Healthcare Policy-Making Process Essay

Healthcare Policy-Making Process Essay

Healthcare Policy-Making Process

Healthcare is among the critical areas of concern in the contemporary world, especially given the current COVID-19 pandemic that weighs heavily on the country’s health policies. Throughout a policy’s history, a bill evolves after it’s formulation and implementation phases through amendments to its existing legislations. The phases of policy-making are interdependent and interactive. Policy-making occurs in a dynamic environment with which the process affects and is affected by external factors.

Formulation Phase

As the first phase, the policy areas emanate from amendments to already existing laws or as new public laws. In the agenda-setting phase, there is an interaction of varying health-related issues and possible solutions. Prior to the policy-making process, some political actors ought to initiate strategies that solve existing problems, and decision making by the legislators pertaining areas for prioritizing throughout the process. (Longest, 2016). It is in this phase that policymakers consider significant relative to populations demands while offering a problem-solution combination. Agenda setting, hence, describes the interplay between problems, possible solutions, and political circumstances emerge.

Legislation Phase

At this phase, policymakers propose specific legislation through proposals or bills. There are 12 steps in the legislative process of the US Congress. The first step involves referring the accounts to standing committees in the House or Senate (Longest 2016). In the second step, the affiliate committee determines the bill’s chance for approval by examining it. Not taking any action of the bill is equivalent to rejecting it (Longest, 2016). Step 3: Subcommittee review entails hearings that allow the formally express opinions of experts or other public officials (Longest, 2016). Mark up is the fourth step in which there are changes and amendments before recommending the bill to the full committee. Step 5 involves Committee Acting to report a bill, and step 6 requires publication of a written report while step 7 entails scheduling floor action. The bill is debated in step 8 and voted for or against in step 9. Suppose the bill is passes, its’ referred to another chamber where it is changed, rejected or approved as it was received. Step 11 entails conference committee action where both house and senate must approve the conference report. Step 12 involves final activities by the Congress or the president sending a veto message to the Congress. Finally, suppose the president vetos a bill, the Congress efforts to override the veto necessitates a two-thirds representation, making the bill’s 13th step.

Implementation Phase

Implementing organizations, primarily departments and agencies, are formed and maintained to undertake the intent of laws. They are implementing health policies duly if they are to affect the determinants of health. In line with policies requiring implementation, the managerial tasks may be simple or straightforward or require massive efforts. According to Longest (2016) the public law’s performance consists of the interplay between designing, operating, rulemaking and evaluation processes. In the designing process, traditional management roles of decision making, organizing, staffing, directing and planning are depicted herein (Longest, 2016). Subsequently, detailed directives are developed in the rulemaking segment by affiliate executive branches (Longest, 2016) The operating phase is affected by the ability of the implementing organization and policy objectives and its capability of managers in implementing entities (Longest, 2016). This phase involves managing resources in ways that facilitate the attainment of goals and objectives

Evaluation/Analysis

            This phase can result in new elements of design, rulemaking, and operating policies. Managers of the implementing agencies may question how effective the procedure is, the components that require revisions and attainment of objectives and whether benefits from the policy justify its costs. Examples of assessments include process and outcome evaluations, formative and summative evaluations, cost-benefit, and cost-effective evaluations (Longest 2016). The executive and legislative are interested in the performance of policies they enact and implement. Policy evaluation is the systematic collection, analysis, and usage of information to answer questions about procedures.

Revision Phase

This phase is imperative because no policy is entirely drawn in its formulation and implementation phases. In a hypothetical policy-making process without a revision phase, policies are implemented in their original versions and then executed. This phase allows adjusting policies to accommodate changing circumstances throughout the process. According to Longest (2016), interest groups, organizations or any individual that may benefit from a bill may seek it’s modification to maintain or increase benefits accrued over time. Besides, when policymakers formulate and implement a policy while observing its operation, they can evaluate it against its objectives and revise it accordingly. Efforts to modify policies are prevalent when preferences and realities do not match.

 The Affordable Care Act (ACA)

President Obama, while having a Democrat majority in both Houses of Congress acknowledged that inadequate insurance was a hindrance to availing medical care in the United States. They mandated expanding healthcare coverage, making the agenda, setting healthcare reform as the number one priority (Longest 2016). Eibner and Nowak (2016) identify that approximately 24 million people gained access to subsidized free care through the expansion of Medicaid and market place tax credits. Conversely, potential concern segments in the Act are related to having regulations that restrict an insurer ability to charge higher premiums for the elderly and sicker citizens, leading to unrequired premiums for younger and healthier citizens. (Eibner & Nowak, 2016).  Additionally, according to Eibner and Nowak (2016), the law could significantly raise federal spending, given the cost of Medicaid expansion coupled with the ACA’s approach to subsidizing health insurances in the marketplaces. If the legislation’s purpose is to increase Medicaid enrollment, successful implementation necessitates enrolling more people into the program, reviewing premiums and implementation cost.

In the ACA case, implementation was challenging due to the need for bargaining with each state in crafting exchanges: Some were federally operated, hybrid, and others were state-operated (Longest, 2016). The performance of ACA involved multiple agencies such as the United States Department of Health and Human Services (HHS), The International Revenue Service. Besides New agencies such as the Center for Medicare and Medicaid Innovation and Independent Payment Advisory Board were established by the ACA. Concerning the expansion of Medicaid expansion, the Supreme Court issued its decision in 2012 that the States were being coerced in violation of the Tenth Amendment into administering the new program (Redhead et al., 2012). However, the court noted that the government would still be allowed to avail federal matching funds affiliated with the expansion: States would decline to participate in Medicaid expansion without financial penalty or comply with the new requirements to receive expansion-related funds (Redhead et al., 2012). The federal government would provide costs for Medicaid expansion while the established agencies implemented the policy’s objectives.

As seen in the ACA process, policy-making in healthcare is a human process that is guided by informed decision making and good judgment. The process is a highly interactive, complex, and cyclical process that involves formulation, implementation, and modification phases.

Healthcare Policy-Making Process Essay

Healthcare Policy-Making Process Essay