Loading...

POLSC431: Public Policy Process

Unit 6: Public Health Policy   The debate over the U.S. government’s role in providing health care for its citizens has become increasingly heated in recent years, with some arguing that the country is behind other industrialized nations in not providing universal medical care to all its citizens, while others argue that federal attempts to mandate health care for all Americans are reminiscent of socialism.  The U.S. government has long been responsible for providing medical care directly through Veterans Administration hospitals and with paying for the costs associated with health care for the elderly and the poor through Medicare and Medicaid—entitlement programs that are largely viewed as politically untouchable.  Still, the rising costs of providing medical care have spurred increasing efforts at reform despite the political consequences as well as increased interests in studying ways to reduce costs through a variety of preventative steps meant to decrease the usage of emergency rooms in favor of clinics.  Another aspect of these debates centers on the confidential relationship between patients and their doctors, who are trusted to make medical decisions but who are sometimes proscribed by government regulations.
 
One area in which the American government has sometimes run into conflict with the medical establishment is in the area of drug policy, which doctors have long campaigned to be seen as a primarily a medical problem rather than a criminal issue.  The success of the American war on drugs, begun in the 1970s but costing ever more every year without seeming to reduce the number of addicts across the country, has been increasingly debated by policymakers in recent years, as many have begun to question the costs of existing drug policies against the seeming success of more liberal drug policies practiced by various European countries.  In the United States, the debate over the decriminalization of drugs has largely focused on marijuana, which has become legal in certain states as a treatment for medical problems if prescribed by a doctor.  Some organizations campaign for outright legalization, while others argue that the law as it currently stands makes it too easy for criminals to take unfair advantage for their own ends.
 
Those who argue in favor of legalizing marijuana often point to the fact that alcohol and cigarettes remain legal despite the health risks involved with their usage.  Indeed, alcohol and cigarette smoking are considered to be the two major preventable causes of illness and death in America today; thus, many argue that those who engage in those types of risky behaviors should have to pay more for their medical care and ought to be restricted in the products they can buy.  This has also led to an increasing focus on why some groups of Americans irrespective of their personal habits seem to live longer than others and to debates over the best way to provide hospice care and other services to those who are dying.  Issues surrounding the end of life, such as whether a patient should have the right to die and what measures should be take to prolong a person’s life, have also brought about a new round of debate on the relationships among medicine, ethics, and law.

Unit 6 Time Advisory
This unit will take you approximately 9.5 hours to complete. 

☐    Subunit 6.1: 2.5 hours

☐    Subunit 6.2: 3.5 hours

☐    Subunit 6.3: 3 hours 

☐    Subunit 6.4: 0.5 hour

Unit6 Learning Outcomes
Learning Outcomes
Upon successful completion of this unit, the student will be able to: - Identify vital issues and specific areas of concern for contemporary American policymakers within the broad field of American public health policy. - Identify key actors and agencies involved in public health policy formulation. - Identify specific issues of concern for American public health, including obesity, smoking, and illegal drug abuse. - Describe various decision frameworks used by policymakers in identifying, formulating, implementing, budgeting, and evaluating public health policy. - Identify key debates in contemporary public health policy as well as the issues at stake and the arguments advanced by each side of the debate. - Explain the difference between such public health care programs as Medicare and Medicaid and privately funded programs. - Explain the context, evolution, and linkages between certain public health policies and within the broader context of American political history.

6.1 Health Care: Debating Costs and Responsibilities   6.1.1 Introducing Health Care Policy in America   - Lecture: MIT: Fundamentals of Public Policy: ”Health Policy Continued Part I” and “Health Policy Continued Part II” Links: MIT: Fundamentals of Public Policy: ”Health Policy Continued Part I” (PDF) and “Health Policy Continued Part II” (PDF)
 
Instructions: Please click on the link above, locate the above PDFs from the linked page, and read these entire presentations (20 pages) on public health policy in the United States.
 
This lecture should take approximately 20 minutes to complete.
  
Terms of Use: Please respect the copyright and terms of use displayed on the webpages above.

6.1.2 Public Usage of Emergency Rooms in California   - Reading: Public Policy Institute of California: Shannon McConville and Helen Lee's “Emergency Department Care in California: Who Uses It and Why” Link: Public Policy Institute of California: Shannon McConville and Helen Lee's “Emergency Department Care in California: Who Uses It and Why” (PDF)
 
Instructions: Please click on the link above, and select the “Full Report” link to read this entire PDF (24 pages) about emergency rooms in California.
 
Reading this text should take approximately 1 hour and 15 minutes to complete.
  
Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

6.1.3 The Relationship between Doctors and Patients   - Lecture: Learner.org: Ethics in America: Episode 4: “Does Doctor Know Best?” Link: Learner.org: Ethics in America: Episode 4: “Does Doctor Know Best?” (Adobe Flash)
 
Instructions: Please click on the link above, and select the VoD icon next to “Does Doctor Know Best” to watch this entire video (approximately 58 minutes) on the relationship between doctors and patients.
 
Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

6.2 Drug Policy: Illegal Substances in America and the Medical Marijuana Debate   6.2.1 The American Drug War   - Lecture: Cosmoslearning.com: “American Drug War: The Last White Hope” Link: Cosmoslearning.com: “American Drug War: The Last White Hope” (Adobe Flash)
 
Also available in:

[YouTube](http://www.youtube.com/watch?v=6CyuBuT_7I4&feature=player_embedded)  
    
 Instructions: Please click on the link above, and watch this entire
video (approximately 2 hours).  This film discusses the war against
illegal drugs in the United States.  
    
 Terms of Use: Please respect the copyright and terms of use
displayed on the webpage above.

6.2.2 Debating Marijuana Policy   - Web Media: The Centennial Institute’s “Marijuana Public Policy Debate” Link: The Centennial Institute’s "Marijuana Public Policy Debate”  (Adobe Flash)

 Instructions: Please click on the link above, and watch the above
video in its entirety (90 minutes)—a panel discussion with law
enforcement, policymakers, and scholars on the issues and options
surrounding the use of medical marijuana.  

 This web media should take approximately 1 hour and 30 minutes to
complete.  

 Terms of Use: Please respect the copyright and terms of use
displayed on the webpage above.  
  

6.3 Major Issues in Contemporary Public Health Policy: Smoking, Obesity, and Aging   6.3.1 Smoking and Obesity in America   - Lecture: MIT: Fundamentals of Public Policy: “Health Policy” Link: MIT: Fundamentals of Public Policy: “Health Policy” (PDF)
 
Instructions: Please click on the link above, locate the above PDF on the linked page, and read this entire presentation (20 pages) on the health problems of smoking and obesity in the United States.
 
This lecture should take approximately 30 minutes to complete.
 
Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.  

6.3.2 Aging and Death in America   - Reading: Public Policy Institute of California: Shannon McConville and Helen Lee's: “Death in the Golden State: Why Do Some Californians Live Longer?” Link: Public Policy Institute of California: Shannon McConville and Helen Lee's: “Death in the Golden State: Why Do Some Californians Live Longer?” (PDF)
 
Instructions: Please click on the link above, and select the “Full Report” link to read this entire PDF (28 pages) about life expectancy in California.

 This reading should take approximately 1 hour and 30 minutes to
complete.  
     
 Terms of Use: Please respect the copyright and terms of use
displayed on the webpage above.
  • Lecture: Learner.org: Ethics in America II: Episode 1: “Three Farewells: Medicine & the End of Life” Link: Learner.org: Ethics in America II: Episode 1: “Three Farewells: Medicine & the End of Life” (Adobe Flash)
     
    Instructions: Please click on the link above, and select the VoD icon next to “Three Farewells: Medicine and the End of Life” to watch this entire video (approximately 57 minutes), in which participants discuss ethics related to death and aging.
     
    Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

6.4 Entitlement Spending: Social Security and Medicare    

  • Web Media: Khan Academy’s “Social Security Intro”  Link: Khan Academy’s “Social Security Intro” (YouTube)
     
    Instructions: Please click on the link above, and watch the video (approx. 6 minutes), which provides an overview on how Social Security works.
     
    Viewing this video and note-taking should take approximately 15 minutes.
     
    Terms of Use: This resource is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. It is attributed to the Khan Academy.

  • Web Media: Khan Academy’s “Medicare Sustainability” Link: Khan Academy’s “Medicare Sustainability” (YouTube)
     
    Instructions: Please click on the link above, and watch the video (approx. 8 minutes), which discusses how Medicare works and provides a critique on the federal program’s sustainability and financial viability over the long-term.
     
    Viewing this video and note-taking should take approximately 15 minutes. 
     
    Terms of Use: This resource is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. It is attributed to the Khan Academy.