Health Policy Analysis: An Interdisciplinary Approach

Description

Drawing from the perspectives of a variety of disciplines, this innovative text is unlike any others of its kind. Health Policy Analysis: An Interdisciplinary Approach, Third Edition analyzes current U.S. health policy and proposes various alternatives for developing future health policy without pushing a single solution set--rather, it considers the viewpoints of economics, political science, management, communications, technology, and public health. Organized into three sections, this unique text first explores the current and historical issues with the U.S. healthcare system and considers the alternatives for future policy that have strong support. It then reviews the political processes that influence planning in various healthcare settings; presents the accepted methods of economic and financial analysis; and addresses the ethical and other value considerations that must enter into the health policy process. Finally, it takes a look at the roles, skills, and leadership that health professionals can bring to the policy making process in their local and national communities. The Third Edition offers: • Coverage of the implementation of the Affordable Care Act to date and the impacts of the 2016 elections are woven throughout chapters 1 through 6. • Greater emphasis on what the Institute of Medicine now calls the learning health system and the greater focus on cost and outcomes, now that the uninsured crisis has been somewhat improved. • New and updated case studies Cover......Page 1 Health Policy Analysis: An Interdisciplinary Approach......Page 2 Copyright Page......Page 3 Dedication......Page 4 Contents......Page 6 Preface......Page 10 Acknowledgments......Page 12 About the Authors......Page 13 PART I The Context......Page 14 The Many Actors......Page 16 Health Care: What Is It?......Page 18 The Policy Analysis Process......Page 20 Professionals and the Policy Process......Page 22 National Systems Differ but Parallels Exist......Page 23 Overarching Medico-Social Issues......Page 24 Impact of Societal Values on Policy Decisions......Page 27 Conclusion......Page 28 Chapter 2 American Exceptionalism—Structural and Conceptual......Page 29 Key Structural Issues......Page 30 Key Conceptual Issues......Page 32 Industrialization and Corporate Lite......Page 38 Conclusion......Page 40 A Chronology......Page 41 The Current “Era” Emerges......Page 49 Employers Want Out: Backing Consumer-Driven Health Care......Page 52 The Law of the Land: The ACA (Temporarily?)......Page 53 Conclusion......Page 56 Case 3: International Comparisons: Where Else Might We Go?......Page 57 Discussion Questions......Page 64 Where Are We?......Page 66 Alignment with the Rest of Society......Page 69 What Do Governments Want?......Page 73 Conclusion......Page 77 Case 4: National Standards on Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS)......Page 78 Discussion Questions......Page 79 Access to Care......Page 81 Quality of Care......Page 92 Enhance Patient Experience......Page 93 Costs of Health......Page 95 Relationships with the External Environment......Page 105 Conclusion......Page 106 Case 5: Global Medical Coverage......Page 107 Discussion Questions......Page 109 PART II The Policy Analysis Process......Page 112 Chapter 6 The Policy Analysis Process: Identification and Definition......Page 114 Getting the Scenario Right......Page 115 Hidden Assumptions......Page 120 Where in the World?......Page 123 Case 6: Small Area Variations......Page 124 Discussion Questions......Page 125 Chapter 7 The Policy Analysis Process: Health Technology Assessment......Page 126 Technological Forecasting......Page 127 Levels of Technological Forecasting......Page 128 Forecasting Methods......Page 132 Organizations Devoted to Healthcare Technology Assessment......Page 136 Where in the World?......Page 137 Case 7: Oregon’s Health Evidence Review Commission......Page 138 Discussion Questions......Page 144 Chapter 8 The Policy Analysis Process: Evidence-Based Medicine......Page 145 Reducing Variation and Saving Resources......Page 146 The Process of Evidence-Based Analysis......Page 147 The Example of NICE......Page 153 Decision Aids......Page 154 Determining Value......Page 156 Case 8: Comparative Effectiveness: Avastin Versus Lucentis......Page 159 Discussion Questions......Page 163 Chapter 9 The Policy Analysis Process: Evaluation of Political Feasibility......Page 164 Terminology......Page 165 Authorizing Environments......Page 166 Key Government Actors......Page 168 Political Inputs......Page 174 Nongovernmental Actors......Page 177 Methods for Analyzing Political Feasibility......Page 180 Critiques of Political Feasibility Analysis......Page 187 Conclusion......Page 188 Case 9: Green Mountain Care......Page 189 Discussion Questions......Page 192 Defining the Healthcare Process Involved......Page 193 Selecting the Analytical Approach......Page 196 Basic Tools......Page 197 Agreeing on the Resources Required......Page 202 Determining Relevant Costs......Page 203 Valuing the Outcomes Produced......Page 205 Dealing with Important Uncertainties......Page 212 Financial Feasibility......Page 214 Considering Distributional Effects......Page 215 Conclusion......Page 217 Case 10: Increasing the Federal Cigarette Excise Tax......Page 218 Discussion Questions......Page 223 Chapter 11 The Policy Analysis Process: Analysis of Values and Social Context......Page 224 Efficiency and Value......Page 225 Informed Consent......Page 226 Professional Ethics......Page 228 Consumer Sovereignty......Page 229 Social Welfare......Page 230 Rationing......Page 231 Influence on Society: A Broader Question......Page 235 Double Checking for Interacting Policies and Contextual Change......Page 236 Trade-Offs......Page 238 Working Out Your Own Scenarios......Page 239 Conclusion......Page 242 Case 11: The Folic Acid Fortification Decision: Before and After......Page 244 Discussion Questions......Page 253 Levels of Implementation Failure......Page 254 Implementation Planning......Page 255 Setting Up to Succeed......Page 260 Providing for Periodic Reviews......Page 263 The Postmortem......Page 264 Conclusion......Page 265 Case 12 : The Troubled Launch of HealthCare.gov......Page 266 Discussion Questions......Page 272 PART III The Professional as Participant......Page 274 Informational Credibility......Page 276 To Influence Globally, Start Locally......Page 277 Health Policy Analysis: A Relevant School for Leadership......Page 278 Enhancing the Professional’s Role......Page 279 Conclusion......Page 281 Case 13: The Data Sharing Proposal......Page 282 Discussion Questions......Page 288 Where to Stand......Page 289 The Physician’s Dilemma......Page 291 Many ACA Provisions Stay in Place, But Uncertainty Continues......Page 292 Conclusion......Page 293 References......Page 296 Index......Page 312