Policy and Health Law Term Paper

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1996 passed Health Insurance Portability and Accountability Act has on healthcare organizational policies. This will be done through answering several review questions.

Law and Organizational Health Care Policy

There are several ways that health law can be conceptualized. Health law can be viewed as entailing not just the law on financing and delivery of healthcare but also all other related areas of study that are associated with the link between health and law. Simply put, healthcare law focuses on judicial, executive, and legislative rules and guidelines that regulate the healthcare industry. The said industry includes healthcare facilities, systems, health care practitioners, medical device manufacturers, pharmaceutical companies, private and public insurers. Each of these stakeholders functions within several different and interrelated legislations (WCL.edu, 2016).

Health policies are the strategies, actions, plans or decisions taken to attain specific healthcare goals in a certain population. A well-drafted health policy is the one which: clearly defines the vision of the policymakers. A clear definition would help to come up with targets and reference points going into the future. A good health policy is also one that prioritizes and assigns roles and responsibilities to different stakeholders; it also helps to build a consensus among all stakeholders and concerned parties (WHO, 2016). A health policy is meant to be a vehicle for innovation and for the discussion of specific issues within the health care system and is intended to improve communications between different parties, such as health care professionals, policymakers, legislators, and researchers involved in the development, implementation and analysis of health systems and healthcare reforms, particularly in developed countries outside the United States (healthpolicyjrnl, 2015).

Legislative vs. Organizational Healthcare Policies

Legislative Policies

A legislative policy is a set of actions undertaken by a lawmaking body so as to obtain an envisioned health results (Cherry & Trotter Betts, 2005). The general healthcare system, including both the private and public sectors, as well as, the political pressures that influence the system, are governed by the policymaking process. All public, and to some extent private sector health related policies, come from federal, state, or local court rulings, regulations or legislations, which shape the provision of healthcare services. The making of policies takes care of different settings that range from open systems that encourage contributions by citizens to closed door systems that involve just handfuls of policymakers. The policymaking setting, the nature of the issue at hand and the intended impact of the health policy, all have effects on the final nature of the policy (Thurber, 1996).

Organizational Policies

Many NGOs, private and public healthcare institutions use procedures and policies to show their regulatory and legal compliance and to achieve their operational goals. The official mandates of many of these institutions might originate from federal regulatory agencies. Healthcare institutions may also form policies and procedures for the purpose of meeting the contractual requirements of their financiers. Large and medium sized healthcare institutions have compliance officers who constantly monitor the implementation of procedures and policies. For instance, a hospital or any other facility that hosts patients might have a general management mandate for the safety of patients. The facility might establish rules or procedures, for instance, it may require that to move a patient from one bed to another, two staffs are required. Another institution dealing with a different area of healthcare may require different procedures and policies to meet the regulatory requirements unique to that area. For instance, a radiology department might need to develop a comprehensive system that captures the receipt, storage, utilization, movement and subsequent disposal of radioactive substances.

Healthcare providers might also develop policies to guide employee conduct. In different works, a policy has been defined as a set guide that instructs staffs on what to do in a particular scenario. Thus, such a guide would not only influence employee conduct, but also create a framework that can help him or her to make decisions.

Healthcare institutions should always update their procedures and policies every time new innovations, inventions, devices, patient protocols or technologies are adopted. The policies should also be constantly monitored, making sure that employees conduct themselves according to the best practices in the industry (Bianca, 2016).

Influence of Politics on Healthcare Policies

As health issues move through the stages of the policymaking processes, there are many things that can affect the processes, including the influences and preferences of legislators, SIGs (Special Interest Groups), organizations, and other powerful persons (Longest, 2006). All of these stakeholders don't necessarily have the same perspective of the issue and often have different and usually competing interest.

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The process is often further complicated by the partisan agenda of the country's two biggest political parties, the Republicans and the Democrats. The party with the majority often has the final say in this complicated process (Abood, 2007).

Throughout our day-to-day lives, politics influence who is given what, how and when. Indeed, like the power of politics that some have defined as the process through which scarce resources are authoritatively allocated (Kalisch & Kalisch, 1982, p. 31). Politics take place when individuals are involved in any decision making process, influencing who gets what in the healthcare system. SIGs and powerful stakeholders use all kinds of problem solving, critical thinking, conflict management, communication, and influence and negotiation skills to get their desired outcome in the policymaking process (Cherry & Trotter Betts, 2005; Kalisch&Kalisch, 1982).

Role and Impact of Governmental and Non-Governmental Regulatory Agencies on Health Care Policy

The source of this intricate system lies in a chain of turf battles amidst opposing interests, which have been waged in the past 150 years. The competition amidst the state and federal authority is preserved in the federalist structure of the American government, and the arguments of today echo early disagreements over which types of power should reside at every level. Majority of the power to manage daily activities exists in the states under the Constitution; however, it is subject to pre-emption at the federal level as soon as certain enumerated issues come into the picture, like foreign relations, interstate business, and defense. This distribution of power developed a source of continuing anxiety in healthcare oversight from the beginning. Taking a long-standing case, chief oversight of majority of the main players in the healthcare system, such as hospitals, insurance companies, and physicians, is achieved by agencies at the state level. In all cases, however, it is managed by federal powers. Likewise, majority of the public health programs, such as sanitation, restaurant checks, and epidemic investigations, are job of the states as well as local regulators, but the federal Centers for Disease Control and Prevention (CDC) acts as a vital resource for collaboration at a national level (Abood, 2007).

During the early 20th century, private regulators joined the scene. The American Medical Association (AMA) funded the establishment of several organizations, which are still essential today in the oversight of the medical profession, with the inclusion of those that endorse medical schools, oversee licensure examinations, and certify experts. These bodies complement the work of governmental regulators. For instance, state medical boards, utilize privately administered tests in awarding medical licenses, and the Medicare program depends on specialty certification as a sign of physician quality. Along the same lines, the industry of hospitality awards its own members as a complementary step to state licensure via the Joint Commission (JCAHO) (Abood, 2007).

Impact of Legislative Policy on Resource Allocation in the Health Care Industry

The idea of making treatment decisions founded on the availability of resources is repulsive to majority. In a perfect world, there would be no restriction to the available resources. In reality, healthcare resources are currently and shall continue to be restricted. Hence, resources are being allocated founded on either explicit or implicit concerns or criteria. As the age of the United States population increases with its pressure on limited resources; managers, providers, policy makers, and even recipients should all become engaged in prioritizing the contradictory claims on these limited resources. For managers of provider organizations and health plans, the challenge is to create and apply a practical, reliable, just, scientifically sound procedure for addressing treatment decisions. Applying a procedure to sensibly or expeditiously address the demands for experimental, extraordinary or expensive care before an organization finds itself in politically transformed state is advised. Van Amerongen (1998) advocates the application of a tactic, which applies the following aspects: flexibility, reliability, total concern of every medical factor, ethical concern for the patient, and optimal results (Maddox, 1998).

Roles of Organizational Stakeholders and Interest Groups Involved in Health Care Laws and Regulations

Numerous state nursing and specialty nursing organizations fund annual state legislative days, provide policy fellowships/internships (Hofler, 2006), and carry out policy workshops, all meant to offer nurses the opportunity to learn more, regarding the present healthcare concerns and the legislative process. They offer new supporters with easy access to more knowledgeable nurse advocates ready to act as mentors. There are several ways of getting actively engaged, varying from simply drafting a letter or making a call,….....

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