<aside> 💡 An Introduction to Health Policy

</aside>

1. Explore the concept and variety of health policies

   • Uses of the word “policy”

     • A field of government activity: foreign policy, economic policy
     • An expression of general purpose or desired state of affairs
     • Specific proposals
     • Decisions of government
     • A program (package of actions)
     • Outputs (what has been delivered?)
     • Outcomes (what has been achieved?)
     • A theory or model
     • A process

   • What is public policy

     • Formal decisions; outputs of governments
     • Dynamic course of action, examination of non-decisions

   • What is health policy

     • Complex network of continuing interactions between actors; articulate ideas of healthcare
     • Affects healthcare system institutions, organizations, services, funding arrangements

   • Definition of health policy:

     

     • Decision that directs public resources in one direction and not another as a result of competition between ideas, interests, and ideologies
     • Action/ intended actions by public, private and voluntary organizations that impact health
     • Includes policies that may be translated to action at later stage
     • Set of actions, decisions, statements of intention
     • Includes what government says they will do, what they do, and what they do not do

   • WHO definition of health policy

     • Decisions, plans, and actions undertaken to achieve specific health care goals
     • Vision for future, short- and medium-term targets
     • Outlines priorities and the expected roles of different groups
     • Builds consensus and informs people

   • What influences health policy?

     • Scientific research generally plays a small role influencing health policy - weighting over other influences is highly variable

     • Influences:

       • Evidence
       • opinion
       • right time + right place
       • historical influences and values within society
       • availability of resources
       • political ambition and personal interests
         • Bottle asthma spacer: example of how powerful images in research affect policy when words alone can’t

       

       

       

       

       

       

       

   • Why should you understand health policy/process?

     • Support: help patients to navigate through health systems
     • Service provision: provide better services to patients
     • Advocacy: influence health system to see opportunities when they arise; be opinion leaders
     • Policy: make new policy; identify stakeholders and form collaborations
     • Education and awareness: teach/promote community awareness
     • Research: create new knowledge for better health policy

   • Lowi typology of policies: predict how will be perceived by stake holders

     • Distributive

       • Provides certain groups with benefits
       • wider distribution, more popular the policy
       • Diffuse or indirect payment for this type of policy
       • More acceptable to the public
       • Easier to implement due to targeting subset of population
       • Examples
         • Veteran or senior health cards (cheaper, free care)
         • National Immunization Program
         • Direct Government Services: Public Schools

     • Regulatory:

       • Limitations, restrictions on individuals, certain groups
       • May result in conflicts:
         • limits to liberty
         • benefiting some groups over others
       • Examples
         • Scopes of practice (prescribing rights)
         • Drug, poisons and controlled substances schedules
         • Smoke free environments
         • Mandatory bike helmets
         • Taxes (fat tax) and incentives (GP practice incentives program)

     • Self-regulatory

       • Powerful groups (eg the medical profession) are given the authority and discretion to formulate and police the regulations governing them

       • Often formed outside public scrutiny (which can create conflict)

       • Medical board of Australia

         • Controlling licensing of who can be a doctor; accreditation of Medical Schools etc.

       • Australian Council on Healthcare Standards

         • Independently accredits public and private hospitals for their compliance to the National Safety and Quality Health Service Standards.
         • Founded by AMA and Australian hospital association

         

     • Redistributive

       • Redistributing wealth, property, rights within population
         • Taxing the "haves" to provide for the "have nots"
         • Two groups: people who benefit, people who are concerned/disadvantaged by policy
         • Meets needs and address inequalities
         • Controversial, idealogical, and partisan
       • Examples
2. Describe with examples of how health policies can influence health and the delivery of health care
3. Identify major actors and stakeholders in the health policy area
4. Identify and describe some factors that can inhibit best practice in policy making processes
5. Outline policy-making processes according to popular models