The process of health policy reforms in the United States involves various entities in both the public and private sectors, including multiple facets of the government. This paper examines various features of the legislative process and their impact on the health policy reform process. The paper also looks at some of the challenges that the US political system faces.
The components involved in the formulation and execution of health policy include issue raising, policy design, accumulation of public support, legislative decision making and development of policy support, and legislative decision making and policy implementation. The first component entails the discovery and acknowledgment of an existing concern that needs to be addressed. Some of the sources of reforms include recommendations from the advisers of the president, cabinet members, expert opinions, and public opinion polls. The process of policy design involves various executive bodies of the government such as “the Health Care Financing Administration and Policy staffs”, who come together to develop the proposals for reforms. The process of developing support for the proposal involves addressing the nation in order to appeal to the public, as well as, enhancing the support of interest groups. The final component involves various meetings between the president and his allies in office, with Congress in order to identify possible challenges that may arise while moving the bills through multiple committees (Shi & Singh, 2005).
The enactment of government health policies is aimed at minimizing the perceived deficiencies in health care delivery. The US political system is faced with numerous challenges. For instance, policy gridlock is a common challenge for proposals that may have the full approval by the public or majority of members in congress but still fail to be passed. Studies show that such episodes of political gridlock are most prevalent in matters pertaining to public health (Oliver, 2006). In addition, it is more challenging for health policy proposals to pass through congress than other proposals, and become law. Studies also show that there are many proposals that face difficulty in gaining approval due to the gridlock of congressional institutions, such as committee structures. Another factor that influences the political system is the existence of policy entrepreneurs, whose role is to influence the voting system and break the legislative gridlock. These entrepreneurs may be members of congress or external individuals or groups such as interest policy brokers. Another shortcoming with the political system in the US is the requirement for strong majority party and committee leaders who are capable of supporting a proposal to achieve the required success (Ruger, 2007).
Health policy initiatives in the last few decades have focused on making health care accessible to people in rural areas, the elderly, as well as, minorities through policy reforms that touch on the cost of care and accessibility of care by increasing providers and enhancing public financing. Health care professionals have a significant impact in making health care accessible to most people. Policies that concern providers ensure that there are sufficient physicians and caregivers in every geographical location (Weissert & Scheller, 2008). The Physicians and caregivers can assist in the reforms that increase the supply of physicians in various parts of the country by encouraging community workers and students to join the profession, and by acting as external entrepreneurs who push various policies. The latter can be effective in influencing the government to increase its assistance to medical students through the provision of grants that take them through the training process, as well as, the expansion of rural health clinics to cover wider regions (Heaney, 2006).
References
Heaney, M. T. (2006). Brokering Health Policy: Coalitions, Parties, and Interest Group Influence. Journal of Health Politics, Policy, and Law, 31(5), 887-944.
Oliver, T. R. (2006). The Politics of Public Health Policy. Annual Review of Public Health, 27, 195-233.
Ruger, J. P. (2007). Health, Health Care, and Incompletely Theorized Agreements: A Normative Theory of Health Policy Decision Making. Journal of Health Politics, Policy, and Law, 32(1), 51-87.
Shi, L., & Singh, D. (2005). Health Policy. Essentials of the US Health Care System, 291-311.
Weissert, C. S., & Scheller, D. (2008). Learning from the States? Federalism and National Health Policy. Public Administration Review, 68(S), S162-S174.