Health Care Policy Is An Anomaly Among Industrialized Nations Example For Students

Health Care Policy Is An Anomaly Among Industrialized Nations The United States’ approach to health care policy is an anomaly among industrialized nations. Disagreement about what the federal government’s role in health care ought to be, combined with the structure of lawmaking institutions, have yielded generations of improvised policies and programs that intend to mollify individual issues created by the health care system rather than comprehensively addressing its flaws. Following World War II, while most industrialized nations were creating national systems for health care in order to promote equality between classes, the US opted to exclude the provision health care from the federal government’s list of responsibilities. Unlike in those industrialized nations, there was no ideological consensus in the US that health care was a right. Therefore, national health care was seen as being outside the purview of the state. In part due to the distinctive, deep-seated suspicion of large government, its role was relegated to tackle piecemeal health care issues as they gained traction though an incremental, â€Å"disjointed† (Lindblom; Tuohy, p. 71) process. The federal government has been essentially limited to use health care policy as a tool only when problems within the existing health care system, such as access, affordability for the consumer, overall cost and efficiency, are framed as discrete, palatable issues at opportune times. Any attempt to create a rational, comprehensive plan, such as a national health plan, has been repeatedly suffocated by warring ideologies and the intricacies of US policy-making system. The following three examples epitomize the way in which federal health care policies are inadvertently borne in response to symptoms of a lacking heath care system. In the 1940s, the federal government began to subsidize hospital construction and improvements with the Hill-Burton Act. In the 1960s, the federal government commenced funding health care coverage for specific, deserving populations with Medicare and Mecaid. Beginning in the 1970s, the federal government became involved in regulatory program aimed to control spending – including the Professional Standards Review Organization. In each of these cases, the federal government had a role because of the specific framing of the finite problem. In the 1940s, the federal government’s involvement with health care policy was initially focused on subsidizing the ‘supply side’ of the health care system. This tactic aimed to expand the US health care system, while appeasing those who believed its operation should be left to the free-market. Federal support began with non-partisan, low-hanging fruit, which included the passage of the Hill-Burton Act. It was a bill that â€Å"appealed to everyone and alienated no one† (Rohrer, p. 141), created in response to geographic variations in hospital services – especially a lack of hospitals in rural America. The bill aimed to expand the physical infrastructure of the US health care system by building (and later, improving) hospitals throughout the country. Some, like the doctor representing the Committee of Physicians for the Improvement of Medicine, knew that targeting one small piece of a flawed health care system was not going to a long-term solution. H e warned that subsidizing hospitals could â€Å"lull the nation into thinking that its health problems were solved† (Rohrer, p. 141; Starr), but that only a national health insurance plan would make accessibility universal. It was clear that the Hill-Burton Act, despite its good intentions, was not the product of a rational, overarching plan to address issues of health care access. Rather, it was a shortsighted attempt to construct and upgrade hospitals that mistakenly oriented the entire health care system to overuse hospitals. In Senator Edward Kennedy’s words, the Hill-Burton Act â€Å"allowed a wasteful, inefficient health care system to perpetuate itself† (p. 144). He called for a restructuring of the health care system to shift the policy community towards planning how the system should operate, rather than implementing reactive bandages. Membrane Physiology EssayThe creation of PSROs was another product of contingencies; a program viewed as acceptable because it was non-threatening, but theoretically could have contained costs had in not been administered by the same group it was trying to influence. That PSROs turned out to be â€Å"better suited to the industry’s expansion than to its retrenchment† (Morone, p. 269) is evidence of the fact that is was created for its mere tolerability. This – and most other regulatory programs at this time – never had the rational, big-picture forethought attached to them to ensure their success One of the major lessons learned from these examples of the federal government’s forays into health care policy is that when incrementalism is the strategy – whether by choice or because of the political climate – it becomes even harder to implement a thoughtful, well-organized program. Coherence and continuity are extremely difficult to plan for without being able to predict what the political climate or national mood will be like, what will have changed and what will be the same. At this point, it seems the federal government is incapable of addressing the flaws of the US healthcare system with an overarching, rational, and thoughtful plan. Implementing such a plan would first require ideological consensus, which seems more and more unlikely in this increasing partisan world. This individualistic, market-driven system has become so engrained into the American conceptualization of the health care system that it is nearly impossible to meaningfully restructure th e health care system. Even with a majority (not consensus) there is so much uncertainty in the lawmaking process and congressional â€Å"institution itself – its intricate rules, processes, folkways, and coalitions.† (Blumenthal and Morone, p. 165). This intersection of ideology and lawmaking almost precludes the passage of a national health plan, without a major cultural shift towards prioritizing health as a human right.