Date: April 14, 2011Date: April 14, 2011

TopicTopic: Policy Making for Health Care : Policy Making for Health Care and the Environment.and the Environment.

AimAim: How does the government form : How does the government form opinions on health care and the opinions on health care and the

environment?environment?

Do NowDo Now: Multiple Choice Questions.: Multiple Choice Questions.

Health Care PolicyHealth Care Policy The Health of AmericansThe Health of Americans

Americans generally lag behind Americans generally lag behind in some key health statistics.in some key health statistics.

Specifically a lower life Specifically a lower life expectancy and higher infant expectancy and higher infant mortality rate.mortality rate.

The Cost of Health CareThe Cost of Health Care Americans spend more than Americans spend more than

any other country.any other country. Doctors don’t compete, private Doctors don’t compete, private

insurance pays, some insurance pays, some procedures are only available procedures are only available in U.S.in U.S.

Health Care PolicyHealth Care Policy Access to Health CareAccess to Health Care

About 16 million About 16 million Americans have no Americans have no health insurance.health insurance.

Often linked to having a Often linked to having a job- lose the job, lose job- lose the job, lose the health insurance.the health insurance.

About 20 million About 20 million Americans have Americans have inadequate health inadequate health insurance.insurance.

Health Care PolicyHealth Care Policy Access to Health CareAccess to Health Care

Health Maintenance Health Maintenance Organization (HMO)Organization (HMO): : provide health care for a provide health care for a yearly fee through contracts yearly fee through contracts or insurance companies. or insurance companies.

Covers about 60 percent of Covers about 60 percent of Americans. Americans.

Managed careManaged care:: focuses focuses more on prevention of more on prevention of illnesses than treatments.illnesses than treatments.

Managed Care is designed Managed Care is designed to reduce costs through to reduce costs through oversight and limiting patient oversight and limiting patient choices.choices.

Health Care PolicyHealth Care Policy The Role of Government in The Role of Government in

Health CareHealth Care Governments have the Governments have the

smallest role.smallest role. MedicareMedicare: provides : provides

hospitalization insurance for hospitalization insurance for elderly and optional elderly and optional coverage for other medical coverage for other medical expenses.expenses.

MedicaidMedicaid: public assistance : public assistance program to provide health program to provide health care for the poor. Paid for by care for the poor. Paid for by national and state national and state governments.governments.

Figure 19.2Figure 19.2

Health Care PolicyHealth Care PolicyWho Pays for Medical Costs…

Policymaking for Health CarePolicymaking for Health Care

Currently…Currently… Competition is often for the most advanced equipment Competition is often for the most advanced equipment

and procedures- which means some cannot afford the and procedures- which means some cannot afford the care.care.

Health care is rationed- some people are allowed Health care is rationed- some people are allowed procedures, some are not.procedures, some are not.

The elderly (through the AARP) have a loud voice in The elderly (through the AARP) have a loud voice in what the government will do.what the government will do.

Business groups are wanting the government to do Business groups are wanting the government to do more as well.more as well.

Policymaking for Health CarePolicymaking for Health Care

The Clinton Heath Care Reform Plan.The Clinton Heath Care Reform Plan.Main idea was to address the costs and Main idea was to address the costs and

access to health care.access to health care.Several taxes were to increase, all of which Several taxes were to increase, all of which

were opposed by those who would pay them.were opposed by those who would pay them.States were to negotiate with providers and States were to negotiate with providers and

handle premiums, plans and payments.handle premiums, plans and payments.Health care industry lobbied hard against it.Health care industry lobbied hard against it. It eventually died in Congress.It eventually died in Congress.

Policymaking for Health CarePolicymaking for Health Care

The Health Policy Issues Ahead.The Health Policy Issues Ahead.Public surveys show people are satisfied, but Public surveys show people are satisfied, but

there is need for reform in the system.there is need for reform in the system.The rising costs of medical care and The rising costs of medical care and

specifically prescription drugs confronts specifically prescription drugs confronts Congress.Congress.

Remains complex, confusing and expensive Remains complex, confusing and expensive with all the providers and governments with all the providers and governments involved.involved.

Environmental PolicyEnvironmental Policy

Economic Growth and the EnvironmentEconomic Growth and the EnvironmentStates compete with each other for business, States compete with each other for business,

which often leaves the environment out.which often leaves the environment out.The EPA set clean air standards for states to The EPA set clean air standards for states to

enforce and carry out.enforce and carry out.The Clean Air Act was amended to try to The Clean Air Act was amended to try to

prevent an area’s air from being degraded by prevent an area’s air from being degraded by industry.industry.

More Americans today favor more regulations.More Americans today favor more regulations.

Environmental PolicyEnvironmental Policy

Environmental Policies in AmericaEnvironmental Policies in AmericaEnvironmental Impacts.Environmental Impacts.

Environmental Impact Statements: report that Environmental Impact Statements: report that specifies likely environmental impact of a proposed specifies likely environmental impact of a proposed action- filed with the EPA.action- filed with the EPA.

Used by environmental groups to challenge and Used by environmental groups to challenge and delay projects they object to.delay projects they object to.

Clean Air.Clean Air.Clean Air Act of 1970: reduce auto pollution.Clean Air Act of 1970: reduce auto pollution.1990 amendments allowed emissions trading.1990 amendments allowed emissions trading.

Environmental PolicyEnvironmental Policy

Environmental Policies in AmericaEnvironmental Policies in AmericaClean Water.Clean Water.

Water Pollution Control Act of 1972: intended to Water Pollution Control Act of 1972: intended to clean up the nation’s rivers and lakes requiring the clean up the nation’s rivers and lakes requiring the use of pollution control technology.use of pollution control technology.

Has helped reclaim numerous rivers and lakes Has helped reclaim numerous rivers and lakes since its passage.since its passage.

But it misses “runoff” pollution from city streets and But it misses “runoff” pollution from city streets and other areas.other areas.

Environmental PolicyEnvironmental Policy

Environmental Policies in AmericaEnvironmental Policies in AmericaWilderness Preservation.Wilderness Preservation.

The U.S. is a world leader in wilderness The U.S. is a world leader in wilderness preservation.preservation.

The national parks and national forests may be The national parks and national forests may be restricted to keep them for future generations.restricted to keep them for future generations.

Endangered Species.Endangered Species.Government protects those species listed as Government protects those species listed as

endangered- regardless of costs.endangered- regardless of costs.Exceptions may be made in some instances.Exceptions may be made in some instances.

Figure 19.3Figure 19.3

Environmental PolicyEnvironmental Policy

Energy, the Environment, and Global Energy, the Environment, and Global WarmingWarming

Sources of Energy

Environmental PolicyEnvironmental Policy

Energy, the Environment, and Global Energy, the Environment, and Global WarmingWarming87% of the nation’s energy comes from coal, 87% of the nation’s energy comes from coal,

oil and natural gas.oil and natural gas.Most controversial energy source is nuclear.Most controversial energy source is nuclear.Policymakers have shown more interest in Policymakers have shown more interest in

conservation, alternative fuels and renewable conservation, alternative fuels and renewable fuel sources.fuel sources.

Environmental PolicyEnvironmental Policy

Energy, the Environment, and Global Energy, the Environment, and Global WarmingWarmingGlobal Warming.Global Warming.

Scientists argue about the effects of accumulations Scientists argue about the effects of accumulations of carbon dioxide in the atmosphere.of carbon dioxide in the atmosphere.

The only way to reduce the problem is to reduce The only way to reduce the problem is to reduce the amount produced.the amount produced.

The costs to do this are immediate, but the effects The costs to do this are immediate, but the effects won’t be visible for decades, if ever.won’t be visible for decades, if ever.

Environmental PolicyEnvironmental Policy

Toxic WastesToxic WastesChemicals and nuclear fuel that are Chemicals and nuclear fuel that are

hazardous to humans and animals.hazardous to humans and animals.Superfund: created in 1980 to clean up Superfund: created in 1980 to clean up

hazardous waste sites.hazardous waste sites.Some sites are completely clean, others may Some sites are completely clean, others may

never be clean enough to use for anything.never be clean enough to use for anything.Current law requires tracking of hazardous Current law requires tracking of hazardous

chemicals, and their disposal.chemicals, and their disposal.

Environmental PolicyEnvironmental Policy

Making Environmental PolicyMaking Environmental PolicyThe issue is political since it puts “public” The issue is political since it puts “public”

goods against other private concerns.goods against other private concerns.There are more groups and more people There are more groups and more people

getting involved in protecting the environment.getting involved in protecting the environment.They are still opposed by those who want to They are still opposed by those who want to

use the land for their own purposes.use the land for their own purposes.Policies will be controversial & expensive.Policies will be controversial & expensive.

Understanding Health Care and Understanding Health Care and Environmental PolicyEnvironmental Policy

Democracy, Health Care, and Democracy, Health Care, and Environmental PolicyEnvironmental PolicyHigh-tech issues limit citizen’s participation.High-tech issues limit citizen’s participation.The issues involve all levels of governments.The issues involve all levels of governments.Relies heavily on group participation.Relies heavily on group participation.Groups can afford the research into the Groups can afford the research into the

science and policy of the issues.science and policy of the issues.

Understanding Health Care and Understanding Health Care and Environmental PolicyEnvironmental Policy

The Scope of Government and Health The Scope of Government and Health Care and Environmental PolicyCare and Environmental PolicyAs citizens want more health care reform, the As citizens want more health care reform, the

size of government will increase.size of government will increase. Increased environmental protection will also Increased environmental protection will also

cause the size of government to go up.cause the size of government to go up.But there are politicians and citizens that want But there are politicians and citizens that want

to strictly evaluate future proposals.to strictly evaluate future proposals.