PHA 308: Health Policy and HC Reform

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1
  • Supreme law of US
  • Source of all govt powers
  • Est. 3 branches of govt

US constitution

2

Under the confines set forth by the Constitution, what type of system have we developed?

"Federalism"

3

What are the main functions of the Constitution?

  • Creation of a national govt
  • Division of power b/t federal and state govts
  • Protection of the various individual liberties of American citizens
4

The national govt includes:

  • Executive branch
  • Legislative branch
  • Judiciary branch
5

True/False: The constitution directly mentions healthcare.

False

6

What does the Constitution give congress the power to do?

  • Collect taxes
  • Pay debts; provide for common defense
  • Provide for general welfare of US
  • Regulate commerce among states
7

Which amendment gave the federal govt the authority to collect income tax?

16th (passed in 1913)

8

The administrative arm of the govt

Executive branch

9

Implements and enforces laws passed by legislative branch

Executive branch

10

Includes President, VP, and cabinet

Executive branch

11

Enacts laws necessary to safeguard population from harm

Legislative branch

12

The Legislative branch has ____ year terms for the House of Reps (435 members)

2

13

The Legislative branch has ____ year terms for the Senate (100 members)

6

14

Interprets law and ensures the other branches' actions conform to the Constitution.

Judiciary branch

15

Who (under the executive branch) is responsible for public health?

CDC

16

What does the CDC do in regards to public health?

Prevention and control of infectious diseases, injuries, workplace hazards, disabilities, and environmental health threats.

17

CDC oversees what organizations?

  • National Center for Health Statistics
  • Healthy People program
18

What are examples of topics of public health priorities?

  • Food safety
  • HC-associated infections
  • HIV in US
  • Motor vehicle injuries
  • Nutrition, physical activity, and obesity
  • Teen pregnancy
  • Tobacco
19

Who (under the executive branch) is responsible for Health research?

  • National Institute of Health (NIH)
  • Agency for HC Research and Quality
20
  • Comprised of 27 health institutes and centers
  • Supports over 38,000 medical and social science research projects nationwide
  • Basic research where commercial interest is lacking
  • National Medical Library
  • PubMed

National Institute of Health (NIH)

21

Creation and dissemination for knowledge that enhances the quality, appropriateness, and effectiveness of health services and access to services

  • Research on health costs, quality, and outcomes
  • Medical expenditures panel survey

Agency for HC Research and Quality

22

Who (under the executive branch) is responsible for public insurance?

Centers for Medicare and Medicaid Services (CMS)

23
  • Largest agency w/ DHHS responsible for implementing most HC related policies (covers 1 in 4 Americans)
  • Has influenced payment models in HC industry (bc is the biggest insurer)

Centers for Medicare and Medicaid Services (CMS)

24

How did CMS influence payment models in the HC industry?

  • Prospective payment system
  • Value-based purchasing
  • Accountable care organization
25

What is a prospective payment system?

A method of reimbursement in which Medicare payment is made based on a predetermined fixed amount (DRG)

26

Who (under the executive branch) is responsible for direct HC provision?

  • VA
  • Dept of Defense
  • State, local and govt hospitals (1010 or 21% of all hospitals)
  • Federal govt hospitals (213)
  • Indian Health Services
  • Health Resources and Services Administration (HRSA)
27

What is the governments role as a regulator?

  • FDA
  • Professional regulation and licensure at the states
  • Regulation of health insurance (commissioner of insurance) and worker's compensation