policy and law issues in terms of the stakeholders whose interests are impacted by certain policy choices or by the passage or interpretation of a law - Patients, health care providers, governments, the public, managed care and traditional insurance companies, employers, the pharmaceutical industry, the medical device industry, the research community, interest groups, and others all may have a strong interest in various policies or laws under debate.

11. Defining PolicyDefining Policy  Who makes policy?  Private actors  Government (federal, state, local)  Authoritative decision makers  Public policy problems  These lie beyond individual patient concerns  Structuring policy options  Mandatory/voluntary  Take action/refrain from acting

12. Federal Policymaking Structure  Legislative branch  House of Representatives  Senate  Executive branch  White House  Administrative agencies  Judicial branch

13. Federal Legislative BranchFederal Legislative Branch  Congress is the lawmaking body of the federal government  Congress consists of Senate and House  Senate  Statewide  2 senators from each state  House  Elected by district  Proportional to population  At least one representative per state

14. Legislative BranchLegislative Branch  Committees  Examples of key health committees:  Senate Finance, subcommittee on health care  Senate Health, Education, Labor and Pension  House Ways and Means  House Appropriations committee, subcommittee on Labor, Health and Human Services, Education, and Related Agencies

15. Legislative BranchLegislative Branch  Constituents  Voters in state or district  Voters in nation  Political party  President

16. Federal Executive Branch (cont’d)  White House  President  Executive offices  Assist and advise president  15 cabinet departments  Interpret and implement laws passed by Congress

17. Federal Executive Branch (cont’d)  Presidential powers/duties  Sets the agenda  Budget proposals  Persuasion (Bully Pulpit)  Sign/veto bills  Executive Orders

18. Federal Executive Branch (cont’d)  Presidential Constituents  Nation (all voters)  Public who voted for president  Political party  Other nations  International organizations  Administrative Agencies  Duties/powers: implement statutes through rulemaking

19. Federal Health BureaucracyFederal Health Bureaucracy  Key agencies  Department of Health and Human Services (HHS)  Department of Veterans Affairs (VA)  Department of Defense (DOD)

20. Federal Health Bureaucracy - HHSFederal Health Bureaucracy - HHS  Key agencies  Administration for Children and Families  Administration on Aging  Agency for Healthcare Research and Quality  Agency for Toxic Substances and Disease Registry  Centers for Disease Control and Prevention  Center for Medicare and Medicaid Services  Food and Drug Administration  Health Resources Services Administration  Indian Health Services  National Institutes of Health  Substance Abuse and Mental Health Services Admin.

21. Federal Health Bureaucracy – VA & DOD  VA  Provides comprehensive care to veterans who were not dishonorably discharged  DOD  TriCare provides health insurance to current and retired military personnel and their families

22. State and Local Policymaking and Health Bureaucracy  State-level policymaking is important  Key decisions are made on the state level  There is variation among states in how policymaking process is structured  State/local health bureaucracy  State level agencies (ex: Medicaid, public health)  Local public health agencies

23. The Role of LawThe Role of Law  The law’s importance in U.S. stems from its primary purpose: to function as the main tool by which we organize ourselves as an advanced, democratic society  A society as sprawling and complex as ours needs formal, enforceable rules of law to provide a measure of control

24. The Role of LawThe Role of Law  The main way the law governs the many kinds of relationships in society is to recognize and establish enforceable legal rights and to create the institutions necessary to define and enforce them  A legal right denotes a power or privilege that has been guaranteed to an individual under the law, not merely something that is claimed as an interest or something that is a matter of governmental discretion

25. Sources of LawSources of Law  Regardless of how “law” is defined, at the core of the legal system lies a body of enforceable written rules: - Constitutions (Federal and State) - Statutes - Regulations - Common law (aka case law), meaning that interpretation of law is based and binding on legal precedent

26. Key Features of the Legal System: Separation of Powers  The legal doctrine that supports the arrangement of shared governance  To guard against a concentration of political power, governmental powers and responsibilities are divided among three separate, co-equal branches  Includes concept of “checks and balances”

27. Key Features of the Legal System: Federalism  Refers to the allocation of Federal and State legal authority  Under the Constitution, the federal government is one of limited powers, while the states more or less retain all powers not expressly left exclusively to the federal government.

28. Key Features of the Legal System: The Special Role of Courts  Courts have responsibility to determine what the Constitution means, permits, and prohibits.  Courts protect and enforce individual legal rights, determine whether the political branches of government have violated the Constitution, and maintain stability in the law through the application of legal precedent

29. End