DETAILED CONTENTS Acronyms and Abbreviations...xvii Preface...xxiii Acknowledgments...xxvii Chapter 1. Health and Health Policy...1 Health Defined...2 Defining Health Policy...9 Forms of Health Policies...13 Categories of Health Policies...17 The Impact of Health Policy on Health Determinants and Health...21 Summary...33 Case Study: U.S. Hospitals and the Civil Rights Act of 1964...34 Chapter 2. The Context of Health Policymaking...49 Federal Government...50 State Government...55 Local Government...56 Governments at All Three Levels Make Health Policy... 57 The Health Policy Market...60 Demanders and Suppliers of Health Policies...64 Interplay Among Demanders and Suppliers in Policy Markets...76 Summary...79 Chapter 3. The Process of Health Policymaking...83 Conceptual Frameworks and Theories of Policymaking... 84 A Core Model of the Public Policymaking Process...85 Formulation Phase...85 Implementation Phase...90 Modification Phase...94 xi
xii Key Features of the Policymaking Process...95 Summary...100 Chapter 4. The Role of Courts in Health Policy and Policymaking...103 The Core Roles of Courts...104 Structure of the Judicial Branch...107 Functioning of the Courts...112 Courts Acting as Referees...114 Courts Acting as Meaning Givers...123 Courts Acting as Rights Enforcers...129 Summary...132 Chapter 5. Policy Formulation: Agenda Setting...135 Agenda Setting...136 Interest Group Involvement in Agenda Setting...145 The Influential Role of Chief Executives in Agenda Setting...158 The Nature of the Health Policy Agenda...159 Summary...160 Chapter 6. Policy Formulation: Development of Legislation... 165 The Choreography of Legislation Development...166 Originating and Drafting Legislative Proposals...170 Introducing and Referring Proposed Legislation to Committees...177 House or Senate Floor Action on Proposed Legislation...183 Conference Committee Actions on Proposed Legislation...183 Presidential Action on Proposed Legislation...184 Legislation Development for the Federal Budget...184 Legislation Development for State Budgets...188 From Formulation to Implementation...190 Summary...191 Chapter 7. Policy Implementation and Implementing Organizations...195 Responsibility for Policy Implementation...197
xiii CMS as an Exemplar Implementing Agency...202 Policy Implementation as Policymaking, but with a Management Aspect...210 Summary...215 Chapter 8. Policy Implementation Activities: Designing, Rulemaking, Operating, and Evaluating...219 Designing...221 Rulemaking...223 Operating...231 Evaluating...245 Summary...254 Chapter 9. Policy Modification...259 Distinguishing Policy Modification from Policy Initiation...262 Medicare: A Long History of Policy Modification in Practice...263 Incrementalism in Policymaking...268 Mechanics of the Modification Phase...270 Participants in All Three Branches of Government Play Roles in Modification...270 Modification Occurs Throughout the Policymaking Process...277 Summary...287 Chapter 10. Building Policy Competence for Health Professionals... 291 Policy Competence Defined...292 The Ethics of Influencing Policymaking...293 Policy Competence for Health Professionals: Influencing Policymaking...297 Observing to Identify Public Policy Information That Is Possibly Important to the Professional...298 Assessing the Level of Importance of Identified Public Policy Information for the Professional...301 Monitoring the Public Policy Information Identified as Important...304 Forecasting the Future Direction of Important Public Policy Information...305
xiv Influencing Policymaking...307 Using Organizational Relationships to Increase Influence in Policymaking...321 The Human Element in Influencing Public Policy Environments...330 Summary...331 Appendix 1. Overview of the Patient Protection and Affordable Care Act...337 Appendix 2. Overview of Medicare...345 Appendix 3. Overview of Medicaid...365 Appendix 4. Briefly Annotated Chronological List of Selected US Federal Laws Pertaining to Health...379 Appendix 5. National Institute of Biomedical Imaging and Bioengineering Establishment Act...439 Appendix 6. Summaries of a Proposed and a Final Rule...445 Appendix 7. News Release: FDA Allows Marketing of First Medical Device to Prevent Migraine Headaches...455 Appendix 8. Smokefree Laws...457 Appendix 9. Laws Implemented by the EPA...461 Appendix 10. Medicare Revisited Again and Again...465 Appendix 11. The United States Constitution and the Federal Government...471 Appendix 12. State Legalization of Recreational Marijuana: Selected Legal Issues...475 Appendix 13. Finding Better Solutions: CMS Innovation Center Develops New Payment and Service Delivery Models... 477 Appendix 14. Coalition Letter Requesting Changes to Meaningful Use for Greater Systems Interoperability...479 Appendix 15. Types of Groups Involved in Financing Political Campaigns...483
xv Appendix 16. Testimony on Heart Disease Education, Analysis Research, and Treatment for Women Act (or HEART for Women Act )...485 Appendix 17. Congressional Conference Committees...489 Appendix 18. The Federal Budget Process...491 Appendix 19. Michigan s Budget Process...501 Appendix 20. Oversight Plan of the House Committee on Energy and Commerce, United States House of Representatives, 113th Congress...507 Appendix 21. MedPAC...513 Appendix 22. Improving Access to Mental Health Services for Veterans, Service Members, and Military Families... 515 Appendix 23. Performance Culture in the Federal Workforce...521 Appendix 24. State Experiences with Implementing the ACA...523 Appendix 25. Lower Costs, Better Care: Reforming Our Health Care Delivery System...529 Appendix 26. Observations on the Department of Homeland Security s (DHS s) Efforts to Identify, Prioritize, Assess, and Inspect Chemical Facilities...537 Appendix 27. Options for Reducing the Deficit: Increase All Taxes on Alcoholic Beverages to $16 per Proof Gallon...541 Appendix 28. Opening Statement: Hearing on Where Have All the Patients Gone? Examining the Psychiatric Bed Shortage...545 Appendix 29. A Proposed Rule on Revision of Nutrition Labels... 549 Appendix 30. Summary of the FDA s Ophthalmic Devices Panel Meeting...551 Index... 553 About the Author... 575 About the Contributor... 577