1. Policymaking for Health Care and the Environment Chapter 19

2. Health Care Policy The Health of Americans – Americans generally lag behind in key areas lower life expectancy (77.9 years) higher infant mortality rate (6.9%) The Cost of Health Care – Americans spend more than any other country 16% of the GDP $7,026 per capita – Doctors don’t compete, private insurance pays, some procedures are only available in U.S.

3. Health Care Policy Access to Health Care – Health Insurance. In 2007 45.7 (15.3%) million Americans have no health insurance. (US Census Bureau) Down from 2006 when 47 million people (15.8%) of Americans had no health insurance (US Census Bureau) Often linked to having a job- lose the job, lose the health insurance. More are underinsured

4. Health Care Policy The Current Role of Government in Health Care – Medicare: provides hospitalization insurance for elderly and optional coverage for other medical expenses. – Medicaid: public assistance program to provide health care for the poor. Paid for by national and state governments.

5. Policymaking for Health Care The Clinton Heath Care Reform Plan. – Main idea was to address the costs and access to health care. – Taxes would rise, big source of opposition – States were to negotiate with providers and handle premiums, plans and payments. – Health care industry lobbied hard against it. – It eventually died in Congress.

6. Environmental Policy Economic Growth and the Environment – States compete with each other for business, which often leaves the environment out. – The EPA set clean air standards for states to enforce and carry out.

7. Environmental Policy Environmental Policies in America – Environmental Impacts. Environmental Impact Statements: report that specifies likely environmental impact of a proposed action- filed with the EPA. Used by environmental groups to challenge and delay projects they object to. http://www.foxnews.com/story/0,2933,450844,00.html?sPage= fnc/us/supremecourt http://www.foxnews.com/story/0,2933,450844,00.html?sPage= fnc/us/supremecourt – Clean Air. Clean Air Act of 1970: reduce auto pollution. 1990 amendments allowed emissions trading.

8. Environmental Policy 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 it misses “runoff” pollution from city streets and other areas.

9. Environmental Policy Environmental Policies in America – Wilderness Preservation. The U.S. is a world leader in wilderness preservation. The national parks and national forests may be restricted to keep them for future generations. – Endangered Species. Government protects those species listed as endangered- regardless of costs. Exceptions may be made in some instances.

10. Environmental Policy Energy, the Environment, and Global Warming – 87% of the nation’s energy comes from coal, oil and natural gas. – Most controversial energy source is nuclear. – Growing focus on conservation, alternative fuels, and renewable fuel sources.

11. Environmental Policy Energy, the Environment, and Global Warming Arguments for:Arguments against:

12. Environmental Policy Toxic Wastes – Chemicals and nuclear fuel that are hazardous to humans and animals. – Superfund: created in 1980 to clean up hazardous waste sites. – Some sites are completely clean, others may never be clean enough to use for anything. – Current law requires tracking of hazardous chemicals, and their disposal.

13. Environmental Policy Making Environmental Policy – The issue is political since it puts “public” goods against other private concerns. – There are more groups and more people getting involved in protecting the environment. – They are still opposed by those who want to use the land for their own purposes. – Policies will be controversial & expensive.